Addressing the Opioid Crisis
Since 1999, more than 1 million people have died from a drug overdose in the United States. In 2021 alone, the Centers for Disease Control and Prevention (CDC) reported 106,669 drug overdose deaths. Nearly 88% of opioid-related overdose deaths involved synthetic opioids (other than methadone).1
With opioid use disorder and overdose deaths continuing to rise, our health plans are addressing the opioid epidemic.
What is opioid use disorder (OUD)?
OUD, as defined by the DSM-5-TR, is a problematic pattern of opioid use leading to clinically significant impairment or distress.2
OUD is classified as a chronic brain disease. It requires treatment and management like any other long-term chronic condition. Individuals with OUD benefit from a comprehensive public health approach that incorporates evidence-based treatments that include medication, behavioral therapy, and community and recovery support.
How managed care is helping to address the opioid epidemic
Our work with populations disproportionately affected by opioids puts Medicaid managed care organizations like us in a unique and critical position to address opioid addiction.
Consider the important role that Medicaid coverage plays:
- Medicaid provides health care coverage and numerous opioid treatment services to those who otherwise might not have it.3
- Medicaid covers a disproportionate share of individuals with opioid addiction. According to the Kaiser Family Foundation, Medicaid covers nearly 4 in 10 nonelderly adults with opioid addiction.4
- According to the Center on Budget and Policy Priorities (CBPP), the expansion of Medicaid has provided treatment to close to 100,000 people and helped reduce the unmet need for treatment of substance-use disorders by 18%.5
Twenty percent of Americans with opioid addiction are still uninsured.6 To effectively treat opioid addiction, patients need personalized, coordinated care with a strong support system.
Learn more about our opioid outreach and treatment efforts and programs.
Which drugs are classified as opioids?
Opioids are a class of drugs that includes legally prescribed pain relievers, synthetic drugs, and illegal drugs. These drugs interact with opioid receptors in the body and brain.7 When opioid drugs bind to these receptors, they can drive up dopamine levels in the brain's reward areas, producing a state of euphoria and relaxation. This feeling of euphoria can lead to misuse and addiction.8
Synthetic and illegal street drugs include:
- Fentanyl
- Heroin
- Carfentanyl
Prescription opioids include painkillers such as:
- Morphine
- Fentanyl
- Methadone
- Buprenorphine
- Hydrocodone
- Oxymorphone
- Oxycodone
- Codeine
- Tramadol
- Buprenorphine
- Dextropropoxyphene
- Carfentanyl
- Meperidine
- Hydromorphone
These painkillers often are referred to under their brand names:
- OxyContin
- Percocet
- Palladone
- Vicodin
- Wildnil
- Darvocet N
- Darvocet
- Percodan
- Demerol
- Dilaudid
- Opana
- Ultiva
- Sublimaze
- Duragesic patch
- Demerol
- Kadian
- Avinza
- Subutex
- Buprenex
- Belbuca
- Brixadi
- Tylenol #3
How do overdoses occur?
Opioid overdoses can occur for several reasons. They can occur deliberately, or accidentally from the misuse of a prescription, an error in dosing, or incompatibility with another medication. Overdoses can also occur if an illicit drug is contaminated with other medications or materials. Anyone who uses opioids for long-term management of chronic pain is at risk for opioid overdose, as are individuals who use heroin or misuse prescription pain relievers.9
Strategies to prevent overdose death include the following recommendations:10
- Encourage providers, people at high risk of overdose, family members, and others to learn how to prevent and manage opioid overdose.
- Ensure access to treatment for individuals who are misusing opioids or who have a substance use disorder.
- Ensure ready access to naloxone.
- Encourage the public to call 911 if they think someone is showing signs of an overdose.
- Encourage prescribers to use state prescription drug monitoring programs (PDMPs).
For more information on opioids, visit the CDC website or the SAMHSA website.
- "Drug Overdose Deaths," Centers for Disease Control and Prevention, https://www.cdc.gov/drugoverdose/deaths/
- American Psychiatric Association, "Opioid Use Disorders," in Diagnostic and Statistical Manual of Mental Disorders (5th ed., text rev.), 2022
- “Chart Book: The Far-Reaching Benefits of the Affordable Care Act’s Medicaid Expansion,” Center on Budget and Policy Priorities, October 2, 2018, https://www.cbpp.org/research/health/chart-book-the-far-reaching-benefits-of-the-affordable-care-acts-medicaid
- “Medicaid’s Role in Addressing the Opioid Epidemic,” Henry J. Kaiser Family Foundation, February 27, 2018, https://www.kff.org/infographic/medicaids-role-in-addressing-opioid-epidemic/
- Kyle Hayes, “Medicaid Expansion Essential to Address Opioid Epidemic,” Center on Budget and Policy Priorities, October 5, 2017, https://www.cbpp.org/blog/medicaid-expansion-essential-to-address-opioid-epidemic
- “The Opioid Epidemic and Medicaid's Role in Facilitating Access to Treatment,” Henry J. Kaiser Family Foundation, April 11, 2017, https://www.kff.org/medicaid/issue-brief/the-opioid-epidemic-and-medicaids-role-in-facilitating-access-to-treatment/
- “Opioids,” National Institute on Drug Abuse, https://www.drugabuse.gov/drugs-abuse/opioids#summary-of-the-issue
- “Fentanyl,” National Institute on Drug Abuse, February 2019, https://www.drugabuse.gov/publications/drugfacts/fentanyl
- Lynn Webster et al., "An analysis of the root causes for opioid-related overdose deaths in the United States," Pain Medicine, Vol. 1, No. 12 (suppl_2), June 2011, S26-35.
- "SAMHSA Opioid Overdose Prevention Toolkit: Opioid Use Disorder Facts," Substance Abuse and Mental Health Services Administration, June 2018, https://store.samhsa.gov/product/Opioid-Overdose-Prevention-Toolkit/SMA18-4742
