Iowa declined in prescription opioid use last year: Study

As the nationwide effort to stem the flow of prescription opioids continues, Iowa remains ahead of the curve, according to a new study.

The insurance organization Blue Cross Blue Shield Association released a report earlier this month examining opioid use disorder diagnoses, prescription rates and use patterns among its commercially insured Blue Cross Blue Shield members.

The report did not include those who were diagnosed with cancer or were undergoing palliative or hospice care.

According to the report, nearly 242,000 members nationwide were diagnosed with opioid use disorder in 2017, about 5.9 members per 1,000.

'Surprisingly, 68 percent of those with opioid use disorder in 2017 had no diagnosed pain condition within that year,” the report stated

Iowa, on the other hand, saw three in 1,000 of its members diagnosed with the disorder this past year, giving it the fourth-lowest rate nationwide, according to Des Moines-based Wellmark Blue Cross and Blue Shield, the state's dominant insurer.

'While we are encouraged by the findings in this report, we can't lose sight that opioid addiction still is an issue in the state,” said Matt Hosford, Wellmark vice president and chief pharmacy officer, in a news release Thursday.

The report, released Thursday, comes as opioid overdose deaths and other related fatalities continue to rise statewide.

The Iowa Department of Public Health has finalized the total opioid overdose deaths and opioid-related deaths from 2017, both of which increased from 2016.

Opioid overdose deaths reached 103 in 2017, up from 86 in 2016. Opioid related deaths - a rate that is inclusive of overdose deaths - increased to 206 this past year, compared to 180 from 2016.

In 2005, Iowa saw 28 overdose deaths and 59 opioid related deaths.

The latest Department of Public Health report did not include a measurement on medicated-assisted treatment for those with opioid use disorder. But last year's study found the 65 percent increase in treatments did not match the 493 percent rate of increase in opioid use disorder diagnoses from 2010 through 2016.

'Identifying evidence-based treatment for these members is a priority,” the 2017 report states.

LIMITING PRESCRIPTIONS

In guidelines released by the federal Centers for Disease Control and Prevention, federal public health officials recommend physicians limit which patients can receive opioids to reduce the amount of painkillers available.

Wellmark stated there was a 30 percent decline in the number of opioid prescriptions given per 1,000 members in Iowa between 2013 and 2017.

The country saw a 29 percent decline overall, from 558 prescriptions per 1,000 members in 2013 to 394 per 1,000 members in 2017.

According to the report, the largest drop was seen in the past two years.

The dose and duration of these prescriptions also has decreased in the past year, the report states.

The CDC recommends a first prescription be less than 50 morphine milligram equivalents per dose and to last no longer than seven days.

According to the report, two-thirds of members' first opioid prescriptions met this criteria.

About two percent of members received a dose greater than 50 morphine milligram equivalents for a period of time longer than eight days.

The study can be read at bcbs.com/the-health-of-america/reports/the-opioid-epidemic-america-update.

l Comments: (319) 368-8536; michaela.ramm@thegazette.com