Treating patients with opioid disorders is not just about treating addiction. Here’s why

Patients with opioid use disorder are much more likely than the general population to have a host of other health conditions, including hepatitis C, post-traumatic stress disorder, and anxiety.

That’s according to a new analysis from health care company Amino, which culled data from the claims of 3.1 million privately insured patients between 2014 and 2016. It calculated the frequency of a slew of health conditions — from back pain to binge drinking — in patients diagnosed with opioid use disorder. Then, it compared those rates to the general patient population.

Here’s what it found.

As the chart shows, patients with opioid use disorder are diagnosed with hepatitis C nine times as often as other patients, at least among the privately insured.

Cases of hepatitis C have skyrocketed as the opioid epidemic has spread: There were an estimated 30,500 new cases in the U.S. in 2014, nearly double the number of new cases in 2011. Most of those new cases are among people who inject drugs such as heroin.

Hepatitis C infections have increased particularly sharply among young people who live in rural areas of Appalachian states, according to the Centers for Disease Control and Prevention.

Painkiller prescriptions for back pain were an early target in the efforts to curb opioid misuse and abuse — and for good reason. The analysis by Amino shows that “failed back syndrome” — a broad category that covers back pain after surgery — is seven times more frequently diagnosed in patients with opioid use disorder.

Earlier this year, the American College of Physicians reviewed the evidence on treating back pain and released a new set of guidelines. Its recommendation: Opioids should be a last resort for treating lower back pain, after every other treatment has failed. It recommendeds patients first try non-drug therapies such as exercise, massage, and yoga.

If those don’t work, the ACP told doctors to have patients pop an over-the-counter pain reliever and wait it out, noting that most back pain improves over time regardless of treatment.

The new report also adds to the evidence of the connection between substance abuse disorders and other mental health conditions.

Alcoholism is diagnosed eight times more often in patients with opioid use disorder, according to the new analysis. And patients with opioid use disorder are also more frequently diagnosed as having suicidal thoughts, anxiety, depression, and insomnia. Many find it difficult to get the care they need. In part, that’s because people with mental health conditions and substance abuse problems are among the most likely to be uninsured.

Former President Barack Obama established a task force last year to tackle that problem. In October, the task force released a report urging mental health and substance abuse treatments to be covered like medical and surgical care.

 © 2017 STAT
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