Opiate dependency among the subscribers of a New York area private insurance plan

Abstract

Objective: To estimate the prevalence of opiate use among the subscribers of a large private insurance plan, Empire Blue Cross and Blue Shield (EBCBS).

Design: Six and a half million hospital inpatient claims for the period January 1, 1982, through June 30, 1992, were reviewed. Thirty-one thousand eight hundred ten different individuals who had a total of 55,143 hospital admissions with a primary diagnosis of opiate dependency (International Classification of Diseases, Ninth Revision, Clinical Modification 304.0 and 304.7) were identified. In the same period, 17,493 EBCBS subscribers (15,191 male and 2302 female) were identified from hospital admissions data as having acquired immunodeficiency syndrome. These data were cross-matched with the opiate dependency data to estimate the "capture" of opiate users in the EBCBS subscribers with acquired immunodeficiency syndrome and to model the size of the opiate using population in EBCBS.

Results: It is estimated that between 1982 and 1992 EBCBS insured approximately 141,000 opiate users, 85,000 of whom are currently insured by EBCBS.

Conclusion: There is a large population of insured opiate users who may be excluded from the estimates of the overall number of opiate users as insured opiate users are less likely to be counted via contact with government agencies. This suggests that current estimates of the number of opiate users and their social characteristics should be reconsidered.