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Expanded opioid addiction care could save lives, cut costs, study shows

Opioid-addiction care of medication and counseling could cut deaths by 16.9% and save up to $105,000 over lifetime of a patient’s care, study shows.

Opioid overdoses during the pandemic surpassed all annual death tolls since the public health crisis began in the 1990s, as Americans lost their jobs, stress levels climbed and lockdowns restricted the use of lifesaving medications at drug-treatment centers, the Centers for Disease Control and Prevention reported. 

More than 87,000 people died of drug overdoses over a 12-month period that ended in September 2020, according to preliminary data from the agency that also cites a 29% hike in drug overdoses in that period.

So a new treatment recommendation by a team of Stanford researchers and Veterans Affairs investigators could not come any sooner. The researchers found that expanding access to a treatment that combines medication and counseling for opioid addiction could lead to a 16.9% reduction in deaths and save as much as $105,000 in individual lifetime clinical care costs.

"Opioid overdoses in the United States likely reached a record high in 2020 because of COVID-19 increasing substance use, exacerbating stress and social isolation, and interfering with opioid treatment," the researchers wrote in their investigation published March 31 in JAMA Psychiatry.

"This treatment has very important benefits. It prevents overdose deaths, improves quality of life and results in patients living longer -- a very substantial benefit," said Douglas Owens, MD, a professor of medicine and director of Stanford Health Policy.

The newly released findings are among outcomes of a 10-year project by a group of scientists that started when the team realized the opioid epidemic was threatening the hard-fought gains in the prevention and control of HIV and the hepatitis C virus.

The project was supported by a MERIT award from the National Institute on Drug Abuse and by funding from the Department of Veterans Affairs to address the impact of opioids on the treatment of other diseases. Owens and Margaret Brandeau, PhD, professor of management science and engineering, have led this team of scientists for two decades.

"The U.S. opioid epidemic has decimated lives and families," said Brandeau, who is co-senior author of the study with Owens. "And it has only gotten worse with COVID-19, as opioid use has increased while at the same time access to treatment has diminished."

There are more than 2 million people in the U.S. with a substance use disorder related to prescription opioid pain medication. The researchers found that the lives of more than 41,000 individuals could be saved over the next five years if those people received medication-assisted treatment combined with overdose education, naloxone -- a medication that reverses the effects of opioid overdose - and had incentives to stay in treatment.

In addition, the researchers estimated that such measures could result in a more than $200 billion in health care and criminal justice cost savings over the lifetimes of those people.

"The health care system clearly has the capacity to provide this treatment, indeed the VA does so on a wide scale already -- but stigma and poor insurance coverage have limited its adoption," said co-author Keith Humphreys, a professor of psychiatry and behavioral science.

Read full story here.

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