Opioid Overdoses and the Limited Treatment of Opioid Use Disorder Continue To Be Concerns for Medicare Beneficiaries

WHY WE DID THIS STUDY

As the nation continues to grapple with the effects of the COVID-19 pandemic, the opioid epidemic continues to surge. In 2021, there were an estimated 81,502 opioid-related overdose deaths in the United States-an all-time high. Accordingly, it is critical to monitor opioid use and access to treatment for beneficiaries with opioid use disorder as well as access to the opioid overdose-reversal drug naloxone.

This data brief provides important information on these topics for beneficiaries in Medicare Part D in 2021. It builds on a series of data briefs released by OIG.

WHAT WE FOUND

About 50,400 Part D beneficiaries experienced an opioid overdose-from prescription opioids, illicit opioids, or both-during 2021. This number is likely higher in that additional beneficiaries could have overdosed but not received medical care that was billed to Medicare, or their claims might have not yet been submitted to Medicare. At the same time, the number of Medicare Part D beneficiaries who received opioids in 2021 decreased to almost a quarter of beneficiaries, extending a downward trend from prior years. Further, fewer Part D beneficiaries were identified as receiving high amounts of opioids or at serious risk. The number of prescribers ordering opioids for large numbers of beneficiaries at serious risk was steady. Still, over 1 million Medicare beneficiaries had a diagnosis of opioid use disorder in 2021, and fewer than 1 in 5 of them received medication to treat their disorder. At the same time, the number of Part D beneficiaries receiving naloxone increased.

WHAT WE CONCLUDE

There is clearly still cause for concern and vigilance, even as some positive trends emerge. Monitoring opioid use and access to medications for the treatment of opioid use disorder as well as to naloxone are critical to addressing the opioid crisis. A December 2021 OIG report recommended that CMS take steps to improve access to medications for the treatment of opioid use disorder and other support services. We continue to call attention to the importance of implementing these recommendations and to ensuring access to treatment for opioid use disorder for Medicare beneficiaries. OIG is also committed to continuing our work on opioid use and access to treatment.