Cost of opioid epidemic: $80 billion

One aspect of the crisis that hasn’t received much attention is the financial impact it is having.

While the opioid epidemic in Connecticut has been well documented during the past several months, one aspect of the crisis that hasn’t received much attention is the financial impact it is having on workplaces and insurance companies in the state.

At a Connecticut Insurance Department Opioid Symposium earlier this month, company executives gave state officials and medical providers an earful on the subject.

Richard Ives, vice president of the Claims Workers Compensation department at Travelers, said the opioid crisis and “the rise in chronic pain” in the country “has had an impact on our business, our customers, and our employees.”

Ives said the costs associated with opioid treatment are close to $80 billion. But, he added that number pales in comparison with the overall “cost of treating the 100 million Americans that suffer from chronic pain. That cost,” Ives said, “is $600 billion.”

Ives said the problem with opioid treatment is that “it doesn’t cure anything. The real issue is that there has been an issue with the rise in chronic pain — pain associated with an injury that lasts beyond acute pain.”

Initially, Ives said, opioids are often prescribed to help those with acute pain symptoms. But, he reiterated, opioids don’t cure the pain, so costs associated with treating chronic pain continue.

Ives said more people suffer from some sort of chronic pain in the country than suffer from diabetes, cancer, and stroke combined.

Dr. Douglas Nemecek, senior medical director at Cigna, told the insurance panel there is “not one silver bullet” in coming up with a comprehensive strategy to combat the opioid epidemic in Connecticut.

Gov. Dannel P. Malloy has charged the Insurance Department with coming up with a strategy to combat the epidemic.

In 2015, there were 697 opioid-involved deaths in the state of Connecticut, 639 of which were Connecticut residents. And 2016 is even worse. At a recent session on drug abuse at Kennedy High School in Waterbury, Assistant U.S. Attorney Tracy Dayton said Connecticut is tracking a record 888 overdose deaths for the 2016 calendar year.

Nemecek said Cigna has a specific goal, working with its network of physicians, to “decrease by 25 percent” the number of opioid prescriptions handed out to patients.

“But we still need to take care of people with pain disorders,” Nemecek said. He added that one of the fundamental issues that needs to be addressed is there “are no national standards” on the distribution of opioids.

“We need standard care measures,” Nemecek said. “We also need to make sure patients are being screened for other issues, such as smoking, anxiety, etc.”

He added that another common sense procedure that needs to be adopted is making sure a patient’s primary care physician is aware when their patient is being prescribed opioids.

The Insurance Department also heard a summary of a recently released report by the Connecticut Opioid Response (CORE) initiative, a group created in partnership with Malloy, the Yale School of Medicine, and Connecticut’s insurance carriers.

In the report, CORE explains its initiative as: “A mechanism to articulate data-driven and evidencebased medical, public health, and policy strategy initiatives related to opioid use disorder, reducing overdose events and a means for achieving those initiatives.”

The report recommends six strategies to combat the opioid epidemic:

• Increase access to highquality treatment with methadone and buprenorphine;

• Reduce overdose risk, especially among those individuals at highest risk;

• Increase adherence to opioid prescribing guidelines among providers, especially those providing prescriptions associated with an increased risk of overdose and death;

• Increase access to and track use of naloxone;

• Increase data sharing across relevant agencies and organizations to monitor and facilitate responses, including rapid responses to outbreaks of overdoses and other opioid-related (e.g.HIV or HCV) events;

• Increase community understanding of the scale of opioid use disorder, the nature of the disorder, and the most effective and evidencebased responses to promote treatment uptake and decrease stigma.

Connecticut Insurance Department Commissioner Katharine Wade said her agency “is trying to be proactive” in dealing with the opioid crisis in the state.

Wade said “the governor and the legislature made some key moves” to combat the crisis in the last legislative session.

Last General Assembly session, legislation was passed placing a 7-day cap on opioid prescriptions, in an effort to reign in what many called the “over-prescribing” of painkillers.

Legislation also was passed requiring first responders to be trained in the use of Narcan and to carry and dispense it. The drug is injected into patients to counter the effects of opioid and heroin overdoses.

The state’s proactive stance was praised by one of those in attendance at the Insurance Department meeting — Sara Kaiser, a drug and alcohol counselor at Aware Recovery Care.

Kaiser, who said she was also an opioid addict, said: “Lots of work needs to be done.

“This is a disease — like cancer. We have to surround people with support,” Kaiser said.