Diagnoses of opioid use disorders (OUDs) have climbed 40% in commercially insured patients since 2021, according to new data from the nonprofit FAIR Health.

FAIR Health is an independent data-focused organization that manages the nation’s largest database of privately billed health insurance claims.

Patients between 31 and 40 years old had the highest percentage of diagnoses in this time frame, accounting for 26.8% of OUDs. Males were more likely than females to be diagnosed with an OUD, as well, according to FAIR Health’s data.

Regardless of insurance coverage, most patients diagnosed with an OUD or SUD do not receive care. However, treatment rates for OUDs among the commercially insured are highest in Tennessee with 1,447 patients out of 100,000 receiving that diagnosis, followed by West Virginia, Kentucky, Arkansas and Delaware, according to FAIR Health.

The group also examined trends in clinicians who treat OUDs. Between 2021 and 2024, the fastest-growing specialty involved in OUD treatment was nurse practitioners. The involvement of these clinicians reportedly increased by 102%, followed by physician assistants at 69% and psychiatric nurses at 66%.

Across a wider patient population, national opioid use trends between 2021 and 2024 showed no change, according to data from the latest National Survey on Drug Use and Health (NSDUH).

The NSDUH report compiled by the Substance Abuse and Mental Health Services Administration (SAMHSA), released in July, found that “among people aged 12 or older, the percentage who had a past year opioid use disorder showed no change from 2021 to 2024.”

For its analysis, FAIR Health reviews data from anonymized commercial insurance claims exclusively. At the same time, SAMHSA collects self-reported data from a multi-stage survey of non-institutionalized Americans aged 12 and older.

“The reasons for the difference between our results and NSDUH’s are likely to be methodological,” a spokesperson for FAIR Health told Behavioral Health Business. “For example, NSDUH uses survey data from the civilian, non-institutionalized U.S. population 12 or older. FAIR Health’s opioid tracker uses claims data from the commercially insured US population of all ages. The NSDUH data are self-reported, whereas FAIR Health’s data are reported on insurance claims by healthcare providers.”

The company’s opioid tracker functions as a heat map illustrating, state by state, the areas where patients with OUDs per 100,000 receiving medical services in 2024 were highest.

While the SAMHSA report focuses on the collective population rather than just commercially insured patients, generally, uninsured or Medicaid beneficiaries have higher substance use disorder (SUD) diagnosis rates when they do receive care.

Previous research from KFF found that “one in five (21%) Medicaid beneficiaries have a substance use disorder, similar to uninsured people (19%), but higher than privately insured people (16%).”

These data points come on the heels of new information from the Centers for Disease Control and Prevention, revealing a 24% decline in drug overdose deaths between 2023 and 2024 across the U.S.
Specifically related to opioids, as of the most recent data from 2023, around 24 of every 100,000 people died from a drug overdose involving any opioid at all.