New Study Reveals 32 Percent of Total Opioid Prescriptions are Being Abused

April 20, 2016

First-of-its-kind research from Castlight Health examines narcotic painkiller abuse in America’s workforce

SAN FRANCISCO – April 20, 2016 – Castlight Health, Inc. (NYSE:CSLT) today released a first-of-its-kind study featuring new data and insights into the prescription painkiller crisis in America’s workforce. The report, The Opioid Crisis in America’s Workforce, reveals that nearly one out of every three (32 percent) opioid prescriptions, which are subsidized by America’s employers, is being abused. It also finds that nationally, 4.5 percent of individuals, on average, who have received an opioid prescription are abusers and account for 32 percent of total opioid prescriptions and 40 percent of opioid prescription spending.

For this report, Castlight Health conducted research on opioid abuse based on aggregated reporting from medical and pharmacy-based claims. These findings are inclusive of de-identified and anonymous health data reporting covering nearly 1 million Americans who use Castlight’s health benefits platform, a subset of Castlight’s broader user population. The study leverages Castlight’s medical and pharmacy reporting over the five-year period from 2011-2015 to provide employers with a more accurate picture of opiate painkiller abuse in the workplace, so they can better understand the extent and depth of the crisis.

Most notably, the analysis found:

  • Nearly one out of every three (32 percent) opioid prescriptions, which are subsidized by America’s employers, is being abused.
  • On average, 4.5 percent of individuals in the United States who have received a prescription for narcotic painkillers are opioid abusers. These individuals account for nearly one-third (32 percent) of total opioid prescriptions and 40 percent of opioid prescription spending.
  • Opioid abusers cost employers nearly twice as much ($19,450) in medical expenses on average annually as non-abusers ($10,853).

“The personal impact that opioid painkiller abuse takes on individuals, their friends, and family is absolutely tragic,” said Kristin Torres Mowat, senior vice president of health plan and strategic data operations at Castlight Health. “This crisis is also having a significant impact on the nation’s employers, both in the form of direct and indirect costs. From higher spending on healthcare, to lost productivity, to the dangers associated with employees abusing medications in the workplace: these are aspects of the crisis that are too often overlooked in the current discussion.”

Additional key insights include:

  • Baby boomers are nearly four times more likely (7.4 percent) to abuse opioids than Millennials (2 percent).
  • Patients living in areas with lower incomes are twice as likely to abuse prescription painkillers as individuals in high-income areas. Additionally, opioid abusers are more likely to live in the rural South.
    • 22 out of the top 25 U.S. cities for opioid abuse are primarily rural and located in Southern states.
  • Among the top 30 largest U.S. cities, eight have higher than average opioid abuse rates. The cities include Las Vegas (7.4 percent), Charlotte (6.2 percent), Kansas City (5.1 percent) Portland (5.0 percent), Tampa (5.0 percent), Indianapolis (4.9 percent), Orlando (4.6 percent), and San Antonio (4.6 percent).
  • Among the top 30 largest U.S. cities, eight have a higher percentage of opioid prescriptions abused than the national benchmark of 32 percent. These cities include Charlotte (44 percent), Las Vegas (41 percent), Kansas City (38 percent), Portland (38 percent), Tampa (37 percent), Indianapolis (35 percent), Chicago (33 percent), and Dallas (33 percent).

The Centers for Disease Control and Prevention (CDC) has called this issue a public health crisis. According to the CDC, nearly 2 million Americans are abusing prescription opioids, resulting in over 16,000 deaths per year. In 2012, 259 million opioid prescriptions were written, enough for every American adult to have their own bottle of pills. Economically, opioid abuse costs the U.S. economy nearly $56 billion and the American Society of Addiction Medicine (ASAM) estimates that employers, which insure about half of all Americans, are losing an average of $10 billion annually from lost work and productivity alone.


Castlight’s primary source of information for this descriptive analysis was de-identified, aggregated data from medical and prescription claims reports, analyzed across broad demographic categories, which included age, income, and geography. In addition, Castlight looked at 2015 annual medical healthcare spend associated with this dataset. For the purposes of this analysis, opioid abuse was defined as meeting the following clinical guidelines: Receiving greater than a cumulative 90-day supply of opioids and receiving an opioid prescription from four or more providers over the five-year period between 2011 and 2015. In defining “opioid abuse,” Castlight referenced the 2015 Pharmacy Quality Alliance’s (PQA) guidelines on high dosage and multiple providers as signals of abuse. Castlight is 100% compliant with all federal privacy laws governing the handling of employee data, including this analysis.

About Castlight Health

Our mission is to empower people to make the best choices for their health and to help companies make the most of their health benefits. We offer a health benefits platform that engages employees to make better healthcare decisions and guides them to the right program, care, and provider. The platform also enables benefit leaders to communicate and measure their programs while driving employee engagement with targeted, relevant communications. Castlight has partnered with more than 190 customers, spanning millions of lives, to improve healthcare outcomes, lower costs, and increase benefits satisfaction.

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