OPIATE DEPENDENCY AMONG THE SUBSCRIBERS OF A NEW-YORK AREA PRIVATE INSURANCE PLAN

Objective.-To estimate the prevalence of opiate use among the subscrib ers of a large private insurance plan, Empire Blue Cross and Blue Shie ld (EBCBS). Design.-Six and a half million hospital inpatient claims f or the period January 1, 1982, through June 30, 1992, were reviewed. T hirty-one thousand eight hundred ten different individuals who had a t otal of 55 143 hospital admissions with a primary diagnosis of opiate dependency (International Classification of Diseases, Ninth Revision, Clinical Modification 304.0 and 304.7) were identified. In the same pe riod, 17 493 EBCBS subscribers (15 191 male and 2302 female) were iden tified from hospital admissions data as having acquired immunodeficien cy syndrome. These data were cross-matched with the opiate dependency data to estimate the ''capture'' of opiate users in the EBCBS subscrib ers with acquired immunodeficiency syndrome and to model the size of t he opiate using population in EBCBS. Results.-It is estimated that bet ween 1982 and 1992 EBCBS insured approximately 141 000 opiate users, 8 5 000 of whom are currently insured by EBCBS. Conclusion.-There is a l arge population of insured opiate users who may be excluded from the e stimates of the overall number of opiate users as insured opiate users are less likely to be counted via contact with government agencies. T his suggests that current estimates of the number of opiate users and their social characteristics should be reconsidered.