FAIR Health: Insured Opioid Use Disorder Diagnoses Climb 32.7% Since 2022

FAIR Health released its annual update of the Opioid Tracker on Wednesday, showing that the share of commercially insured patients carrying an opioid use disorder diagnosis rose 32.7 percent nationally between 2022 and 2025. In 2022 the tracker counted 449 patients with such a diagnosis per 100,000 patients receiving medical services; by 2025 that figure had reached 596.

The tracker is a free, interactive heat map built on the nonprofit's repository of commercial health claims, and Wednesday's release also included a separate user's guide explaining how states can read their own data. FAIR Health holds what it describes as the nation's largest collection of commercial claims data, growing by more than five billion validated medical services a year, and is a national Qualified Entity certified by the Centers for Medicare & Medicaid Services, meaning it also receives claims for everyone enrolled in traditional Medicare Parts A, B and D.

The state map tilts heavily toward the South and Appalachia

Tennessee recorded the highest rate in the country in 2025, with 1,551 patients diagnosed with opioid use disorder per 100,000 — roughly two and a half times the national rate. West Virginia followed at 1,528, then Mississippi at 1,373, Arkansas at 1,320 and Delaware at 1,256.

Five states — Tennessee, West Virginia, Mississippi, Arkansas and Delaware — now sit at more than twice the national rate, and the cluster of Southern and Appalachian states at the top of the map is difficult to read as a statistical artifact.

Counseling and methadone bundles dominate the spending

Nationally in 2025, alcohol and substance abuse services and treatments were the procedure code category with the highest utilization among commercially insured patients with an opioid use disorder diagnosis, accounting for 39.0 percent of all claim lines carrying that diagnosis.

The single code with the largest aggregate allowed amount was G2067 — the weekly bundle for medication-assisted treatment with methadone — at 9.4 percent of aggregate allowed amounts for the diagnosis, with an average allowed amount of $243. That figure is the negotiated in-network fee for the week of treatment, combining what the health plan pays with the patient's in-network cost sharing.

Methadone for opioid use disorder is dispensed almost entirely through federally certified opioid treatment programs rather than retail pharmacies, so the code's prominence in a commercial claims set reflects care delivered at those sites. The opioid treatment program model remains the most regulated route into medication-assisted treatment in the country, and access varies sharply by county.

Who is being diagnosed — and by whom

Diagnoses clustered in middle age: patients aged 41 to 50 made up 28.1 percent of the total age distribution nationally in 2025. Men accounted for 56.1 percent of patients with the diagnosis, women 43.9 percent.

The fastest-growing specialty involved in treatment was nurse practitioners, whose share of claim lines rose 67 percent between 2022 and 2025. Psychiatric nurses were next at 47 percent, followed by emergency medicine at 44 percent. The shift toward nurse practitioners is consistent with a broader redistribution of substance use disorder care away from specialty addiction medicine and into primary care and retail clinic settings, where prescribing capacity expanded after federal training requirements for buprenorphine were eliminated.

What the tracker does not measure

The Opioid Tracker is a claims-based instrument, which shapes what it can and cannot say. It counts people whose care was billed to a commercial plan and whose clinician recorded an opioid use disorder diagnosis — not people with the condition. States with aggressive screening and coding practices will look worse than states with large uninsured or Medicaid populations, whose residents are largely absent from a commercial claims repository.

FAIR Health notes that the underlying data also cannot distinguish a first diagnosis from a re-diagnosis, or measure whether a patient stayed in treatment after the initial encounter. In a year when provisional federal overdose data has shown a third consecutive annual decline, the tracker's rising diagnosis counts point in the opposite direction — a divergence that may reflect better case-finding among insured patients rather than worsening prevalence.

People looking for treatment for opioid addiction can find medication-assisted programs and levels of care through the opioid rehab directory.