Opioid use disorder diagnoses among commercially insured patients rose 32.7% from 2022 to 2025, and Tennessee has the highest rate

Opioid use disorder diagnoses among commercially insured patients in the United States rose 32.7% between 2022 and 2025, from 449 to 596 per 100,000 patients, and Tennessee had the highest state rate in 2025 at 1,551 per 100,000. The figures come from the annual update to FAIR Health’s Opioid Tracker, released on Oct. 14, 2026.

The tracker is built from insurance claims, so it counts diagnoses and billed services, not every person with the condition. That makes it a window onto one part of the system, privately insured patients, rather than a census of the crisis, and FAIR Health presents it as a free, interactive tool that includes a user’s guide alongside the annual update.

The national rise and the five highest states

FAIR Health, a national nonprofit, says in its press release that commercially insured patients with an opioid use disorder diagnosis increased by 32.7% from 2022 to 2025. The rate is measured per 100,000 patients receiving medical services. The same release was distributed through EurekAlert and lists the five states with the highest 2025 rates.

Tennessee led at 1,551 per 100,000, followed closely by West Virginia at 1,528. Mississippi came third at 1,373, Arkansas fourth at 1,320 and Delaware fifth at 1,256. The national rate of 596 means that even the fifth-ranked state, Delaware, sits at more than double the national figure, and Tennessee’s rate is roughly two and a half times as high. The gap between first and second place is only 23 per 100,000, so the order at the top could easily change in the next update.

Those state rates are not directly comparable to the national trend line, because the state ranking is a single-year 2025 snapshot while the 32.7% compares two years. The release does not give each state’s 2022 figure in its text, which leaves the state-level trend out of the top-line numbers, but the tracker’s state infographics show the change in rate since 2022 for every state, along with each state’s top procedure categories and codes and its patient age and gender distribution. A reader curious about a single state would start there, not with the national headline number.

Who is being diagnosed and who is treating them

People aged 41 to 50 made up the largest share of diagnoses, at 28.1%. Males accounted for 56.1% of patients and females for 43.9%. By category of service, alcohol and substance abuse services and treatments had the most utilization, at 39.0% of claim lines that carried an opioid use disorder diagnosis. A claim line is an individual service on a claim, so the percentage describes the mix of billed services, not the share of people.

The costliest single item was the weekly methadone treatment bundle, billed under procedure code G2067. It accounted for 9.4% of aggregate allowed amounts, with an average allowed amount of $243. The allowed amount is the negotiated in-network fee, including both the plan’s payment and the patient’s cost sharing, so the $243 average describes a price paid for a week of medication-assisted treatment under commercial plans rather than a cash price.

The fastest-growing providers, measured by change in their share of claim lines from 2022 to 2025, were nurse practitioners, up 67%, psychiatric nurses, up 47%, and emergency medicine physicians, up 44%. The release gives no counts of clinicians or patients behind those percentages. Growth in a share does not mean those clinicians treat the most patients; it means their portion of billed services rose faster than that of other specialties.

FAIR Health’s 2025 update against earlier tallies

The previous annual update used a different window. FAIR Health’s October 2025 description of the tracker reported a rise from 386 to 539 per 100,000, or 39.8%, between 2021 and 2024, with Tennessee also leading that year at 1,447 per 100,000, according to Axios coverage of that release. Set side by side, the 2024 top five in the Axios account was Tennessee, West Virginia, Kentucky at 1,281, Arkansas at 1,218 and Delaware at 1,165, so Mississippi appears in the 2025 top five where Kentucky was a year earlier, and each position on the new list carries a higher rate than the same position a year earlier. Because the windows differ in length and start year, the smaller percentage in the new update should not be read as a slowdown without more data.

Several limits come with the dataset. It covers only commercially insured patients, so Medicare, Medicaid and the uninsured, where opioid use disorder is also treated, are outside it. The release does not explain how a patient was identified or counted, and diagnoses and claims can shift with coding practice and changes in insurance coverage, which means part of any increase could reflect more diagnosing or billing for the condition rather than only more disorder. The release also quotes no named official; its only listed individuals are media contacts.

For readers wanting more of the same kind of material, EurekAlert’s medicine news section carries related releases. The tracker itself, with its heat map and state-by-state infographics, is the place to check an individual state’s top procedure codes and age and gender mix.

This article was produced with the assistance of AI and reviewed by Morning Overview editors prior to publication.

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