The Social Life of Opioids

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By Maia Szalavitz

In the story of America’s opioid crisis a recent tripling in prescriptions of the painkillers is generally portrayed as the villain. Researchers and policy makers have paid far less attention to how social losses—including stagnating wages and fraying ties among people—can increase physical and emotional pain to help drive the current drug epidemic.

But a growing body of work suggests this area needs to be explored more deeply if communities want to address the opioid problem. One study published earlier this year found that for every 1 percent increase in unemployment in the U.S., opioid overdose death rates rose by nearly 4 percent.

Another recent study from researchers at Harvard University and Baylor College of Medicine reported U.S. counties with the lowest levels of “social capital”—a measure of connection and support that incorporates factors including people’s trust in one another and participation in civic matters such as voting—had the highest rates of overdose deaths. That review of the entire U.S. mined data from 1999 through 2014 and showed counties with the highest social capital were 83 percent less likely to be among those with high levels of overdose. Areas with low social capital, in contrast, were the most likely to have high levels of such “deaths of despair,” with overdose alone killing at least 16 people per 100,000.

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