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Cited by 923Opioid Use Disorder TreatmentSubstance Abuse Treatment and OutcomesHIV, Drug Use, Sexual Risk

Opioid crisis: no easy fix to its social and economic determinants

Open access
Dasgupta, Nabarun, Beletsky, Leo, Ciccarone, Daniel·2018·American Journal of Public Health
DOI 10.2105/ajph.2017.304187PMC PMC5846593
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Abstract

The accepted wisdom about the US overdose crisis singles out prescribing as the causative vector. Although drug supply is a key factor, we posit that the crisis is fundamentally fueled by economic and social upheaval, its etiology closely linked to the role of opioids as a refuge from physical and psychological trauma, concentrated disadvantage, isolation, and hopelessness. Overreliance on opioid medications is emblematic of a health care system that incentivizes quick, simplistic answers to complex physical and mental health needs. In an analogous way, simplistic measures to cut access to opioids offer illusory solutions to this multidimensional societal challenge. We trace the crisis' trajectory through the intertwined use of opioid analgesics, heroin, and fentanyl analogs, and we urge engaging the structural determinants lens to address this formidable public health emergency. A broad focus on suffering should guide both patient- and community-level interventions.

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  • The opioid crisis in Appalachia has led to reduced workforce productivity, increased healthcare costs, and strained social services.

    “The epidemic has led to reduced workforce productivity, increased healthcare costs, and strained social services.”

    From Trauma-Informed Research-Practice Partnership Building to Support Early Childhood Educators in an Appalachian Community (2023) · cites this paper as Dasgupta et al., 2018

    The supplied Abstract passages discuss economic hardship as a driver of opioid use and describe gaps in treatment access in Appalachian states. Searches for workforce productivity, healthcare costs, and strained social services found no passage in our copy stating that the epidemic caused those three effects. (LLM, conf=0.72)

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  • Paramount are the social determinants of health, particularly given associations between social disadvantage and the lifetime accumulation of stress and trauma, as well as how social factors impact opioid use and nutritional status.

    “Paramount are the social determinants of health, particularly given associations between social disadvantage and the lifetime accumulation of stress and trauma, as well as how social factors impact opioid use (224, 225) and nutritional status (226, 227).”

    From A Biopsychosocial Overview of the Opioid Crisis: Considering Nutrition and Gastrointestinal Health (2019) · cites this paper as [225]

  • Opioid overdose-related mortality has also increased substantially in Sweden.

    “opioid overdose-related mortality has also increased substantially in Sweden”

    From Association of opioid prescription initiation during adolescence and young adulthood with subsequent substance-related morbidity (2020) · cites this paper as [2]

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Research works printed but not linked: 6

  1. [7]US Government. Summary and recommendations of the 1980 White House conference on prescription drug misuse, abuse and diversion. In: Wilford BB, editor. Balancing the Response to Prescription Drug Abuse. Chicago, IL: American Medical Association; 1990. pp. 301–307. [Google Scholar]
  2. [8]Wailoo K. Pain: A Political History. Baltimore, MD: Johns Hopkins University Press; 2014. [Google Scholar]
  3. [16]Wesson D. Prescription drug abuse, fault-finding, and responsibility. In: Wilford B, editor. Balancing the Response to Prescription Drug Abuse. Chicago, IL: American Medical Association; 1990. [Google Scholar]
  4. [33]McCaig L. Historical Estimates From the Drug Abuse Warning Network, 1978–94. Estimates of Drug-Related Emergency Department Episodes. Rockville, MD: Substance Abuse and Mental Health Services Administration; 1996. [Google Scholar]
  5. [47]Beletsky L, LaSalle L, Newman M, Paré JM, Tam JS, Tochka A. Fatal re-entry: legal and programmatic opportunities to curb opioid overdose among individuals newly released from incarceration. Northeast Univ Law J. 2015;7(1):155–215. [Google Scholar]
  6. 60b.Bechteler SS, Kane-Willis K. Whitewashed: the African American opioid epidemic. Available at: https://www.thechicagourbanleague.org/cms/lib/IL07000264/Centricity/Domain/1/Whitewashed%20AA%20Opioid%20Crisis%2011-15-17_EMBARGOED_%20FINAL.pdf. Accessed December 14, 2017. [Google Scholar]

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Authors
Dasgupta, N., Beletsky, L., & Ciccarone, D.
Affiliations
University of North Carolina at Chapel Hill (US)
ORCID
Venue
American Journal of Public Health
Publisher
American Public Health Association
Published
2018-02
Volume
108
Issue
2
Pages
182-186
ISSN
  • 0090-0036 (ISSN-L)
  • 1541-0048
DOI
10.2105/ajph.2017.304187
PMC
PMC5846593
OpenAlex
W2776828305
Cited by
923
References
60
Citations by year
2026: 61 · 2025: 72 · 2024: 89 · 2023: 106 · 2022: 116 · 2021: 145 · 2020: 154 · 2019: 129 · 2018: 50
FWCI
85.51
Type
journal article
Language
en
Open access
Locations
  • American Journal of Public Health (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
  • SSRN Electronic Journal (submittedVersion)
  • RePEc: Research Papers in Economics (submittedVersion)
Funders
  • National Institutes of Health
  • National Institute on Drug Abuse (R01DA039073, R37DA019829, R01DA037820)
Topics
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Opioid Use Disorder Treatment
  • Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
  • Health Sciences › Medicine › Epidemiology › HIV, Drug Use, Sexual Risk
Keywords
opioid epidemic, opioid overdose, opioid prescribing, heroin, fentanyl analogs, opioid analgesics, social determinants of health, economic hardship, trauma, isolation, concentrated disadvantage, opioid access, public health interventions
MeSH terms
Analgesics, Opioid, Drug Industry, Humans, Opioid-Related Disorders, Pain, United States, Drug Overdose, Prescription Drug Misuse

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