ArticleThe International journal on drug policy2020
Drivers of opioid use in Appalachian Pennsylvania: Cross-cutting social and community-level factors.
Article in The International journal on drug policy, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers, 1 of them a synthesis that pooled it.
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Who cites it
14 citing papers in PubMed, 1 synthesis or guideline pooled it, 20 citations in OpenAlex.
- Examining the Relationship between Social Connection and Opioid Misuse: A Systematic Review.Substance use & misuse · 2021Pooled it
- Qualitative evidence for the determinants of deaths of despair: a scoping review.BMC public health · 2026Article
- Associations of community socioeconomic factors and opioid use disorder across an urban-to-rural spectrum in Pennsylvania: an electronic health record-based case-control study.Social psychiatry and psychiatric epidemiology · 2025Article
- Predicting fatal opioid-involved overdoses: A social-ecological framework matched to a linked-data warehouse.The International journal on drug policy · 2025Article
- HIV and Hepatitis C Among People Who Inject Drugs in Memphis, Tennessee: an Intersectional Risk Environment Analysis of the Social Determinants of Health.Journal of racial and ethnic health disparities · 2025Article
- Article
- A Case of Human Trafficking in Appalachia and What Emergency Physicians Can Learn from It.The western journal of emergency medicine · 2023Article
- High-risk Individuals and Naloxone Use: Implications for THN Programs in Rural Appalachian Communities.Journal of Appalachian health · 2023Article
- Adverse Childhood Experiences and Overdose: Lessons From Overdose Data to Action.American journal of preventive medicine · 2022Article
- A qualitative examination of recent increases in methamphetamine use in a cohort of rural people who use drugs.Drug and alcohol dependence · 2021Article
- A comparison of methods for measuring spatial access to health care.Health services research · 2021Article
- Social vulnerabilities for substance use: Stressors, socially toxic environments, and discrimination and racism.Neuropharmacology · 2021Review
- Social Ecological Model of Problem Gambling: A Cross-National Survey Study of Young People in the United States, South Korea, Spain, and Finland.International journal of environmental research and public health · 2021Article
- Understanding Polarizing Community Perspectives on Harm Reduction Strategies: Challenges to Addressing the Opioid Crisis in Appalachian Pennsylvania.Journal of Appalachian health · 2021Article
Corrections and comments
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Authors and funding
4 authors at 1 institution in 1 country.
Funding
Abstract
backgroundFour Appalachian states including Pennsylvania (PA) have the highest drug overdose rates in the country, calling for better understanding of the social and economic drivers of opioid use in the region. Using key informant interviews, we explored the social and community drivers of opioid use in a non-urban Appalachian Pennsylvania community.
methodsIn 2017, we conducted qualitative interviews with 20 key stakeholders from a case community selected using the results from quantitative spatial models of hospitalizations for opioid use disorders. In small town located 10 miles outside Pittsburgh, PA, we asked participants to share their perceptions of contextual factors that influence opioid use among residents. We then used qualitative thematic analysis to organize and generate the results.
resultsParticipants identified several contextual factors that influence opioid use among residents. Three cross-cutting thematic topics emerged: 1) acceptance and denial of use through familial and peer influences, community environments, and social norms; 2) impacts of economic shifts and community leadership on availability of programs and opportunities; and 3) the role of coping within economic disadvantage and social depression.
conclusionUncovering multi-level, contextual drivers of opioid use can benefit the development of future public health interventions. These results suggest that social and community-level measures of structural deprivation, acceptance and/or denial of the opioid epidemic, community engagement and development, social support, and social depression are important for future research and programmatic efforts in the Appalachian region.
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