ArticleAddiction (Abingdon, England)2023
Understanding the differential effect of local socio-economic conditions on the relation between prescription opioid supply and drug overdose deaths in US counties.
Article in Addiction (Abingdon, England), 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 1 of them a synthesis that pooled it.
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Who cites it
10 citing papers in PubMed, 1 synthesis or guideline pooled it, 17 citations in OpenAlex.
- Social and economic determinants of drug overdose deaths: a systematic review of spatial relationships.Social psychiatry and psychiatric epidemiology · 2024Pooled it
- Chasing the Wrong Door for 30 Years: Is Suzetrigine the Key to Selective Pain Relief?Medicina (Kaunas, Lithuania) · 2026Review
- Scoping evidence review on the prevention and treatment of opioid overdose.Harm reduction journal · 2026Review
- Barriers beyond behavior: structural determinants of behavioral health treatment disparities among Hispanics in the U.S.Frontiers in public health · 2026Article
- Demographic characteristics and repeat overdose risk factors in 601 patients with intentional drug overdose in the emergency department: a cross-sectional study.Frontiers in psychiatry · 2026Article
- The Contribution of Social and Structural Determinants of Health Deficits to Mental and Behavioral Health Among a Diverse Group of Young People.International journal of environmental research and public health · 2025Article
- Risk factors for persistent fatal opioid-involved overdose clusters in Massachusetts 2011-2021: a spatial statistical analysis with socio-economic, accessibility, and prescription factors.BMC public health · 2024Article
- Exploring Opioid Prescription Patterns and Overdose Rates in South Carolina (2017-2021): Insights into Rising Deaths in High-Risk Areas.Healthcare (Basel, Switzerland) · 2024Article
- Community-level determinants of stakeholder perceptions of community stigma toward people with opioid use disorders, harm reduction services and treatment in the HEALing Communities Study.The International journal on drug policy · 2023Article
- Visual Analytics for Data-Driven Understanding of the Substance Use Disorder Epidemic.Inquiry : a journal of medical care organization, provision and financingArticle
Corrections and comments
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Authors and funding
6 authors at 4 institutions in 1 country.
Funding
Abstract
BACKGROUND AND
aimsBoth local socio-economic conditions and prescription opioid supply are associated with drug overdose deaths, which exhibit substantial geographical heterogeneity across the United States. We measured whether the associations of prescription opioid supply with drug overdose deaths vary by local socio-economic conditions.
designEcological county-level study, including 3109 US counties between 2006 and 2019 (n = 43 526 county-years) using annual mortality data.
settingUnited States. CASES: A total of 711 447 drug overdose deaths. MEASUREMENTS: We modeled overdose counts using Bayesian hierarchical Poisson models, estimating associations between four types of drug overdose deaths (deaths involving any drugs, any opioid, prescription opioids only and heroin), prescription opioid supply and five socio-economic indicators: unemployment, poverty rate, income inequality, Rey index (components include mean household income, % high school graduates, % blue-collar workers and unemployment rate), and American human development index (HDI; an indicator of community wellbeing).
findingsDrug overdose deaths and all substance-specific overdose deaths were higher in counties with higher income inequality [adjusted odds ratios (aORs) = 1.09-1.13], Rey index (aORs = 1.15-1.21) and prescription opioid supply (aORs = 1.14-1.21), and lower in counties with higher HDI scores (aORs = 0.75-0.92). Poverty rate, income inequality and HDI scores were found to modify the effect of prescription opioid supply on heroin overdose deaths. The plot of the interactions showed that when disadvantage is high, increasing prescription opioid supply does not increase heroin overdose deaths. The less disadvantage there is, indicated by lower poverty rates, higher HDI scores and lower income inequality, the greater the effect of increasing prescription opioid supply relative to population size on heroin overdose deaths in US counties.
conclusionsIn the United States, prescription opioid supply is associated with higher drug overdose deaths; associations are stronger in counties with less disadvantage and less income inequality, but only for heroin overdose deaths.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.