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Opioid Crisis — A Result of Poverty, Availability and Pain

Image Credit: Waking Times

By Dr. Mercola | Waking Times

In recent years, the devastating effects of wanton opioid use have become unmistakable, with opioid overdoses killing 47,600 Americans in 2017 alone. As of June 2017, opioids became the leading cause of death among Americans under the age of 50, and President Trump declared the opioid crisis a public health emergency that year in October.


I’ve written many previous articles detailing the background of how the U.S. ended up here. While the opioid crisis was largely manufactured by drug companies hell-bent on maximizing profits, leading to exaggerated and even fraudulent claims about the drugs’ safety profile, the increased availability of opioids isn’t the sole cause.

A Perfect Storm of Poverty, Trauma, Availability and Pain

As noted in a January 2020 article in The Atlantic, “researchers … say opioid addiction looks like the result of a perfect storm of poverty, trauma, availability and pain.”

Commenting on some of the research cited in that article, David Powell, senior economist at Rand, told The Atlantic that to produce the most lethal drug epidemic America has ever seen “you need a huge rise in opioid access, in a way that misuse is easy, but you also need demand to misuse the product.”

Poverty and pain, both physical and emotional, fuel misuse. If economic stress or physical pain (or both) is a factor in your own situation, please be mindful that seeking escape through opioid use can easily lead to a lethal overdose. The risk of death is magnified fivefold if you’re also using benzodiazepine-containing drugs.


The Hidden Influence of Poverty and Trauma

Several investigations seeking to gain insight into the causes fueling the opioid epidemic have been conducted in recent years. The findings reveal common trends where emotional, physical and societal factors have conspired to bring us to the point where we are today.

Among them is a 2019 study in the Medical Care Research Review journal, which looked at the effects of state-level economic conditions — unemployment rates, median house prices, median household income, insurance coverage and average hours of weekly work — on drug overdose deaths between 1999 and 2014. According to the authors:

“Drug overdose deaths significantly declined with higher house prices … by nearly 0.17 deaths per 100,000 (~4%) with a $10,000 increase in median house price. House price effects were more pronounced and only significant among males, non-Hispanic Whites, and individuals younger 45 years.

 

Other economic indicators had insignificant effects. Our findings suggest that economic downturns that substantially reduce house prices such as the Great Recession can increase opioid-related deaths, suggesting that efforts to control access to such drugs should especially intensify during these periods.”

Similarly, an earlier investigation, published in the International Journal of Drug Policy in 2017, connected economic recessions and unemployment with rises in illegal drug use among adults.

Twenty-eight studies published between 1990 and 2015 were included in the review, 17 of which found that the psychological distress associated with economic recessions and unemployment was a significant factor. According to the authors:

“The current evidence is in line with the hypothesis that drug use increases in times of recession because unemployment increases psychological distress which increases drug use. During times of recession, psychological support for those who lost their job and are vulnerable to drug use (relapse) is likely to be important.”

Abuse-related trauma is also linked to unemployment and financial stress, and that too can increase your risk of drug use and addiction. As noted in The Atlantic, when the coal mining industry in northeastern Pennsylvania collapsed, leaving many locals without job prospects, alcohol use increased, as did child abuse. Many of these traumatized children, in turn, sought relief from the turmoil and ended up becoming addicted to opioids.

Free Trade Effects Implicated in Opioid Crisis

Another 2019 study published in Population Health reviewed the links between free trade and deaths from opioid use between 1999 and 2015, finding that “Job loss due to international trade is positively associated with opioid overdose mortality at the county level,” and that this association was most significant in areas where fentanyl was present in the heroin supply.

Overall, for each 1,000 people who lost their jobs due to international trade — commonly due to factory shutdowns — there was a 2.7% increase in opioid-related deaths. Where fentanyl was available, that percentage rose to 11.3%. The study “contributes to debates in the social sciences concerning the negative consequences of free trade,” the authors note, adding:

“Scholars have long focused on the positive effect of international trade on the overall economy, while also noting that it causes layoffs and bankruptcy for some groups.

 

Recent influential work by Autor, Dorn, and Hanson demonstrates that these negative impacts of trade are actually highly localized, with layoffs, unemployment, and lower wages concentrated in specific labor markets.

 

This study furthers our understanding of the local consequences of international trade by looking beyond wages and employment levels to the potential impact on opioid-related overdose death.”

Opioid Makers Have Had a Direct Impact

The National Bureau of Economic Research has also contributed to the discussion with the working paper “Origins of the Opioid Crisis and Its Enduring Impacts,” issued November 2019.

In it, they highlight “the role of the 1996 introduction and marketing of OxyContin as a potential leading cause of the opioid crisis,” showing that in states where triplicate prescription programs were implemented, OxyContin distribution rates were half that of states that did not have such programs.

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