Social and Community Consequences of the Opioid Epidemic
By Colleen Heflin
Before the COVID19 pandemic started to dominate the collective consciousness, the opioid crisis in the United States was widely recognized as one of the most important public health emergencies of our time. In 2019, almost 50,000 people died from an opioid overdose in the United States, almost sixfold the level from 2000. In 2020, the number of opioid-related deaths surged almost 40% from the prior year to about 69,000 and then spiked a further 20% to almost 81,000 deaths in 2021.
Some of the conditions brought about by COVID19 pandemic—including isolation and overburdened health systems—likely contributed to the rise in opioid overdoses, and both the COVID19 and opioid crises put pressure on the same public health, social service, and education systems.
However, to this point much of the opioid epidemic research has been focused on those most directly impacted by the epidemic: individuals with opioid substance use disorder. Academics and practitioners have addressed questions such as: How do we best help addicted individuals deal with and overcome their dependence? How do we best save lives in our communities? How do we decrease the spread of the epidemic going forward?
Moreover, recent high-profile litigation and settlements among states and local governments with drug companies have highlighted some of the costs of the opioid epidemic, with huge dollar amounts on the table in some of these cases. While these figures are notable, the total societal costs of the opioid epidemic are likely much higher when the less direct harm that is visited on communities by the crisis is factored into the equation.
With this in mind, the research in our volume contributes to our understanding of the consequences of the opioid epidemic in a variety of societal and community domains, such as: education; household formation; child well-being; labor markets; housing security; food security; and public budgets. In many of these topics, there is little existing research.
While acknowledging methodological challenges to working in this area, we identify a few key takeaways.
First, individuals involved with opioid addiction face more than a serious health issue. There is an urgent need for holistic policies that treat the whole person. For example, individuals with opioid use disorder may have critical food and housing needs that make it harder for treatment programs to be successful. While their addiction-related health needs require significant focus, opioid-related policy should address their needs holistically.
Second, individuals involved with opioid use disorder are embedded in families and communities and serve societal roles as parents and care-givers, and employees. The disruption caused by opioid use can cascade out to the family system across multiple generations, impacting the effectiveness of our educational system, straining social services such as child welfare, increasing food insecurity, and reducing productivity, ultimately creating fiscal burdens beyond the direct effects documented to date at the local and state level. This suggests that solutions need to also be far-reaching and encompassing.
Finally, given that the demographics of opioid addiction are shifting to look more like other margins of inequality, policy approaches informed by a social determinants of health frame are increasingly relevant. And given that opioid addiction is morphing once again into a fentanyl crisis, the need to focus on US societal structures which address loneliness and despair are more critical now than ever.
Article Details
The Social and Community Consequences of the Opioid Epidemic
Rajeev Darolia and Colleen Heflin
First published online March 20, 2023
DOI: 10.1177/00027162231157569
The ANNALS of the American Academy of Political and Social Science
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