What's Driving the Opioid Crisis? Pieces of the Puzzle

Drug overdoses are now the leading cause of death among Ohioans less than age 55 . More than two million Americans are estimated to be dependent on opioids, and more Americans now use prescription painkillers than tobacco (Katz, 2017). The emergency nature of the crisis has fueled speculation and action that, in some cases, has generated unintended negative impacts. For instance, there is some evidence that reducing the availability of prescription opioids – through prescription drug monitoring programs, for example – may have increased use of non-prescription opioids like Heroine (Ali et al. 2017). However, in reality, researchers are just beginning to understand the underlying individual, community and health system causes of the epidemic. This presentation will provide an overview of the leading hypotheses intended to explain why some areas have experienced worse opioid misuse and death than others. Our talk will outline some leading theories, including supply-side theories that attribute the crisis to doctor, hospital and pharmaceutical company behaviors; economic theories, that attribute the crisis to economic declines in many communities; and mental health theories, that examine the role that underlying mental health conditions play in drug misuse. We will examine what evidence exists for each theory, and whether they help explain the patterns in drug deaths that we see in Ohio. We will also provide our view of areas that need more work, explaining why some types of research in the area are difficult to implement. The intended audience for this presentation includes other researchers beginning to examine the opioid crisis, and community partners on the frontline of the epidemic who are looking to understand its causes to implement effective treatment and prevention approaches. The co-presenters, Drs. Lauren Jones and Mike Betz – both assistant professors of human sciences, are working on several of opioid-related projects, including one that was recently funded by the Institute of Policy Research at Ohio State investigating the relationship between wage declines in certain areas and opioid deaths. Mike Betz recently presented a similar talk at the OSU Extension Family and Consumer Sciences conference.AUTHOR AFFILIATION: Lauren Jones, Assistant Professor, Department of Human Sciences, jones.2846@osu.edu (Corresponding Author); Mike Betz, Assistant Professor, Department of Human Sciences.Drug overdoses are now the leading cause of death among Ohioans less than age 55. More than two million Americans are estimated to be dependent on opioids, and more Americans now use prescription painkillers than tobacco (Katz, 2017). The presenters will provide an overview of the leading hypotheses to explain why some areas have experienced worse opioid misuse and death than others. We will outline some leading theories, including supply-side theories that attribute the crisis to doctor, hospital and pharmaceutical company behaviors; economic theories that attribute the crisis to economic declines in many communities; and mental health theories that examine the role underlying mental health conditions play in drug misuse. We will examine what evidence exists for each theory and whether they help explain the patterns in drug deaths we see in Ohio