The iatrogenic epidemic of prescription drug abuse: county-level determinants of opioid availability and abuse.

Abstract:

BACKGROUND:Opioid use and abuse in the United States continues to expand at an alarming rate. In this study, we examine the county-level determinants of the availability and abuse of prescription opioids to better understand the socio-ecological context, and in particular the role of the healthcare delivery system, on the prescription drug abuse epidemic. METHODS:We use community-level information, data from Indiana's prescription drug monitoring program in 2011, and geospatial regression methods to identify county-level correlates of the availability and abuse of prescription opioids among Indiana's 92 counties. RESULTS:The findings suggest that access to healthcare generally, and to dentists and pharmacists in particular, increases the availability of prescription opioids in communities, which, in turn, is associated with higher rates of opioid abuse. CONCLUSIONS:The results suggest that the structure of the local healthcare system is a major determinant of community-level access to opioids adding to a growing body of evidence that the problem of prescription opioid abuse is, at least in part, an "iatrogenic epidemic."

journal_name

Drug Alcohol Depend

authors

Wright ER,Kooreman HE,Greene MS,Chambers RA,Banerjee A,Wilson J

doi

10.1016/j.drugalcdep.2014.03.002

subject

Has Abstract

pub_date

2014-05-01 00:00:00

pages

209-15

eissn

0376-8716

issn

1879-0046

pii

S0376-8716(14)00777-7

journal_volume

138

pub_type

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