Opioid Addiction: Who’s At Risk?

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The opioid crisis makes headlines all over the United States, with a growing number of the population dependent on opioids, and the number of opioid-related overdoses and fatalities also climbing.

But the crisis hasn’t affected all groups equally.

Which populations were the hardest-hit?

A new study looked at Health Department records from the state of Ohio to determine which demographic groups were most affected. To reach their conclusions, researchers examined fatal overdoses in Ohio between 2010 and 2017. Their findings paint a picture of who is most likely to be affected by this crisis.

They found that the opioid crisis affects young white men the most. During the period the researchers analyzed, white men between the ages of 30 and 39 suffered the most fatalities and were the most at risk. Black men ages 30 to 39 were the next most affected group. Across the board, women and older adults were less likely to be affected.

Cases Clustered in Hot Spots

In addition to breaking down the impact along population lines like age, gender, and racial makeup, researchers looked at the geographic regions most affected. The impact of the opioid crisis varies greatly by region.

The researchers identified a total of 12 clusters across the state of Ohio that they designated as hot spots – areas with the highest rate of fatal overdoses. These regions contained 21% of the state’s at-risk population — but 40% of the opiate-related fatalities.

What characterized these disproportionately affected areas?

The researchers found that in these clusters – most of them in urban areas, and most in the Southwestern part of the state – had established corridors of illegal drug flow and a history of illegal drug traffic.

A Complex Picture

The study co-authors were part of a task force established in 2017 to determine the causes of the epidemic of opioid addiction and opioid-related deaths.  A partnership between the University of Cincinnati researchers, the Ohio State Health Department, and other participants, the task force seeks to identify the underlying causes of opioid addiction and opioid overdose.

Their findings paint a complex picture. One significant factor is the large number of Americans who suffer from chronic pain.

When it comes to treating severe pain, opiates work. The drugs block pain receptors on the nerve cells in the brain and spinal cord, wiping out the sensation of pain.

But this type of drug is dangerous for several reasons. Opiates are addictive, and they affect the body’s response to endorphins —  the natural chemicals that make people feel better. The result is that everyday activities such as eating, drinking, or exercising become less pleasurable. An opioid-addicted patient will seek increasingly high doses of the drug to feel the same level of pleasure or contentment.

Unintended Consequences

The crisis had its roots in these legal – and presumably safe, if used properly – controlled substances being overprescribed. Its next phase began, paradoxically, out of efforts to control the first one. As concerns grew about the over-prescription and overuse of legal opioids, legislators began calling for restrictions on their use, due to concerns about addiction and overdose.

These laws had the desired effect of making legal opioids less easily available. But, as laws were passed and enforced limiting the easy access of patients to the legal painkillers they had come to rely on, many turned to illegal substances, such as heroin, which remained cheap and relatively easy to obtain.

The rise of fentanyl further complicated the picture. Fentanyl is a synthetic opioid that’s much more potent than its legal cousin morphine, and is often added to heroin and other illegal drugs. Fentanyl carries a much higher risk of overdose.

Further Study Needed

The aim of the Ohio study was to establish risk factors for opioid addiction and opioid overdose, and while the focus of the study was limited geographically, the researchers came to some useful conclusions. Accordingly, the study’s co-authors hope to expand their analysis to the areas most affected by the crisis.

This makes sense: analysis of the problem’s underlying cause is the first step toward mitigating it. However, access to regional data on overdose deaths will be slow, and is affected by privacy laws. In the meantime, the results of this small regional study can help identify at-risk groups – young men, urban populations, and those suffering chronic pain. The next step in battling this growing crisis of opioid addiction is to develop a considered approach to educate those at risk, and supporting the affected populations.