Report Publish Date: 2023
This report proposes important and urgent actions policymakers can take to reduce substance misuse and overdose by tackling the social conditions that contribute to the U.S. opioid crisis.
The authors organize their recommendations according to four federal overdose prevention priorities. They focus on policies that address social conditions that lead to substance misuse and overdose:
Social factors such as housing, poverty, transportation, working conditions, and food insecurity, as well as structural racism and other forms of discrimination, contribute to the opioid overdose crisis, the authors write. This report recommends practices and policies that are backed by research. If put in place, they could help prevent and reduce substance misuse and overdose by tackling the social conditions that lead to them.
A group of experts developed the report. They were convened by the Interdisciplinary Association of Population Health Sciences to support the National Academy of Medicine Medicine’s Action Collaborative on Countering the U.S. Opioid Epidemic.
The authors say, “Priorities reflected in this document arose from a learning curriculum developed by the expert group, including a review of the literature and a series of closed workshops that convened academics, advocates, people with lived experience of opioid use, clinicians, policymakers, health systems leaders and payers, to examine the intersection of social determinants of health with the overdose crisis at the policy and service levels.”
To show how the policies can be put in place, the authors include short case studies from across the country.
“We focus on strategies that address the continuum of overdose risk, from opioid use initiation and active opioid use, to opioid use disorder, to nonfatal and fatal overdose.”
—Magdalena Cerdá and Bennett Allen, New York University; Kelly R. Knight, University of California, San Francisco
“These actionable strategies are intended to guide policymakers at all levels of government as they implement their response to the overdose crisis,” the authors write.
$202,770
Awarded on: 08/05/2021
Timeframe: 2021-2023
Grant number: 78796
Location: Clearfield, UT
Interdisciplinary Association for Population Health Science Clearfield, UT 84016
websiteMore than 100,000 people died in the United States from drug overdoses in 2021, the highest number ever recorded in one year. Most of these overdoses involved opioids, and many involve multiple drugs. Black and Native American and indigenous people have experienced the highest rise in opioid overdose deaths in 2013–20, with current overdose rates surpassing those of white Americans. Since 2020, the greatest increase in overdose was observed in poor, urban communities with greater concentration of racial/ethnic minoritized groups such as Black and Hispanic people.
Social Determinants of Health (SDOH) are defined in Healthy People 2030 as “the conditions in the environments where people are born, live, learn, work, play, worship and age that affect a wide range of health, functioning, and quality-of-life outcomes and risks.” Examples of SDOH include poverty, unemployment, housing, working conditions, transportation, and food insecurity, among others. Critical to this definition is the idea that resources and services needed to promote health and prevent illness are impacted by social structures, policies, and economic systems that shape inequities in health and healthcare. Social structural factors that influence the distribution of resources, services, and community and individual vulnerability include structural racism, structural violence, sexism, ableism, homophobia and other beliefs and practices, both historic and contemporary, that result in diminished opportunities for well-being in the US.
SDOH such as structural racism, criminalization of substance use, deindustrialization, limitations to employment opportunities, and the increasing concentration of poverty have contributed to the disparate rise in overdose in poor communities and among racial/ethnic minoritized groups. SDOH also shape who can access and benefit from services that improve the health of people who use drugs. To effectively respond to this public health crisis, we must enact policies that address the social determinants of overdose risk.
We focus on strategies that address the continuum of overdose risk, from opioid use initiation and active opioid use, to opioid use disorder, to nonfatal and fatal overdose. This document is aimed at policymakers at all levels of government, as well as representatives of government agencies such as health and human services, public safety, and education.
Priorities for action were developed by a group of experts convened by the Interdisciplinary Association of Population Health Sciences to support the National Academy of Medicine Medicine’s Action Collaborative on Countering the U.S. Opioid Epidemic in integrating a social determinants of health perspective into their work. Priorities reflected in this document arose from a learning curriculum developed by the expert group, including a review of the literature and a series of closed workshops that convened academics, advocates, people with lived experience of opioid use, clinicians, policymakers, health systems leaders and payers, to examine the intersection of social determinants of health with the overdose crisis at the policy and service levels.
Interdisciplinary Association of Population Health Sciences, 2023
This study and report was conducted and created by the following:
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