Is the Opioid Epidemic Driven By Family Consumption?

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According to a new study in the American Sociological Review, if one family member uses prescription opioids, it’s likely that others in the family will soon be using them, too.

“Through some combination of social learning and access to excess opioids in the medicine cabinet, the rate of PO (prescription opioid) use increases in families in which one person introduces these medications to the household,” the study said.

The study, conducted by Mathijs de Vaan and Toby Stuart, sociologists at the Haas School of Business of the University of California at Berkeley, analyzed hundreds of millions of medical claims and nearly 14.5 million opioid prescriptions in Massachusetts between 2010 and 2015.

They found that the use of POs was a “social behavior,” like smoking or alcohol consumption, that influenced the behavior of other members of a household. Family members whose pain has been ameliorated by opioids will act as persuasive examples for others in the household who will ask their doctor for a similar prescription—even though it may not be necessary or appropriate for their medical condition.

Research has shown that the easy availability of prescription medications is a “central culprit” of the opioid crisis, the authors said, noting that in 2012 alone, U.S. physicians wrote 255 million opioid prescriptions—representing 81.3 scripts per 100 citizens—a rate four and a half times higher than consumption in European countries.

It was no coincidence that pharmaceutical companies reaped enormous profits from the combination of rising patient demand for opioids and the willingness of physicians to prescribe them, they wrote.

“The aggressive marketing tactics of a few pharmaceutical companies have influenced physician prescribing behavior to the point that these practices constitute a true root cause of the proliferation of POs,” the study said.

Significantly, the phenomenon of spreading family opioid consumption was more likely to occur in lower-income households, the authors added.

The data showed that individuals in families with higher socioeconomic status were prescribed fewer opioids, thus reducing the chances that other household members would ask for opioid pain relief.

The reason, they suggested, is that individuals in lower-income households were “less informed” about the potential for abuse and about alternative forms of pain relief, and “therefore more influenced” by other family members.

But they noted that this hypothesis needed further study.

“Given the well-documented and substantial variation in opioid use across spatial areas, we believe it is important to further explore the dynamics of (socioeconomic status) and the diffusion of opioid use.”

The authors said their findings suggested that more research was needed to understand the sociological factors driving the opioid epidemic.

“More generally, we hope our work is a further prompt to sociologists to become more active in examining the provision of health care,” the authors said.

“We offer a sociological explanation for why prescription drugs are such a common treatment option for pain, but we also uncover other important puzzles that could be tackled using a sociological lens.”

You can read the full study here.

Maria Trovato is a TCR news intern.

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