Socioeconomic Status and Opioid Overdose
The intrinsic nature of a health crisis is never merely pertinent to the disease itself and its direct health impacts. Often, the root cause of the issue lies in the socioeconomic and structural factors that predispose certain populations to health risks.
When individuals consume more than the recommended or reasonable amount of substances like drugs or alcohol, they are subject to an overdose, leading to negative health effects and often, death. Opioid-induced overdosing is not unlike other health crises, as socioeconomic status affects an individual’s availability to opioids, exposure to addiction and drug use, and accessibility to receive adequate treatment. In Canada, opioid overdose risks are disproportionately high in low-income, marginalized, and racialized communities. This relationship is to be explored throughout this text.
Environmental factors play a significant role in establishing an individual’s relationship with opioids and can desensitize a person from its lethal effects. Low-income communities have a greater number of psychological, financial, and environmental stressors, which create a need to rely on a quick, easy fix to temporarily manage their emotions. Factors such as poverty, housing, food and employment insecurity, and the pressure to provide for their family, make individuals more prone to mental health issues like anxiety and depression and build a reliance on substance use as a coping mechanism. In a longitudinal study regarding this correlation in conjunction with hospitalization and emergency department visit rates in Canada, it was concluded that socioeconomic status (SES) exposes certain populations to psychosocial factors such as housing and income insecurity, which, in turn, increases mortality rates (Alsabbagh et al., 2022). According to a systematic review regarding the determinants of opioid overdose in Canada and the United States, systemic and social determinants such as geography, media coverage, socioeconomic status (SES), prescription drug monitoring programs (PDMP), and area urbanization are all contributing factors to the increasing mortality rates due to opioids in Canada and the United States (Nicholas et al., 2014). In understanding these relationships, it is vital for individuals in authority to create a space for discussion and implement structural change.
Increasing opioid prescription rates also contribute to the rising opioid-induced overdose numbers. Opioids were primarily prescribed to patients to aid in pain relief and management. According to an article, the lack of economic opportunity drives individuals towards opioid and alcohol use, however, opioids only heighten and worsen symptoms of depression, creating a toxic cycle of substance abuse and increasing suicidal ideations (Bohnert & Ilgen, 2019). In addition, the same article detailed an association between increased suicide rates and the heightened opioid prescription dosage. A lower SES and the mental and physical stressors associated with it, coupled with high opioid prescription rates, increase mortality rates through overdosing and suicide.
In North America, the healthcare system requires a greater number of restrictions and formalities to authorize access to prescribed opioids as well as a decreased prescription rate and dosage. Individuals demonstrating symptoms of reliance or addiction should not simply be denied access to opioids, but also must be given access to care facilities that specialize in helping individuals overcome their addiction. A strategy of dismissal and ignorance is unproductive, thus, the only way to efficiently tackle the increasing opioid-induced mortality is to consider its socioeconomic determinants and create an avenue for accessibility, accommodations, and rehabilitation.
References
Alsabbagh, M. W., Cooke, M., Elliott, S. J., Chang, F., Shah, N. U., & Ghobrial, M. (2022). Stepping up to the Canadian opioid crisis: a longitudinal analysis of the correlation between socioeconomic status and population rates of opioid-related mortality, hospitalization and emergency department visits (2000-2017). Health promotion and chronic disease prevention in Canada : research, policy and practice, 42(6), 229–237. https://doi.org/10.24095/hpcdp.42.6.01
Bohnert, A. S. B., & Ilgen, M. A. (2019). Understanding Links among Opioid Use, Overdose, and Suicide. The New England journal of medicine, 380(1), 71–79. https://doi.org/10.1056/NEJMra1802148
Nicholas B. King, Veronique Fraser, Constantina Boikos, Robin Richardson, Sam Harper, “Determinants of Increased Opioid-Related Mortality in the United States and Canada, 1990–2013: A Systematic Review”, American Journal of Public Health 104, no. 8 (August 1, 2014): pp. e32-e42.