A Diagram of the Social-Ecological Conditions of Opioid Misuse and Overdose

Benjamin R. Brady (), Ehmer A. Taj, Elena Cameron, Aaron M. Yoder and Jennifer S. De La Rosa
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Benjamin R. Brady: Comprehensive Pain and Addiction Center, University of Arizona Health Sciences, Tucson, AZ 85721, USA
Ehmer A. Taj: Comprehensive Pain and Addiction Center, University of Arizona Health Sciences, Tucson, AZ 85721, USA
Elena Cameron: Comprehensive Pain and Addiction Center, University of Arizona Health Sciences, Tucson, AZ 85721, USA
Aaron M. Yoder: Comagine Health, Seattle, WA 98133, USA
Jennifer S. De La Rosa: Comprehensive Pain and Addiction Center, University of Arizona Health Sciences, Tucson, AZ 85721, USA

IJERPH, 2023, vol. 20, issue 20, 1-19

Abstract: The United States is experiencing a crisis of opioid misuse and overdose. To understand the underlying factors, researchers have begun looking upstream to identify social and structural determinants. However, no study has yet aggregated these into a comprehensive ecology of opioid overdose. We scoped 68 literature sources and compiled a master list of opioid misuse and overdose conditions. We grouped the conditions and used the Social Ecological Model to organize them into a diagram. We reviewed the diagram with nine subject matter experts (SMEs) who provided feedback on its content, design, and usefulness. From a literature search and SME interviews, we identified 80 unique conditions of opioid overdose and grouped them into 16 categories. In the final diagram, we incorporated 40 SME-recommended changes. In commenting on the diagram’s usefulness, SMEs explained that the diagram could improve intervention planning by demonstrating the complexity of opioid overdose and highlighting structural factors. However, care is required to strike a balance between comprehensiveness and legibility. Multiple design formats may be useful, depending on the communication purpose and audience. This ecological diagram offers a visual perspective of the conditions of opioid overdose.

Keywords: opioid use disorder; overdose; social determinants; social ecology (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2023
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