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

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Listed:
  • Benjamin R. Brady

    (Comprehensive Pain and Addiction Center, University of Arizona Health Sciences, Tucson, AZ 85721, USA
    School of Interdisciplinary Health Programs, College of Health and Human Services, Western Michigan University, Kalamazoo, MI 49008, 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
    Lifecourse Epidemiology of Adiposity and Diabetes (LEAD) Center, University of Colorado, Aurora, CO 80045, USA)

  • Jennifer S. De La Rosa

    (Comprehensive Pain and Addiction Center, University of Arizona Health Sciences, Tucson, AZ 85721, USA
    Department of Family and Community Medicine, College of Medicine, University of Arizona, Tucson, AZ 85721, USA)

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.

Suggested Citation

  • Benjamin R. Brady & Ehmer A. Taj & Elena Cameron & Aaron M. Yoder & Jennifer S. De La Rosa, 2023. "A Diagram of the Social-Ecological Conditions of Opioid Misuse and Overdose," IJERPH, MDPI, vol. 20(20), pages 1-19, October.
    • Handle: RePEc:gam:jijerp:v:20:y:2023:i:20:p:6950-:d:1263972
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    References listed on IDEAS

    as
    1. Dasgupta, N. & Beletsky, L. & Ciccarone, D., 2018. "Opioid Crisis: No Easy Fix to Its Social and Economic Determinants," American Journal of Public Health, American Public Health Association, vol. 108(2), pages 182-186.
    2. Renger, Ralph & Foltysova, Jirina & Becker, Karin L. & Souvannasacd, Eric, 2015. "The power of the context map: Designing realistic outcome evaluation strategies and other unanticipated benefits," Evaluation and Program Planning, Elsevier, vol. 52(C), pages 118-125.
    3. Joyce Manchester & Riley Sullivan, 2019. "Exploring causes of and responses to the opioid epidemic in New England," New England Public Policy Center Policy Reports 19-2, Federal Reserve Bank of Boston.
    4. King, N.B. & Fraser, V. & Boikos, C. & Richardson, R. & Harper, S., 2014. "Determinants of increased opioid-related mortality in the united states and canada, 1990-2013: A systematic review," American Journal of Public Health, American Public Health Association, vol. 104(8), pages 32-42.
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