Epidemiology of the U.S. opioid crisis: the importance of the vector

Annals of the New York Academy of Sciences
Wilson Compton, Christopher M Jones

Abstract

The roots of the remarkably lethal U.S. opioid crisis are complex and inextricably entangled with healthcare, especially in its treatment of another serious health problem: pain. Failures of the healthcare system-including lack of both training in pain management and caution in using an addictive class of medications-precipitated the rise in opioid misuse and addiction over the past two decades, but a wider range of social and economic forces has helped perpetuate the crisis and altered its character. The classic epidemiologic host-agent-environment triad can be augmented for the purpose of elucidating the current opioid crisis by addition of the "vector" to emphasize the importance of purveyors of opioids (licit and illicit), leading to our proposing an expanded host-agent-vector-environment model. Interventions addressing multiple components are needed, including solutions that account for behaviors of all vectors associated with the crisis. For prescription opioids, the vectors include clinicians and pharmaceutical-related companies involved in marketing, prescribing, distributing, and dispensing opioid medications; for illicit opioids, they include drug manufacturing and distribution networks. Attending to the vectors of op...Continue Reading

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Citations

Dec 11, 2019·Journal of Clinical Medicine·Francisco Herrera-GómezF Javier Álvarez
Aug 12, 2020·Journal of American College Health : J of ACH·Lisa L WeyandtCaroline Sweeney
Nov 10, 2020·The American Journal of Drug and Alcohol Abuse·Christina M CutterMahshid Abir
Jan 24, 2021·Social Science & Medicine·Carl A LatkinBasmattee Boodram
Nov 5, 2020·Journal of General Internal Medicine·Wilson M ComptonCarlos Blanco
Nov 15, 2020·Molecular Psychiatry·Wilson M ComptonRobert L DuPont
May 1, 2021·Behavioral Sciences·Carl A LatkinOluwaseun Falade-Nwulia
May 9, 2021·International Journal of Health Economics and Management·William EncinosaThomas M Selden
Sep 30, 2020·Journal of Addiction Medicine·Wilson M Compton, Marsha F Lopez
Jul 11, 2021·Biomedicine & Pharmacotherapy = Biomédecine & Pharmacothérapie·Yaoyuan LiBaojin Hua
Jun 27, 2020·Progress in Neuro-psychopharmacology & Biological Psychiatry·Justin HudakEric L Garland

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