Measuring the Longer Term Social Burdens of the Opioid Crisis on Local Communities

成果项目 阿片类药物危机是美国的一个公共卫生紧急事件，不仅影响使用者， 毒品，也包括那些在家庭/家庭和社区中爱毒品的人。虽然研究人员和 政策制定者往往关注吸毒者所经历的直接后果， 过量，滥用和依赖，有相当少的证据量化间接， 阿片类药物危机对家庭的下游影响（例如，祖父母养育、儿童福利）和 社区（例如，劳动力参与率、犯罪率）。不断演变的全面影响， 阿片类药物危机是一项政策优先事项。在这个项目中，我们将研究阿片类药物的下游后果， 危机我们将评估这些结果，考虑到阿片类药物危机的最新过渡，首先从处方药 阿片类药物到海洛因，其次是过渡到非法制造的芬太尼， 多物质使用。我们将分析与家庭/住户构成和代际相关的结果 动态以及社区组成和劳动力市场。我们将研究社区定义为 地理（州、县）和人口特征（城市/农村状况、种族/民族、社会经济 状态）。 此外，我们将研究为什么阿片类药物危机对一些社区的影响不成比例。我们将 研究阿片类药物危机下游后果的变化如何导致社区 复原力、有区别的毒品相关刑事执法和/或有区别的公共卫生政策 应答这涉及编制一个描述复原力因素的社区特征数据库 (e.g.,教育、社会联系）以及差别执法措施（例如，过量的药物- 相关逮捕）和政策反应（例如，卫生支出）。还涉及建立指数 描述弹性、执行和政策响应。这一分析将为未来的政策提供信息， 旨在公平分配资源并阻止阿片类药物危机的发展。 在量化阿片类药物危机及其下游之间不断演变和可变的关系之后， 我们将制定一个程序，系统和全面地量化成本， 鸦片危机这一程序将侧重于家庭/住户的间接费用， 这将有助于与吸毒者所经历的直接成本进行比较。我们将 评估每一波阿片类药物危机的成本，并描述成本如何随着时间的推移而变化。这 分析将为阿片类药物危机的成本以及这些成本如何变化提供一种方法和公共指标 跨社区这项研究将有助于研究界和政策制定者充分了解 类阿片危机的成本范围，包括哪些因素成本最高。

Outcomes Project ABSTRACT The opioid crisis is a public health emergency in the United States affecting not only the people who use drugs but also those who love them in their families/households and communities. While researchers and policymakers are often focused on the direct outcomes experienced by people who use drugs such as overdoses, misuse, and dependence, there is substantially less evidence quantifying the indirect, downstream consequences of the opioid crisis on households (e.g., grandparenting, child welfare) and communities (e.g., labor force participation, crime rates). The evolving and comprehensive impacts of the opioid crisis are a policy priority. In this project, we will study the downstream consequences of the opioid crisis. We will evaluate these outcomes given recent transitions of the opioid crisis first from prescription opioids to heroin, followed by the transition to illicitly manufactured fentanyl and the subsequent growth in polysubstance use. We will analyze outcomes related to family/household composition and intergenerational dynamics as well as community composition and labor market. We will examine communities defined by geography (state, county) and demographic characteristics (urban/rural status, race/ethnicity, socioeconomic status). Moreover, we will examine why the opioid crisis has disproportionately impacted some communities. We will examine how variation in the downstream consequences of the opioid crisis results from community resilience, differential drug-related criminal-legal enforcement, and/or differential public health policy responses. This involves compiling a database of community characteristics describing resilience factors (e.g., education, social connectedness) as well as measures of differential enforcement (e.g., excess drug- related arrests) and policy responses (e.g., health spending). Also involved is the creation of indices describing resilience, enforcement, and policy response. This analysis will inform how future policies can be designed to equitably allocate resources and stem the progression of the opioid crisis. After quantifying the evolving and variable relationship between the opioid crisis and its downstream consequences, we will develop a procedure to systematically and comprehensively quantify the costs of the opioid crisis. This procedure will focus on the indirect costs experienced by families/households and communities and will enable comparisons to the direct costs experienced by people who use drugs. We will assess costs for each wave of the opioid crisis and describe how the costs have changed over time. This analysis will generate a method and public metrics for the costs of the opioid crisis and how these costs vary across communities. This research will help the research community and policymakers understand the full scope of the costs of the opioid crisis, including which factors are most costly.