The rates of prescription opioid poisoning are concentrated in ‘hot spots,’ typically in rural areas, small towns, and suburban areas, according to a recent study from the University of California, Davis.

Researchers sought to determine reasons why prescription opioid poisonings occur in these areas and determined that they occur for three reasons — availability of prescription opioids, medical need for prescription opioids, and economic stressors.

The rate of prescription opioid poisonings is closely correlated with an increase in the supply of prescription opioids. The primary suppliers are pharmacies, as they are the main source of dispensation. Researchers concluded that areas with a higher density of pharmacies had higher rates of hospital discharges related to prescription opioids.

Rural areas also have a high concentration of residents who are employed in manual labor industries, leading to higher rates of self-reported workplace injuries and consequently a higher supply of prescription opioids. “Higher levels of chronic pain associated with the predominance of manual labor industries may, partly, explain the higher rates of nonmedical [prescription opioid] use in rural and suburban/exurban compared to urban areas,” researchers wrote.

Rural and suburban communities with higher unemployment, low median income and poverty are also more vulnerable to the abuse of prescription opioids, researchers stated. The abuse stems from “a way to manage chronic stress and resulting anxious and mood disorders.” They concluded that although the loss of health insurance for those that are unemployed may reduce access to prescription opioids through formal channels, lower levels of income “may contribute particularly to [prescription opioid] poisoning risk in exurban and rural areas.”

Researchers used annual California zip code levels of hospital discharges related to prescription opioid poisonings from 2001 to 2011 and correlated these with population and environmental characteristics. Results of their analysis showed that… (continue reading)