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Incarceration, falling incomes fueled US opioid crisis: Study

A homeless man pauses along the street on June 03, 2019 in Albuquerque, New Mexico, one of the poorest states in the United States and a surge in drug use. (AFP photo)

The rapid expansion of the prison population in the United States over the past four-decades may have helped fuel America’s deadly drug epidemic, a new study suggests.

Large increases in admission rates to prisons were associated with a 2.6 percent rise in drug overdose deaths in a US county, according to the study by the University of Massachusetts and published Wednesday in the medical journal Lancet Public Health.

The study involved 2,640 US counties between 1983 and 2014 and analyzed mortality data from the US National Vital Statistics System and Institute for Health Metrics and Evaluation, household income data from the US Census Bureau, and incarceration data by county from the Vera Institute of Justice.

The study also found that a significant drop in median household income was associated with a nearly 13 percent increase in fatal overdose rates in a county.

The study reportedly is the first to analyze the impact of incarceration on drug mortality at the county level.

Researchers also found that on average, counties with the highest incarceration rates saw a drug mortality rate 54 percent higher than the rate among counties with the lowest incarceration rates.

"In communities with high incarceration rates, it's making their lives much worse, and making them much more likely to use drugs dangerously," says Lawrence King, co-author of the study and an economics professor at the University of Massachusetts in Amherst.

"It's not as big a factor as economic decline, but it's a very big substantial factor, and much bigger than the prescription rates of opioids," he added.

The Unites States has the highest incarceration rate in the world, with over 2.2 million people behind bars. While the country represents about 4.3 percent of the world's population, it houses around 22 percent of the world's prisoners.

Over 70,000 people died of drug overdoses across the US in 2017, and most deaths were opioid-related, according to the Centers for Disease Control and Prevention (CDC).  

The drug epidemic has hit the country so hard that it's contributed to a falling life expectancy for Americans in recent years.

The rise of drug-related deaths has been blamed largely on the social and economic decay in parts of the US that led to explosions of so-called deaths of despair from drugs, alcohol and suicide.

The surging availability of opioids in the form of prescription painkillers as a result of aggressive marketing by drug companies since the 1990s has been another major factor for the rising drug death rate.

"We can't just think about the supply of drugs, but about why people use drugs," King says. "The contextual factors are super important – and that isn't just economic decline. The US has the highest incarceration rate in the world, and that has major public health impacts."


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