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. 2020 Aug 6;18(1):87.
doi: 10.1186/s12961-020-00596-8.

The opioid crisis: a contextual, social-ecological framework

Mohammad S Jalali  1   2 , Michael Botticelli  3 , Rachael C Hwang  4 , Howard K Koh  5   6 , R Kathryn McHugh  7   8
Affiliations

The opioid crisis: a contextual, social-ecological framework

Mohammad S Jalali et al. Health Res Policy Syst. .

Abstract

The prevalence of opioid use and misuse has provoked a staggering number of deaths over the past two and a half decades. Much attention has focused on individual risks according to various characteristics and experiences. However, broader social and contextual domains are also essential contributors to the opioid crisis such as interpersonal relationships and the conditions of the community and society that people live in. Despite efforts to tackle the issue, the rates of opioid misuse and non-fatal and fatal overdose remain high. Many call for a broad public health approach, but articulation of what such a strategy could entail has not been fully realised. In order to improve the awareness surrounding opioid misuse, we developed a social-ecological framework that helps conceptualise the multivariable risk factors of opioid misuse and facilitates reviewing them in individual, interpersonal, communal and societal levels. Our framework illustrates the multi-layer complexity of the opioid crisis that more completely captures the crisis as a multidimensional issue requiring a broader and integrated approach to prevention and treatment.

Keywords: opioid use disorder; opioids; social-ecological framework.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Social-ecological framework of the opioid crisis. Socio-demographic factors consist of age, race, gender, ethnicity, education, income and unemployment factors
See this image and copyright information in PMC

Comment on

  • doi: 10.1186/s12961-020-00598-6

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