Katherine M. Keyes, Magdalena Cerdá, and Sandro Galea are with the Department of Epidemiology, Columbia University, New York, NY. Joanne E. Brady is with the Department of Epidemiology and the Department of Anesthesiology, Columbia University. Jennifer R. Havens is with the Department of Behavioral Science, Center on Drug and Alcohol Research, University of Kentucky College of Medicine, Lexington.
Am J Public Health. 2014 Feb;104(2):e52-9. doi: 10.2105/AJPH.2013.301709. Epub 2013 Dec 12.
Nonmedical prescription opioid misuse remains a growing public problem in need of action and is concentrated in areas of US states with large rural populations such as Kentucky, West Virginia, Alaska, and Oklahoma. We developed hypotheses regarding the influence of 4 factors: (1) greater opioid prescription in rural areas, creating availability from which illegal markets can arise; (2) an out-migration of young adults; (3) greater rural social and kinship network connections, which may facilitate drug diversion and distribution; and (4) economic stressors that may create vulnerability to drug use more generally. A systematic consideration of the contexts that create differences in availability, access, and preferences is critical to understanding how drug use context varies across geography.
非医疗处方类阿片类药物滥用仍是一个亟待解决的公共卫生问题，且主要集中在美国农村人口较多的州，如肯塔基州、西弗吉尼亚州、阿拉斯加州和俄克拉荷马州。我们提出了以下 4 个因素的影响假设：（1）农村地区开出的阿片类药物处方较多，从而为非法市场的出现提供了可乘之机；（2）年轻成年人外流；（3）农村社会和亲属关系网络联系更加紧密，这可能会助长药物转移和分销；（4）经济压力可能会使人们更易普遍染上毒瘾。系统地考虑造成供应、获取和偏好差异的因素，对于理解毒品使用背景在地理上的差异至关重要。
