Department of Emergency Medicine, Michigan Medicine, Ann Arbor, MI, USA.
Acute Care Research Unit, Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, MI, USA.
Am J Drug Alcohol Abuse. 2021 May 4;47(3):305-310. doi: 10.1080/00952990.2020.1836186. Epub 2020 Nov 9.
It has been almost 3 years since the opioid epidemic was declared a national public health emergency under federal law. Solutions have focused on supply-reduction strategies. These approaches, however, have failed to significantly curtail opioid overdose and related death. Demand for opioid use arising from social networks and environment is an important contributing factor to the current opioid epidemic. Adoption of existing underused methods is needed to drive further progress. This Perspective proposes the social contagion model as a promising framework through which to operationalize evaluation of the influence of social networks and environment in the opioid epidemic and argues for its greater application. Comparing the current epidemic with previous opioid epidemics reiterates the utility of the social contagion model. This model acknowledges social network influence on individual behavior. It leverages tools from epidemiology, permits evaluation of interpersonal influence, facilitates consideration of disproportionate and collateral effects, and overcomes limitations of traditional models and geographic assumptions inherent to many approaches surrounding the current opioid epidemic. Analyzing the opioid epidemic within a social contagion framework will enhance evaluation methods and enable the design of interventions to reflect the actual demands of the current crisis. If the influence of social networks and environment is not considered, the devastating toll of the opioid epidemic could grow.
自联邦法律宣布阿片类药物泛滥为全国公共卫生紧急事件以来，已经过去了将近 3 年。解决方案侧重于减少供应的策略。然而，这些方法未能显著减少阿片类药物过量和相关死亡。社交网络和环境中对阿片类药物使用的需求是当前阿片类药物泛滥的一个重要促成因素。需要采用现有的未充分利用的方法来推动进一步的进展。本观点提出社会传染模型作为一个有前途的框架，通过该框架可以对社交网络和环境在阿片类药物泛滥中的影响进行评估，并主张更广泛地应用该模型。将当前的流行疫情与以前的阿片类药物流行疫情进行比较，再次证明了社会传染模型的实用性。该模型承认社交网络对个人行为的影响。它利用流行病学工具，允许评估人际影响，便于考虑不成比例和附带影响，并克服了当前阿片类药物流行疫情周围许多方法所固有的传统模型和地理假设的局限性。在社会传染框架内分析阿片类药物流行疫情将增强评估方法，并能够设计干预措施，以反映当前危机的实际需求。如果不考虑社交网络和环境的影响，阿片类药物泛滥的破坏性影响可能会加剧。
