How We’re Duped by Data
Cover Story
Social-network experts at Berkeley have identified an important driver of the opioid epidemic in the U.S.: family.
In a study published in American Sociological Review, Asst. Prof. Mathijs De Vaan and Prof. Toby Stuart show that the likelihood of someone using opioids increases significantly once a family member living in the same household has a prescription. The study is one of the few analyses of the opioid crisis that finds a causal link between a specific action—in this case, the introduction of painkillers into a home—and their growing use.
In 2015, the amount of opioids prescribed was enough for every American to be medicated around the clock for 3 weeks.
De Vaan and Stuart analyzed hundreds of millions of medical claims and almost 14 million opioid prescriptions written between 2010 and 2015 in Massachusetts. They tracked family members’ health care through shared medical insurance policy numbers. The researchers focused on emergency room visits only, where patients are randomly assigned to doctors who prescribe opioids at vastly different rates. This eliminated the possibility that family members got prescriptions from the same doctor, such as a primary care physician. Here are some of their findings.
For families living in the same household
Likelihood of someone obtaining a prescription for opioids: 19% to 100+% HIGHER* within a year after a relative receives a script. * Low-income households have the highest percentage.
WHY?
When one person takes painkillers, other relatives observe its effects firsthand. Relatives may be tempted to experiment with leftover pills as patients typically receive more pills than they need.
Ways to address the social contagion
- States that track prescription drug use and provide that information to doctors could also include data on family members’ access to medications. To avoid privacy violations, the program could simply issue a risk score that would signal to doctors that their patient has been indirectly exposed to painkillers at home.
- Policymakers could expand existing efforts to collect leftover prescription drugs—namely through National Prescription Drug Take Back Day—by paying people to return their excess supply.
- Doctors should be trained on how to push back when patients ask for painkillers.
In Context
Between 1999 and 2016, more than 200,000 people in the United States died from overdoses related to prescription opioids. In 2017, opioids were involved in 47,600 overdose deaths. Fatal overdoses from opioid analgesics are now more prevalent than deaths from either suicides or auto accidents.
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