Tracing an Epidemic

How opioid use spreads in families, worsening crisis

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.

Ways to address the social contagion

  1. 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.
  2. 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.
  3. Doctors should be trained on how to push back when patients ask for painkillers.