Report: Opioid Epidemic Strikes Unmarried, Uneducated Worst

New numbers from Sen. Lee initiative detail the social shape of the opioid epidemic

An addict cooks heroin in order to inject it / Getty Images
November 1, 2017

American adults with less education and who are divorced or unmarried are far more likely to fall prey to America's opioid epidemic, a new report concluded.

Sen. Mike Lee's (R., Utah) Social Capital Project (SCP) released "The Numbers Behind the Opioid Crisis" on Tuesday. The SCP investigates the current state of American "associational" life, the "web of social relationships through which we pursue joint endeavors," including families, churches, workplaces, and other social organizations. This, the second full report from the SCP, focuses on the impact of the opioid epidemic in America.

Significantly, the report highlights not only how many people are affected by the opioid epidemic—almost 50,000 deaths in 2016, a well-known if shocking number—but the portions of the population who are most impacted by it: the young, the unmarried, and the undereducated.

Education and marriage are key predictors of opioid abuse. One third of Americans over 25 had at least a bachelor's degree and that group accounted for only 9 percent of all opioid overdose deaths, according to the report. Forty percent had a high school degree or less, yet represented 68 percent of opioid overdose deaths. The remaining 23 percent of opioid deaths are attributable to the 27 percent of the population with only "some" college education.

The division among Americans is also pronounced when comparing married/widowed Americans to their single or divorced peers. Sixty-eight percent of Americans over 25 were married or widowed in 2015, and accounted for only 28 percent of opioid overdose deaths. By contrast, never-married and divorced Americans over 25 are 32 percent of the population, but account for 71 percent of all opioid overdose deaths.

In other words, the opioid epidemic hits disproportionately those without access to education or marriage.

"Since at least Durkheim, we have known that marriage is an important source of social integration," said Bradford Wilcox, senior fellow at the Institute for Family Studies. "This new report indicates that today's 'deaths of despair' are much more common among men and women who are never married or divorced. That is, Americans who are disconnected from one of our nation's core institutions: marriage."

In a twist, the report does find opioid use creates communities. "In some areas, illegal pills are a form of community currency, with those who use opioids daily having relatively more social connections," it notes, alluding to an analysis of social networks in Appalachia.

But, these networks remain "relatively isolated" from other friends and family members, who often are unaware of their relative or friend's abuse of opioids—one survey cited by the report found that one-third of respondents couldn't identify the signs of prescription drug abuse. In other words, while opioid users can have more social connections, those social connections are mostly to other opioid users.

The report emphasizes the broader scale of the epidemic—opioids are responsible for more than three quarters of the 64,000 drug overdose deaths in America in 2016, and are the number one cause of injury death in the United States, outpacing homicide, suicide, and car crashes. Drug overdose is the leading cause of death for Americans under 50, much of which is attributable to opioids. Almost 1 in 7 Americans have abused prescription opioids at some point in their lives.

All of this, the report argues, must be addressed not only from the perspective of economic immiseration, but also by working to restore America's tattered social fabric.

"We documented dramatically higher rates of opioid overdose mortality among single men who have no more than a high school education as compared with their married counterparts. That difference hints that being embedded within social relationships may protect against addiction or make treatment more successful, though the evidence is only suggestive," it reads.

Addressing the opioid epidemic has been a major focus of President Donald Trump's administration. Last week, Trump announced the designation of the epidemic as a public health crisis, stopping short of declaring a national emergency as he had previously promised. Nonetheless, the designation brings new resources—access to telemedicine, reduction in red tape, and a redistribution of funds to better address the needs of HIV/AIDS sufferers who are addicted to opioids—to the crisis claiming almost 140 lives a day.

Published under: Opioids