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by the Brookings Institution last year, Princeton economist Alan Krueger demonstrated that there were significant regional variations in opioid prescribing practices , irrespective of medical condition.[ 3 ] He also found that labor force participation fell more in counties where more opioids were prescribed. Labor force participation is a key indicator of economic health, and the underlying factors that cause voters to choose specific candidates may be related to the same underlying social conditions that predispose individuals to seek and potentially misuse opioids . THE 12 P'S A political interpretation of the authors' findings would, therefore, be overly simplistic. Readers must acknowledge the complexity of the social, economic, and historical conditions that have led to differences in opioid prescribing rates. To assist in understanding these conditions, we have identified what we call the "12 P's of the prescription drug abuse epidemic" (see the box on this page). Listen American Accent
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1/18/2020 The 12 P's of the Prescription Drug Abuse Epidemic: Discovery Service for Western Governors University eds.a.ebscohost.com.wgu.idm.oclc.org/eds/detail/detail?vid=6&sid=b53faedd-6d63-4938-9f45-23e74181065d%40sessionmgr4008&bdata=JnNpdGU… 3/5 Predatory promotion: The marketing practices for some pharmaceutical products as they relate to increasing opioid prescriptions in certain regions of the country have been reported extensively. Profligate prescribing: Over the past few decades, there has been a strong push to increase the treatment of pain, which has resulted in significant increases in the prescribing of opioids both by providers who were attempting to help their patients and by those motivated by profit. It should be pointed out, parenthetically, that Rolheiser et al. do not distinguish between opioids prescribed for pain and those used for medication-assisted treatment. This distinction would be useful in further analysis of their data. Physical pain: There is no doubt that many of the congressional districts with the highest rates of opioid prescribing are those that have a history of employment opportunities (coal mining, logging, construction, manufacturing, and related activities) that are associated with both acute and chronic injury and resulting pain, which has resulted in long-term treatment with opioids , fueling the current epidemic. Psychologic pathology: Many of these same regions of the country have seen their main employment opportunities disappear, resulting in depression and hopelessness, which, in turn, can lead to drug-seeking behaviors. In a toxic, and somewhat ironic, cycle, many displaced workers became dependent on opioids and have been sidelined from labor force participation, even as the economy began to strengthen, leaving recovering industries with an unmet need for workers.
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