Outcomes Related to Changes in Illicit and Prescription Opioid Use and the Response in Providing or Receiving Treatment

For much of the last two decades, prescription opioid misuse and heroin use were preceded by prescription opioid use. As policies have shifted and illicit opioids became more widely available, illicit opioid use became more prevalent, and there is now a growing population that is first exposed to opioid use by using heroin or fentanyl. While much of the increase in opioid mortality appears to be linked to the use of illicit opioids, In this paper I investigate demographic and socio-economic characteristics of opioid use at the individual level and examine treatment seeking behavior between patients using only prescription opioids, only heroin, and patients using both heroin and prescription opioids. I then investigate the how demographic and socio-economic risk factors for prescription and illicit opioid overdose rates at the county level differ between areas of high and low prescribing. Finally, I investigate how areas of high prescription mortality and areas of high illicit opioid mortality influence the availability of treatment centers for opioid use disorder.