A Critical Review of the Social and Behavioral Contributions to the Overdose Epidemic

Magdalena Cerdá, Noa Krawczyk, Leah Hamilton, Kara E. Rudolph, Samuel R. Friedman, Katherine M. Keyes

Research output: Chapter in Book/Report/Conference proceedingChapter

2 Scopus citations


More than 750,000 people in the United States died from an overdose between 1999 and 2018; two-thirds of those deaths involved an opioid. In this review, we present trends in opioid overdose rates during this period and discuss how the proliferation of opioid prescribing to treat chronic pain, changes in the heroin and illegally manufactured opioid synthetics markets, and social factors, including deindustrialization and concentrated poverty, contributed to the rise of the overdose epidemic. We also examine how current policies implemented to address the overdose epidemic may have contributed to reducing prescription opioid overdoses but increased overdoses involving illegal opioids. Finally, we identify new directions for research to understand the causes and solutions to this critical public health problem, including research on heterogeneous policy effects across social groups, effective approaches to reduce overdoses of illegal opioids, and the role of social contexts in shaping policy implementation and impact.

Original languageEnglish (US)
Title of host publicationAnnual Review of Public Health
PublisherAnnual Reviews Inc.
Number of pages20
StatePublished - Apr 1 2020
Externally publishedYes

Publication series

NameAnnual Review of Public Health
ISSN (Print)0163-7525
ISSN (Electronic)1545-2093


  • demand
  • opioids
  • overdose
  • policy
  • social determinants
  • supply

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health


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