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Tufts Public Health

Tracking the Shifting Landscape of the Opioid Crisis

“We want to be forward-looking to identify areas that might be vulnerable in the future, not just where most deaths have been in the past,” said Jared Sawyer, A19, MG20 (MPH), who led a portion of the project. Photo: Shutterstock
Tuesday, September 21, 2021

Few if any communities in the United States have escaped the opioid crisis, and in 2020, opioid overdose deaths rose sharply across the entire country. But the crisis plays out differently from place to place and over time. In some states, the crisis is more profound in rural communities while in other states, it’s more of a problem in cities. The drugs in question vary from prescription opioids like oxycodone to heroin to, most recently, fentanyl, which is 50 to 100 times stronger than morphine and a primary driver of the rise in overdose deaths since 2013. And the demographics of the most affected populations change over time as well.

The shifting landscape of the opioid overdose epidemic makes it hard for local public health officials and policymakers to see which communities in their state are most at risk and how to help them.

“All communities are not created equal,” said Thomas Stopka, an epidemiologist and associate professor at Tufts University School of Medicine. “The risk factors related to opioid overdose may not be as intense in some locations compared to others.”

Stopka and his team recently completed county-level assessments of 10 states, highlighting the communities most at risk for a spike in opioid overdose deaths and identifying areas where services for opioid users are lacking.

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