Giving Compass' Take:

•  Tanvi Misra, writing for Pacific Standard, discusses a new working paper by sociologist Shannon Monnat at Syracuse University, that examines how economic distress is a factor in both urban and rural areas where there is high opioid use. 

• How can donors use this information to address the opioid crisis? 

• Read more about how philanthropy can tackle the opioid crisis. 

In 2017, opioid overdose deaths in the United States reached a record high. And mayors and local leaders across the country have been scrambling to figure out what's driving this precipitous rise of opioid mortality in the last two decades. Several theories have been aired, from aggressive Big Pharma marketing to anxiety among Baby Boomers. Unfortunately, no one-size-fits-all answer exist—how and why this public-health problem manifests locally varies greatly across the U.S.

That's according to a new working paper by Syracuse University sociologist Shannon Monnat and the Institute for New Economic Thinking. It finds that one narrative that gained steam after the 2016 election—the notion of the modern opioid crisis as a disproportionately rural phenomenon that emerged outside of the cities where the "War on Drugs" has been raging for more than three decades—doesn't hold up.

Instead, in both rural and urban communities, two key factors—economic distress and supply of opioids—predict the rate of opioid deaths.

"I really do want to push back against this cliche that addiction does not discriminate," Monnat says. "The physiological processes that underlie addiction themselves may not discriminate, but the factors that put people in communities at higher risk are are not spatially random."

"What that means is that drug mortality rates aren't higher in economically distressed places simply because they've had a greater supply of opioid prescribing there," she said. "There's something about economic distress in and of itself that helps to explain the variation that we're seeing across the country and the magnitude of the drug crisis."

How important these factors were also varied: Generally, economic distress seemed to be a stronger determinant in rural areas, whereas in urban areas, it was the supply of drugs. But the effect of these factors was not observed just within county lines.

Read the full article about opioid overdose by Tanvi Misra at Pacific Standard