The Needle and the Damage Done

Published on October 28, 2019

It’s not who you think.

That’s the immediate observation we made after examining a dataset of 200,000 individuals, over 6,000 of whom had an opioid disorder diagnosis. What are some of the distinguishing behaviors of people with an opioid addiction problem? Some behaviors that got flagged were not surprising; others prompted deeper thought and empathy for those who struggle with depression, pain, and anxiety.

The negative stereotype of addiction is all too strong. The Mayo Clinic, for example, lists genetic, social and psychological factors associated with opioid misuse and addiction, ranging from poverty and unemployment to a history of substance abuse, stressful life circumstances, thrill-seeking behaviors, and association with criminal activity.

We uncovered a more nuanced picture. But before we delve into our findings, a note of caution: the behaviors that showed up in our analysis should not be considered causal or predictive factors, but rather, correlative ones. They help paint a more complete portrait of individuals who are statistically more or less likely to develop an opioid addiction.

Our data science team matched this data set with our Carrot Health consumer database, and then looked for variables that were significantly over- or under-indexed. To be “over-indexed” means the opioid user sub-group had a significantly higher occurrence of this behavior compared to the overall data set. When the behavior was “under-indexed”, it means the opioid user sub-group had a statistically lower occurrence of that behavior.

Looking at documented medical conditions, the opioid user sub-group had a higher occurrence of depression, pain, and anxiety. That’s not too surprising. Analyzing the consumer data, however, revealed some interesting over-indexed variables:

Source: Carrot Health

With the possible exception of “renter”, each of these variables seem to indicate economic and personal stability. A dog owner who has children, enjoys collecting and baking, donates to charities, and travels frequently… is not the stereotypical picture of a person vulnerable to addiction.

On the other hand, the top under-indexed consumer variables did reinforce the idea that personal and economic stability help safeguard people from addiction:

Source: Carrot Health

In this case, home ownership, marriage and small business ownership stand out. As to the significance of the higher-than-average tendency to make stationary purchases online… your guess is as good as ours.

Finally, we also noticed trends in musical preferences:

Source: Carrot Health

Under-indexed music preferences seem more sedate and calming, while over-indexed ones are usually considered more emotional, and related to difficult, lonely, sad, or challenging life experiences.

Perhaps this provides a thread of insight worth following. The cohort of individuals susceptible to opioid abuse disorder are productive, engaged members of society undergoing the usual stresses and pressures of life who, perhaps, have a tendency toward emotional conditions that can be reinforced by depression and anxiety.

We don’t want to over-conclude. But this line of thinking does illuminate an often overlooked factor in the opioid crisis – the role of mental health.

Opioid addiction is a complex challenge exacerbated by many systemic societal and health industry problems, including drug marketing, distribution, manual prescription authorization, and economically depressed regions or industries. People who struggle with opioid dependency cross gender lines, socio-economic status, geographic region and age. How can we identify specific individuals who are likely to develop addiction and address their needs better?

At the recent HLTH 2019 Conference in Las Vegas (the epicenter of the casino vacation), panelist Benjamin Miller, Chief Strategy Officer at Well Being Trust, spoke about the devastation of lives lost to preventable mental health conditions. In 2017, 151,000 Americans died from drugs, alcohol and suicide. And Allina Health CEO, Dr. Penny Wheeler, talked about the lack of financial parity in America’s Mental Health Parity Act, and how that impedes providers from treating mental health problems in their patients.

The consumer data that Carrot Health curates and analyzes helps surface and expose the reality of these challenges, while identifying those who are statistically likeliest to succumb before they do. Consumer data is not causal, but it does indicate risks, tendencies, and trends that can give providers, payers and policy makers greater insights into the vulnerabilities of specific people who need pre-emptive care to avoid succumbing to opioid addiction or more effective treatment to overcome an addiction.

If, as a society, we are going to effectively combat the greatest health crisis of our generation, it is clear that better mental health treatment needs to be front and center.

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