The Journey to Overdose: Using Spatial Social Network Analysis as a Novel Framework to Study Geographic Discordance in Overdose Deaths

Keywords: overdose, spatial social network, spatial analysis, hotspot, opioid
Abstract Type: Paper Abstract

Abstract

The United States is in the midst of a drug overdose epidemic. The epidemic is being fueled by synthetic opioids, primarily fentanyl. Disadvantaged and marginalized communities have been hit particularly hard. Many drug overdose deaths are geographically discordant (the individuals who die from drug overdoses do not reside in the locale where the overdose occurs). For example, in Milwaukee County, Wisconsin, 26.72% of drug overdose deaths have involved individuals from neighborhoods/communities that differ from those in which the fatal overdose occurs. The recognition that there is geographic discordance in many overdose deaths illustrates that for every overdose, there is a journey. While each journey is unique, much can be learned about factors that contribute to overdose risk by understanding common characteristics of those whose overdoses are geographically discordant, their community of origin/export, the overdose destination/import community, as well as the distance traveled from a person’s residence to the overdose location. In this paper, we propose a novel framework to understand the journey to overdose through spatial social network analysis. The framework will allow us to (i) pinpoint focal points of geographically discordant overdose deaths (ii) unveil hotspots of discordant (e.g., imported) drug overdoses, and (iii) investigate variables that differentiate discordant from non-discordant overdose deaths. We apply this framework to study Milwaukee County, a diverse and segregated metropolitan area in southeastern Wisconsin that has experienced a steady increase in overdose deaths.