U.S. Car Plant Closures Linked to 85 Percent Spike in Opioid Overdoses, Study Shows

Car plant closures in the U.S. have been linked to a rise in fatal opioid overdoses, in a study suggesting the erosion of economic opportunities has played a part in the ongoing opioid crisis.

In counties affected by automotive manufacturers shutting down, the number of people who fatally overdosed on painkillers was 85 percent higher after five years compared with areas where plants remained open, according to a paper published in the journal JAMA Internal Medicine.

Researchers examined data collected between January 1, 1999 and December 31, 2016 on 112 industrial counties mainly in the South and Midwest: areas which dominated U.S. manufacturing and were therefore most likely to be worst hit. Using figures from the U.S. National Center for Health Statistics and the U.S. Census Bureau, the team looked at how many adults aged between 18 to 65 years old died of opioid overdoses during this period.

On a local level, plant closures are often unexpected by workers, and are culturally and economically significant, the authors explained. More widely, they are viewed as symptomatic of a gradual decline in U.S. manufacturing over the past two decades, which has in turn been linked with the opioid crisis, they said.

Over the course of the study, 29 counties were affected by a plant closure, while 83 counties weren't. The data revealed plant closures were followed by a statistically significant increase in deaths due to opioids overdoses. After five years, mortality rates increased by 8.6 deaths deaths per 100,000 in such regions, compared with areas not hit by a factory shutting down. That amounted to an 85 percent increase, the authors said.

White men aged between 18 to 34-years-old saw the biggest increases in opioid overdose deaths, followed by those of the same ethnicity in the 35 to 65 age group.

"These findings highlight the potential importance of eroding economic opportunity as a factor in the US opioid overdose crisis," the authors wrote.

The research comes amid an opioid overdose epidemic which kills 130 Americans die every day on average, according to the U.S. Centers for Disease Control and PRevention. Of the over 70,200 people who died of a drug overdose in 2017, around 68 percent had taken an opioid. That included prescription and illegal drugs like heroin and its stronger synthetic counterpart fentanyl. The crisis started after a rise in opioid prescriptions in the 1990s.

Study co-author Dr. Atheendar Venkataramani, assistant professor in the division of health policy at the Perelman School of Medicine, said in a statement: "Major economic events, such as plant closures, can affect a person's view of how their life might be in the future. These changes can have a profound effect on a person's mental well-being, and could consequently influence the risk of substance use."

Venkataramani told Newsweek: "Our study shows that erosion of economic opportunity—in this case, the closure of historically significant local automotive plants— may have substantial negative impacts on health.

"More specific to the opioid crisis, it tells us that economic and social forces may have played an important role in certain local areas, in addition to the increasing availability of prescription, illicit, and synthetic opioids. In terms of this latter point, our findings line up with research linking U.S. trade policy to opioid overdose deaths," he said.

Venkataramani said he and colleagues have been interested for several years in how economic opportunities may shape the health of a population.

"That is, does the American dream affect America's health? For example, higher prospects for upward mobility may raise people's sense of the economic and social returns of being healthy, leading to better health behaviors and health or may directly increase hope, which may have positive effects on mental and physical health."

Acknowledging the limitations of the work, Venkataramani said: "As with any observational, area-level data, we could not prove that auto plants caused opioid overdose deaths." The team was also unable to explore the mechanisms behind the association they uncovered.

"Our findings are specific to the time period and industry we studied, and so we would urge caution in generalizing them," he added.

Venkataramani said: "The findings call for health care systems, providers, and public health agencies to target screening and rapid treatment for diseases such as substance use disorder in these areas. Such a targeted approach may help nip any growing health calamities at the bud.

"Our findings also call for further work on local, state, and national policies that may help build resilience in areas facing economic and social change. Identifying factors that lead to resilience is something we are working on now," he said.

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A stock image shows the body of a car on a conveyor belt. Getty