TY - JOUR
T1 - Longitudinal Changes in the County-Level Relationship Between Opioid Prescriptions and Child Maltreatment Reports, United States, 2009–2018
AU - Kim, Hyunil
AU - Song, Eun Jee
AU - Windsor, Liliane
N1 - Publisher Copyright:
© 2023 Global Alliance for Behavioral Health and Social Justice
PY - 2023/5/15
Y1 - 2023/5/15
N2 - This article examines whether county opioid prescription rates were associated with county child maltreatment report (CMR) rates in the United States and whether this relationship changed over time. We linked multiple national data sets to assemble retail opioid prescription data, CMR data, rural–urban codes (to control for urbanicity), and census data (to control for other community characteristics, such as poverty rates) covering 2009–2018. Multilevel linear modeling analyzed the linked data. We found that the strength of the county-level relationship between opioid prescription rates and CMR rates increased almost linearly during the study period. The relationship was not significant in 2009–2011; it became significant in 2012 and grew stronger in the next 6 years. In 2012, there was one more CMR per 1, 000 children in a county for every 14.3 more opioid prescriptions per 100 people. In 2018, the number of prescriptions related to this effect was 3.6. In other words, the county-level relationship between opioid prescriptions and CMRs was four times as strong in 2018 as it had been in 2012. This trend was also observed within all subgroups of child age and sex. By type, this trend was somewhat more pronounced for neglect, but somewhat less for sexual abuse. Our findings suggest a growing need for greater efforts to prevent child maltreatment in communities with high opioid prescription rates. Further research is warranted to reveal the underlying factors for this concerning trend.
AB - This article examines whether county opioid prescription rates were associated with county child maltreatment report (CMR) rates in the United States and whether this relationship changed over time. We linked multiple national data sets to assemble retail opioid prescription data, CMR data, rural–urban codes (to control for urbanicity), and census data (to control for other community characteristics, such as poverty rates) covering 2009–2018. Multilevel linear modeling analyzed the linked data. We found that the strength of the county-level relationship between opioid prescription rates and CMR rates increased almost linearly during the study period. The relationship was not significant in 2009–2011; it became significant in 2012 and grew stronger in the next 6 years. In 2012, there was one more CMR per 1, 000 children in a county for every 14.3 more opioid prescriptions per 100 people. In 2018, the number of prescriptions related to this effect was 3.6. In other words, the county-level relationship between opioid prescriptions and CMRs was four times as strong in 2018 as it had been in 2012. This trend was also observed within all subgroups of child age and sex. By type, this trend was somewhat more pronounced for neglect, but somewhat less for sexual abuse. Our findings suggest a growing need for greater efforts to prevent child maltreatment in communities with high opioid prescription rates. Further research is warranted to reveal the underlying factors for this concerning trend.
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U2 - 10.1037/ort0000682
DO - 10.1037/ort0000682
M3 - Article
C2 - 37184964
AN - SCOPUS:85166909624
SN - 0002-9432
VL - 93
SP - 375
EP - 388
JO - American Journal of Orthopsychiatry
JF - American Journal of Orthopsychiatry
IS - 5
ER -