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Study finds correlation between U.S. opioid deaths and auto plant closures

A recent study published in the medical journal JAMA Internal Medicine and co-authored in part by researchers from the University of Pennsylvania has found a correlation between automotive assembly plant closures in the U.S. and opioid overdose deaths. 

Dr. Atheendar Venkataramani, the lead author on the UPenn study, and a team of researchers spent about a year combing through a list of all the automotive plants that were in operation in the U.S. since 2000, and comparing plant closure numbers to opioid overdose deaths.

“About five years after a plant closure, the opioid overdose mortality rate — and that’s per 100,000 people — was 85 per cent higher than one would expect had the plant not closed,” said Venkataramani. 

Researchers also found that young, non-Hispanic white men were disproportionately affected by opioid overdose death following an automotive plant closure.

According to the study’s findings, just more than 20 non-Hispanic white men between the ages of 18 and 34 died for every 100,000 people.

In contrast, almost 13 non-Hispanic white men between the ages of 35 and 64 died for every 100,000 people.

A study co-authored in part by researchers at the University of Pennsylvania showed that non-Hispanic white men were disproportionately affected by opioid overdose deaths following automotive plant closures. (Submitted by Dr. Atheendar Venkataramani)

The study found no significant increases in deaths among non-Hispanic white women between the ages of 35 and 65, Hispanic white men and women and non-white men and women. 

Despite the study’s findings, Venkataramani explained that the type of research conducted means that researchers can’t conclusively state that automotive plant closures cause an increase in opioid overdose deaths.

“Because ours is not a clinical trial where the exposure is randomized to people and we’re doing work with observational data, that type of research design can’t prove that the exposure causes the outcome,” he said. “So we can’t say that we can prove it.”

Venkataramani said that his team “did a number of tests” to see if there was a factor other than automotive plant closures that drove the trend in increased opioid overdose deaths. 

… Ours is not a clinical trial where the exposure is randomized to people … – Dr. Atheendar Venkataramani, University of Pennsylvania

“We don’t find any evidence of something else that was going on at the same time,” he said. “Putting all that circumstantial evidence together, we think this is probably what’s happening, but we can’t prove it.”

Though he said it was possible that plant closures in Ontario — like the recent closure in Oshawa, Ont. and the upcoming Nemak plant closure in west Windsor — could suggest Canadians will see a similar increase in opioid overdose deaths, Venkataramani was hesitant to suggest that a similar trend will take place over the course of the next few years.

“The one thing about our study is that the plant closures we looked at occurred really between 2002 and 2009, during a time when there was less recognition about the opioid crisis here in the U.S.,” he said.

“So it’s possible that in today’s day and age, when we know a lot more about the opiate crisis, we’re more aggressive in screening for substance use disorder, and that there’s more responsible prescribing, that plant closures may not have the same kind of effect that we saw they did in the last 20 years.”

A total of 48 people died of opioid-related causes in Windsor-Essex throughout 2018.

Preliminary data released by Public Health Ontario shows that 38 of the 152 people who visited Windsor emergency rooms due to opioid poisoning died in the first six months of 2019.

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