Opioid Syndemic

The opioid epidemic continues to be an ongoing public health crisis in the United States. However, the public health crisis is really a syndemic driven by opioid misuse. A syndemic is when multiple epidemics interact synergistically within specific social, spatial, and temporal contexts. The opioid syndemic consists of the overlapping epidemics of opioid use disorder, fatal and non-fatal overdose, HIV, and hepatitis C (HCV). Collectively, the syndemic leads to significant morbidity and mortality.

Despite its public health importance, the epidemiology of the opioid syndemic is challenging to study. There is a lack of direct data on the local prevalence of opioid misuse. Available surveillance data are limited by aggregation, bias, and legal restrictions. Screening and diagnosis of infectious disease like HIV and HCV can also be challenging, complicating interpretations of data. Because it is a syndemic, it is inherently a multivariate problem that requires modeling the synergy and dependence across epidemics. These factors all complicate the analysis and interpretation of data related to the opioid syndemic. It also presents an opportunity for the creative application and development of statistical methodology to produce new epidemiological insights on important public health questions. 

My research on the opioid syndemic has addressed several applied and methodological themes including:

• Factor Models

• Prevalence Estimation

• Applied Epidemiology