{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T02:24:52Z","timestamp":1790216692914,"version":"4.1.0"},"reference-count":107,"publisher":"MDPI AG","issue":"20","license":[{"start":{"date-parts":[[2023,10,20]],"date-time":"2023-10-20T00:00:00Z","timestamp":1697760000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"University of Arizona Health Sciences Comprehensive Pain and Addiction Center"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>The United States is experiencing a crisis of opioid misuse and overdose. To understand the underlying factors, researchers have begun looking upstream to identify social and structural determinants. However, no study has yet aggregated these into a comprehensive ecology of opioid overdose. We scoped 68 literature sources and compiled a master list of opioid misuse and overdose conditions. We grouped the conditions and used the Social Ecological Model to organize them into a diagram. We reviewed the diagram with nine subject matter experts (SMEs) who provided feedback on its content, design, and usefulness. From a literature search and SME interviews, we identified 80 unique conditions of opioid overdose and grouped them into 16 categories. In the final diagram, we incorporated 40 SME-recommended changes. In commenting on the diagram\u2019s usefulness, SMEs explained that the diagram could improve intervention planning by demonstrating the complexity of opioid overdose and highlighting structural factors. However, care is required to strike a balance between comprehensiveness and legibility. Multiple design formats may be useful, depending on the communication purpose and audience. This ecological diagram offers a visual perspective of the conditions of opioid overdose.<\/jats:p>","DOI":"10.3390\/ijerph20206950","type":"journal-article","created":{"date-parts":[[2023,10,20]],"date-time":"2023-10-20T07:25:22Z","timestamp":1697786722000},"page":"6950","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["A Diagram of the Social-Ecological Conditions of Opioid Misuse and Overdose"],"prefix":"10.3390","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3534-1027","authenticated-orcid":false,"given":"Benjamin R.","family":"Brady","sequence":"first","affiliation":[{"name":"Comprehensive Pain and Addiction Center, University of Arizona Health Sciences, Tucson, AZ 85721, USA"},{"name":"School of Interdisciplinary Health Programs, College of Health and Human Services, Western Michigan University, Kalamazoo, MI 49008, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ehmer A.","family":"Taj","sequence":"additional","affiliation":[{"name":"Comprehensive Pain and Addiction Center, University of Arizona Health Sciences, Tucson, AZ 85721, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elena","family":"Cameron","sequence":"additional","affiliation":[{"name":"Comprehensive Pain and Addiction Center, University of Arizona Health Sciences, Tucson, AZ 85721, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aaron M.","family":"Yoder","sequence":"additional","affiliation":[{"name":"Comagine Health, Seattle, WA 98133, USA"},{"name":"Lifecourse Epidemiology of Adiposity and Diabetes (LEAD) Center, University of Colorado, Aurora, CO 80045, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer S.","family":"De La Rosa","sequence":"additional","affiliation":[{"name":"Comprehensive Pain and Addiction Center, University of Arizona Health Sciences, Tucson, AZ 85721, USA"},{"name":"Department of Family and Community Medicine, College of Medicine, University of Arizona, Tucson, AZ 85721, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,10,20]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Courtwright, D.T. 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