The influence of the built environment on drug misuse and abuse

Abstract

Drug misuse and overdoses (DMO) continue to rise in the United States and around the world. As the COVID-19 pandemic lockdown brought America to a standstill, the drug overdose epidemic took a sharp turn for the worse. Poorly built environments have been said to pose greater risks for substance use. The inequitable race and socioeconomic status distribution of the built environment might be tipping drug overdose and deaths toward minority populations. This review examined the contribution of the built environment to drug misuse and overdose to identify further research and policy needs. Databases like PubMed and Google Scholar were searched for peer-reviewed empirical studies in the English language published from 2010 to March 2021. MeSH search terms were built environment, overdose, drug, and drug overdose. Using the PRISMA flow diagram of article selection, title, and abstract screening plus text narrative synthesis of included articles were done. The built environment features making it more conducive to initiating and maintaining DMO included disinvestment, geographical context (urban versus rural), spatial characteristics of the built environment, easy access to drugs, low access to interventions, and built-environment-associated environmental and social stressors. Built environment features play some roles in drug misuse problems. Policies and programs are needed that place the built environment at the centre of health, drug overdose prevention, and harm reduction, provide increased treatment facilities for addicted persons, ensure stricter opioid prescription measures, and address poverty as well as hopelessness due to disinvestment.