  This study investigates the national opioid crisis by exploring three key
social and environmental drivers: opioid-related mortality rates, opioid
prescription dispensing rates, and disability rank ordered rates. We introduce
a spatial Kalman filter to examine each factor individually and their potential
intra-relationships. This study utilizes county level data, spanning the years
2014 through 2020, on the rates of opioid-related mortality, opioid
prescription dispensing, and disability. To successfully estimate and predict
trends in these opioid-related socioenvironmental factors, we augment the
Kalman Filter with a novel spatial component. Through this construction we
analyze opioid vulnerability at the national scale, creating heat maps and a
hotspot analysis. Our spatial Kalman filter demonstrates strong predictive
performance. These predictions are used to uncover pronounced vulnerability
profiles for both the rates of opioid-related mortality and disability, finding
that the Appalachian region is likely the nation's most vulnerable area to
these two factors. This contrasts with a chaotic vulnerability profile found
for the dispensing rates. We suggest that the rates of opioid-related mortality
and disability are connected and propose that this connection is unlikely to be
found in the realm of prescription opioids. Our analysis indicates that
prescription opioids are not the primary drivers of opioid-related deaths
across the country. We advocate for comprehensive solutions which extend beyond
limiting prescription opioids.
