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U.S. counties that heavily favoured Donald Trump in the 2016 presidential election were more likely to have high rates of prescription opioid use, according to a new study published in the Journal of the American Medical Association.

For the study, researchers examined the Medicare prescription files of over 3.7 million Americans, identified chronic users of prescription opioids — those with prescriptions lasting 90 days or longer — and compared their data with presidential voting data.

The cross-sectional analysis revealed that Trump garnered nearly 60 per cent of the vote, on average, in the 700 counties that had the highest rates of chronic prescription opioid use.

By comparison, he only got about 39 per cent of the vote across 638 counties with below-average opioid prescription rates.

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Researchers cautioned that the findings do not mean that opioid use caused people to vote for Trump, or vice-versa.

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Rather, the correlation is largely down to the fact that many of the factors contributing to opioid use also contributed to a desire to vote for Trump, such as low income, poor employment prospects, disability and inadequate insurance.

These socio-economic factors accounted for about two-thirds of the link between prescription opioid use and voting for Trump; the remaining one-third is likely down to psycho-social factors that are difficult to measure, such as dissatisfaction, a lack of hopefulness and a feeling of being marginalized, the researchers wrote.

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The association between prescription opioid use and voting Republican adds to a growing body of evidence showing that people in economically and socially challenged communities supported Trump, states the paper.

These links are not surprising, researchers add, “because aspects of the narrative analyzing the presidential vote echoed themes that occur in explanations for high opioid use” — namely, economic stress and a feeling of being marginalized.

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The findings suggest that public health policy seeking to stem the opioid epidemic must be informed not merely by medical factors, but also social and economic ones, the paper concludes.

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