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  1. Free, publicly-accessible full text available January 1, 2025
  2. In recent years, the US has experienced an opioid epidemic with an unprecedented number of drugs overdose deaths. Research finds such overdose deaths are linked to neighborhood-level traits, thus providing opportunity to identify effective interventions. Typically, techniques such as Ordinary Least Squares (OLS) or Maximum Likelihood Estimation (MLE) are used to document neighborhood-level factors significant in explaining such adverse outcomes. These techniques are, however, less equipped to ascertain non-linear relationships between confounding factors. Hence, in this study we apply machine learning based techniques to identify opioid risks of neighborhoods in Delaware and explore the correlation of these factors using Shapley Additive explanations (SHAP). We discovered that the factors related to neighborhoods’ environment, followed by education and then crime, were highly correlated with higher opioid risk.We also explored the change in these correlations over the years to understand the changing dynamics of the epidemic. Furthermore, we discovered that, as the epidemic has shifted from legal (i.e., prescription opioids) to illegal (e.g., heroin and fentanyl) drugs in recent years, the correlation of environment, crime and health related variables with the opioid risk has increased significantly while the correlation of economic and socio-demographic variables has decreased. The correlation of education related factors has been higher from the start and has increased slightly in recent years suggesting a need for increased awareness about the opioid epidemic. 
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