Such maladaptive behaviors have been noted in other resource-constrained environments such as insulin underutilization (Herkert et al., 2019), delayed healthcare utilization (Ratnapradipa et al., 2023) due to cost, underutilization of medication for opioid use disorder due to stigma (Madden, 2019), or pregnancy termination without medical supervision due to restrictive abortion laws (Harris and Grossman, 2020). This evidence concerns the gene INS and opioid use disorder.