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Syringe exchange programs and harm reduction: New evidence in the wake of the opioid epidemic

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  • Packham, Analisa

Abstract

In light of the recent opioid crisis, many public health entities have called for an expansion in syringe exchange programs (SEPs), which provide access to sterile syringes and facilitate safe needle disposal for injection drug users. This paper uses a newly constructed administrative dataset to estimate the effects of recent SEP openings on HIV diagnoses and drug-related deaths. I find that SEP openings decrease HIV rates by up to 18.2 percent. However, I present new evidence that SEPs increase rates of opioid-related mortality. Effects are largest in rural counties and in counties that adopted SEPs after the influx of fentanyl to the US, suggesting that needle exchanges may be less effective during periods when illicit opioids are widely available, especially in areas with high barriers to substance abuse treatment.

Suggested Citation

  • Packham, Analisa, 2022. "Syringe exchange programs and harm reduction: New evidence in the wake of the opioid epidemic," Journal of Public Economics, Elsevier, vol. 215(C).
    • Handle: RePEc:eee:pubeco:v:215:y:2022:i:c:s0047272722001359
    DOI: 10.1016/j.jpubeco.2022.104733
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    References listed on IDEAS

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    1. Jeff DeSimone, 2005. "Needle exchange programs and drug injection behavior," Journal of Policy Analysis and Management, John Wiley & Sons, Ltd., vol. 24(3), pages 559-577.
    2. Clément de Chaisemartin & Xavier D'Haultfœuille, 2020. "Two-Way Fixed Effects Estimators with Heterogeneous Treatment Effects," American Economic Review, American Economic Association, vol. 110(9), pages 2964-2996, September.
    3. Swensen, Isaac D., 2015. "Substance-abuse treatment and mortality," Journal of Public Economics, Elsevier, vol. 122(C), pages 13-30.
    4. Manasi Deshpande & Yue Li, 2019. "Who Is Screened Out? Application Costs and the Targeting of Disability Programs," American Economic Journal: Economic Policy, American Economic Association, vol. 11(4), pages 213-248, November.
    5. Harold A. Pollack, 2001. "Cost-effectiveness of Harm Reduction in Preventing Hepatitis C among Injection Drug Users," Medical Decision Making, , vol. 21(5), pages 357-367, October.
    6. Molly Schnell & Janet Currie, 2018. "Addressing the Opioid Epidemic: Is There a Role for Physician Education?," American Journal of Health Economics, University of Chicago Press, vol. 4(3), pages 383-410, Summer.
    7. Goodman-Bacon, Andrew, 2021. "Difference-in-differences with variation in treatment timing," Journal of Econometrics, Elsevier, vol. 225(2), pages 254-277.
    8. Bondurant, Samuel R. & Lindo, Jason M. & Swensen, Isaac D., 2018. "Substance abuse treatment centers and local crime," Journal of Urban Economics, Elsevier, vol. 104(C), pages 124-133.
    9. Doleac, Jennifer & Mukherjee, Anita, 2018. "The Moral Hazard of Lifesaving Innovations: Naloxone Access, Opioid Abuse, and Crime," IZA Discussion Papers 11489, Institute of Labor Economics (IZA).
    10. Sun, Liyang & Abraham, Sarah, 2021. "Estimating dynamic treatment effects in event studies with heterogeneous treatment effects," Journal of Econometrics, Elsevier, vol. 225(2), pages 175-199.
    11. Anca M. Grecu & Dhaval M. Dave & Henry Saffer, 2019. "Mandatory Access Prescription Drug Monitoring Programs and Prescription Drug Abuse," Journal of Policy Analysis and Management, John Wiley & Sons, Ltd., vol. 38(1), pages 181-209, January.
    12. Harold A. Pollack, 2001. "Can We Protect Drug Users from Hepatitis C?," Journal of Policy Analysis and Management, John Wiley & Sons, Ltd., vol. 20(2), pages 358-364.
    13. Callaway, Brantly & Sant’Anna, Pedro H.C., 2021. "Difference-in-Differences with multiple time periods," Journal of Econometrics, Elsevier, vol. 225(2), pages 200-230.
    14. Thomas C. Buchmueller & Colleen Carey, 2018. "The Effect of Prescription Drug Monitoring Programs on Opioid Utilization in Medicare," American Economic Journal: Economic Policy, American Economic Association, vol. 10(1), pages 77-112, February.
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    More about this item

    Keywords

    Syringe exchange programs; Opioid crisis; HIV;
    All these keywords.

    JEL classification:

    • K42 - Law and Economics - - Legal Procedure, the Legal System, and Illegal Behavior - - - Illegal Behavior and the Enforcement of Law
    • I10 - Health, Education, and Welfare - - Health - - - General
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health

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