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Links between COVID-19 lockdowns and drug overdose deaths, evidence from panel data

Author

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  • Wang, Yimin

Abstract

This paper studies the impacts of divergent state government responses to the COVID-19 pandemic on drug overdose deaths. Using Difference-in-Differences method, I exploit the cross-state variation in the timing of lockdown policies to examine how COVID-19 lockdowns affected drug overdose deaths. To the author’s knowledge, this is the first study that comprehensively examines the causal links between COVID-19 lockdowns and drug overdose deaths in the US. By emphasizing the impacts of lockdown “mandates” vs. “recommendations,” I find credible evidence supporting that the implementation of lockdown mandates led to more drug overdose deaths. My baseline estimates indicate a 15% to 20% increase in drug overdose deaths. To make my results generalizable, I examine three potential mechanisms, including labor market outcomes, mental health, and isolation. I find that isolation induced by the COVID-19 lockdown mandates likely contributes to the increase in drug overdose deaths, while there is only weak evidence that labor market outcomes and mental health serve as plausible channels.

Suggested Citation

  • Wang, Yimin, 2025. "Links between COVID-19 lockdowns and drug overdose deaths, evidence from panel data," Economics & Human Biology, Elsevier, vol. 58(C).
    • Handle: RePEc:eee:ehbiol:v:58:y:2025:i:c:s1570677x25000437
    DOI: 10.1016/j.ehb.2025.101510
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    1. Campos-Mercade, Pol & Meier, Armando N. & Schneider, Florian H. & Wengström, Erik, 2021. "Prosociality predicts health behaviors during the COVID-19 pandemic," Journal of Public Economics, Elsevier, vol. 195(C).
    2. Hollingsworth, Alex & Ruhm, Christopher J. & Simon, Kosali, 2017. "Macroeconomic conditions and opioid abuse," Journal of Health Economics, Elsevier, vol. 56(C), pages 222-233.
    3. Brzezinski, Adam & Deiana, Guido & Kecht, Valentin & Van Dijcke, David, 2020. "The COVID-19 Pandemic: Government vs. Community Action Across the United States," INET Oxford Working Papers 2020-06, Institute for New Economic Thinking at the Oxford Martin School, University of Oxford.
    4. Thomas Hale & Noam Angrist & Rafael Goldszmidt & Beatriz Kira & Anna Petherick & Toby Phillips & Samuel Webster & Emily Cameron-Blake & Laura Hallas & Saptarshi Majumdar & Helen Tatlow, 2021. "A global panel database of pandemic policies (Oxford COVID-19 Government Response Tracker)," Nature Human Behaviour, Nature, vol. 5(4), pages 529-538, April.
    5. Allcott, Hunt & Boxell, Levi & Conway, Jacob & Gentzkow, Matthew & Thaler, Michael & Yang, David, 2020. "Polarization and public health: Partisan differences in social distancing during the coronavirus pandemic," Journal of Public Economics, Elsevier, vol. 191(C).
    6. Hoehn-Velasco, Lauren & Silverio-Murillo, Adan & de la Miyar, Jose Roberto Balmori, 2021. "The great crime recovery: Crimes against women during, and after, the COVID-19 lockdown in Mexico," Economics & Human Biology, Elsevier, vol. 41(C).
    7. Dore, Emily C. & Wurapa, Jordan, 2024. "The long-term health effects of childhood exposure to social and economic policies: A scoping review," Social Science & Medicine, Elsevier, vol. 352(C).
    8. ChaeWon Baek & Peter B. McCrory & Todd Messer & Preston Mui, 2021. "Unemployment Effects of Stay-at-Home Orders: Evidence from High-Frequency Claims Data," The Review of Economics and Statistics, MIT Press, vol. 103(5), pages 979-993, December.
    9. Kim, Bokyung, 2021. "Must-access prescription drug monitoring programs and the opioid overdose epidemic: The unintended consequences," Journal of Health Economics, Elsevier, vol. 75(C).
    10. Ashesh Rambachan & Jonathan Roth, 2023. "A More Credible Approach to Parallel Trends," The Review of Economic Studies, Review of Economic Studies Ltd, vol. 90(5), pages 2555-2591.
    11. García-Prado, Ariadna & González, Paula & Rebollo-Sanz, Yolanda F., 2022. "Lockdown strictness and mental health effects among older populations in Europe," Economics & Human Biology, Elsevier, vol. 45(C).
    12. Brian Beach & Karen Clay & Martin Saavedra, 2022. "The 1918 Influenza Pandemic and Its Lessons for COVID-19," Journal of Economic Literature, American Economic Association, vol. 60(1), pages 41-84, March.
    13. Alberto Abadie & Alexis Diamond & Jens Hainmueller, 2015. "Comparative Politics and the Synthetic Control Method," American Journal of Political Science, John Wiley & Sons, vol. 59(2), pages 495-510, February.
    14. Durante, Ruben & Guiso, Luigi & Gulino, Giorgio, 2021. "Asocial capital: Civic culture and social distancing during COVID-19," Journal of Public Economics, Elsevier, vol. 194(C).
    15. Alberto Abadie & Javier Gardeazabal, 2003. "The Economic Costs of Conflict: A Case Study of the Basque Country," American Economic Review, American Economic Association, vol. 93(1), pages 113-132, March.
    16. 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).
    17. Goodman-Bacon, Andrew, 2021. "Difference-in-differences with variation in treatment timing," Journal of Econometrics, Elsevier, vol. 225(2), pages 254-277.
    18. Daniel I. Rees & Joseph J. Sabia & Laura M. Argys & Dhaval Dave & Joshua Latshaw, 2019. "With a Little Help from My Friends: The Effects of Good Samaritan and Naloxone Access Laws on Opioid-Related Deaths," Journal of Law and Economics, University of Chicago Press, vol. 62(1), pages 1-27.
    19. William N. Dowd, 2023. "The effect of untargeted naloxone distribution on opioid overdose outcomes," Health Economics, John Wiley & Sons, Ltd., vol. 32(12), pages 2801-2818, December.
    20. Carpenter, Christopher S. & McClellan, Chandler B. & Rees, Daniel I., 2017. "Economic conditions, illicit drug use, and substance use disorders in the United States," Journal of Health Economics, Elsevier, vol. 52(C), pages 63-73.
    21. Xu, Yiqing, 2017. "Generalized Synthetic Control Method: Causal Inference with Interactive Fixed Effects Models," Political Analysis, Cambridge University Press, vol. 25(1), pages 57-76, January.
    22. Kirill Borusyak & Xavier Jaravel & Jann Spiess, 2024. "Revisiting Event-Study Designs: Robust and Efficient Estimation," The Review of Economic Studies, Review of Economic Studies Ltd, vol. 91(6), pages 3253-3285.
    23. Mathur, Neil K. & Ruhm, Christopher J., 2023. "Marijuana legalization and opioid deaths," Journal of Health Economics, Elsevier, vol. 88(C).
    24. Jennifer L. Doleac & Anita Mukherjee, 2022. "The Effects of Naloxone Access Laws on Opioid Abuse, Mortality, and Crime," Journal of Law and Economics, University of Chicago Press, vol. 65(2), pages 211-238.
    25. Jeffrey M Wooldridge, 2023. "Simple approaches to nonlinear difference-in-differences with panel data," The Econometrics Journal, Royal Economic Society, vol. 26(3), pages 31-66.
    26. Timothy Besley & Sacha Dray, 2022. "Pandemic responsiveness: Evidence from social distancing and lockdown policy during COVID-19," PLOS ONE, Public Library of Science, vol. 17(5), pages 1-20, May.
    27. Bairoliya, Neha & İmrohoroğlu, Ayşe, 2023. "Macroeconomic consequences of stay-at-home policies during the COVID-19 pandemic," European Economic Review, Elsevier, vol. 152(C).
    28. Fernanda Marquez-Padilla & Biani Saavedra, 2022. "The unintended effects of the COVID-19 pandemic and stay-at-home orders on abortions," Journal of Population Economics, Springer;European Society for Population Economics, vol. 35(1), pages 269-305, January.
    29. Jaesang Sung & Will Davis & Qihua Qiu, 2024. "The effects of COVID‐19 lockdown on the body weight and lifestyle behaviors of U.S. adults," Southern Economic Journal, John Wiley & Sons, vol. 90(4), pages 900-948, April.
    30. Stephen R. Barnes & Louis‐Philippe Beland & Jason Huh & Dongwoo Kim, 2022. "COVID‐19 lockdown and traffic accidents: Lessons from the pandemic," Contemporary Economic Policy, Western Economic Association International, vol. 40(2), pages 349-368, April.
    31. Barrios, John M. & Benmelech, Efraim & Hochberg, Yael V. & Sapienza, Paola & Zingales, Luigi, 2021. "Civic capital and social distancing during the Covid-19 pandemic☆," Journal of Public Economics, Elsevier, vol. 193(C).
    32. 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.
    33. Baker, Andrew C. & Larcker, David F. & Wang, Charles C.Y., 2022. "How much should we trust staggered difference-in-differences estimates?," Journal of Financial Economics, Elsevier, vol. 144(2), pages 370-395.
    34. Goolsbee, Austan & Syverson, Chad, 2021. "Fear, lockdown, and diversion: Comparing drivers of pandemic economic decline 2020," Journal of Public Economics, Elsevier, vol. 193(C).
    35. Ruhm, Christopher J., 2019. "Drivers of the fatal drug epidemic," Journal of Health Economics, Elsevier, vol. 64(C), pages 25-42.
    36. Dang, Hai-Anh H. & Trinh, Trong-Anh, 2021. "Does the COVID-19 lockdown improve global air quality? New cross-national evidence on its unintended consequences," Journal of Environmental Economics and Management, Elsevier, vol. 105(C).
    37. Abadie, Alberto & Diamond, Alexis & Hainmueller, Jens, 2010. "Synthetic Control Methods for Comparative Case Studies: Estimating the Effect of California’s Tobacco Control Program," Journal of the American Statistical Association, American Statistical Association, vol. 105(490), pages 493-505.
    38. Ioana Popovici & Johanna Catherine Maclean & Bushra Hijazi & Sharmini Radakrishnan, 2018. "The effect of state laws designed to prevent nonmedical prescription opioid use on overdose deaths and treatment," Health Economics, John Wiley & Sons, Ltd., vol. 27(2), pages 294-305, February.
    39. Chen, Yuyu & Zhou, Li-An, 2007. "The long-term health and economic consequences of the 1959-1961 famine in China," Journal of Health Economics, Elsevier, vol. 26(4), pages 659-681, July.
    40. Susan L. Averett & Julie K. Smith & Yang Wang, 2019. "Medicaid expansion and opioid deaths," Health Economics, John Wiley & Sons, Ltd., vol. 28(12), pages 1491-1496, December.
    41. 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.
    42. Saravana Ravindran & Manisha Shah, 2023. "Unintended consequences of lockdowns, COVID-19 and the Shadow Pandemic in India," Nature Human Behaviour, Nature, vol. 7(3), pages 323-331, March.
    43. Jonathan Roth & Pedro H. C. Sant'Anna, 2023. "When Is Parallel Trends Sensitive to Functional Form?," Econometrica, Econometric Society, vol. 91(2), pages 737-747, March.
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    JEL classification:

    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health
    • J08 - Labor and Demographic Economics - - General - - - Labor Economics Policies
    • R10 - Urban, Rural, Regional, Real Estate, and Transportation Economics - - General Regional Economics - - - General

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