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Understanding the demographics of the opioid overdose death crisis

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  • David Powell

    (RAND)

Abstract

The United States is facing an unprecedented drug overdose crisis, distinguished from prior epidemics by its severity, widespread impact, and demographic incidence. This study examines demographic overdose trends during the opioid crisis relative to historical disparities. Using a simple decomposition framework, I assess the contributions of specific demographic factors while accounting for other characteristics, finding that many disparities intensify when adjusted for covarying factors. Additionally, I analyze the long-term impacts of OxyContin’s launch, discovering that it induced substantial differences in overdose rates by sex and education. While OxyContin contributed to some racial/ethnic disparities, there is evidence that other factors independently shaped these trends. Nonetheless, all demographic groups were substantially impacted by the introduction and promotion of OxyContin. This research highlights how certain groups have been disproportionately affected by the opioid crisis and the foundational role of supply-side shocks to opioid access in explaining the demographics of the overdose death crisis.

Suggested Citation

  • David Powell, 2025. "Understanding the demographics of the opioid overdose death crisis," Journal of Population Economics, Springer;European Society for Population Economics, vol. 38(3), pages 1-31, September.
    • Handle: RePEc:spr:jopoec:v:38:y:2025:i:3:d:10.1007_s00148-025-01108-0
    DOI: 10.1007/s00148-025-01108-0
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    1. Janet Currie & Jonas Jin & Molly Schnell, 2019. "US Employment and Opioids: Is There a Connection?☆," Research in Labor Economics, in: Health and Labor Markets, volume 47, pages 253-280, Emerald Group Publishing Limited.
    2. Damon Clark & Heather Royer, 2013. "The Effect of Education on Adult Mortality and Health: Evidence from Britain," American Economic Review, American Economic Association, vol. 103(6), pages 2087-2120, October.
    3. A. Colin Cameron & Jonah B. Gelbach & Douglas L. Miller, 2008. "Bootstrap-Based Improvements for Inference with Clustered Errors," The Review of Economics and Statistics, MIT Press, vol. 90(3), pages 414-427, August.
    4. Powell, David & Pacula, Rosalie Liccardo & Taylor, Erin, 2020. "How increasing medical access to opioids contributes to the opioid epidemic: Evidence from Medicare Part D," Journal of Health Economics, Elsevier, vol. 71(C).
    5. Adriana Lleras-Muney, 2005. "The Relationship Between Education and Adult Mortality in the United States," The Review of Economic Studies, Review of Economic Studies Ltd, vol. 72(1), pages 189-221.
    6. Sean F Altekruse & Candace M Cosgrove & William C Altekruse & Richard A Jenkins & Carlos Blanco, 2020. "Socioeconomic risk factors for fatal opioid overdoses in the United States: Findings from the Mortality Disparities in American Communities Study (MDAC)," PLOS ONE, Public Library of Science, vol. 15(1), pages 1-16, January.
    7. David Roodman & James G. MacKinnon & Morten Ørregaard Nielsen & Matthew D. Webb, 2019. "Fast and wild: Bootstrap inference in Stata using boottest," Stata Journal, StataCorp LLC, vol. 19(1), pages 4-60, March.
    8. Michael R Betz & Lauren E Jones, 2018. "Wage and Employment Growth in America’s Drug Epidemic: Is All Growth Created Equal?," American Journal of Agricultural Economics, Agricultural and Applied Economics Association, vol. 100(5), pages 1357-1374.
    9. Hollingsworth, Alex & Ruhm, Christopher J. & Simon, Kosali, 2017. "Macroeconomic conditions and opioid abuse," Journal of Health Economics, Elsevier, vol. 56(C), pages 222-233.
    10. Paul Novosad & Charlie Rafkin & Sam Asher, 2022. "Mortality Change among Less Educated Americans," American Economic Journal: Applied Economics, American Economic Association, vol. 14(4), pages 1-34, October.
    11. Costas Meghir & Mårten Palme & Emilia Simeonova, 2018. "Education and Mortality: Evidence from a Social Experiment," American Economic Journal: Applied Economics, American Economic Association, vol. 10(2), pages 234-256, April.
    12. Andrew Halpern-Manners & Jonas Helgertz & John Robert Warren & Evan Roberts, 2020. "The Effects of Education on Mortality: Evidence From Linked U.S. Census and Administrative Mortality Data," Demography, Springer;Population Association of America (PAA), vol. 57(4), pages 1513-1541, August.
    13. David Powell & Rosalie Liccardo Pacula, 2021. "The Evolving Consequences of OxyContin Reformulation on Drug Overdoses," American Journal of Health Economics, University of Chicago Press, vol. 7(1), pages 41-67.
    14. Abby Alpert & David Powell & Rosalie Liccardo Pacula, 2018. "Supply-Side Drug Policy in the Presence of Substitutes: Evidence from the Introduction of Abuse-Deterrent Opioids," American Economic Journal: Economic Policy, American Economic Association, vol. 10(4), pages 1-35, November.
    15. Matthew D. Webb, 2023. "Reworking wild bootstrap‐based inference for clustered errors," Canadian Journal of Economics/Revue canadienne d'économique, John Wiley & Sons, vol. 56(3), pages 839-858, August.
    16. Kerwin Kofi Charles & Erik Hurst & Mariel Schwartz, 2019. "The Transformation of Manufacturing and the Decline in US Employment," NBER Macroeconomics Annual, University of Chicago Press, vol. 33(1), pages 307-372.
    17. Abby Alpert & William N Evans & Ethan M J Lieber & David Powell, 2022. "Origins of the Opioid Crisis and its Enduring Impacts [Synthetic Control Methods for Comparative Case Studies: Estimating the Effect of California's Tobacco Control Program]," The Quarterly Journal of Economics, Oxford University Press, vol. 137(2), pages 1139-1179.
    18. Arias, E. & Eschbach, K. & Schauman, W.S. & Backlund, E.L. & Sorlie, P.D., 2010. "The hispanic mortality advantage and ethnic misclassification on US death certificates," American Journal of Public Health, American Public Health Association, vol. 100(S1), pages 171-177.
    19. repec:eme:rlec11:s0147-912120190000047009 is not listed on IDEAS
    20. Jessica Y. Ho, 2017. "The Contribution of Drug Overdose to Educational Gradients in Life Expectancy in the United States, 1992–2011," Demography, Springer;Population Association of America (PAA), vol. 54(3), pages 1175-1202, June.
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    JEL classification:

    • I12 - Health, Education, and Welfare - - Health - - - Health Behavior
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health
    • J11 - Labor and Demographic Economics - - Demographic Economics - - - Demographic Trends, Macroeconomic Effects, and Forecasts
    • J15 - Labor and Demographic Economics - - Demographic Economics - - - Economics of Minorities, Races, Indigenous Peoples, and Immigrants; Non-labor Discrimination

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