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The Role of Friends in the Opioid Epidemic

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Abstract

The role of friends in the US opioid epidemic is examined. Using data from the National Longitudinal Survey of Adolescent Health (Add Health), adults aged 25-34 and their high school best friends are focused on. An instrumental variable technique is employed to estimate peer effects in opioid misuse. Severe injuries in the previous year are used as an instrument for opioid misuse in order to estimate the causal impact of a person’s best friends’ opioid misuse on their own misuse. The estimated peer effects are significant: Having a best friend who misuses opioids following a serious injury increases the probability of own opioid misuse by around 7 percentage points in a population where 17 percent ever misuses opioids. The effect is concentrated among non-college graduates and peers with strong ties who are central in their friendship networks. Peer opioid misuse eventually leads to deteriorating health and opioid addiction.

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  • Effrosyni Adamopoulou & Jeremy Greenwood & Nezih Guner & Karen Kopecky, 2025. "The Role of Friends in the Opioid Epidemic," Working Papers wp2025_2520, CEMFI.
    • Handle: RePEc:cmf:wpaper:wp2025_2520
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    JEL classification:

    • C26 - Mathematical and Quantitative Methods - - Single Equation Models; Single Variables - - - Instrumental Variables (IV) Estimation
    • D10 - Microeconomics - - Household Behavior - - - General
    • I12 - Health, Education, and Welfare - - Health - - - Health Behavior
    • J11 - Labor and Demographic Economics - - Demographic Economics - - - Demographic Trends, Macroeconomic Effects, and Forecasts

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