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The Downward Spiral

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  • Jeremy Greenwood
  • Nezih Guner
  • Karen A. Kopecky

Abstract

To analyze the opioid epidemic, we construct a model where individuals, with and without pain, choose whether to misuse opioids knowing the probabilities of addiction and dying. These odds are functions of opioid use. Markov chains are estimated from the US data for the college and non–college educated that summarize the transitions into and out of opioid addiction as well as to a deadly overdose. We construct a structural model that matches the estimated Markov chains. We also examine the epidemic’s drivers and the impact of medical interventions.

Suggested Citation

  • Jeremy Greenwood & Nezih Guner & Karen A. Kopecky, 2022. "The Downward Spiral," FRB Atlanta Working Paper 2022-4, Federal Reserve Bank of Atlanta.
    • Handle: RePEc:fip:fedawp:94785
    DOI: 10.29338/wp2022-04
    Note: Francesco Chiocchio, Michele Federle, and Jordan Herring provided excellent research assistance. This working paper is a preliminary version of the research. The views expressed here are those of the authors and not necessarily those of the Federal Reserve Bank of Atlanta or the Federal Reserve System. Any remaining errors are the authors' responsibility.
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    1. Casey B. Mulligan, 2020. "Prices and Federal Policies in Opioid Markets," Working Papers 2020-10, Becker Friedman Institute for Research In Economics.
    2. Roozbeh Hosseini & Kai Zhao & Karen Kopecky, 2018. "How Important Is Health Inequality for Lifetime Earnings Inequality?," 2018 Meeting Papers 1093, Society for Economic Dynamics.
    3. Miron, Jeffrey A & Zwiebel, Jeffrey, 1991. "Alcohol Consumption during Prohibition," American Economic Review, American Economic Association, vol. 81(2), pages 242-247, May.
    4. Carter,Susan B. & Gartner,Scott Sigmund & Haines,Michael R. & Olmstead,Alan L. & Sutch,Richard & Wri (ed.), 2006. "The Historical Statistics of the United States 5 Volume Hardback Set," Cambridge Books, Cambridge University Press, number 9780521817912, September.
    5. Jeremy Greenwood & Philipp Kircher & Cezar Santos & Michèle Tertilt, 2019. "An Equilibrium Model of the African HIV/AIDS Epidemic," Econometrica, Econometric Society, vol. 87(4), pages 1081-1113, July.
    6. Viscusi, W Kip & Aldy, Joseph E, 2003. "The Value of a Statistical Life: A Critical Review of Market Estimates throughout the World," Journal of Risk and Uncertainty, Springer, vol. 27(1), pages 5-76, August.
    7. Strulik, Holger, 2021. "From pain patient to junkie: An economic theory of painkiller consumption and its impact on wellbeing and longevity," Journal of Health Economics, Elsevier, vol. 76(C).
    8. Jeremy Greenwood & Nezih Guner & Karen A. Kopecky, 2022. "Substance Abuse during the Pandemic: Implications for Labor-Force Participation," Economie d'Avant Garde Research Reports 35, Economie d'Avant Garde.
    9. Cawley, John & Ruhm, Christopher J., 2011. "The Economics of Risky Health Behaviors," Handbook of Health Economics, in: Mark V. Pauly & Thomas G. Mcguire & Pedro P. Barros (ed.), Handbook of Health Economics, volume 2, chapter 0, pages 95-199, Elsevier.
    10. Chaloupka, Frank, 1991. "Rational Addictive Behavior and Cigarette Smoking," Journal of Political Economy, University of Chicago Press, vol. 99(4), pages 722-742, August.
    11. Robert E. Hall & Charles I. Jones, 2007. "The Value of Life and the Rise in Health Spending," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 122(1), pages 39-72.
    12. Matthew C. Harris & Lawrence M. Kessler & Matthew N. Murray & Beth Glenn, 2020. "Prescription Opioids and Labor Market Pains: The Effect of Schedule II Opioids on Labor Force Participation and Unemployment," Journal of Human Resources, University of Wisconsin Press, vol. 55(4), pages 1319-1364.
    13. Mark V. Pauly & Thomas G. Mcguire & Pedro P. Barros (ed.), 2011. "Handbook of Health Economics," Handbook of Health Economics, Elsevier, volume 2, number 2.
    14. Luiz Brotherhood & Philipp Kircher & Cezar Santos & Michéle Tertilt, 2020. "An Economic Model of the COVID-19 Pandemic With Young and Old Agents: Behavior, Testing and Policies," CRC TR 224 Discussion Paper Series crctr224_2020_175v2, University of Bonn and University of Mannheim, Germany.
    15. Casey B. Mulligan, 2020. "Prices and Federal Policies in Opioid Markets," NBER Working Papers 26812, National Bureau of Economic Research, Inc.
    16. Panos Margaris & Johanna Wallenius, 2024. "Can Wealth Buy Health? A Model of Pecuniary and Non-Pecuniary Investments in Health," Journal of the European Economic Association, European Economic Association, vol. 22(3), pages 1097-1138.
    17. Michael Kremer, 1996. "Integrating Behavioral Choice into Epidemiological Models of AIDS," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 111(2), pages 549-573.
    18. David M. Cutler & Edward L. Glaeser, 2021. "When Innovation Goes Wrong: Technological Regress and the Opioid Epidemic," Journal of Economic Perspectives, American Economic Association, vol. 35(4), pages 171-196, Fall.
    19. Casey B. Mulligan, 2022. "Lethal Unemployment Bonuses? Substitution and Income Effects on Substance Abuse, 2020-21," NBER Working Papers 29719, National Bureau of Economic Research, Inc.
    20. Michael Kremer, 1996. "Integrating Behavioral Choice into Epidemiological Models of the AIDS Epidemic," NBER Working Papers 5428, National Bureau of Economic Research, Inc.
    21. David M. Cutler & Edward L. Glaeser, 2021. "When Innovation Goes Wrong: Technological Regress and the Opioid Epidemic," NBER Working Papers 28873, National Bureau of Economic Research, Inc.
    22. Alan B. Krueger, 2017. "Where Have All the Workers Gone? An Inquiry into the Decline of the U.S. Labor Force Participation Rate," Brookings Papers on Economic Activity, Economic Studies Program, The Brookings Institution, vol. 48(2 (Fall)), pages 1-87.
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    Cited by:

    1. Jeremy Greenwood & Nezih Guner & Karen A. Kopecky, 2022. "Substance Abuse during the Pandemic: Implications for Labor-Force Participation," Working Papers 1335, Barcelona School of Economics.
    2. Chaoran Chen & Zhigang Feng & Jiaying Gu, 2022. "Health, Health Insurance, and Inequality," Working Papers tecipa-730, University of Toronto, Department of Economics.
    3. Casey B. Mulligan, 2022. "Lethal Unemployment Bonuses? Substitution and Income Effects on Substance Abuse, 2020-21," NBER Working Papers 29719, National Bureau of Economic Research, Inc.

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    More about this item

    Keywords

    addiction; college/non–college educated; deaths; fentanyl; Markov chain; medical interventions; opioids; OxyContin; pain; prices; structural model;
    All these keywords.

    JEL classification:

    • D11 - Microeconomics - - Household Behavior - - - Consumer Economics: Theory
    • D12 - Microeconomics - - Household Behavior - - - Consumer Economics: Empirical Analysis
    • E13 - Macroeconomics and Monetary Economics - - General Aggregative Models - - - Neoclassical
    • I12 - Health, Education, and Welfare - - Health - - - Health Behavior
    • I31 - Health, Education, and Welfare - - Welfare, Well-Being, and Poverty - - - General Welfare, Well-Being
    • J11 - Labor and Demographic Economics - - Demographic Economics - - - Demographic Trends, Macroeconomic Effects, and Forecasts
    • J17 - Labor and Demographic Economics - - Demographic Economics - - - Value of Life; Foregone Income

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