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The Moral Hazard of Lifesaving Innovations: Naloxone Access, Opioid Abuse, and Crime

Author

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  • Doleac, Jennifer

    () (University of Virginia)

  • Mukherjee, Anita

    () (University of Wisconsin-Madison)

Abstract

The United States is experiencing an epidemic of opioid abuse. In response, many states have increased access to naloxone, a drug that can save lives when administered during an overdose. However, naloxone access may unintentionally increase opioid abuse through two channels: (1) reducing the risk of death per use, thereby making riskier opioid use more appealing, and (2) saving the lives of active drug users, who survive to continue abusing opioids. By increasing the number of opioid abusers who need to fund their drug purchases, naloxone access laws may also increase theft. We exploit the staggered timing of naloxone access laws to estimate the total effects of these laws. We find that broadening naloxone access led to more opioid-related emergency room visits and more opioid-related theft, with no reduction in opioid-related mortality. These effects are driven by urban areas and vary by region. We find the most detrimental effects in the Midwest, including a 14% increase in opioid-related mortality in that region. We also find suggestive evidence that broadening naloxone access increased the use of fentanyl, a particularly potent opioid. While naloxone has great potential as a harm-reduction strategy, our analysis is consistent with the hypothesis that broadening access to naloxone encourages riskier behaviors with respect to opioid abuse.

Suggested Citation

  • Doleac, Jennifer & Mukherjee, Anita, 2018. "The Moral Hazard of Lifesaving Innovations: Naloxone Access, Opioid Abuse, and Crime," IZA Discussion Papers 11489, Institute for the Study of Labor (IZA).
  • Handle: RePEc:iza:izadps:dp11489
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    References listed on IDEAS

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    1. Cohen, Alma & Dehejia, Rajeev, 2004. "The Effect of Automobile Insurance and Accident Liability Laws on Traffic Fatalities," Journal of Law and Economics, University of Chicago Press, vol. 47(2), pages 357-393, October.
    2. Abby Alpert & David Powell & Rosalie Liccardo Pacula, 2017. "Supply-Side Drug Policy in the Presence of Substitutes: Evidence from the Introduction of Abuse-Deterrent Opioids," NBER Working Papers 23031, National Bureau of Economic Research, Inc.
    3. repec:aph:ajpbhl:10.2105/ajph.2012.300989_9 is not listed on IDEAS
    4. repec:wly:jpamgt:v:36:y:2017:i:2:p:390-417 is not listed on IDEAS
    5. Abby Alpert & David Powell & Rosalie Liccardo Pacula, 2017. "Supply-Side Drug Policy in the Presence of Substitutes Evidence from the Introduction of Abuse-Deterrent Opioids," Working Papers WR-1181, RAND Corporation.
    6. Alma Cohen & Liran Einav, 2003. "The Effects of Mandatory Seat Belt Laws on Driving Behavior and Traffic Fatalities," The Review of Economics and Statistics, MIT Press, vol. 85(4), pages 828-843, November.
    7. Daniel I. Rees & Joseph J. Sabia & Laura M. Argys & Joshua Latshaw & Dhaval Dave, 2017. "With a Little Help from My Friends: The Effects of Naloxone Access and Good Samaritan Laws on Opioid-Related Deaths," NBER Working Papers 23171, National Bureau of Economic Research, Inc.
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    More about this item

    Keywords

    naloxone; opioids; moral hazard;

    JEL classification:

    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health
    • K42 - Law and Economics - - Legal Procedure, the Legal System, and Illegal Behavior - - - Illegal Behavior and the Enforcement of Law
    • D81 - Microeconomics - - Information, Knowledge, and Uncertainty - - - Criteria for Decision-Making under Risk and Uncertainty

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