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

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  • Doleac, Jennifer

    (Texas A&M University)

  • 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 of Labor Economics (IZA).
  • Handle: RePEc:iza:izadps:dp11489
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    3. Pohl, R. Vincent, 2018. "Time Trends Matter: The Case of Medical Cannabis Laws and Opioid Overdose Mortality," MPRA Paper 87237, University Library of Munich, Germany.
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    5. Deiana, C. & Giua, L. & Nisticò, R., 2020. "Opium Price Shocks and Prescription Opioids in the US," Health, Econometrics and Data Group (HEDG) Working Papers 20/23, HEDG, c/o Department of Economics, University of York.
    6. Manuel Hoffmann & Roberto Mosquera & Adrian Chadi, 2019. "Vaccines at Work," TWI Research Paper Series 116, Thurgauer Wirtschaftsinstitut, Universität Konstanz.
    7. Rostislav Staněk & Ondřej Krčál & Katarína Čellárová, 2021. "Pull yourself up by your bootstraps: Identifying procedural preferences against helping others in the presence of moral hazard," MUNI ECON Working Papers 2021-11, Masaryk University.
    8. Deiana Claudio & Giua Ludovica, 2021. "The Intended and Unintended Effects of Opioid Policies on Prescription Opioids and Crime," The B.E. Journal of Economic Analysis & Policy, De Gruyter, vol. 21(2), pages 751-792, April.
    9. Claudio Deiana & Vikram Maheshri & Giovanni Mastrobuoni, 2020. "Migrants at Sea: Unintended Consequences of Search and Rescue Operations," Carlo Alberto Notebooks 636, Collegio Carlo Alberto.
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    11. Dena Bravata & Jonathan H. Cantor & Neeraj Sood & Christopher M. Whaley, 2021. "Back to School: The Effect of School Visits During COVID-19 on COVID-19 Transmission," NBER Working Papers 28645, National Bureau of Economic Research, Inc.
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    13. David Beheshti, 2019. "Adverse health effects of abuse‐deterrent opioids: Evidence from the reformulation of OxyContin," Health Economics, John Wiley & Sons, Ltd., vol. 28(12), pages 1449-1461, December.
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    15. Analisa Packham, 2019. "Are Syringe Exchange Programs Helpful or Harmful? New Evidence in the Wake of the Opioid Epidemic," NBER Working Papers 26111, National Bureau of Economic Research, Inc.
    16. Casey B. Mulligan, 2020. "Prices and Federal Policies in Opioid Markets," Working Papers 2020-10, Becker Friedman Institute for Research In Economics.
    17. Monica Deza & Johanna Catherine Maclean & Keisha T. Solomon, 2020. "Local Access to Mental Healthcare and Crime," NBER Working Papers 27619, National Bureau of Economic Research, Inc.
    18. Casey B. Mulligan, 2020. "Prices and Federal Policies in Opioid Markets," NBER Working Papers 26812, National Bureau of Economic Research, Inc.
    19. Cornelius A. Rietveld & Pankaj C. Patel, 2021. "Prescription opioids and new business establishments," Small Business Economics, Springer, vol. 57(3), pages 1175-1199, October.
    20. Gal Wettstein, 2019. "Health insurance and opioid deaths: Evidence from the Affordable Care Act young adult provision," Health Economics, John Wiley & Sons, Ltd., vol. 28(5), pages 666-677, May.
    21. Lorán Chollete & Sharon G. Harrison, 2021. "Unintended Consequences: Ambiguity Neglect and Policy Ineffectiveness," Eastern Economic Journal, Palgrave Macmillan;Eastern Economic Association, vol. 47(2), pages 206-226, April.
    22. Ruhm, Christopher J., 2019. "Drivers of the fatal drug epidemic," Journal of Health Economics, Elsevier, vol. 64(C), pages 25-42.

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    More about this item

    Keywords

    naloxone; opioids; moral hazard;
    All these keywords.

    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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