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The Opioid Epidemic: Causes and Consequences

Author

Listed:
  • Carolina Arteaga Cabrales
  • Victoria Barone

Abstract

This paper studies the origins and consequences of the opioid epidemic. Drawing on recently unsealed documents from state litigation against Purdue Pharma, we instrument for the supply of prescription opioids by exploiting features of the initial marketing of OxyContin. We find that moving from the 25th-to-the-75th percentile in the distribution of prescription opioid supply increases deaths from prescription opioids by 89% and deaths from all opioids by 39%. This corresponds to over 200,000 deaths. We estimate that the opioid crisis did not have an effect on labor market outcomes, such as labor force participation or employment rates, but it had adverse effects on socioeconomic conditions, as indicated by increased claims from SNAP and disability and increased crime. We estimate decreases in pregnancy duration, birth weight and health at birth but no effect on infant mortality and we estimate an increase in fertility rates.

Suggested Citation

  • Carolina Arteaga Cabrales & Victoria Barone, 2021. "The Opioid Epidemic: Causes and Consequences," Working Papers tecipa-698, University of Toronto, Department of Economics.
  • Handle: RePEc:tor:tecipa:tecipa-698
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    References listed on IDEAS

    as
    1. Deiana, Claudio & Giua, Ludovica, 2018. "The US Opidemic: Prescription Opioids, Labour Market Conditions and Crime," MPRA Paper 85712, University Library of Munich, Germany.
    2. Anne Case & Angus Deaton, 2017. "Mortality and Morbidity in the 21st Century," Brookings Papers on Economic Activity, Economic Studies Program, The Brookings Institution, vol. 48(1 (Spring), pages 397-476.
    3. 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).
    4. Bogdan Savych & David Neumark & Randall Lea, 2019. "Do Opioids Help Injured Workers Recover and Get Back to Work? The Impact of Opioid Prescriptions on Duration of Temporary Disability," Industrial Relations: A Journal of Economy and Society, Wiley Blackwell, vol. 58(4), pages 549-590, October.
    5. 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.
    6. Molly Schnell & Janet Currie, 2018. "Addressing the Opioid Epidemic: Is There a Role for Physician Education?," American Journal of Health Economics, University of Chicago Press, vol. 4(3), pages 383-410, Summer.
    7. Esa Eslami & Kai Filion & Mark Strayer, 2011. "Characteristics of Supplemental Nutrition Assistance Program Households: Fiscal Year 2010," Mathematica Policy Research Reports a748e33a1cf4400b86b386017, Mathematica Policy Research.
    8. Park, Sujeong & Powell, David, 2021. "Is the rise in illicit opioids affecting labor supply and disability claiming rates?," Journal of Health Economics, Elsevier, vol. 76(C).
    9. Beth Ann Griffin & Megan S. Schuler & Elizabeth A. Stuart & Stephen Patrick & Elizabeth McNeer & Rosanna Smart & David Powell & Bradley Stein & Terry Schell & Rosalie Liccardo Pacula, 2020. "Variation in Performance of Commonly Used Statistical Methods for Estimating Effectiveness of State-Level Opioid Policies on Opioid-Related Mortality," NBER Working Papers 27029, National Bureau of Economic Research, Inc.
    10. Bo E. Honoré & Adriana Lleras-Muney, 2006. "Bounds in Competing Risks Models and the War on Cancer," Econometrica, Econometric Society, vol. 74(6), pages 1675-1698, November.
    11. Carpenter, Christopher S. & McClellan, Chandler B. & Rees, Daniel I., 2017. "Economic conditions, illicit drug use, and substance use disorders in the United States," Journal of Health Economics, Elsevier, vol. 52(C), pages 63-73.
    12. Dionissi Aliprantis & Mark E. Schweitzer, 2018. "Opioids and the Labor Market," Working Papers (Old Series) 1807, Federal Reserve Bank of Cleveland.
    13. 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.
    14. Mark Strayer & Joshua Leftin & Esa Eslami, 2012. "Characteristics of Supplemental Nutrition Assistance Program Households: Fiscal Year 2011 (Executive Summary)," Mathematica Policy Research Reports 3b40cdf51e57416d86aad1472, Mathematica Policy Research.
    15. Douglas Almond & Hilary W. Hoynes & Diane Whitmore Schanzenbach, 2011. "Inside the War on Poverty: The Impact of Food Stamps on Birth Outcomes," The Review of Economics and Statistics, MIT Press, vol. 93(2), pages 387-403, May.
    16. Dhaval Dave & Monica Deza & Brady Horn, 2021. "Prescription drug monitoring programs, opioid abuse, and crime," Southern Economic Journal, John Wiley & Sons, vol. 87(3), pages 808-848, January.
    17. Abby E. Alpert & Sarah E. Dykstra & Mireille Jacobson, 2020. "How Do Prescription Drug Monitoring Programs Reduce Opioid Prescribing? The Role of Hassle Costs versus Information," NBER Working Papers 27584, National Bureau of Economic Research, Inc.
    18. Janet Currie & Hannes Schwandt, 2021. "The Opioid Epidemic Was Not Caused by Economic Distress but by Factors That Could Be More Rapidly Addressed," The ANNALS of the American Academy of Political and Social Science, , vol. 695(1), pages 276-291, May.
    19. Kelsey Farson Gray & Esa Eslami, "undated". "Characteristics of Supplemental Nutrition Assistance Program Households: Fiscal Year 2012 (Summary)," Mathematica Policy Research Reports 28c24002c5844538b29cdbb3a, Mathematica Policy Research.
    20. Lynch, Sean & Sherman, Laura & Snyder, Susan M. & Mattson, Margaret, 2018. "Trends in infants reported to child welfare with neonatal abstinence syndrome (NAS)," Children and Youth Services Review, Elsevier, vol. 86(C), pages 135-141.
    21. repec:mpr:mprres:7612 is not listed on IDEAS
    22. Engy Ziedan & Robert Kaestner, 2020. "Effect of Prescription Opioids and Prescription Opioid Control Policies on Infant Health," NBER Working Papers 26749, National Bureau of Economic Research, Inc.
    23. Van Zee, A., 2009. "The promotion and marketing of oxycontin: Commercial triumph, public health tragedy," American Journal of Public Health, American Public Health Association, vol. 99(2), pages 221-227.
    24. Harris, Matthew & Kessler, Lawrence & Murray, Matthew & Glenn, Beth, 2017. "Prescription Opioids and Labor Market Pains: The Effect of Schedule II Opioids on Labor Force Participation and Unemployment," MPRA Paper 86586, University Library of Munich, Germany, revised 28 Mar 2018.
    25. 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.
    26. Isaiah Andrews & James H. Stock & Liyang Sun, 2019. "Weak Instruments in Instrumental Variables Regression: Theory and Practice," Annual Review of Economics, Annual Reviews, vol. 11(1), pages 727-753, August.
    27. repec:mpr:mprres:7613 is not listed on IDEAS
    28. Anne Case & Angua Deaton, 2015. "Rising morbidity and mortality in midlife among white non-Hispanic Americans in the 21st century," Working Papers 15078.full.pdf, Princeton University, Woodrow Wilson School of Public and International Affairs, Research Program in Development Studies..
    29. Kasey Buckles & William N. Evans & Ethan M.J. Lieber, 2020. "The Drug Crisis and the Living Arrangements of Children," NBER Working Papers 27633, National Bureau of Economic Research, Inc.
    30. 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. 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.

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    More about this item

    Keywords

    Opioids; Mortality; Health;
    All these keywords.

    JEL classification:

    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health
    • I30 - Health, Education, and Welfare - - Welfare, Well-Being, and Poverty - - - General
    • J13 - Labor and Demographic Economics - - Demographic Economics - - - Fertility; Family Planning; Child Care; Children; Youth

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