Working Paper: NBER ID: w28873
Authors: David M. Cutler; Edward L. Glaeser
Abstract: The fourfold increase in opioid deaths between 2000 and 2017 rivals even the COVID-19 pandemic as a health crisis for America. Why did it happen? Measures of demand for pain relief – physical pain and despair – are high and in many cases rising, but their increase was nowhere near as large as the increase in deaths. The primary shift is in supply, primarily of new forms of allegedly safer narcotics. These new pain relievers flowed in greater volume to areas with more physical pain and mental health impairment, but since their apparent safety was an illusion, opioid deaths followed. By the end of the 2000s, restrictions on legal opioids led to further supply-side innovations which created the burgeoning illegal market that accounts for the bulk of opioid deaths today. Because opioid use is easier to start than end, America’s opioid epidemic is likely to persist for some time.
Keywords: No keywords provided
JEL Codes: I0; J1
Edges that are evidenced by causal inference methods are in orange, and the rest are in light blue.
| Cause | Effect |
|---|---|
| supply-side innovations in the legal opioid market (D43) | increase in opioid-related deaths (I12) |
| increase in opioid-related deaths (I12) | opioid crisis severity in areas with higher levels of physical pain and mental health impairments (I12) |
| restrictions on legal opioids post-2011 (L65) | shift towards illegal opioids (heroin and fentanyl) (K42) |
| increased legal opioid prescriptions + misleading marketing + shift to illegal substances (K42) | persistent opioid epidemic (I12) |