Working Paper: NBER ID: w30926
Authors: John Cawley; Davide Dragone
Abstract: Some harm reduction strategies encourage individuals to switch from a harmful addictive good to a less harmful addictive good; examples include e-cigarettes (substitutes for combustible cigarettes) and methadone and buprenorphine (substitutes for opioids). These have proven to be controversial. Advocates argue that people struggling with addiction benefit because they can switch to a less harmful substance, but opponents argue that this could encourage abstainers to begin using the harm-reduction method or even, eventually, the original addictive good. This paper builds on theories of addiction to model the introduction of a harm reduction method, and demonstrates the conditions under which each side is correct.
Keywords: Harm Reduction; Addiction; Health Policy; Substitution Effects
JEL Codes: D11; I12; I18
Edges that are evidenced by causal inference methods are in orange, and the rest are in light blue.
| Cause | Effect |
|---|---|
| The introduction of a harm reduction method (Y20) | increased health harms (I12) |
| The introduction of a harm reduction method (Y20) | decreased health harms (I12) |
| The introduction of a harm reduction method (Y20) | previous users quitting the original addictive good (I12) |
| The introduction of a harm reduction method (Y20) | abstainers starting to use the harm reduction method (C24) |
| The introduction of a harm reduction method (Y20) | abstainers reverting to the original addictive good (I12) |
| enjoyableness and addictiveness of the harm reduction method (C90) | decreased health harms (I12) |
| enjoyableness and addictiveness of the harm reduction method (C90) | increased health harms (I12) |
| previous users of an original addictive good (D16) | switch to a harm reduction method (C24) |
| abstainers (Y70) | encouraged to use the harm reduction method (C90) |
| abstainers (Y70) | resurgence in the use of the original addictive good (I12) |