For the past several years the U.S. has been undergoing an opioid epidemic.
Opioids are drugs, whether illegal or prescription, that reduce the intensity of pain signals reaching the brain and affect those brain areas controlling emotion, which diminishes the effects of a painful stimulus. According to the Centers for Disease Control (CDC), in 2013 there were more than 249 million prescriptions for opioid pain medication written by healthcare providers. This is enough for every adult in America to have a bottle of pills.
In 2014, more people died from drug overdoses than in any year on record, and the majority of drug overdose deaths—more than six out of ten—involved an opioid. A study of emergency rooms in the U.S. found that since 1999, the number of overdose deaths involving opioids (including prescription opioid pain relievers and heroin) nearly quadrupled. Altogether nearly half a million people died from drug overdoses in the years from 2000-2014, and 40 more Americans die every day from an opioid overdose.
Last year the Nobel-prize winning economist Angus Deaton and his wife Anne Case wrote an influential paper claiming the problem wasn’t with the opioids but with the social and economic conditions that lead people to take the drugs. They
attributed the rising mortality to “deaths of despair” which they consider a form of suicide that “respond(s) more to prolonged economic conditions than to short-term fluctuations, and especially social dysfunctions … that come with prolonged economic distress.”
But research continues to show that economic distress is not the driving force behind this epidemic.
Earlier this year I noted a study that found it was the “drug environment” rather than the economy that is the key driver in rising drug fatalities. Another, more recent, study by three economists from Princeton University has also found there is no causal connection between opioid use and unemployment.
What the researchers found was that increased use of opioids had a slight (3.8-5.2 percent) increase on employment among women. This is likely a result of pain management allowing some women to remain in or return to the workforce. For men, there was no observable relationship between opioid use and employment.
“Overall, our findings suggest that there is no simple causal relationship between economic conditions and the abuse of opioids,” say the researchers. “Therefore, while improving economic conditions in depressed areas is desirable for many reasons, it is unlikely to curb the opioid epidemic.”
There are two reasons such findings are important (assuming they are acknowledged and taken seriously). The first is they show that doubling down on government intervention in the economy won’t solve the opioid crisis. Too often, this epidemic is used as an excuse to support failed policies in the belief that we “must do something or more people will die.” But if economic factors are not driving the epidemic, then it’s callous and disgusting to use opioid overdoes to promote policies that would have no effect on these “deaths of despair.”
The second is that the opioid epidemic reveals a societal breakdown which cannot simply be attributed to economics. When we believed opioid abuse was something restricted to unemployed coal miners in Appalachia it was easier to dismiss it as a problem of economics and the solution to be more wealth redistribution. The more we recognize that the crisis transcends economic classes, though, the more we have to admit that’s it’s likely driven by a deep-rooted moral decay in society.
Knowing this drug epidemic is not primarily about economics won’t solve the problem. But it’s only by being clear-eyed and honest about what is causing the crisis that we will finally be able to save our addicted neighbors.