March 14, 2018

Batten's Doleac to CNN: Opioid Overdose Antidote Policies "May be Making Things Worse"

(Editor’s note: This story appears in full here. This excerpt is posted with permission from CNN.)

Dangerous opioid use gains appeal with access to lifesaving drug, researchers speculate. But in some states, increased access was associated with fewer opioid deaths.

——

“The main takeaway is that broadening access to naloxone leads to an increase in opioid abuse”: Jennifer Doleac.​

Naloxone, a drug that rapidly reverses opioid overdose, has become more widely available as the United States struggles with an epidemic of drug abuse.

“While naloxone can be a good harm-reduction strategy, it’s clear that naloxone access alone is not a solution to the opioid epidemic,” said Batten’s Jennifer Doleac, one of the study’s authors and an Assistant Professor of Public Policy and Economics. “As currently implemented, these policies may be making things worse.”

But state laws that provide wider access to naloxone, sold under brand names including Narcan, may unintentionally increase opioid abuse, according to a new study published in SSRN, a collaborative research network, by Doleac and a co-author.

“ ‘Moral hazard’ is an economic term meaning that people will do more of something when it becomes less risky,” Doleac said. She gave the classic example of automobile seat belts, which may encourage more reckless driving, according to some studies.

For the new study, a working paper, Doleac and co-author Anita Mukherjee, an Assistant Professor at the Wisconsin School of Business at the University of Wisconsin-Madison, examined the effects of broadened access to the lifesaving drug across the United States.

“We were interested in to what extent making opioid abuse less risky leads to more opioid abuse,” Doleac said.

She and Mukherjee estimated the effects of naloxone access laws across the 50 states and made comparisons across regions.

“Even though the risk of death per opioid use has fallen, the number of uses increases enough that the same number of people are dying,” Doleac said. Overall, broader access to the drug also has no net effect on mortality rates, she noted, though in some regions, increased deaths occurred.

As access to a lifesaving drug reduces the risk of overdose death, more dangerous drug use—including higher doses—becomes more appealing, the researchers speculated. Such increased abuse may even lead to higher death rates. 

Originally used only by doctors and first responders, naloxone can quickly restore normal respiration to a person whose breathing has slowed or stopped due to an overdose of heroin or prescription painkillers, according to the National Institute on Drug Abuse. In recent years, some states have expanded naloxone access—by permitting purchase without a prescription, for example – as a response to the epidemic of opioid abuse.

For the new study, a working paper, Doleac and co-author Anita Mukherjee, an Assistant Professor at the Wisconsin School of Business at the University of Wisconsin-Madison, examined the effects of broadened access to the lifesaving drug across the United States.