Did Americans Turn to Opioids Out of Despair—or Just Because They Were There?

Batten's Chris Ruhm shows that the opioid epidemic in the United States more likely has been driven by drug availability than by the despair of people using the drugs. (map courtesy U.S. Centers for Disease Control and Prevention)

(Editor’s note: This excerpt from New York magazine is posted with permission.)

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In a working paper for the National Bureau of Economic Research, Batten’s Christopher Ruhm suggests that economic and social conditions have received undue emphasis in the media’s accounts of the opioid crisis…He concluded that, at most, only ten percent of the increase in opioid drug overdose deaths since 1999 (can be blamed on) poor economic conditions.

Ruhm (collected) county-level data on…“deaths of despair”—drug overdoses, suicides, and alcohol-induced deaths. Ruhm then looked at five measures of economic health in each county: rates of poverty and unemployment, the relative vulnerability of local industries to competition from foreign imports, median household income, and home prices…He found only a weak correlation between economic hardship and the prevalence of such deaths.

Ruhm’s research both clarifies and complicates our understanding of the opioid epidemic’s causes…Economic and social factors may have contributed to the kindling—but the explosion in the supply of opioids was a flamethrower…Supply factors (are) the simplest and most compelling explanations for…exceptional rates of opioid use—how our government regulates these medicines, and how our doctors prescribe them.

…when the company that owned the OxyContin (drug) patent…began marketing it as a safe treatment for chronic pain in the 1990s—and doctors began prescribing the pills en masse—a surge in drug abuse and overdoses was sure to follow, regardless of the strength of America’s economy and social fabric.

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Additional stories about Ruhm’s research:

“Why a better economy won’t stop the opioid epidemic”, Vox.com

“What we’re getting wrong about ‘deaths of despair’”, MarketWatch

”Supply, Not Despair, Caused the Opioid Epidemic”, Bloomberg

”Cheap Drugs, Not Economic Woes, Drive Opioid Overdose Deaths, Paper Argues”, The Wall Street Journal

”Rising Opioid Deaths: Is the Cause Economic Despair Or Skyrocketing Supply?”, Mother Jones

”Study: Don’t blame opioid crisis on the economy”, Axios

”Everyone Knows Rural Americans are Overdosing on ‘Despair,” Right?”, The Daily Yonder

”The US opioid epidemic isn’t about despair—it’s about supply”, Quartz

”Economic Factors Can’t Explain Opioid Addiction, Research Says”, The Fix

”The opioid crisis: A consequence of U.S. economic decline?”, The Washington Center for Equitable Growth

”A Nation of Junkies? Study Eschews Economic Despair Opioid Theory”, PJ Media

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