Rising Opioid Deaths: Is the Cause Economic Despair Or Skyrocketing Supply?

How much has the opioid epidemic been a response to poor economic conditions? Eric Levitz points us today to a new paper from Christopher Ruhm of the University of Virginia. He examined changes in economic conditions at the county level to see how much this explained the change in death rates from opioids. In order not to keep you in suspense, the answer is “not much”:

Economic conditions explained only 8 percent of the change in overdose deaths from all drugs and 7 percent of the change in deaths from opioid painkillers—and even that small effect probably goes away if you control for additional unobservable factors. It explained none of the change in deaths from heroin, fentanyl, and other illegal opioids. Ruhm comments:

These results suggest that the “deaths of despair” framing, while provocative, probably do not explain the main sources of the fatal drug epidemic and imply that efforts to improve economic conditions in distressed locations, while desirable for other reasons, are unlikely to yield significant reductions in drug mortality. Such results probably should not be surprising since drug fatalities increased substantially – including a rapid acceleration of illicit opioid deaths – after the end of the Great Recession (i.e. subsequent to 2009), when economic performance considerably improved.

Ruhm concludes that the real reason for the rise in deaths from opioids is simple: it’s because they were there. We’ve long known that illicit drugs are faddish—heroin in the 70s, cocaine in the 80s, marijuana in the 90s—and the fads depend a lot on which drugs are in wide supply. In this case, when the supply of OxyContin skyrocketed, so did overdose deaths from OxyContin. Ditto for fentanyl, the current scourge. Wait a decade and it will be something else.

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WHO DOESN’T LOVE A POSITIVE STORY—OR TWO?

“Great journalism really does make a difference in this world: it can even save kids.”

That’s what a civil rights lawyer wrote to Julia Lurie, the day after her major investigation into a psychiatric hospital chain that uses foster children as “cash cows” published, letting her know he was using her findings that same day in a hearing to keep a child out of one of the facilities we investigated.

That’s awesome. As is the fact that Julia, who spent a full year reporting this challenging story, promptly heard from a Senate committee that will use her work in their own investigation of Universal Health Services. There’s no doubt her revelations will continue to have a big impact in the months and years to come.

Like another story about Mother Jones’ real-world impact.

This one, a multiyear investigation, published in 2021, exposed conditions in sugar work camps in the Dominican Republic owned by Central Romana—the conglomerate behind brands like C&H and Domino, whose product ends up in our Hershey bars and other sweets. A year ago, the Biden administration banned sugar imports from Central Romana. And just recently, we learned of a previously undisclosed investigation from the Department of Homeland Security, looking into working conditions at Central Romana. How big of a deal is this?

“This could be the first time a corporation would be held criminally liable for forced labor in their own supply chains,” according to a retired special agent we talked to.

Wow.

And it is only because Mother Jones is funded primarily by donations from readers that we can mount ambitious, yearlong—or more—investigations like these two stories that are making waves.

About that: It’s unfathomably hard in the news business right now, and we came up about $28,000 short during our recent fall fundraising campaign. We simply have to make that up soon to avoid falling further behind than can be made up for, or needing to somehow trim $1 million from our budget, like happened last year.

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