The popular narrative states that the opioid epidemic—which has claimed so many lives that it’s bringing down U.S. life expectancy—can be traced to economic and social despair; i.e. people without jobs and without options were more likely to problematically use drugs.
However, a new working paper challenges that belief, using analysis to show that economic factors can explain—at most—10% of the increase in drug use and overdose death rates, which have increased in many parts of the country.
The paper, published by economist Christopher Ruhm, challenges previous research that characterizes opioid overdoses as “deaths of despair” caused by economic factors such as high rates of poverty and unemployment.
In the paper Ruhm measured death rates against poverty rates, median household incomes, home prices, unemployment rates, and import exposure, according to Vox. He found that the correlation was much less definitive than the common narrative would indicate.
“You should expect to see higher rates of death in counties that have done worse [economically] than in those that have done better, but also that that should be a causal factor rather than just a correlation,” Ruhm said. However, he found that the link was weak. “The economic conditions can only explain a small amount—less than 10%, probably much less than 10%—of the change [in overdose deaths].”
Ruhm told Vox that the connection between economic factors and overdose deaths was likely even weaker than his paper showed, since there were factors that he could not control for.
“For example, people who are less educated are probably at greater risk as this drug environment gets riskier,” Ruhm said. “And in rural areas, education levels tend to be lower. So some of that correlation—which is relatively weak to start with—is not caused by economic conditions; it’s that the people at risk happen to live in areas that tended to have lower economic growth.”
While the media and public latched onto the narrative of “deaths of despair” caused by economic factors, Ruhm says that we need to look beyond that if we’re going to address the opioid epidemic.
“Efforts to improve economic conditions in distressed locations, while desirable for other reasons, are not likely to yield significant reductions in drug mortality,” Ruhm wrote in the paper.
Ruhm says that socioeconomic factors and ease of access to opioids have all contributed to the opioid epidemic, and therefore all must be addressed to reduce death rates. He also calls for more research on the subject, saying his paper is just the beginning.
“In no way am I claiming that this is the last word on this subject,” he said. “In my view, it’s the first careful analysis.”
