Thread by @NicoleOzm

A Manufactured Tragedy: The Origins and Deep Ripples of the Opioid Epidemic, presented by @caroartc at @WiEMecon

Overdose deaths involving opioids have increased dramatically in the US, and more the 300,000 have died due to this since 1999.

How did we get here? This question is difficult to answer because there are both demand- and supply-side factors

This paper proposes an instrumental variable based on Purdue Pharama (the company that produced OxyContin)’s marketing strategy which initially targeted the cancer pain market (and even worse, then doubled down to promote even more sales among the highest prescribers)

The main identification strategy is IV, where cancer rates in the pre-OxyContin time period instrument for the difference in prescription opioids (from the pre-Oxy to post-Oxy periods), which then impact the differences in outcomes of interest.

There’s a first stage, folks! Commuting zones with the highest cancer rates during the time of OxyContin’s launch received 1.96 more doses of opioids per capita.

The other identification assumption is in parallel trends in cancer rates. There’s evidence of parallel pre-trends, so we’re okay here! (See the paper for a full discussion of the identification strategy and assumptions)

The results are in: moving from a low-cancer area to a high-cancer area (in which marketing Oxy was prioritized by Purdue) leads to an increase in opioid mortality and SNAP claims, and worse infant health.

There’s a lot more to learn in the paper. Check it out here! cowles.yale.edu/3a/opioidsarte…