Ryan Kasuba and Cloud Deng

Abstract:

Over the past two decades, the United States has experienced dramatic growth in deaths due to opioid misuse. Many explanations for this increase have been posited on both the supply side (prescriber behavior, the introduction of synthetic fentanyl, etc.) and the demand side (economic and social exclusion, working conditions, inadequate access to care, etc.). The impact of acute, exogenous shocks, economic or otherwise, has seen little study. Previous research has hypothesized a positive impact of natural disasters on opioid misuse, largely stemming from disruptions in opioid treatment programs but also due to injury and economic/social disruption. However, no study has estimated the size and existence of such an effect. Using a panel data set covering all US counties from 2010 to 2017, we conduct the first estimate of the role of a natural disaster – an acute exogenous shock – on deaths from drug overdose. Our study finds that, contrary to theoretical predictions, overdose deaths do not increase following a natural disaster. We then investigate the conditioning role of social capital. Our findings contribute to the study of exogenous events on opioid misuse, and suggest that policy efforts should be focused on persistent social factors, including social capital.