Wednesday, March 29, 2017

The opioid epidemic

A great blog piece at Bruegel (click here to see it) gives more data on the opioid crisis.  From the article:

According to the Centers for Disease Control and Prevention, 91 Americans die every day from an opioid overdose. From 2000 to 2015, more than half a million people died from drug overdoses. Overdoses from prescription opioids are a driving force: since 1999, the amount of prescription opioids sold in the U.S. nearly quadrupled, and deaths from prescription opioids – drugs like oxycodone, hydrocodone, and methadone – have more than quadrupled.

This epidemic may have led to Trump's successful presidential bid.  A Penn State researcher found that:

Trump over-performed the most in counties with the highest drug, alcohol and suicide mortality rates, and that much of this relationship is accounted for by economic distress and the proportion of working-class residents.

So where did the crisis come from? A piece in The Conversation (go here to read it) cites three major causes:
  1. Theodore Cicero and Matthew Ellis of Washington University in St. Louis write that the roots of the epidemic can be traced back to changes in pain management. When pain began to be treated as the “fifth vital sign,” prescriptions to treat it soared.
  2. Richard Gunderman of the University of Indiana argues we should not let pharmaceutical companies, particularly Purdue Pharma, off the hook. The company aggressively marketed OxyContin, Gunderman says, knowing that it could be easily abused. Prescriptions for the powerful – and highly addictive – drug for non-cancer pain soared from 670,000 in 1997 to 6.2 million by 2002.
  3. Jeannie DiClementi, of Indiana University-Purdue University Fort Wayne explains how the abuse of prescription pain drugs spread to abuse of heroin. It wasn’t a big leap, as the chemical structures are similar. 

     I see lots of market failures here.  What do you see?


  1. I think I see failure of the FDA and their role in regulating drugs. How could these drugs hit the market and people not be aware of its effect. I also think doctors should take blame for prescribing these drugs to their patients. This is a failure at every level of healthcare delivery/administration (insurance companies, pharmaceutical firms, hospitals, doctors).

  2. If by "market failure" you mean being blind to externalities, I agree. Some context is that I am a large fan of sin taxes and the legalization and regulation of certain vice industries to move them from black markets to legitimate markets. The regulation part of "legalize and regulate" is the failure here; opioid abuse is the negative externality that was ignored in favor of self-interest to the pharaceutical companies and physicians who benefit from the sale of opioid pain killers.

    And I am implying that the addictive effects of Oxy and other opioids was well known, but ignored. It was negligence, not ignorance, that created this problem. The social cost of opioids was neglected, and it ended up costing us far more than we prediction. A pretty good cautionary tale I'd say.