An age-old problem lies at the center of the opioid crisis. Is it driven by people seeking escape or relief — by a demand for drugs? Or instead, are poor prescribing practices and a cheap heroin supply responsible?
Of course, the answer is a mix of both. But to chip away at that puzzle, a team of researchers including Stanford economist Matthew Gentzkow, PhD, and MIT's Amy Finkelstein, PhD, and Heidi Williams, PhD, a visiting professor at Stanford, has examined the role of migration in the use of opioids.
The thought was they could control for personal factors (i.e. mental health, education level, family support) by following individuals as they moved. And they found that indeed, community-level factors, such as the local availability of prescription opioids, are important and individuals are more likely to abuse opioids if they move to a county where the opioid abuse rate is higher than at their previous home.
Both supply and demand are clearly important, Gentzkow explained in the piece. "Our results suggest that supply-side would account for about 30 percent of what's different and the individual circumstances would account for about 70 percent," Gentzkow says in a recent Stanford Institute for Economic Policy Research article.
The article explains:
Their migration analysis is based on the data of a random sample of 1.5 million recipients of the Supplemental Security Disability Insurance enrolled in Medicare Part D, the federal prescription drug benefit program, from 2006 to 2014...
A main finding cited in the study: When individuals move to a county where the rate of opioid abuse is 20 percent higher than from where they moved, a migrant’s rate of abuse increases by 6 percent.
The extent of that jump suggests that 30 percent of the difference in abuse can be tied to place, according to their calculations.
The research suggests that policies to control the supply of opioids are a key part of an overall strategy to rein in the epidemic.
“The magnitude of the opioid crisis is simply staggering, and trying to make progress on understanding the underlying causes of the crisis is — or should be — on the ‘wish list’ of many researchers,” Williams says in the article.
Photo by John-Mark Smith