Findings

What the people want

Kevin Lewis

October 29, 2019

The War on Drugs 2.0: Darknet Fentanyl's Rise and the Effects of Regulatory and Law Enforcement Action
Jacob Miller
Contemporary Economic Policy, forthcoming

Abstract:
U.S. overdose deaths attributed to synthetic opioids, such as fentanyl, have increased from under 3,000 in 2013 to nearly 20,000 in 2016, making up half of all opioid‐related overdose deaths. Using web scrapes of darknet markets from 2014 to 2016, I provide historical prices for fentanyl and its most popular analogues and find that fentanyl vendors priced fentanyl in 2014 at a 90% discount compared to an equivalent dose of heroin. Using regression discontinuity, I evaluate the effects of two major law enforcement and regulatory events. I find minimal lasting effects of U.S. legal actions intended to disrupt darknet markets, but there are statistically significant indications of a price increase corresponding with regulatory action in China. Despite these indications of some regulatory success, fentanyl prices remained approximately 90% cheaper than heroin.


Substitution of marijuana for opioids in a national survey of US adults
Julie Ishida et al.
PLoS ONE, October 2019

Abstract:
Opioid prescriptions for chronic pain and subsequent opioid-related complications have risen dramatically in the US. Recent data suggest that medical marijuana laws have been associated with lower state-level opioid overdose mortality. In a national survey, we examined the prevalence of substitution of marijuana for opioids among US adults taking opioids for pain. Using GfK’s KnowledgePanel, we conducted an Internet-based survey of a nationally representative sample of 16,280 adults in 2017 about individual perceptions and use of marijuana. We developed questions designed to assess the extent and reasons for substitution of marijuana for opioids. We examined opioid substitution among respondents with a history of ever using marijuana who used opioids in the past 12 months. There were 9,003 respondents, corresponding to a 55.3% response rate. The mean age was 48 years. Among the 5% (n = 486) who reported ever using marijuana and using opioids in the past year, 43% used opioids daily, and 23% reported current (past 30 day) marijuana use. Forty-one percent reported a decrease or cessation of opioid use due to marijuana use; 46% reported no change in opioid use; and 8% reported an increase in opioid use. We found that a substantial number of US adults reported that they substituted marijuana for opioids.


Did the War on Terror Ignite an Opioid Epidemic?
Resul Cesur, Joseph Sabia & David Bradford
NBER Working Paper, September 2019

Abstract:
Grim national statistics about the U.S. opioid crisis are increasingly well known to the American public. Far less well known is that U.S. war veterans are at ground zero of the epidemic, facing an overdose rate twice that of civilians. Post-9/11 deployments to Afghanistan and Iraq have exposed servicemembers to injury-related chronic pain, psychological trauma, and cheap opium supplies, each of which may fuel opioid addiction. This study is the first to estimate the causal impact of combat deployments in the Global War on Terrorism on opioid abuse. We exploit a natural experiment in overseas deployment assignments and find that combat service substantially increased the risk of prescription painkiller abuse and illicit heroin use among active duty servicemen. War-related physical injuries, death-related battlefield trauma, and Post-Traumatic Stress Disorder emerge as primary mechanisms. The magnitudes of our estimates imply lower-bound combat exposure-induced health care costs of $1.04 billion per year for prescription painkiller abuse and $470 million per year for heroin use.


Operational Sex Ratio Predicts Binge Drinking Across U.S. Counties
Toe Aung et al.
Evolutionary Psychology, September 2019

Abstract:
Previous research suggests that binge drinking among young men serves as a “costly signal” to potential mates, such that the binge drinker is capable of bearing the harmful consequences of alcohol consumption. Here, we propose that binge drinking among young adults is conditionally dependent upon the signaler’s willingness to take risks, which is influenced by the local operational sex ratio (OSR). Using archived binge drinking estimates from 2009 to 2012 and Census Bureau records of OSRs, we tested the relationship between OSR and binge drinking rates at the county level across 3,143 U.S. counties against hypotheses drawn from evolutionary theory. Results from our mixed-effects models revealed that a higher overall OSR (i.e., more eligible men compared to women) was associated with higher male binge drinking rates but lower female binge drinking rates. A higher OSR particularly in the 20-29 and 50+ age groups predicted higher male binge drinking rates but lower female binge drinking rates. Our findings generally support predictions derived from evolutionary theory and suggest that binge drinking may function as a costly sexual signal, conditionally regulated by age and the local sex ratio.


Effects of a brief cognitive reappraisal intervention on reductions in alcohol consumption and related problems
Lindsey Rodriguez et al.
Psychology of Addictive Behaviors, forthcoming

Abstract:
Research has shown links between interpersonal conflict and problematic drinking behaviors as a way to cope. The present research examined the effects of a brief interpersonal conflict cognitive reappraisal intervention on short-term reductions in alcohol-related problems in a sample of college student drinkers. Undergraduates who were regular drinkers (N = 190) participated in a randomized control online study, completing self-reported measures of alcohol consumption and alcohol-related problems at baseline and 2 weeks later. After completing the baseline survey, participants completed a brief writing intervention during which they were asked to reflect on a recent interpersonal conflict and write about it from 1 of 3 possible perspectives, 2 of which were targeting cognitive reappraisal (i.e., a neutral, third-party perspective and the other party’s perspective), their own perspective, or to reflect on their activities that day (control). Results from negative binomial regression models supported both reappraisal conditions: Compared with control, those who thought about the conflict from a neutral third-party perspective and those who thought about the conflict from the other party’s perspective reported significantly fewer drinking problems at follow-up. Results from this study suggest preliminary efficacy of a single-session writing intervention aimed at reappraising interpersonal conflict.


Dynamic Social Interactions and Health Risk Behavior
Tiziano Arduini et al.
NBER Working Paper, September 2019

Abstract:
We study risky behavior of adolescents. Concentrating on smoking and alcohol use, we structurally estimate a dynamic social interaction model in the context of students' school networks included in the National Longitudinal Study of Adolescent Health (Add Health). The model allows for forward-looking behavior of agents, addiction effects, and social interactions in the form of preferences for conformity in the social network. We find strong evidence for forward looking dynamics and addiction effects. We also find that social interactions in the estimated dynamic model are quantitatively large. A misspecified static model would fit data substantially worse, while producing a much smaller estimate of the social interaction effect. With the estimated dynamic model, a temporary shock to students' preferences in the 10th grade has effects on their behavior in grades 10, 11, 12, with estimated social multipliers 1:53, 1:03, and 0:76, respectively. The multiplier effect of a permanent shock is much larger, up to 3:7 in grade 12. Moreover (semi-) elasticities of a permanent change in the availability of alcohol or cigarettes at home on child risky behavior implied by the dynamic equilibrium are 25%, 63%, and 79%, in grades 10, 11, 12, respectively.


Opioid Crisis Effects On Municipal Finance
Kimberly Rodgers Cornaggia et al.
Pennsylvania State University Working Paper, September 2019

Abstract:
This paper provides county-level evidence on the impact of opioid abuse on U.S. municipalities' tax revenues, law enforcement costs, credit risk, and access to finance. Complementing prior research on various costs of the crisis mostly at state- and national levels, we offer a first close look at the effects of the crisis at a much more granular level of government to quantify more accurately capital market impacts relevant to municipalities that need financing for schools, utilities, roads, and other infrastructure projects. Our analysis is based on a comprehensive database compiled from various sources, some of which have not been heretofore explored in the literature. Employing a battery of empirical approaches (panel fixed effect regressions, instrumental variable regressions, and difference-in-differences analysis), we find evidence of a significant causal increase in municipal borrowing costs and a reduction in credit ratings. However, the economic magnitude of these effects is surprisingly small given evidence of substantially reduced tax revenue and increased law enforcement costs. Our results indicate either that the economic impact of the opioid crisis on local government finance is not yet a significant credit risk factor, or that credit rating agencies and municipal bond investors overlook a significant credit risk factor.


The Composition and Magnitude of Alcohol Taxes in States: Do They Cover Alcohol-Related Costs?
Jason Blanchette, Frank Chaloupka & Timothy Naimi
Journal of Studies on Alcohol and Drugs, July 2019, Pages 408-414

Method: The amount of tax (in dollars per standard drink) by state was estimated from data on state ad valorem excise, specific excise, and sales taxes in 2010 obtained from the Alcohol Policy Information System and Tax Foundation. These taxes were summed, and specific excise taxes were assessed as a proportion of total state taxes. Tax data on beer were analyzed for all 50 states. Tax data for wine and distilled spirits were restricted to the 32 license states and Washington, D.C., with fully privatized distribution systems. Total alcohol taxes for the 32 license states were compared on a per-drink basis with published state estimates of the cost of excessive drinking in these states in 2010.

Results: Specific excise taxes accounted for a weighted median of 20.1% of total state alcohol tax revenue in the 32 license states and Washington, D.C. The median total alcohol tax per drink (based on all federal and state taxes) was $0.21, which accounted for 26.7% of the median cost to government and 10.3% of the median total economic cost of excessive drinking.


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