The US opioid epidemic isn’t about despair—it’s about supply
January 25, 2018
In 2017, Princeton economists Anne Case and Angus Deaton released an explosive research paper: “Mortality and morbidity in the 21st century.” Following up on research they published in 2015, the duo found that death rates for middle-aged white Americans without a college degree rose significantly between 1999 and 2015.
Case and Deaton credited the increase to rising deaths from drug overdoses and suicide—what they called “deaths of despair.” The researchers connected the uptick in such deaths to worsening economic conditions for this group, from a decline in income to a lower likelihood of having a job or getting married over this period.
Case and Deaton are highly influential researchers (Deaton won the 2015 Nobel Prize in economics), and their compelling conclusions fit a common story about the economic suffering of America’s white working class. “The news media—left, right, and center—had a pre-existing narrative of middle-aged white malaise, and they slotted the Case and Deaton reports into that narrative,” wrote Columbia University statistician Andrew Gelman on his blog.
Yet there is good reason to believe that Case and Deaton are wrong.
A newly released working paper from the National Bureau of Economic Research, by economist Christopher Ruhm, challenges the claim that these are “deaths of despair.” Rather, Ruhm’s analysis suggests that mortality is rising due to the increased availability of highly addictive opioids, and that economic conditions do little to predict where the epidemic has hit hardest. In other words, the US is facing a drug crisis, not an economic one.