TY - JOUR
T1 - What Is Driving the Drug Overdose Epidemic in the United States?
AU - Thombs, Ryan P.
AU - Thombs, Dennis L.
AU - Jorgenson, Andrew K.
AU - Harris Braswell, Taylor
PY - 2020
Y1 - 2020
N2 - The demand-side perspective argues that the drug overdose epidemic is a consequence of changes in the economy that leave behind working-class people who lack a college education. In contrast, the supply-side perspective maintains that the epidemic is primarily due to changes in the licit and illicit drug environment, whereas a third, distinct perspective argues that income inequality is likely a key driver of the epidemic. To evaluate these competing perspectives, we use a two-level random intercept model and U.S. state-level data from 2006 to 2017. Contrary to the demand-side approach, we find that educational attainment is not associated with drug-related mortality. In support of the supply-side approach, we provide evidence indicating that opioid prescription rates are positively associated with drug-related mortality. We also find that income inequality is a key driver of the epidemic, particularly the lack of resources going to the bottom 20% of earners. We conclude by arguing that considerations of income inequality are an important way to link the arguments made by the demand-side and the supply-side perspectives.
AB - The demand-side perspective argues that the drug overdose epidemic is a consequence of changes in the economy that leave behind working-class people who lack a college education. In contrast, the supply-side perspective maintains that the epidemic is primarily due to changes in the licit and illicit drug environment, whereas a third, distinct perspective argues that income inequality is likely a key driver of the epidemic. To evaluate these competing perspectives, we use a two-level random intercept model and U.S. state-level data from 2006 to 2017. Contrary to the demand-side approach, we find that educational attainment is not associated with drug-related mortality. In support of the supply-side approach, we provide evidence indicating that opioid prescription rates are positively associated with drug-related mortality. We also find that income inequality is a key driver of the epidemic, particularly the lack of resources going to the bottom 20% of earners. We conclude by arguing that considerations of income inequality are an important way to link the arguments made by the demand-side and the supply-side perspectives.
KW - deaths of despair
KW - drug overdose epidemic
KW - income inequality
KW - mortality
KW - population health
UR - http://www.scopus.com/inward/record.url?scp=85088120175&partnerID=8YFLogxK
U2 - 10.1177/0022146520939514
DO - 10.1177/0022146520939514
M3 - Article
C2 - 32674692
AN - SCOPUS:85088120175
JO - Journal of Health and Social Behavior
JF - Journal of Health and Social Behavior
SN - 0022-1465
ER -