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March 7, 2017

Study finds link between unemployment, increased opioid overdose rates

Daily Briefing

New research finds a correlation between increases in opioid overdoses and unemployment.

Study details

For the study, researchers from Indiana University and the University of Virginia examined county-level mortality data spanning the entire country from 1999 to 2014, as well as state- and county-level emergency department (ED) data spanning from 2002 to 2014 i

  • Arizona;
  • Florida;
  • Kentucky;
  • Maryland; and
  • New Jersey.

The researchers examined the relationship between an area's unemployment rate and the rate of deaths related to opioid overdoses.


The researchers found that a one percentage-point increase in the unemployment rate was linked with an approximate 3.6 percent increase in the rate of fatal overdoses related to opioids, as well as a 7 percent increase in ED visits related to opioid overdoses.

"Overall, we obtain strong evidence that opioid-related deaths and [ED] visits increase during times of economic weakness, although the results vary somewhat with the unit of observation (county vs. state) and the exact specifications estimated," the researchers wrote.


The researchers said the findings were surprising, in part because U.S. residents' use of alcohol displays a very different trend. According to Christopher Ruhm, one of the study's co-authors, U.S. residents tend to purchase less alcohol during economic slumps.

Further, they noted that that lower-income individuals might be expected to reduce their purchases of opioids or illicit drugs during periods of unemployment and—without full-time employment to occupy their days—devote more time to healthy behaviors such as exercise. But "neither of these appear to be a dominant factor for opioids or other drugs that lead to [ED] visits or deaths," they wrote.

Previous studies have seen similar trends. For instance, a study conducted by researchers from the Federal Reserve Board and Yale University found that suicide and drug overdose rates spiked in areas where increase trade with China in the early 2000s caused unemployment rates to increase.

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Therefore, the researchers suggest the "dominant factor linking macroeconomic conditions to health outcomes … may be that fatal and near-fatal abuse of opioids often (and increasingly, over time) reflect[s] a physical manifestation of mental health problems that have long been known to increase in periods of economic decline." According to U.S. News & World Report, this means the uptick in opioid misuse during periods of high unemployment could linked to a mental health condition rather than a physical one.

Ruhm said, "We've known for a while now that ... mental health often gets worse" in tough economic times, adding, "We have lots of reason to believe that people may be turning to opioids as a reflection of their bad mental health."

The researchers say further research into the connections between physical, mental, and economic well-being is needed. Such research could help guide future actions by providers and policymakers, the Washington Post's "Wonklog" reports (Guo, "Wonkblog," Washington Post, 3/3; Soergel, U.S. News & World Report, 2/27; Hollingsworth et al., National Bureau of Economic Research, February 2017).

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