Abstract
America is in undergoing an epidemic of opioid related deaths. Analysts have emphasized two different (but not mutually exclusive) arguments. Supply based explanations emphasize the immoral activity of pharmaceutical companies from 1996 to aggressively market opioids. They typically use prescription rates as a measure of this variable. Demand based explanations emphasize the demand for opioids caused by economic hardship. This paper demonstrates that prescription rates are not entirely exogenous. We show that the decline of average household income from 1979 to 1989 at the county level is a significant predictor of opioid prescription rates in 2010. This is consistent with research that shows that childhood trauma predicts adult drug abuse. The policy implications of this finding are that an adequate response to the opioid epidemic must address economic dislocation and insecurity.
