Drug Environment and Economic Changes in the Epidemic


This paper (Opioids_EconomyModels) presents findings about how county-level economic conditions and drug environment changes affect the increase of drug morality rates. Check out the link for the full paper and to gain a better understanding of what a “drug environment” is and how economic conditions change over time.

Author: Christopher J. Ruhm at the University of Virginia

Ruhm, C. J. (2019). Drivers of the fatal drug epidemic. Journal of Health Economics, 64, 25-42. https://doi.org/10.1016/j.jhealeco.2019.01.001 


Drug overdose deaths continue to plague our country and now exceed motor vehicle fatalities. It is important to uncover potential reasons for this epidemic and how we can work to address this problem. Economics, geographic location and drug components may all have an impact on drug mortality. This article investigates whether the main cause for the drug mortality increase is from demand-side (county-level economics) or supply-side (drug environment changes) factors. Several key findings and future directions are provided as a product of this research.


Key findings:

  • In counties with a decreasing economy, drug mortality rates were higher than more affluent counties.
    • Some county level correlations seemed highly unlikely until it was determined that applied county level characteristics caused the proposed economic impact to decrease.
  • The results of this study, give initial support to the hypothesis that drug environmental changes affect drug related deaths. Specifically, when observing groups such as sex and age, there was a significant increase in deaths


Future directions:

  • The data shows that fatal overdoses may be influenced by economic or changes in drug composition, however additional work should focus on identifying omitted variables that may have lead to these results.
  • The findings of this research may support current progress made to address the potential risks of opioid use. Areas of progress include but are not limited to: development of abuse-deterrent drug formulations, mandatory prescription drug monitoring programs, consumer and prescriber drug education.

Want to read more about Christopher’s work? This PubMed link shows additional publications.