The Opioid Overdose Epidemic and Indirect Contagion in Supply Networks

Abstract

This study develops and tests theory about social contagion processes in supply chains. In contrast to conventional social contagion theory, which is based on exposure through proximity and homophily, we argue that supply chain participants can be exposed indirectly to peers through shared suppliers. We further argue that some suppliers are better positioned to reduce the uncertainty associated with adopting new practice because they have experience on the supply side of the practice. This takes on a social contagion aspect when we theorize that the number of indirect ties to peers who engage in a practice drives both increase behavior and adoption of extreme practice. Using data on the opioid supply chain we find support for our theory while controlling for alternative explanations like contagion from nearby peers and location in susceptible markets. Using generalized linear mixed models we show that ties to experienced suppliers and indirect ties to peers engaged in extreme opioid retailing are associated with increased retailer purchases and achievement of extreme retailer status.