Abstract

The United States suffered a dramatic and well-documented increase in drug-related deaths from 2000 to 2018, primarily driven by prescription and non-prescription opioids, and concentrated in white and working-class areas. A growing body of research focuses on the causes, both medical and social, of this opioid crisis, but little work as yet on its larger ramifications. Using novel public records of accidental opioid deaths linked to behavioral political outcomes, we present causal analyses showing that opioid overdoses have significant political ramifications. Those close to opioid victims vote at lower rates than those less affected by the crisis, even compared to demographically-similar friends and family of other unexpected deaths. Moreover, among those friends and family affected by opioids, Republicans are 25% more likely to defect from the party than the statewide average Republican, while Democrats are no more likely to defect; Independents are moderately more likely to register as Democrats. These results illustrate an important research design for inferring the effects of tragic events and speak to the broad social and political consequences of what is becoming the largest public health crisis in modern United States history.

Highlights

  • The opioid epidemic is a problem rooted in a social, economic, and political context [5, 6]

  • In contrast to other studies examining the effects of tragedy on political participation, we find that friends and family of opioid overdose victims are less likely to turn out to vote than they were before tragedy struck, even compared to victims of premature cancer or a demographically-matched sample of registrants without familial opioid overdoses

  • To avoid this inferential pitfall we identify a control group of individuals who prematurely died of cancer, and perform coarsened exact matching with Mahalanobis distance [24] to obtain a sample of individuals who died of cancer that look demographically identical to our sample of individuals who died of opioid overdoses

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Summary

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The opioid crisis in the United States
Voter files
Overdose file
Obituary records
Overdose Deaths
Election turnout
Party defection
Discussion
Findings
Author Contributions
Full Text
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