ABSTRACT
We use a difference-in-differences design to study the effect of opioid use on traffic fatalities. Following Alpert et al., we focus on the 1996 introduction and marketing of OxyContin, and we examine its long-term impacts on traffic fatalities involving Schedule II drugs or heroin. Based on the national fatal vehicle crash database, we find that the states heavily targeted by the initial marketing of OxyContin (i.e., non-triplicate states) experienced 2.4 times more traffic fatalities (1.6 additional deaths per million individuals) involving Schedule II drugs or heroin during 2011-2019, when overdose deaths from heroin and fentanyl became more prominent. We find no difference in traffic fatalities until after the mid-2000s between states with and without a triplicate prescription program. The effect is mainly concentrated in fatal crashes with drug involvement of drivers ages between 25 and 44. Our results highlight additional long-term detrimental consequences of the introduction and marketing of OxyContin.
Subject(s)
Accidents, Traffic , Opioid-Related Disorders , Humans , Accidents, Traffic/mortality , Adult , Male , Opioid-Related Disorders/mortality , Female , United States/epidemiology , Analgesics, Opioid , Middle Aged , Oxycodone , Drug Overdose/mortality , Fentanyl/poisoning , Heroin/poisoningABSTRACT
Recent papers have documented positive externalities of Medicaid expansions on several non-health related variables, such as crime, financial stress, child support, and child abuse. In this paper, we investigate the relationship between access to public health insurance and foster care admissions following state decisions to expand Medicaid coverage after the Affordable Care Act. Over 70% of all foster care admissions are related to child abuse incidents, which have been found to decrease following the Medicaid expansions. Our results suggest that the Medicaid expansions are associated with a large decrease in foster care admissions, driven by neglect incidents.
Subject(s)
Medicaid , Patient Protection and Affordable Care Act , Child , Health Services Accessibility , Hospitalization , Humans , Insurance Coverage , Insurance, Health , United StatesABSTRACT
We investigate the implementation of Medicare Part D and estimate that this prescription drug benefit program reduced elderly mortality by 2.2% annually. This was driven primarily by a reduction in cardiovascular mortality, the leading cause of death for the elderly. There was no effect on deaths due to cancer, a condition whose drug treatments are covered under Medicare Part B. We validate these results by demonstrating that the changes in drug utilization following the implementation of Medicare Part D match the mortality patterns we observe. We calculate that the value of the mortality reduction is equal to $5 billion per year.