scholarly journals The Economic Underpinnings of the Drug Epidemic

2019 ◽  
Author(s):  
Nathan Seltzer
Keyword(s):  
Labor Market ◽  
Labor Markets ◽  
Drug Overdose ◽  
Manufacturing Sector ◽  
State Level ◽  
Opioid Overdose ◽  
Transformative Change ◽  
Drug Deaths ◽  
Overdose Deaths ◽  
The U.S

U.S. labor markets have experienced transformative change over the past half century. Spurred on by global economic change, robotization, and the decline of labor unions, state labor markets have shifted away from an occupational regime dominated by the production of goods to one characterized by the provision of services. Prior studies have proposed that deterioration of employment opportunities may be associated with the rise of substance use disorders and drug overdose deaths, yet no clear link between changes in labor market dynamics in the U.S. manufacturing sector and drug overdose deaths has been established. Using restricted-use vital registration records between 1999-2017 that comprise over 700,000 drug deaths, I test two questions. First, what is the association between manufacturing decline and drug and opioid overdose mortality rates? Second, how much of the increase in these drug-related outcomes can be accounted for by manufacturing decline? The findings provide strong evidence that restructuring of the U.S. labor market has played an important upstream role in the current drug crisis. Up to 77,000 overdose deaths for men and up to 40,000 overdose deaths for women are attributable to the decline of state-level manufacturing over this nearly two-decade period. These results persist in models that adjust for other social, economic, and policy trends changing at the same time, including the supply of prescription opioids. Critically, the findings signal the value of policy interventions that aim to reduce persistent economic precarity experienced by individuals and communities, especially the economic strain placed upon the middle class.

Economic Conditions and Drug and Opioid Overdose Deaths

2017 ◽  
Vol 76 (4) ◽  
pp. 462-477 ◽  
Author(s):  
Ezequiel Brown ◽  
George L. Wehby
Keyword(s):  
Drug Overdose ◽  
Fixed Effects ◽  
House Prices ◽  
Insurance Coverage ◽  
House Price ◽  
State Level ◽  
Economic Conditions ◽  
Prescription Opioid ◽  
Opioid Overdose ◽  
Overdose Deaths

We examine the effects of state-level economic conditions including unemployment rates, median house price, median household income, insurance coverage, and annual and weekly work time on deaths on drug overdose deaths including from opioids and prescription opioids between 1999 and 2014. We employ difference-in-differences estimation controlling for state and year fixed effects, state-specific time trends, and demographic characteristics. Drug overdose deaths significantly declined with higher house prices, an effect driven by reduction in prescription-opioid mortality, by nearly 0.17 deaths per 100,000 (~4%) with a $10,000 increase in median house price. House price effects were more pronounced and only significant among males, non-Hispanic Whites, and individuals younger 45 years. Other economic indicators had insignificant effects. Our findings suggest that economic downturns that substantially reduce house prices such as the Great Recession can increase opioid-related deaths, suggesting that efforts to control access to such drugs should especially intensify during these periods.

Drug overdose deaths at work, 2011–2016

2019 ◽  
Vol 25 (6) ◽  
pp. 577-580 ◽  
Author(s):  
Hope M Tiesman ◽  
Srinivas Konda ◽  
Lauren Cimineri ◽  
Dawn N Castillo
Keyword(s):  
Drug Overdose ◽  
Negative Binomial ◽  
Occupational Injuries ◽  
Negative Binomial Regression ◽  
Opioid Overdose ◽  
Full Time ◽  
Demographic Groups ◽  
Drug Overdoses ◽  
The Impact ◽  
Overdose Deaths

Drug overdose fatalities have risen sharply and the impact on US workplaces has not been described. This paper describes US workplace overdose deaths between 2011 and 2016. Drug overdose deaths were identified from the Census of Fatal Occupational Injuries and fatality rates calculated using denominators from the Current Population Survey. Fatality rates were compared among demographic groups and industries. Negative binomial regression was used to analyse trends. Between 2011 and 2016, 760 workplace drug overdoses occurred for a fatality rate of 0.9 per 1 000 000 full-time equivalents (FTEs). Workplace overdose fatality rates significantly increased 24% annually. Workplace overdose fatality rates were highest in transportation and mining industries (3.0 and 2.6 per 1 000 000 FTEs, respectively). One-third of workplace overdose fatalities occurred in workplaces with fewer than 10 employees. Heroin was the single most frequent drug documented in workplace overdose deaths (17%). Workplace overdose deaths were low, but increased considerably over the six-year period. Workplaces are impacted by the national opioid overdose epidemic.

scholarly journals Higher-Education Policies and the College Wage Premium: Cross-State Evidence from the 1990s

2006 ◽  
Vol 96 (4) ◽  
pp. 959-987 ◽  
Author(s):  
Nicole M Fortin
Keyword(s):  
Higher Education ◽  
Labor Market ◽  
Labor Markets ◽  
Wage Premium ◽  
Education Policies ◽  
Supply Effect ◽  
Higher Education Policies ◽  
National Market ◽  
Enrollment Rates ◽  
The U.S

Exploiting differences across U.S. states, this paper demonstrates that there is a tight link between higher education policies, past enrollment rates, and recent changes in the college wage premium among labor market entrants. The analysis reveals, however, that this relationship is much weaker in states with high private enrollment rates, high levels of interstate mobility, or interstate trade. The within-state estimates of the own-cohort relative supply effect shed some light on the extent to which the U.S. labor market can be characterized as a single national market or a collection of state-specific labor markets.

Die Ursachen der transatlantischen Produktivitätswachstumsunterschiede

2006 ◽  
Vol 55 (1) ◽  
Author(s):  
Rudolf Besch ◽  
Guido Zimmermann
Keyword(s):  
Labor Market ◽  
Labor Markets ◽  
Productivity Growth ◽  
Service Sector ◽  
Market Reforms ◽  
Lower Productivity ◽  
Long Run ◽  
Labor Market Reforms ◽  
Increase Productivity ◽  
The U.S

AbstractThis paper gives a survey on the causes of the divergence in productivity growth rates between the U.S. and Europe in the last 15 years. It is shown that Europe’s lag in productivity growth can be traced to relative lower productivity growth in the service sector. This is due to over-regulated goods, capital, land, and labor markets. Although there is a consensus that in the long run no relationship exists between productivity growth and labor market performance, in terms of policy, well-specified labor market reforms are recommended to increase productivity growth in Europe. For labor market reforms are a necessary complement for productivity-enhancing product market reforms.

De-Territorializing Labor Law

2009 ◽  
Vol 3 (2) ◽  
pp. 189-222 ◽  
Author(s):  
Guy Mundlak
Keyword(s):  
Labor Market ◽  
Labor Markets ◽  
Labor Law ◽  
State Level ◽  
The State ◽  
Nation State ◽  
Partial Protection ◽  
Original Intent ◽  
Structural Imbalance ◽  
National Borders

Labor law was traditionally a domestic project, defined on the basis of a geographic territory or a synthetic community; its norms were determined by the state and applied to employers and workers who resided within the state. Commonly, labor law is administered on a territorial basis, applies to incoming workers, and stops at the borders in respect of other states' sovereignty when capital migrates. Globalization affects the background in which labor law operates, including the increased interdependence of markets, the constitution of communities that transcend national borders, and the development of institutions outside and within the nation-state, which displace the locus of regulation from the traditional state level. De-territoriality claims that territory and sovereignty should be understated within the dominion of labor law in order to correct a deep structural imbalance in labor markets. This imbalance was not created by globalization, and as long as it appeared in a consistent yet bounded manner in each and every state, labor law's project was rendered possible by territorial arrangements. With the process of globalization, the territorial solutions previously created within labor law are no longer adequate. When territoriality is adhered to, migrating workers receive partial protection, while migrating capital can easily choose its most convenient forum as a means, inter alia, of undermining labor law's protection to workers. De-territorialization seeks to restore the original intent of labor law's project, which is to level off the distinct strategies that are available to labor and capital in a globalized labor market.

scholarly journals Pandemic meets epidemic: Co-location of COVID-19 and drug overdose deaths in the United States

2021 ◽  
Vol 6 (4) ◽  
pp. 174-178
Author(s):  
Navya Tripathi ◽  
Nancy Hardt
Keyword(s):  
United States ◽  
Spatial Correlation ◽  
Drug Overdose ◽  
Hot Spot ◽  
State Level ◽  
The United States ◽  
Time Step ◽  
Access To Treatment ◽  
Control And Prevention ◽  
Overdose Deaths

Drug overdose deaths (DOD) in the last two decades have increased over 300 percent. In 2019 alone, 71,000 deaths represented a 7% increase from the previous year. According to recent data released by the Center for Disease Control and Prevention (CDC), 81,230 overdose deaths occurred in the United States from June 2019 to May 2020, the highest number of DOD recorded in a 12-month period. Early 2020 saw the spread of the COVID-19 pandemic in the United States, which CDC suggests has amplified the previously alarming rise in drug-related mortalities. A hot spot analysis of COVID-19 and DOD rates, as well as a spatial correlation between the two datasets at the state level on a monthly time step, showed a significant increase in DOD during the COVID-19 pandemic. This study, conducted for the period of March through July 2021, showed a spatial correlation between the two types of mortalities in the initial months of 2020. Furthermore, the hot spots for both types of mortalities were concentrated in the northeastern states. The COVID-19 mortalities shifted southeast in July 2020, but DOD data was unavailable for further analysis. Since DOD are a leading contributor to preventable deaths, the results of the study may help focus the efforts of effective and innovative programs to reduce substance use disorder and related mortality through increased access to treatment. During the pandemic, access to such facilities was reduced.

Promoting Sustainable Responses to the US Opioid Epidemic with Community-Academic Partnerships: Qualitative Outcomes from a Statewide Program.

2021 ◽  
Author(s):  
David L. Driscoll ◽  
Alison Evans Cuellar ◽  
Vinod Agarwal ◽  
Debra Jones ◽  
Kathy Hosig ◽  
...  
Keyword(s):  
Drug Overdose ◽  
Academic Support ◽  
The State ◽  
National Institutes Of Health ◽  
Opioid Overdose ◽  
Evidence Based ◽  
Community Agencies ◽  
Health Services Administration ◽  
Nominal Categories ◽  
Overdose Deaths

Abstract Background: Drug overdose deaths in the United States have continued to increase at an alarming rateThe United States is facing two devastating public health crises– the opioid epidemic and the COVID-19 pandemic. Within this context, one of the most ambitious implementation studies in addiction research is moving forward. Launched in May 2019, the HEALing Communities Study (HCS) was developed by the National Institutes of Health (NIH) and the Substance Abuse and Mental Health Services Administration (SAMHSA) as part of the Helping to End Addiction Long-termSM Initiative (National Institutes of Health, 2020). The goal for this research was to reduce opioid overdose deaths by 40 % in three years by enhancing and integrating the delivery of multiple evidence-based practices (EBPs) with proven effectiveness in reducing opioid overdose deaths across health care, justice, and community settings. This paper describes the initial vision, goals, and objectives of this initiative; the impact of COVID-19; and the potential for knowledge to be generated from HCS at the intersection of an unrelenting epidemic of opioid misuse and overdoses and the ravishing COVID-19 pandemic.. The Substance Abuse and Mental Health Services Administration distributed more than $7 billion between January 2016 and June 2020 to address the drug overdose crisis. The funds were intended to support evidence-based responses, including medications for opioid use disorder, and other prevention, treatment and recovery activities. Although the SOR grants support much-needed community level interventions, many of the services they support may not be sustainable. Methods: This paper describes a statewide effort to support local entities through SAMHSA’s State Opioid Response (SOR) grants in Virginia. Our investigators conducted detailed needs assessment exercises with community agencies across the state, and collaboratively developed requests for proposals (RFPs) to sustain their SOR programs. We distributed the RFPs to prospective partners at universities across the state, and provided all responsive proposals to local agencies who selected the proposal most likely to meet their needs. Our investigators also conducted an inductive, three-phase content analysis approach to examine the RFPs submitted to the VHEOC to identify nominal categories of support requested of the academic partners. Results: Our investigators received and coded 27 RFPs from ten community agencies representing four of five regions of the state. We identified six nominal categories of academic support with high inter-coder agreement. The six categories of support requested of the academic partners were program development and support, literature review and best practices, outreach and education, data analysis and interpretation, program evaluation, and grant writing assistance. Several RFPs requested up to three categories of support in a single project. Conclusions: Our analysis of the requests received by the consortium identified several categories of academic support for SOR-grantees addressing the drug overdose crisis. The most common requests related to development and maintenance of supportive collaborations, which existing research has demonstrated is necessary for the long-term sustainability of SOR-funded services. In this way, the academic partners served as a source of support for sustainable SOR-funded programs. As the state opioid response program is implemented nationally, we hope that other states will consider similar models in response to the opioid crisis.

Looking for Work, Searching for Workers: American Labor Markets During Industrialization. By Joshua L. Rosenbloom. New York: Cambridge University Press, 2002. Pp. xvi, 208. $20.00, paper.

2003 ◽  
Vol 63 (1) ◽  
pp. 286-288
Author(s):  
Price V. Fishback
Keyword(s):  
New York ◽  
Labor Market ◽  
World War I ◽  
Labor Markets ◽  
Undergraduate Students ◽  
World War ◽  
Cambridge University ◽  
Statistical Studies ◽  
The U.S ◽  
American Labor

Joshua Rosenbloom provides a superb study of the operations of the U.S. labor market between the Civil War and World War I. The book weaves fascinating descriptions of the various ways in which employers and workers established connections together with clear summaries of an extensive amount of background quantitative work. Although the analysis is firmly grounded on a series of more technical statistical studies, most of the book does not emphasize econometrics. Instead, the findings are effectively summarized using graphs, simple means and telling anecdotes that illustrate the experiences of many workers. The book is beautifully written and can be used by economists, historians, and both graduate and undergraduate students to obtain a clearer understanding of how markets work.

scholarly journals State-Level Strategies for Reducing Prescription Drug Overdose Deaths: Utah's Prescription Safety Program

Pain Medicine ◽  
2011 ◽  
Vol 12 (suppl 2) ◽  
pp. S66-S72 ◽  
Author(s):  
Erin M. Johnson ◽  
Christina A. Porucznik ◽  
Jonathan W. Anderson ◽  
Robert T. Rolfs
Keyword(s):  
Prescription Drug ◽  
Drug Overdose ◽  
State Level ◽  
Safety Program ◽  
Overdose Deaths

scholarly journals Improving risk factor identification for opioid overdose deaths in Tennessee

2019 ◽  
Vol 11 (1) ◽  
Author(s):  
Sarah J. Nechuta ◽  
Jenna Moses ◽  
Molly Golladay ◽  
Adele Lewis ◽  
Julia Goodin ◽  
...  
Keyword(s):  
Risk Factor ◽  
Drug Overdose ◽  
Medical Examiner ◽  
Prescription Opioid ◽  
Opioid Overdose ◽  
Prescription Opioids ◽  
Death Certificates ◽  
Postmortem Toxicology ◽  
Icd 10 ◽  
Overdose Deaths

ObjectiveTo examine specific drugs present based on postmortem toxicology for prescription opioid, heroin, and fentanyl overdoses classified based on ICD-10 coding. To compare drugs identified from postmortem toxicology with those listed on the death certificate for opioid overdoses.IntroductionUsing death certificates alone to identify contributing substances in drug overdose deaths may result in misclassification and underestimation of the burden of illicit and prescription opioids and other drugs in drug-related deaths. To enable timely and targeted prevention in Tennessee (TN), the identification and monitoring of new drugs and trends in use should utilize toxicology and medicolegal death investigation data directly, as recommended by others 1-3. These data can inform mortality outcome definitions for improved surveillance and risk factor identification 4-7. To our knowledge, this is the first analysis to use statewide linked toxicology and death certificate data in TN.MethodsWe identified 615 opioid involved overdose deaths in TN of unintentional (underlying ICD-10 codes: X40-X44) or undetermined (underlying ICD-10 codes: Y10-Y14) intent during June 1st to December 31st 2017. Utilizing the Interim Medical Examiner Database (I-MED), we identified postmortem toxicology reports for 454 cases, which were from one of three national laboratories used by a state Regional Forensic Center. Toxicology data were abstracted and independently verified by two co-authors and linked to the TN death statistical file that included cause of death information (literal text and ICD-10 codes) and demographics. The analysis focuses on cases with an available toxicology report.ResultsWe identified 171 prescription opioid overdoses, 221 fentanyl overdoses, and 113 heroin overdoses. Table 1 displays postmortem toxicology profiles for major drugs/classes. For prescription opioid deaths (excluding fentanyl and heroin), positive toxicology results for prescription opioids were as follows: methadone (11%), buprenorphine (14%), hydrocodone (14%), oxycodone (36%) and oxymorphone (also a metabolite, 47%). Benzodiazepines were present in close to 58% of prescription opioid overdoses; stimulants (cocaine, amphetamines, methamphetamines) in about 25%. For fentanyl and heroin deaths, prescription opioids were detected in about 26% and 34%, respectively; stimulants in about 57.9% and 52.2%, respectively, and benzodiazepines 36-37%. Fentanyl was present on toxicology in about half of heroin overdoses, and 6–monoacetylmorphine in 72.6%.ConclusionsUsing medical examiners’ data, including toxicology data, improves estimation of contributing drugs involved in opioid deaths. This analysis provides jurisdiction-specific data on drugs that can help with monitoring trends and informs risk factor identification. Future work includes adding information on prescribed opioid and benzodiazepines using TN’s Prescription Drug Monitoring Database and evaluating demographic variation in contributing drugs between toxicology and DC data to identify susceptible populations.References1. Slavova S, O'Brien DB, Creppage K, Dao D, Fondario A, Haile E, Hume B, Largo TW, Nguyen C, Sabel JC, Wright D, Council of S, Territorial Epidemiologists Overdose S. Drug Overdose Deaths: Let's Get Specific. Public Health Rep.2. Horon IL, Singal P, Fowler DR, Sharfstein JM. Standard Death Certificates Versus Enhanced Surveillance to Identify Heroin Overdose-Related Deaths. Am J Public Health. 2018;108(6):777-81.3. Mertz KJ, Janssen JK, Williams KE. Underrepresentation of heroin involvement in unintentional drug overdose deaths in Allegheny County, PA. J Forensic Sci. 2014;59(6):1583-5.4. Landen MG, Castle S, Nolte KB, Gonzales M, Escobedo LG, Chatterjee BF, Johnson K, Sewell CM. Methodological issues in the surveillance of poisoning, illicit drug overdose, and heroin overdose deaths in new Mexico. Am J Epidemiol. 2003;157(3):273-8.5. Davis GG, National Association of Medical E, American College of Medical Toxicology Expert Panel on E, Reporting Opioid D. Complete republication: National Association of Medical Examiners position paper: Recommendations for the investigation, diagnosis, and certification of deaths related to opioid drugs. J Med Toxicol. 2014;10(1):100-6.6. Slavova S, Bunn TL, Hargrove SL, Corey T. Linking Death Certificates, Postmortem Toxicology, and Prescription History Data for Better Identification of Populations at Increased Risk for Drug Intoxication Deaths. Pharmaceutical Medicine. 2017;31(3):155-65.7. Hurstak E, Rowe C, Turner C, Behar E, Cabugao R, Lemos NP, Burke C, Coffin P. Using medical examiner case narratives to improve opioid overdose surveillance. Int J Drug Policy. 2018;54:35-42. 

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