Prescription for Disaster

Abstract A county’s fraction of adults in 1990 on Social Security Disability Insurance (SSDI) is a strong predictor of growth in local drug death rates after 2000. The part of the SSDI rate related to drug deaths is not proxying for well-known contributors to the drug crisis, e.g. OxyContin. Instead, it appears to capture the fraction of people in chronic pain. We show that in the late 1990s, physicians began prescribing opioids more aggressively to treat pain. Taken together, our estimates suggest that drug deaths rates would be 43% lower in 2015 had prescribing practices stayed at 1995 levels.