Prescription Opioids and Economic Hardship in France

Ilaria Natali, Mathias Dewatripont, Victor Ginsburgh and Michel Goldman
Authors registered in the RePEc Author Service: Patrick Legros

No 14403, CEPR Discussion Papers from C.E.P.R. Discussion Papers

Abstract: This paper studies how opioid analgesic sales are related to socioeconomic conditions in France. Using the OpenHealth database on prescription opioid retail sales at the district level from 2008 to 2017, we show that increases in the poverty rate induce more sales: a one percentage point increase in poverty produces, approximately, a ten percent increase in opioid sales. Our analysis further shows that opioid sales are positively related to the share of middle-aged people and the share of individuals with basic education only, while they are negatively related to population density. We identify the causal effects of economic conditions on opioid sales by using two alternative strategies. First, we implement a Two-Stage Least Squares (2SLS) approach, where we instrument for poverty by exploiting a reform aimed at reducing poverty of low-income individuals. Second, we use a three-dimensional panel model that allows us to control for a large pool of potential confounding factors. We are among the ï¬ rst to address potential reverse causality issues in this context. Our results suggest that middle-aged individuals and people with lower education levels are mostly at risk and should be carefully screened before and monitored after being treated. Pharmacovigilance should be more intensively addressed towards poor and rural areas. We conclude that a combination of policies aimed at improving economic prospects and strictly monitoring access to opioid medications would be beneï¬ cial for reducing opioid-related harm.

Keywords: Prescription opioids; Socioeconomic conditions; France (search for similar items in EconPapers)
JEL-codes: I11 I15 I18 (search for similar items in EconPapers)
Date: 2020-02
References: View references in EconPapers View complete reference list from CitEc
Citations: View citations in EconPapers (2)

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Related works:
Journal Article: Prescription opioids and economic hardship in France (2023)
Working Paper: Prescription Opioids and Economic Hardship in France (2020)
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