Why a Study on Opioids Ignited a Twitter Firestorm

With the opioid epidemic claiming more than 100 lives a day in the U.S., every state now has some sort of law expanding access to naloxone, also known as Narcan. Naloxone is an opioid antagonist that makes someone who has overdosed start breathing again. Sometimes, its powers are said to bring an overdose victim “back to life.” That led two economists to wonder, does the prospect of not dying from opioids make people more likely to use opioids? And are they more likely to, ultimately, die as a result?

The two researchers—Jennifer Doleac, of the University of Virginia, and Anita Mukherjee, of the University of Wisconsin—looked at the time period before and after different naloxone-access laws were put into place, such as providing legal immunity to people who prescribed or administered the drug and allowing anyone to buy naloxone in a pharmacy without a prescription.

After naloxone-access laws take effect, they found, arrests related to the possession and sale of opioids went up, as did opioid-related ER visits. Meanwhile—and most worryingly—there was no overall impact on the death rate. In fact, in the Midwest, the implementation of naloxone laws led to a 14 percent increase in opioid-related mortality, they found.

To Doleac, it’s an example of moral hazard. In other words, “anytime you make something less dangerous, people are going to do more of it,” she told me. In one study, for example, giving teens free condoms actually led to an increase in teen pregnancy. In this case, the study purports that heroin users figured they stood a good chance of being revived if they overdosed, so they kept on using.

Doleac announced her findings with a Twitter thread:

My paper on Naloxone access and opioid abuse (joint work with @anita_mukherjee) is now online:

“The Moral Hazard of Lifesaving Innovations: Naloxone Access, Opioid Abuse, and Crime”https://t.co/QWDgcOe2CQ pic.twitter.com/8dlQkYm9ex

— Jennifer Doleac (@jenniferdoleac) March 6, 2018

She was not quite “ratioed,” to use the digerati term for a tweet that garners more responses than approvals. But she nevertheless prompted a vigorous online debate that raged for nearly a week. In the white-paper-reading realm, that’s practically World War III.

Public-health people were, perhaps understandably, alarmed by Doleac and Mukherjee’s findings, suggesting they might lead cities and states to pull back from providing naloxone freely. Naloxone access is considered a pillar of “harm reduction,” or the idea that if people can’t immediately be …read more

Source:: The Atlantic – Health

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