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Abstract: This paper studies the origins and consequences of the opioid epidemic. Drawing on recently unsealed documents from state litigation against Purdue Pharma, we instrument for the supply of prescription opioids by exploiting features of the initial marketing of OxyContin. We find that moving from the 25th-to-the-75th percentile in the distribution of prescription opioid supply increases deaths from prescription opioids by 89% and deaths from all opioids by 39%. This corresponds to over 200,000 deaths. We estimate that the opioid crisis did not have an effect on labor market outcomes, such as labor force participation or employment rates, but it had adverse effects on socioeconomic conditions, as indicated by increased claims from SNAP and disability and increased crime. We estimate decreases in pregnancy duration, birth weight and health at birth but no effect on infant mortality and we estimate an increase in fertility rates.
Keywords: Opioids, Mortality, Health
JEL Classification: I18, I30, J13