Abstract: This paper estimates the effects of the opioid epidemic on political outcomes by leveraging rich geographic variation in exposure to the crisis. We study its effect on the Republican vote share in House and presidential elections from 1982 to 2020. Our results suggest that greater exposure to the opioid epidemic continuously increased the Republican vote share, starting in the early 2000s. This higher vote share translated into additional seats won by Republicans in the House from 2014 until 2020, as well as House members holding more conservative views. These effects are explained by voters changing their views rather than compositional changes.
Keywords: Opioids, Mortality, Voting, Polarization
JEL Classification: D72; I12; I18; J13