The Moral Hazard of Lifesaving Innovations: Naloxone Access, Opioid Abuse, and Crime

Abstract

The U.S. is experiencing an epidemic of opioid abuse. In response, states have implemented a variety of policies including increased access to naloxone, a drug that can save lives when administered during an overdose. However, widespread naloxone access may lead to increased opioid abuse by reducing the risk of death per use, thereby enabling continued or riskier opioid use. By increasing the demand for opioids, naloxone access may also impact crime, especially theft. In this paper, we use the staggered timing of state-level naloxone access laws as a natural experiment to measure the effects of broadening access to this lifesaving drug. We find that broadened access led to more opioid-related emergency room visits and more opioid-related theft, with no reduction in opioid-related mortality. These effects are driven by urban areas and vary with local access to substance abuse treatment. We find the most detrimental effects in the Midwest, including a 14% increase in opioid-related mortality in that region. While naloxone has great potential as a harm-reduction strategy, our analysis supports the concern that it encourages riskier behaviors with respect to opioid abuse.

JEL Classification: I18, K42, D81