Prescription Opioids and Economic Hardship in France

46 Pages Posted: 3 Mar 2020

See all articles by Ilaria Natali

Ilaria Natali

Université Libre de Bruxelles (ULB)

Mathias Dewatripont

Université Libre de Bruxelles (ULB) - European Center for Advanced Research in Economics and Statistics (ECARES); Centre for Economic Policy Research (CEPR)

Victor Ginsburgh

Université Libre de Bruxelles (ULB) - European Center for Advanced Research in Economics and Statistics (ECARES)

Michel Goldman

Université Libre de Bruxelles (ULB)

Patrick Legros

Université Libre de Bruxelles (ULB)

Date Written: February 2020

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 fi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 beneficial for reducing opioid-related harm.

Keywords: France, Prescription Opioids, Socioeconomic conditions

JEL Classification: I11, I15, I18

Suggested Citation

Natali, Ilaria and Dewatripont, Mathias and Ginsburgh, Victor and Goldman, Michel and Legros, Patrick, Prescription Opioids and Economic Hardship in France (February 2020). CEPR Discussion Paper No. DP14403, Available at SSRN: https://ssrn.com/abstract=3547334

Ilaria Natali

Université Libre de Bruxelles (ULB) ( email )

CP 132 Av FD Roosevelt 50
Brussels, Brussels 1050
Belgium

Mathias Dewatripont (Contact Author)

Université Libre de Bruxelles (ULB) - European Center for Advanced Research in Economics and Statistics (ECARES) ( email )

Ave. Franklin D Roosevelt, 50 - C.P. 114
Brussels, B-1050
Belgium
+32 2 650 4217/4 (Phone)
+32 2 650 4475 (Fax)

Centre for Economic Policy Research (CEPR)

London
United Kingdom

Victor Ginsburgh

Université Libre de Bruxelles (ULB) - European Center for Advanced Research in Economics and Statistics (ECARES) ( email )

Ave. Franklin D Roosevelt, 50 - C.P. 114
Brussels, B-1050
Belgium

Michel Goldman

Université Libre de Bruxelles (ULB) ( email )

CP 132 Av FD Roosevelt 50
Brussels, Brussels 1050
Belgium

Patrick Legros

Université Libre de Bruxelles (ULB) ( email )

CP 132 Av FD Roosevelt 50
Brussels, Brussels 1050
Belgium

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