The Role of Friends in the Opioid Epidemic

Abstract

The role of friends in the US opioid epidemic is examined. Using data from the National Longitudinal Survey of Adolescent Health (Add Health), adults aged 25-34 and their high school best friends are focused on. An instrumental variable technique is employed to estimate peer effects in opioid misuse. Severe injuries in the previous year are used as an instrument for opioid misuse in order to estimate the causal impact of someone misusing opioids on the probability that their best friends also misuse. The estimated peer effects are significant: Having a best friend with a reported serious injury in the previous year increases the probability of own opioid misuse by around 7 percentage points in a population where 17 percent ever misuses opioids. The effect is driven by individuals without a college degree and those who live in the same county as their best friends.

Note:

Funding Information: This research uses data from Add Health, funded by grant P01 HD31921 (Harris) from the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), with cooperative funding from 23 other federal agencies and foundations. Add Health is currently directed by Robert A. Hummer and funded by the National Institute on Aging cooperative agreements U01 AG071448 (Hummer) and U01AG071450 (Aiello and Hummer) at the University of North Carolina at Chapel Hill. No direct support was received from grant P01-HD31921 for this project. Adamopoulou acknowledges financial support by the German Research Foundation (through the CRC-TR-224 project A3).

Conflict of Interests: The authors have no conflicts of interest to declare that are relevant to the content of this article.

Keywords: opioid, peer-group effects, friends, instrumental variables, Add Health, severe injuries

JEL Classification: C26, D10, I12, J11