How to save a life? Exploring the role of expanded naloxone access amid rising opioid deaths — pdf updated 10/7/2025
Abstract: Recent public policies addressing the opioid epidemic are focusing on minimizing the harm from opioid overdoses. However, there is evidence that harm-reduction legislation has not worked as intended, prompting the question of whether reducing health risks created a moral hazard and incentivized increase opioid use. I examine the moral hazard question in-depth by evaluating the effects of prescribing authority for pharmacists and statewide standing orders for opioid antagonists on opioid use, mortalities, and treatment admissions. I do not find evidence supporting the moral hazard theory, or that increased interaction with healthcare providers increased the number of treatment admissions. Instead, I show that areas with less exposure to fentanyl saw decreases in opioid deaths, while areas with more exposure saw no change. This suggests that societal changes in drug consumption prevented the legislation, and subsequent increased access to opioid antagonists, from decreasing deaths as intended.
Hooked before cooked: Neonatal abstinence syndrome and state-level opioid policies — pdf
Abstract: Neonatal abstinence syndrome (NAS) occurs when babies are exposed to opioids while in-utero and experience drug withdrawal after birth. NAS is associated with negative long-term health effects including developmental delays and motor problems. Over the past 20 years, the rate of NAS occurrence has increased nearly tenfold. In this paper, I study how eight opioid-related policies have affected the rate of NAS in the U.S. population. Previous research has shown select state-level policies to have mixed and potentially contradictory effects on NAS. I expand the set of laws considered and provide new evidence on whether a policies’ target group or incentive mechanism creates differential impact on NAS occurrence. My results show statistically significant decreases in the rate of NAS following the passage of two opioid laws: initial prescription limitations and naloxone access laws. The former works by reducing the days supplied for new opioid prescriptions. The latter increases access to an opioid overdose reversal drug. Despite using two different mechanisms, each law’s estimated magnitude is around 2600 fewer cases on average. This paper presents policymakers with two effective legislative strategies for reducing a negative externality of the opioid epidemic, while still balancing opioids as a necessary form of pain relief.
The Real Promise: Downstream Achievement Increases When Education Payoffs Are More Certain with Jessica Drescher, Virginia Graves, and Benjamin Meadows
Abstract: We document forward-looking behavior in parents and their children when uncertainty decreases around a future payoff. Specifically, we examine Promise programs -- which "promise" to fulfill any unmet financial needs for college attendance -- upon young children in elementary and middle school. We merge the range of all promise programs to the universe of United States district-level achievement data and find indeed, the announcement of a promise program boosts the cohort-level of achievement scores in grades 3-8 between .1 and .15 of a standard deviation for math and between .05 and .1 of a standard deviation for reading, depending on the cohort.