No War on Opioids? Race, Medical Missteps, and Support for Punitive Drug Policy

• In Event: Deaths of Despair? Framing the Opioid Epidemic

Abstract

It has been widely noted that response to the opioid epidemic has been different from past war on drugs initiatives. Multiple explanations have been offered for this more health care oriented response, including the privilege conferred by the racial, socioeconomic, and geographic profile of those effected by the epidemic, as well as the perceived culpability of physicians, pharmaceutical executives, and regulators. Although we study the shift towards health care oriented drug policies in historical context, it is difficult to isolate the causal effects of co-occurring trends; the conditions under which people become addicted to opioids, as well as who has become addicted have both changed. In light of this difficulty, we focus on explaining modern day variation in public preferences for health policies aimed at preventing opioid addiction and combating related challenges. We present a comprehensive analysis of the association between perceptions of who is affected by opioid addiction, perceptions of why they face addiction, and preferred drug policies. Although the extent to which we can manipulate these perceptions is limited, we additionally present results from an original survey experiment in which respondents evaluate a factorial vignette with independently randomized demographics and conditions under which the individual was exposed to opioids. We report effects of vignette characteristics on blame for addiction, deservingness of punishment and medical assistance, and policy preferences. This helps us understand the intersection of race and conditions of exposure in the foundations of modern drug policy preferences.

Author

• Lilla Orr, Yale