Beyond the Sacklers: Free-trade policies contributed to the opioid epidemic

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In a commentary in STAT and a scientific report in SSM-Population Health, Adam Dean and Simeon Kimmel explore the connections between the opioid epidemic and free trade agreements.  They argue that the trade crisis and the opioid crisis feed on each other. Economists have explained how free trade lowers wages and employment levels for less-educated manufacturing workers in the U.S. Relatively good jobs with high wages and benefits are disappearing, while factory closings damage the social fabric of their surrounding communities.

Free trade policies hit Appalachia, a region of 420 counties across 14 states, especially hard. The region accounts for only 8% of the United States population but suffered 16% of all trade-related job losses over the past 20 years. To examine the connection between trade policies and opioid deaths, the authors analyzed county-level data from both the Department of Labor and the Centers for Disease Control and Prevention. They found that for every 1,000 people who lost their jobs in a county there was a 2.7% rise in opioid-related overdose deaths. After fentanyl entered regional heroin supplies in 2013, the same 1,000 trade-related job losses led to an 11.3% spike in overdose deaths.

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