A new study has ignited controversy in the world of drug abuse prevention, applying the economic theory of "moral hazard" to the opioid crisis.
The working paper, posted March 6, examines the effects of laws that have increased access to anti-overdose medication naloxone. It found an increase in opioid-related ER visits and criminal activity, while mortality from opioid overdoses was unaffected, or even rose in certain areas.
Naloxone, an opioid antagonist medication that can save the life of an overdose victim, has been heralded as a key to curbing the opioid crisis. All 50 states and the District of Columbia have passed laws making naloxone more accessible.
But Jennifer Doleac of the University of Virginia and her co-author Anita Mukherjee of the University of Wisconsin argue in their study that naloxone is another example of a lifesaving innovation that results in a moral hazard.
Moral hazard is the theory that when you give people a safeguard to protect them against risky behavior, they will do the risky behavior more. For example, a 1975 study argued that safety features in cars made people drive more recklessly and get in more accidents.
"Broad naloxone access doesn't seem to be helping and might be making things worse," Doleac said in an interview. "We don't have clear answers yet. That's one of the depressing parts of working on this topic."
Doleac and Mukherjee examined data from 2006-2015 and found that after laws made naloxone easier to access, opioid-related ER visits and crimes increased. Opioid-related deaths did not decrease, but increased 14 percent in the Midwest.