Business Cycles and Admissions to Substance Abuse Treatment

Abstract

We study the effect of business cycles on admissions to specialty substance abuse treatment using administrative data between 1992 and 2015. We proxy business cycles with the state unemployment rate and apply a panel fixed‐effects model. While previous economic research has shown that substance abuse is counter‐cyclical, we observe no change in the total number of admissions across the business cycle. However, focusing on average effects misses important heterogeneity. In substance‐specific regressions we find statistically significant evidence that heroin‐related admissions are counter‐cyclical while stimulant‐related admissions are procyclical. Our findings add to the literature on business cycles and health. (JEL I1, J2)

Must‐access prescription drug monitoring programs and retail opioid sales

“…Further, research by Maclean et al. (2020) examining substance abuse treatment admissions suggests that changes in treatment rates are impacted by macroeconomic conditions, which could also influence the prescribing rates of buprenorphine and methadone. Thus, implementing must‐access PDMPs may have had little effect on the retail sales of these opioids.…”

“…For example, it is possible that retail prescriptions for buprenorphine were already trending up in response to increased awareness of, and focus on, the opioid epidemic. Further, research by Maclean et al (2020) examining substance abuse treatment admissions suggests that changes in treatment rates are impacted by macroeconomic conditions, which could also influence the prescribing rates of buprenorphine and methadone. Thus, implementing must-access PDMPs may have had little effect on the retail sales of these opioids.…”

Losing Insurance and Psychiatric Hospitalizations

“…recessions are linked with insurance (Cawley and Simon, 2005;Cawley et al, 2015), psychiatric disorders (Ruhm, 2015;Carpenter et al, 2017;Hollingsworth et al, 2017), and psychiatric healthcare use (Bradford and Lastrapes, 2014;Maclean et al, 2020). 12 The NIS is not designed to be state representative.…”

Identifying the Impact of the Business Cycle on Drug-Related Harms in European Countries

“…Admission to treatment depends mainly on the supply of treatment, which may tend to decrease during economic recessions due to public austerity measures. Therefore, the capacity of these services to absorb a rise in the demand during economic downturns might become an active restriction, which is difficult to capture with available data (MacLean et al, 2020). Costa et al (2011) used data for treatment demand in Europe, over the 2002-2007 period.…”