What question did this study set out to answer?

Assess the relationship between SSDI rates and drug death rates, focusing on opioid prescribing and chronic pain.

January 15, 2026

Prescription for Disaster

WEWilliam N. EvansUniversity of Notre Dame ELEthan M.J. LieberUniversity of Notre Dame

Key Points

Assess the relationship between SSDI rates and drug death rates, focusing on opioid prescribing and chronic pain.
Analyzed county SSDI rates from 1990 to examine correlations with drug death rates after 2000.
Studied prescribing practices and the rise of opioid prescriptions in the late 1990s.
Utilized estimates to determine the impact of these practices on drug death rates.
Found SSDI rates predict local drug death rates after 2000.
Identified that aggressive opioid prescribing practices contributed to rising drug deaths.
Estimated 43% reduction in drug death rates if prescribing had remained at 1995 levels.

Abstract

A county’s fraction of adults in 1990 on Social Security Disability Insurance (SSDI) is a strong predictor of growth in local drug death rates after 2000. The part of the SSDI rate related to drug deaths is not proxying for well-known contributors to the drug crisis, e.g. OxyContin. Instead, it appears to capture the fraction of people in chronic pain. We show that in the late 1990s, physicians began prescribing opioids more aggressively to treat pain. Taken together, our estimates suggest that drug deaths rates would be 43% lower in 2015 had prescribing practices stayed at 1995 levels.

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Cite This Study

Evans et al. (Mon,) studied this question.

synapsesocial.com/papers/69683e135818e7dbd7c6318a https://doi.org/https://doi.org/10.3368/jhr.0724-13685r2

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