{"id":42601,"date":"2018-03-09T03:00:07","date_gmt":"2018-03-09T08:00:07","guid":{"rendered":"http:\/\/quotulatiousness.ca\/blog\/?p=42601"},"modified":"2018-03-08T13:21:47","modified_gmt":"2018-03-08T18:21:47","slug":"bad-news-about-the-peltzman-effect-and-opiate-use","status":"publish","type":"post","link":"https:\/\/quotulatiousness.ca\/blog\/2018\/03\/09\/bad-news-about-the-peltzman-effect-and-opiate-use\/","title":{"rendered":"Bad news about the Peltzman Effect and opiate use"},"content":{"rendered":"

Megan McArdle<\/a> recounts the US federal government’s attempt to improve automobile safety in the 1960s and the surprisingly mixed results of those efforts on overall safety for drivers (better), pedestrians (worse) and the frequency of non-fatal accidents (higher). Those results were summarized by Sam Peltzman as indicating that most of us have an innate tendency to take more risks when we’re less likely to suffer the costs of those risks (hence, the “Peltzman Effect”). She then talks about a tragic new instance of this in the opiate crisis:<\/p>\n

A chemical called naloxone acts as an \u201copioid antagonist\u201d \u2014 which is to say, it reverses the drug\u2019s effects on the body. It can thus save people who have overdosed. <\/p>\n

As opioid usage has worsened in the United States, more and more jurisdictions have acted to increase access to naloxone. Not only first responders but also friends, family and even librarians have started to administer it. These state laws were passed at different times, giving researchers Jennifer Doleac and Anita Mukherjee a sort of a natural experiment: They could look at what happened to overdoses in areas that liberalized naloxone access and compare the trends there to places that hadn\u2019t changed their laws. <\/p>\n

Their results are grim, to say the least: \u201cWe find that broadening Naloxone access led to more opioid-related emergency room visits and more opioid-related theft, with no reduction in opioid-related mortality.\u201d <\/p>\n

You can never assume that the results of one study, however well done, are correct. But these results look pretty robust. If they hold up, they would mean that naloxone is not saving lives; all we\u2019re doing is spending a lot of money on naloxone to generate some increase in crime.<\/p>\n

It makes a certain amount of sense that the Peltzman Effect would show up particularly strongly in drug users; after all, drugs hijack the brain\u2019s reward system, redirecting it toward drug-seeking even at high personal risk. Drug users, one would think, would be highly likely to recalibrate their risk-taking so that the risk of death remains constant, while the frequency and potency of drug use increases.<\/p>\n

The coldly logical response to this would seem to be to discontinue naloxone use. But there\u2019s something repulsive about that conclusion, and Doleac and Mukherjee can\u2019t bring themselves to go there. \u201cOur findings do not necessarily imply that we should stop making Naloxone available to individuals suffering from opioid addiction,\u201d they write, \u201cor those who are at risk of overdose. They do imply that the public health community should acknowledge and prepare for the behavioral effects we find here.\u201d <\/p><\/blockquote>\n","protected":false},"excerpt":{"rendered":"

Megan McArdle recounts the US federal government’s attempt to improve automobile safety in the 1960s and the surprisingly mixed results of those efforts on overall safety for drivers (better), pedestrians (worse) and the frequency of non-fatal accidents (higher). Those results were summarized by Sam Peltzman as indicating that most of us have an innate tendency […]<\/p>\n","protected":false},"author":1,"featured_media":35193,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"jetpack_post_was_ever_published":false,"_jetpack_newsletter_access":"","_jetpack_dont_email_post_to_subs":false,"_jetpack_newsletter_tier_id":0,"_jetpack_memberships_contains_paywalled_content":false,"_jetpack_memberships_contains_paid_content":false,"footnotes":""},"categories":[66,13],"tags":[59,343,119,243],"class_list":["post-42601","post","type-post","status-publish","format-standard","hentry","category-health-science","category-usa","tag-addiction","tag-crimeandpunishment","tag-drugs","tag-medicine"],"jetpack_featured_media_url":"https:\/\/quotulatiousness.ca\/blog\/wp-content\/uploads\/2016\/06\/favicon.png","jetpack_shortlink":"https:\/\/wp.me\/p2hpV6-b57","jetpack_sharing_enabled":true,"_links":{"self":[{"href":"https:\/\/quotulatiousness.ca\/blog\/wp-json\/wp\/v2\/posts\/42601","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/quotulatiousness.ca\/blog\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/quotulatiousness.ca\/blog\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/quotulatiousness.ca\/blog\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/quotulatiousness.ca\/blog\/wp-json\/wp\/v2\/comments?post=42601"}],"version-history":[{"count":1,"href":"https:\/\/quotulatiousness.ca\/blog\/wp-json\/wp\/v2\/posts\/42601\/revisions"}],"predecessor-version":[{"id":42602,"href":"https:\/\/quotulatiousness.ca\/blog\/wp-json\/wp\/v2\/posts\/42601\/revisions\/42602"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/quotulatiousness.ca\/blog\/wp-json\/wp\/v2\/media\/35193"}],"wp:attachment":[{"href":"https:\/\/quotulatiousness.ca\/blog\/wp-json\/wp\/v2\/media?parent=42601"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/quotulatiousness.ca\/blog\/wp-json\/wp\/v2\/categories?post=42601"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/quotulatiousness.ca\/blog\/wp-json\/wp\/v2\/tags?post=42601"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}