This paper studies the short- and long-run impacts of substance use disorder (SUD) treatment on human capital accumulation and labor market outcomes among at-risk adolescents. Specifically, I study the effect of one of the most common types of SUD treatment programs for adolescents—residential treatment center schools, which provide clinical SUD treatment and have a school on site. Using administrative data that link individual-level records across multiple government agencies in Texas, I examine within-individual changes in outcomes around the time of SUD treatment with a difference-in-differences design. I find that treated students experience declines in chronic absenteeism, disciplinary action, and course failure in the first two years following SUD treatment relative to a matched comparison group. I also find positive long-term impacts on college enrollment by age 20 and employment at ages 17–20. Heterogeneity analysis reveals that the positive impacts of SUD treatment center schools are nearly universal across demographic characteristics. My findings suggest that SUD treatment among adolescents may have lasting consequences and is a promising tool to promote human capital development among at-risk youth.
While growing evidence suggests that the opioid crisis has reduced employment levels, little is known about how the crisis has affected job skill requirements—tools that employers use to screen job candidates. Using data on the near universe of US job vacancies, this paper studies the impact of the opioid crisis on employers' job skill requirements. Specifically, we investigate the effect of the reformulation of OxyContin, which represents one of the most substantial reductions in the availability of abusable prescription opioids. Prior studies have documented that the reformulation resulted in a large transition from prescription opioids to more dangerous illicit opioids. Using a difference-in-differences event study design that exploits firm-level variation in exposure to reformulation, we show that this transition toward illicit opioids has reduced employment at the firm level. Furthermore, we find that firms have increased requirements for cognitive and computer skills in response to this crisis. Finally, we find that the reformulation has resulted in reductions in local store sales, firm revenue, and firm capital stock, highlighting how the opioid crisis may impact firms' hiring decisions by affecting various aspects of firms' constraints and considerations. Our findings emphasize the distributional consequences of this crisis: less-skilled workers may experience a disproportionate impact from the increased skill requirements, even among workers without a history of opioid use disorders.
The Opioid Crisis and the Location of Work: Evidence from Online Job Profile Data.
with Minseog Kim and Geunyong Park (SSRN Working Paper #4788254)
While growing evidence indicates that the opioid crisis has led to a reduction in local labor supply, whether this decline can be attributable to worker flow in and out of the local area remains unclear. Using over 130 million online job profiles of workers in the US, this paper investigates the effect of the opioid crisis on workers' location choices. Our job profile data capture worker-level job transitions from 2007 to 2019, allowing us to measure the inflow and outflow of workers for every county pair. We use a difference-in-differences design that leverages geographic variation in exposure to the 2010 reformulation of OxyContin, which led to a large transition from prescription opioids to illicit opioids. We find strong evidence that this transition toward illicit opioids resulted in an increased net outflow of workers away from counties more affected by the reformulation relative to those less affected. Moreover, we show that the increase in net outflow is more pronounced among higher-skilled workers, leading to a substantial decrease in the average skill level of the workers in highly exposed areas. Finally, we investigate the economic consequences of the net outflow among high-skilled workers and demonstrate that the reformulation is associated with a decline in local innovation in terms of patent filings and startup formation. Overall, our findings suggest that the opioid crisis adversely affects both the quantity and quality of local labor supply by influencing workers' location choices, eventually leading to a deterioration in the economic prospects of affected areas.
The opioid crisis in the United States has reached unprecedented levels, but little is known about the role of pharmacists. Using large-scale data from pharmacists' online job profiles linked with data on opioid dispensing at the pharmacies where they work after graduation, we investigate how the financial burden of pharmacy education influences their career choices and subsequent dispensing behaviors. We compare opioid dispensing quantities across pharmacists working in the same county but trained at institutions with different tuition costs. First, we show that pharmacies dispensing more opioids tend to provide higher wages. Second, we find that even among pharmacies in the same county, pharmacists from higher-tuition institutions are more likely to work at pharmacies with higher opioid dispensing. Lastly, we demonstrate that the positive association between pharmacy education costs and opioid dispensing is stronger among pharmacists who are in their first two years post-graduation, male pharmacists, and those working in areas with more severe prescription opioid use. Our findings suggest that pharmacists from institutions with higher tuition, who likely face greater student debt, may be more inclined to work at pharmacies that dispense larger quantities of opioids due to financial concerns.
We examine how shootings at schools—an increasingly common form of gun violence in the United States—impact the educational and economic trajectories of students. Using linked schooling and labor market data in Texas from 1992 to 2018, we compare within-student and across-cohort changes in outcomes following a shooting to those experienced by students at matched control schools. We find that school shootings increase absenteeism and grade repetition; reduce high school graduation, college enrollment, and college completion; and reduce employment and earnings at ages 24–26. We further find school-level increases in the number of leadership staff and reductions in retention among teachers and teaching support staff in the years following a shooting. The adverse impacts of shootings span student characteristics, suggesting that the economic costs of school shootings are universal.
A growing literature has examined how mandatory access prescription drug monitoring programs (MA PDMPs), laws that require providers to consider a patient’s prescription history before prescribing controlled substances, affect opioid-related outcomes. However, little is known about their impact on non-opioid-related outcomes. In this paper, we examine the effect of MA PDMPs on prescribing patterns of stimulants and benzodiazepines. Using a difference-in-differences event study design, we show that MA PDMPs led to decreases in stimulant prescribing. In contrast, we find suggestive evidence that benzodiazepine prescriptions increase following the implementation of a MA PDMP. Our findings highlight that MA PDMPs do have effects on non-opioid drug prescribing, but these effects differ substantially across drug types.
Must-Access Prescription Drug Monitoring Programs and the Opioid Overdose Epidemic: The Unintended Consequences.
Journal of Health Economics, 75: 102408, January 2021. [published version] [online appendix]
Although supply-side drug policies that limit access to legal opioids have reduced prescription opioid abuse, growing evidence shows that these policies have had the unintended consequence of increasing use of illegal opioids, including heroin. I add to this literature by studying the consequences of must-access prescription drug monitoring programs (PDMPs), which legally require providers to access a state-level database with a patient's prescription history before prescribing controlled substances under certain circumstances. Using a difference-in-differences specification, I find strong evidence that must-access PDMPs have increased heroin death rates. My estimates indicate that two years after implementation, must-access PDMPs were associated with 0.9 more heroin deaths per 100,000 in a half-year period, relative to control states. My results suggest that even if must-access PDMPs reduce prescription opioid deaths, the decrease is offset by a large increase in illegal opioid deaths.
Dynamics of Adolescents' Life Satisfaction and Effect of Class Rank Percentile: Evidence from Korean Panel Data.
with Jinook Jeong
Journal of Economic Psychology, 59: 8-28, April 2017. [published version]
This study investigates the dynamics of adolescents’ life satisfaction and the effects of academic success on life satisfaction using the Korean Youth Panel Survey (KYPS) 2003–2007 data. Unlike previous studies, our dynamic ordered probit models allow for persistence in life satisfaction which is attributable both to unobserved individual heterogeneity and to state dependence. First, we find that strong state dependence exists in adolescents’ life satisfaction, that is, current life satisfaction is significantly affected by the previous state. Second, we show that academic success undoubtedly has a positive effect on adolescents’ life satisfaction even after controlling for state dependence. Finally, we present that there exists an interesting gender difference: boys show stronger persistence in the state of high life satisfaction, whereas girls have stronger persistence in dissatisfaction.