https://macropaperwarehouse.com/authors/victoria-barone/Victoria BaroneHugo -- gohugo.ioen-ushttps://macropaperwarehouse.com/papers/republican-support-and-economic-hardship-the-enduring-effects-of-the-opioid-epidemic/https://macropaperwarehouse.com/papers/republican-support-and-economic-hardship-the-enduring-effects-of-the-opioid-epidemic/<p>This paper establishes a causal connection between the opioid epidemic and the political realignment toward the Republican Party in the United States from the mid-2000s through 2022. The authors—Carolina Arteaga and Victoria Barone—exploit rich geographic variation in Purdue Pharma&rsquo;s initial marketing strategy for OxyContin, drawn from unsealed litigation records, to construct a quasi-exogenous measure of community-level exposure to the epidemic.</p> <p>The identification strategy rests on a documented feature of OxyContin&rsquo;s 1996 launch: Purdue initially targeted the established cancer pain market—physicians and patients already using MS Contin—as an entry point into the much larger noncancer pain market. Areas with higher cancer mortality in 1996 received disproportionate pharmaceutical marketing, leading to outsized opioid prescription growth that spilled over from cancer patients to the broader population through shared physicians. The authors use 1996 commuting-zone (CZ) cancer mortality rates as a proxy for this initial targeting, interacted with year fixed effects in an event-study specification with CZ and state-year fixed effects. The sample covers 625 CZs across the continental United States from 1982 to 2022.</p>