Association for Public Policy Analysis & Management

The number of opioid prescriptions in the United States reached more than 227 million in 2015 – enough to provide 9 out of 10 American adults with a prescription – and there were just over 33,000 opioid-related deaths in that year. Pharmaceutical companies are one of the biggest political contributors, spending eight times more than the NRA in order to influence thousands of lawmakers. Since lobbying has a fundamental impact on American policymaking, this paper will assess whether or not political contributions affect the adoption of state-level opioid policies. Moreover, it will explore how those policies are ultimately associated with opioid overdose deaths. Given how these policies affect individual access to opioids, understanding this relationship will be of interest to those seeking to curb the opioid epidemic. I hypothesize that states with more pharmaceutical lobbyists and higher levels of political contributions will implement less strict opioid policies and experience higher levels of opioid-related overdoses. To test these hypotheses, I will utilize a unique dataset from the Associated Press “Politics of Pain” initiative which records the amount of state lobbying and contributions to individual political candidates by pain medication manufacturers from 2000 to 2015. I will merge this data to state-level data on opioid policy adoption, opioid abuse and deaths, and socio-demographic characteristics of the state. I will use a two-stage least squares models to control for the potential endogeneity of political contributions and to predict the impact of lobbying on policy adoption and the impact those policies ultimately have on opioid-related overdoses and deaths.