The Silent Killing of Middle-Aged Women: The Effect of School Shootings on Opioid-overdose Deaths

The United States is in the middle of an opioid epidemic which kills over 60,000 citizens every year. Several studies have investigated the effect of macroeconomic condition and opioid-related policies. However, the effect of environmental shocks on opioid misuse leading to opioid-overdose deaths is under-studied. Using a difference-in-differences model, monthly county-level data on opioid-related mortality for 2005-2016 and all shootings occurred in elementary, middle, and high schools; I show that average monthly county-level opioid death rates increase by fifty percent in the first two months following a shooting incident. Event study analysis indicates that the adverse effect disappears after two months. The effect is limited to the county in which the shooting happens, while adjacent counties and the rest of the state do not get affected. In addition, the effect is observed among women, mainly those age 35-64. These women are most likely those who have school-age children. Overall, estimates imply that school shooting incidents in the U.S. kill almost twice as many individuals due to opioid overdose as they do at the scene.