The Effect of Evictions on Opioid Mortality

The crisis surrounding opioid overdose deaths, which have risen by more than 430 percent since 2000, has received substantial academic, policy, and media attention. Often characterized as “deaths of despair,” accidental drug overdoses have complex causes, which include economic stress. One of the most disruptive stressors faced by individuals at risk for accidental drug overdose is the risk of eviction from their home; however, there is no existing research testing the association between the rates of eviction and the rate of opioid-related mortality in the U.S. We combined data on eviction rates at the county level with data on count-level opioid-related deaths in the U.S. from the Vital Statistics Multiple Cause of Death microfiles from 2000 to 2016 to provide the first estimates of this relationship. We estimate a first stage model of evictions, using landlord-tenant state policies and state civil court caseload burden as instruments, and then estimate the causal impact of evictions on opioid mortality using 2SLS. We find positive and statistically significant association between evictions and opioid mortality at the county level. The magnitude of this association varies by type of opioid and by county urbanicity. Proposed changes to Housing and Urban Development policy which are expected to substantially increase the risk of eviction should be evaluated in light of their potential for worsening an already-acute opioid mortality crisis.