@article{ref1,
title="Higher unemployment benefits are associated with reduced drug overdose mortality in the United States before and during the COVID-19 pandemic",
journal="International journal on drug policy",
year="2024",
author="Martins, Silvia S. and Segura, Luis E. and Marziali, Megan E. and Bruzelius, Emilie and Levy, Natalie S. and Gutkind, Sarah and Santarin, Kristen and Sacks, Katherine and Fox, Ashley",
volume="130",
number="",
pages="e104522-e104522",
abstract="OBJECTIVES: Overdose mortality rates in the United States remain critical to population health. Economic , such as unemployment, are noted risk factors for drug overdoses. The COVID-19 pandemic exacerbated economic hardship; as a result, the US government enacted income protection programs in conjunction with existing unemployment insurance (UI) to dampen COVID-19-related economic consequences. We investigate whether UI, operationalized as the weekly benefit allowance (WBA) replacement rate, is negatively associated with drug-related overdoses. <br><br>METHODS: Data from the pooled 2014-2020 Detailed Restricted Mortality files for all counties from the Centers for Disease Control and Prevention, restricted to people ≥18 years of age, aggregated at the county-quarter level (n = 89,914). We included any fatal drug, opioid, and stimulant overdose. We modeled the association between WBA replacement rate (e.g., a greater proportion of weekly earnings replaced by UI) on each county-level age-adjusted mortality outcome using separate linear regression models during 2014-2020, pre-COVID (2014-2018), and post-COVID (2019-2020). We conducted sensitivity analyses using multi-level linear regression models. <br><br>RESULTS: Results indicated that a more robust WBA replacement rate any drug (Risk Difference [RD]: -0.06, 95 % Confidence Interval [CI]: -0.08, -0.05), opioid (RD: -0.04, 95 % CI: -0.06, -0.03), and stimulant (RD: -0.03, 95 % CI: -0.04, -0.02) across the entire study period (2014-2020). A more robust WBA replacement rate was associated with fewer fatal drug, opioid and stimulant overdoses in the pre-COVID-19 period and on fatal any drug and stimulant overdoses in the COVID-19 period. <br><br>CONCLUSIONS: Findings support the notion that income protection policies, such as robust UI, can have a supportive role in preventing fatal drug overdoses, calling for a broader discussion onthe role of the safety net programs to buffer drug-related harms.<p /> <p>Language: en</p>",
language="en",
issn="0955-3959",
doi="10.1016/j.drugpo.2024.104522",
url="http://dx.doi.org/10.1016/j.drugpo.2024.104522"
}