The Opioid Crisis and Republican Vote Share

Over the past two decades, the U.S. has experienced a spike in overdose deaths involving opioids. Demographically, the communities who have been affected most severely by this crisis are non-Hispanic Whites from the rural working class–the same demographic that propelled Donald Trump’s 2016 bid for the White House to victory. Starting from this insight, this paper analyses the 2016 U.S. Presidential Election and its links to the opioid crisis. Many of the factors that contributed to the surge in support for Trump are captured well by a variety of socioeconomic indicators, such as unemployment and poverty rates. However, there are many politically salient aspects of de-industrialisation and social decay–such as perceived social immobility and the loss of a sense of community–that are not captured by these socioeconomic indicators but are also amongst the leading causes of opioid addiction. This paper argues that this high degree of congruence of the causes of addiction and of the surge in support for Trump renders county-level opioid prescription rates a powerful proxy-measure of these otherwise elusive aspects. To investigate this claim, this paper employs multivariate regression analysis to evaluate the relationship between opioid prescription rates and Republican vote share on a county-level using data from the Centers for Disease Control and Prevention (CDC) and from the MIT Election Lab. Two hypotheses are investigated: Firstly, that the change of opioid prescription rates between 2008 and 2016 and the change in vote share for the Republican Party across the same period are positively correlated. Secondly, that the explanatory power of the statistical model is significantly increased by including opioid prescription rates versus only including standard socioeconomic indicators. The results of this paper are potentially significant for a number of reasons. For one, establishing a more powerful and complete model of voting behaviour using a better set of indicators than past models is, in itself, important. Furthermore, the link between opioid addiction and the populist backlash suggests that policies devised for preventing and treating addiction could be effective in depolarising postindustrial societies.