文章基本信息

标题：Drug Prices and Emergency Department Mentions for Cocaine and Heroin
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作者：Jonathan P. Caulkins
期刊名称：American journal of public health
印刷版ISSN：0090-0036
出版年度：2001
卷号：91
期号：9
页码：1446-1448
语种：English
出版社：American Public Health Association
摘要：Objectives . In this report, the author illustrates the historic relation between retail drug prices and emergency department mentions for cocaine and heroin. Methods . Price series based on the Drug Enforcement Administration's System to Retrieve Information From Drug Evidence database were correlated with data on emergency department mentions from the Drug Abuse Warning Network for cocaine (1978–1996) and heroin (1981–1996). Results . A simple model in which emergency department mentions are driven by only prices explains more than 95% of the variation in emergency department mentions. Conclusions . Fluctuations in prices are an important determinant of adverse health outcomes associated with drugs. Most US drug control spending seeks to restrain supply, 1 which—unless it makes drugs physically scarce—affects use primarily through prices. 2 Hence, a key question concerns the extent to which drug prices affect use, particularly heavy or problematic use. 3 If use is not related to price, this focus on supply factors, and much of the literature on controlling drug markets, may be misguided. 4 Economists take it as an article of faith that use responds to price changes; they even have a term for quantifying the concept. The price elasticity of demand is the percentage change in consumption associated with a 1% increase in price. Other economists are more skeptical, believing that there may be an elasticity of demand for conventional goods, and perhaps even marijuana, but not for cocaine and heroin. I am not an economist, but I have some sympathy for economists' view in this case. The purpose of this report is to show some figures that might help a noneconomist understand intuitively that price variations may be related to drug use and associated health consequences, at least at the aggregate level. For cocaine and heroin, the figures presented here correlate retail prices, numbers of emergency department (ED) mentions, and numbers of mentions one might expect if prices were the only thing that affected ED mentions. Such correlations are not a significant contribution to the economics literature. Besides offering the usual admonition that “correlation does not imply causality,” an econometrician would note that prices and measures related to consumption are simultaneously determined, so price is an endogenous variable. To quantify the effect of price on consumption, one must “identify” the system with some “instrumental variable.” This is routine work for econometricians, and a growing literature empirically estimates elasticities of demand for addictive substances. 5 This literature generally finds that consumption of drugs such as cigarettes, alcohol, marijuana, and cocaine is surprisingly responsive to price changes. Econometric studies can, however, be bewildering to the uninitiated. In my experience, citing these studies to an audience skeptical that prices influence drug use is of little value. Nevertheless, simple descriptive plots, even if they offer no quantitative estimate of the elasticity of demand, can persuade skeptics of the basic point that price matters.