In this paper, I propose an economic theory that addresses the epidemic character of opioid epidemics. I consider a community in which individuals are heterogenous with respect to the experience of chronic pain and susceptibility to addiction and live through two periods. In the first period they consider whether to treat pain with opioid pain relievers (OPRs). In the second period they consider whether to continue non-medical opioid use to mitigate cravings from addiction. Non-medical opioid use is subject to social disapproval, which depends negatively on the share of opioid addicts in the community. An opioid epidemic is conceptualized as the transition from an equilibrium at which opioid use is low and addiction is highly stigmatized to an equilibrium at which opioid use is prevalent and social disapproval is low. I show how such a transition is initiated by the wrong belief that OPRs are not very addictive. Under certain conditions there exists an opioid trap such that the community persists at the equilibrium of high opioid use after the wrong belief is corrected. Refinements of the basic model consider the recreational use of prescription OPRs and an interaction between income, pain, and addiction.

中文翻译：

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阿片类药物流行病。

在本文中，我提出了一种解决阿片类药物流行病流行特征的经济学理论。我考虑的社区中，个人在慢性疼痛和成瘾易感性方面是异类的，并且经历了两个时期。在第一阶段，他们考虑是否使用阿片类药物缓解剂（OPR）治疗疼痛。在第二阶段，他们考虑是否继续使用非医学类阿片类药物以减轻对成瘾的渴望。非医学类阿片类药物的使用会受到社会的反对，这在很大程度上取决于社区中阿片类药物成瘾者的比例。阿片类药物流行病的概念是从低阿片类药物使用和成瘾的平衡过渡到阿片类药物使用普遍和社会反对程度低的平衡。我展示了这样的过渡是如何由于错误的信念而引发的，即OPR不是很容易上瘾。在某些情况下，存在阿片类药物陷阱，这样，在纠正错误的信念之后，社区就可以维持在高阿片类药物使用量的平衡状态。基本模型的改进考虑了处方OPR的娱乐性使用以及收入，痛苦和成瘾之间的相互作用。