Counties consuming lots of opioids were also more likely to vote for President Donald Trump in the 2016 election, according to a study published recently by the Journal of the American Medical Association's online portal.
The study, "Association of Chronic Opioid Use With Presidential Voting Patterns in US Counties in 2016," compares county-level results in the 2016 presidential election to rates of long-term opioid prescription among Medicare Part D enrollees, who make up about 72 percent of the Medicare population.
Opioid prescriptions are tied to, although not exclusively causative of, the opioid overdose crisis currently sweeping America. Variations in long-term prescription rates mirror county-level opioid overdose death rates, according to the study. Individuals in general do not overdose on prescribed opioids, but prescription pills are frequently diverted from their original recipient and abused by third parties.
The study's analysis yielded confirmation of the much-noted relationship between the Trump vote and opioid consumption rates. In the 700-some counties with statistically significantly higher rates of opioid prescription, the vote for Trump averaged around 60 percent; in those counties with significantly lower rates of prescription, the vote averaged around 39 percent.
This effect persisted even when a number of controls were applied to a model of the relationship. The study's authors accounted for factors such as household income, education, religious attendance, race, and gender. The relationship between Republican presidential vote and opioid prescription rate did not only remain statistically significant in the presence of these controls: it actually had the greatest explanatory power in terms of variance in the prescription rate.
The study's authors conducted the same analysis using the share of votes accrued by congressional Republicans, rather than Trump, in each county. There was a similar correlation between congressional vote and opioid prescription rate as with the Presidential vote, a phenomenon which persisted when congressional vote was added to the controlled model. However, in both cases, the congressional Republican vote was less predictive of the opioid prescription rate than the presidential vote (notably, the congressional and presidential votes were highly correlated).
What all of this suggests is straightforward: those counties most hooked on opioids—and, likely, also most feeling the effects of long-run opioid addiction—were also those which most strongly preferred to put Trump in the White House. That relationship persists, the study concluded, even when controlling for a number of potentially confounding factors, suggesting that the particular circumstances which have produced the epidemic themselves galvanized the Trump vote.