Has the Opioid Crisis Affected Student Learning? A National Analysis of Growth Rates

• DOI: http://doi.org/10.1177/00027162231151524
• Published date: 01 September 2022
• Date: 01 September 2022

234 ANNALS, AAPSS, 703, September 2022

DOI: 10.1177/00027162231151524

Has the Opioid

Crisis Affected

Student

Learning?

A National

Analysis of

Growth Rates

By

JESSICA DRESCHER,

LILY STEYER,

CARRIE TOWNLEY-

FLORES,

and

KEITH HUMPHREYS

1151524ANN The Annals of the American AcademyHas the opioid crisis affected student learning?

research-article2023

The potential spillover effects of the United States’

opioid epidemic on children’s educational outcomes

have received surprisingly little attention from research-

ers. Accordingly, this study leverages national datasets

of county-level opioid prescription rates and public

school students’ third- to eighth-grade academic

achievement to provide the first analysis of associations

between community opioid prevalence and children’s

learning rates. We find that students in counties with

higher community opioid presence learn more slowly

than peers in counties with low community opioid

presence, both in aggregate and across different racial,

ethnic, and socioeconomic groups of students.

Moreover, within states we observe a small significant

negative association between community opioid pres-

ence and student learning rates. This association is

similar in rural and nonrural communities. These find-

ings underscore the urgency of conceptualizing the

opioid epidemic as a community-level crisis, with

potentially long-lasting implications for children’s

future educational attainment and life outcomes.

Keywords: opioids; education; learning rates; student;

growth

The U.S. is in the midst of an opioid addic-

tion and overdose crisis. Between 1999 and

2010, prescription opioid sales quadrupled; and

between 2000 and 2014, the country experi-

enced a 200 percent increase in the rate of

Correspondence: jesscboyle@stanford.edu

Jessica Drescher (jesscboyle@stanford.edu) is a doctoral

candidate in education policy at Stanford University

and is a Health Policy Research Scholar with the Robert

Wood Johnson Foundation. Her current research

is focused on describing variation in educational

outcomes and examining the relationship between social

conditions and academic achievement.

Lily Steyer (lsteyer@stanford.edu) is a doctoral candi-

date in education policy at the Stanford University

Graduate School of Education. She studies socioeco-

nomic and racial inequalities in children’s physical,

cognitive, and social-emotional development and the

role of social policy in advancing equity.

HAS THE OPIOID CRISIS AFFECTED STUDENT LEARNING? 235

overdose deaths involving opioids (Centers for Disease Control and Prevention

2011; Rudd et al. 2016). The crisis has disproportionately hit specific counties

and states, with some areas of the country being showered with more than 100

opioid pills per resident per year (Eyre 2020; Humphreys et al. 2022). As a point

of reference, evidence suggests that ten to fifteen opioid pills are sufficient for

recovery from most surgical operations, meaning that these communities were

experiencing an influx of opioid pills that would cover treatment for seven to ten

surgeries per resident per year (Hill et al. 2017).

The adverse impacts of the crisis have been documented in many domains, but

surprisingly little attention has been directed to understanding how the opioid

crisis has affected children’s educational outcomes. Adverse childhood experi-

ences such as parental drug use can negatively affect life outcomes, including

academic performance (Jimenez et al. 2016). Children of opioid-addicted indi-

viduals have increased risk of emotional issues, behavioral problems, and poor

social skills, which contribute to poor academic performance (Peisch et al. 2018).

In addition to this direct link between parents and children, community drug use

in the child’s broader social environment outside the home is also linked to det-

rimental outcomes for children (Wolf et al. 2016). Understanding whether and to

what extent student learning has been disrupted by the opioid epidemic is a

hugely important, surprisingly understudied topic.

Two recent papers have shown that various measures of the opioid crisis are

associated with lower levels of academic achievement. Darolia, Owens, and Tyler

(this volume) find strong correlations between counties that have high drug-

related mortality rates and counties with worse test score outcomes among third-

and eighth-grade students. Although the authors find that, overall, mortality rates

are more strongly associated with test scores in nonrural counties, among rural

counties they observe that these relationships are stronger in areas with higher

mortality rates and higher degrees of geographic isolation for third-grade stu-

dents. Cotti, Gordanier, and Ozturk (2020) link 11 years of prescription data in

South Carolina to third- through eighth-grade test scores over the same period,

finding that increased prescription rates are associated with a reduction in White

Carrie Townley-Flores (ctflores@stanford.edu) is a doctoral candidate in education policy at

the Stanford University Graduate School of Education. Her research focuses on how early

childhood policies, events, and opportunities in health and education affect children’s long-

term outcomes.

Keith Humphreys (knh@stanford.edu) is the Esther Ting Memorial Professor in the Department

of Psychiatry at Stanford University and a Senior Research Career Scientist in the Veterans

Health Administration. He leads the Stanford-Lancet Commission on the North American

Opioid Crisis.

NOTE: This article would not have been possible without the assistance of Sean Reardon and

Demetra Kalogrides. We thank Sam Owens for his assistance with the distress map. The

research described here was supported by a grant from the Institute of Education Sciences

(R305B140009) and by the Robert Wood Johnson Foundation through the Health Policy

Research Scholars fellowship award. The opinions expressed are those of the authors and do

not represent views of the Institute of Education Sciences, the U.S. Department of Education,

the Board of Trustees of the Leland Stanford Junior University, or the Foundation.