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

AuthorJessica Drescher,Lily Steyer,Carrie Townley-Flores,Keith Humphreys
Published date01 September 2022
Date01 September 2022
234 ANNALS, AAPSS, 703, September 2022
Has the Opioid
Crisis Affected
A National
Analysis of
Growth Rates
1151524ANN The Annals of the American AcademyHas the opioid crisis affected student learning?
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;
The U.S. is in the midst of an opioid addic-
tion and overdose crisis. Between 1999 and
DOI: 10.1177/00027162231151524
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.
Correction (April 2023): Article updated online to cor-
rect the acronym SEDA, and some grammatical errors in
the text. The URLs for Anderson, 2019; Data Quality
Campaign, 2019; and Quast, 2018 have been updated in
the references.
2010, prescription opioid sales quadrupled; and between 2000 and 2014, the
country experienced a 200 percent increase in the rate of overdose deaths involv-
ing 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 sug-
gests that ten to fifteen opioid pills are sufficient for recovery from most surgical
operations, meaning that these communities were experiencing an influx of opi-
oid 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.

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