The Societal Effects of Harm Reduction

Abstract

ABSTRACT My dissertation consists of three chapters. The first chapter investigates the impact of syringe service program (SSP) legislation on fatal and nonfatal overdoses in Tennessee. Leveraging a 2018 law I utilize a difference-in-differences model using SSPs as a proxy for naloxone distribution. I find a significant increase in the gross number of overdoses in counties that implemented an SSP but not in the rate of overdoses in those counties. The second chapter examines the effect of SSP legislation on county-level crime. Many opponents of SSPs and harm reduction in general use “Not in my backyard” as an argument suggesting that these social services increase crime and drug use. I use a recent Tennessee law legalizing SSPs to identify if they do in fact increase crime. I find that implementation of SSPs does not have a significant effect on crime. The third chapter studies the effects of a federal regulation on sodium permanganate, an ingredient in the manufacturing of cocaine, on illicit drug use and overdose deaths, finding a significant increase in heroin use after the regulation but no other significant effects of illicit drug use or mortality.