Did the Opioid Epidemic Help Republicans Win?

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Feb 2, 2026

Carolina Arteaga, assistant economics professor at the University of Toronto who studies the opioid epidemic's economic and political effects. She discusses research linking opioid exposure to rising Republican vote share. They cover Purdue’s marketing, how local media framed the crisis as crime not health, population and fertility shifts, and whether migration or persuasion drove political change.

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INSIGHT

Opioid Exposure Shifted Political Alignment

Carolina Arteaga finds a causal link from opioid exposure to rising Republican vote share across multiple elections.
The opioid epidemic reshaped community conditions and political trust, nudging many places rightward over decades.

INSIGHT

Purdue's Targeting Creates Research Lever

Purdue marketed OxyContin to cancer-treatment physicians to expand opioid prescribing beyond terminal care.
That targeted push created exogenous variation researchers use to link 1996 cancer prevalence to later opioid exposure.

INSIGHT

Cumulative Social Harms Drove Voting Change

The epidemic produced a cascade: more prescriptions, overdoses, disability, poverty, then political shifts.
Those economic and social harms accumulated and translated into higher Republican vote share by the 2010s.

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Over less than 25 years, the opioid epidemic killed over 800,000 Americans. These deaths and the resulting economic and political ramifications were unequally distributed across the country. Some places were ravaged, others barely noticed what was happening.

In this episode, host Jerusalem Demsas is joined by economist Carolina Arteaga to unpack new research linking the opioid crisis to increasing vote share for the Republican party. They dig into how a public-health catastrophe came to be a law and order issue, how conservative-leaning media covered the crisis differently, and how much of the shift can really be chalked up to persuasion. Plus: the surprising fertility finding in hard-hit areas and what it might say about opportunity and family formation.

The Argument is a podcast dedicated to honest, unflinching debate about the biggest questions facing democracy, culture, and our future. As the host, Editor-in-Chief Jerusalem Demsas brings together voices across the political spectrum to argue, challenge, and persuade. Each episode is a space where disagreements are confronted directly, with clarity and conviction, rather than hidden or shouted down.

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Articles, studies, and posts referenced in the episode can be found on our website.

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