The opioid crisis in the United States and Canada has reached unprecedented levels. One understudied dimension is its impact on the next generation. We use linked administrative data from the Canadian province of British Columbia (where opioid death rates exceed the US national average) that links birth records since 2000 to health, education, well-being and mortality for both the mother and the child. We have three main findings. First, the number of newborns exposed to opioids in utero (obtained from data linking newborn and mother medical records) is many times larger than commonly reported statistics which rely on diagnoses of neonatal abstinence syndrome. Second, exposure to in utero opioids is associated with large and persistent adverse child health, human capital, and well-being outcomes; these associations are above and beyond what is predicted by the mother’s socioeconomic status and the newborn’s health. Finally, two different quasi-experiments provide suggestive evidence that causal estimates are qualitatively similar, but noisy.

Dr. Simard-Duplain is an Assistant Professor in the Department of Economics, at Carleton University. Her research focuses on the determination of health and labour market outcomes. She is particularly interested in the interaction of policy and family in mitigating or exacerbating inequalities, through both intrahousehold family dynamics and intergenerational transmission mechanisms. She received her PhD in 2019 from the Vancouver School of Economics, University of British Columbia.