It's Only a Crisis if It's Fit to Print: Examining the Relationship Between Overdose Rates, News Coverage, and the Presence of the Opioid Crisis in State Legislative Campaigns.

Context: The modern opioid epidemic has been an increasingly prominent issue within the national media, culminating in significant attention during the 2016 and 2020 national elections, with non-uniform campaign attention at the state level. This paper explores the driving factors in this disparity, examining how public perception of the opioid crisis is shaped by its associated deaths and coverage of the issue in local media.

Methods: We model the presence of opioid policy and rhetoric in state legislative campaigns against both the abundance state-level news coverage and recorded overdose rates, including key controls for important demographic variables.

Findings: We find that news attention is the strongest predictor of campaign attention in state level campaigns. Further, while news media and actual overdose deaths can have a reinforcing effect, increasing candidate attention to an issue, media attention can also influence candidates through framing, encouraging increase attention in particular communities framed as major concerns within the media.

Conclusions: These results contribute to our understanding of opioid reform at the state level and speak to the impact of news media in both raising awareness and shaping frames about even highly salient issues in public health and beyond.