Supply-Side Drug Policy in the Presence of Substitutes: Evidence from the Introduction of Abuse-Deterrent Opioids

Abstract

Overdose deaths from prescription opioid pain relievers nearly quadrupled between 1999 and 2010. We study the consequences of one of the largest supply disruptions to date to abusable opioids—the introduction of an abuse-deterrent version of OxyContin in 2010. Supply-side interventions that limit access to opioids may have the unintended consequence of increasing use of substitute drugs, including heroin. Exploiting cross-state variation in OxyContin exposure, we find that states with the highest initial rates of OxyContin misuse experienced the largest increases in heroin deaths. Our results imply that the recent heroin epidemic is largely due to the reformulation of OxyContin. (JEL I12, I18)

Mortality Quadrupled Among Opioid-Driven Hospitalizations, Notably Within Lower-Income And Disabled White Populations

“…2,36,37 Second, the price of prescription opioids such as oxycodone has remained higher than or increased relative to the price of heroin, which has likely contributed to the substitution pattern seen here and more broadly nationwide. 38,39 Third, as the medical and public health communities respond to the opioid crisis, less severe cases of opioid poisoning may have been increasingly treated in the field, outpatient settings, or the emergency department, thus leaving a greater proportion of more severe cases for inpatient admission.…”

Addressing the Opioid Epidemic: Is There a Role for Physician Education?

“…In addition to the introduction of PDMPs, 5 researchers have examined the impact of the introduction of abuse-deterrent opioids (Cicero and Ellis, 2012; Alpert et al, 2016; Evans et al, 2017), the strengthening of pain clinic laws (Kennedy-Hendricks et al, 2016; Meinhofer, 2016), and improvements in access to opioid antagonists such as naloxone (Mueller et al, 2015; Rees et al, 2017) on opioid abuse and related health outcomes. To the best of our knowledge, this is the first study to examine whether additional physician training is likely to have a significant role to play in addressing the opioid epidemic.…”

Impact of Florida's prescription drug monitoring program and pill mill law on high‐risk patients: A comparative interrupted time series analysis

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