How Increasing Medical Access to Opioids Contributes to the Opioid Epidemic

Evidence from Medicare Part D

Published in: Journal of Health Economics, Volume 71 (May 2020). doi: 10.1016/j.jhealeco.2019.102286

Posted on RAND.org on June 26, 2020

by David Powell, Rosalie Liccardo Pacula, Erin Audrey Taylor

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Drug overdoses involving opioid analgesics have increased dramatically since 1999, representing one of the United States' top public health crises. Opioids have legitimate medical functions, but they are often diverted, suggesting a tradeoff between improving medical access and nonmedical abuse. We provide causal estimates of the relationship between the medical opioid supply and drug overdoses using Medicare Part D as a differential shock to the geographic distribution of opioids. Our estimates imply that a 10% increase in opioid medical supply leads to a 7.1% increase in opioid-related deaths among the Medicare-ineligible population, suggesting substantial diversion from medical markets.

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