Can Policy Affect Initiation of Addictive Substance Use? Evidence from Opioid Prescribing

44 Pages Posted: 26 Jun 2019 Last revised: 22 Jun 2023

See all articles by Daniel W. Sacks

Daniel W. Sacks

Indiana University - Kelley School of Business - Department of Business Economics & Public Policy

Alex Hollingsworth

Indiana University Bloomington - School of Public & Environmental Affairs (SPEA)

Thuy Dieu Nguyen

Indiana University Bloomington

Kosali Ilayperuma Simon

Indiana University

Date Written: June 2019

Abstract

Drug control policy can have unintended consequences by pushing existing users to alternative, possibly more dangerous substances. Policies that target only new users may therefore be especially promising. Using commercial insurance claims data, we provide the first evidence on a set of new policies intended to reduce opioid initiation in the form of limits on initial prescription length. We also provide the first evidence on the impact of must-access prescription drug monitoring programs (MA-PDMPs), laws that do not target new users, on initial opioid use. Although initial limit policies reduce the average length of initial prescriptions, they do so primarily by raising the frequency of short prescriptions, resulting in increases in opioids dispensed to new users. In contrast, we find that MA-PDMPs reduce opioids dispensed to new users, even though they do not explicitly set out to do so. Neither policy significantly affects extreme use such as doctor shopping among new patients, because such behavior is very rare.

Suggested Citation

Sacks, Daniel W. and Hollingsworth, Alex and Nguyen, Thuy Dieu and Simon, Kosali Ilayperuma, Can Policy Affect Initiation of Addictive Substance Use? Evidence from Opioid Prescribing (June 2019). NBER Working Paper No. w25974, Available at SSRN: https://ssrn.com/abstract=3408906

Daniel W. Sacks (Contact Author)

Indiana University - Kelley School of Business - Department of Business Economics & Public Policy ( email )

Bloomington, IN 47405
United States

Alex Hollingsworth

Indiana University Bloomington - School of Public & Environmental Affairs (SPEA) ( email )

1315 East Tenth Street
Bloomington, IN 47405
United States

HOME PAGE: http://alexjhollingsworth.com

Thuy Dieu Nguyen

Indiana University Bloomington ( email )

Kosali Ilayperuma Simon

Indiana University ( email )

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