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Pathways into Opioid Dependence: Evidence from Practice Variation in Emergency Departments

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  • Sarah Eichmeyer
  • Jonathan Zhang

Abstract

We use practice variation across physicians to uncover the role of medical care in causing opioid dependence. Using health records of 2 million US veterans with emergency department visits, we find that quasi-random assignment to a top (versus bottom) decile prescribing provider significantly increases subsequent opioid use and misuse rates. Instrumental variable results show that opioid prescription receipt leads to a 20 percent increase in the probability of long-term prescription opioid use and sizable increases in the development of opioid use disorder and opioid overdose mortality. We find suggestive evidence of transition into illicit opioids due to prescription opioid exposure.

Suggested Citation

  • Sarah Eichmeyer & Jonathan Zhang, 2022. "Pathways into Opioid Dependence: Evidence from Practice Variation in Emergency Departments," American Economic Journal: Applied Economics, American Economic Association, vol. 14(4), pages 271-300, October.
    • Handle: RePEc:aea:aejapp:v:14:y:2022:i:4:p:271-300
    DOI: 10.1257/app.20210048
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    Citations

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    Cited by:

    1. Ruenzi, Stefan & Maeckle, Kai, 2023. "Friends with Drugs: The Role of Social Networks in the Opioid Epidemic," VfS Annual Conference 2023 (Regensburg): Growth and the "sociale Frage" 277574, Verein für Socialpolitik / German Economic Association.
    2. Adamopoulou, Effrosyni & Greenwood, Jeremy & Guner, Nezih & Kopecky, Karen, 2024. "The Role of Friends in the Opioid Epidemic," CEPR Discussion Papers 18803, C.E.P.R. Discussion Papers.
    3. Eichmeyer, Sarah & Zhang, Jonathan, 2023. "Primary care providers’ influence on opioid use and its adverse consequences," Journal of Public Economics, Elsevier, vol. 217(C).
    4. Johannes W. Ligtenberg & Tiemen Woutersen, 2024. "Multidimensional clustering in judge designs," Papers 2406.09473, arXiv.org.
    5. Attema, Arthur E. & Galizzi, Matteo M. & Groß, Mona & Hennig-Schmidt, Heike & Karay, Yassin & L’Haridon, Olivier & Wiesen, Daniel, 2023. "The formation of physician altruism," Journal of Health Economics, Elsevier, vol. 87(C).

    More about this item

    JEL classification:

    • I11 - Health, Education, and Welfare - - Health - - - Analysis of Health Care Markets
    • I12 - Health, Education, and Welfare - - Health - - - Health Behavior
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health

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