IDEAS home Printed from https://ideas.repec.org/a/eee/jhecon/v75y2021ics0167629620310547.html
   My bibliography  Save this article

Must-access prescription drug monitoring programs and the opioid overdose epidemic: The unintended consequences

Author

Listed:
  • Kim, Bokyung

Abstract

Although supply-side drug policies that limit access to legal opioids have reduced prescription opioid abuse, growing evidence shows that these policies have had the unintended consequence of increasing use of illegal opioids, including heroin. I add to this literature by studying the consequences of must-access prescription drug monitoring programs (PDMPs), which legally require providers to access a state-level database with a patient's prescription history before prescribing controlled substances under certain circumstances. Using a difference-in-differences specification, I find strong evidence that must-access PDMPs have increased heroin death rates. My estimates indicate that two years after implementation, must-access PDMPs were associated with 0.9 more heroin deaths per 100,000 in a half-year period, relative to control states. My results suggest that even if must-access PDMPs reduce prescription opioid deaths, the decrease is offset by a large increase in illegal opioid deaths.

Suggested Citation

  • Kim, Bokyung, 2021. "Must-access prescription drug monitoring programs and the opioid overdose epidemic: The unintended consequences," Journal of Health Economics, Elsevier, vol. 75(C).
  • Handle: RePEc:eee:jhecon:v:75:y:2021:i:c:s0167629620310547
    DOI: 10.1016/j.jhealeco.2020.102408
    as

    Download full text from publisher

    File URL: http://www.sciencedirect.com/science/article/pii/S0167629620310547
    Download Restriction: Full text for ScienceDirect subscribers only

    File URL: https://libkey.io/10.1016/j.jhealeco.2020.102408?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    As the access to this document is restricted, you may want to search for a different version of it.

    References listed on IDEAS

    as
    1. Frank, Richard G. & Zeckhauser, Richard J., 2007. "Custom-made versus ready-to-wear treatments: Behavioral propensities in physicians' choices," Journal of Health Economics, Elsevier, vol. 26(6), pages 1101-1127, December.
    2. William N. Evans & Ethan M. J. Lieber & Patrick Power, 2019. "How the Reformulation of OxyContin Ignited the Heroin Epidemic," The Review of Economics and Statistics, MIT Press, vol. 101(1), pages 1-15, March.
    3. Abby Alpert & David Powell & Rosalie Liccardo Pacula, 2018. "Supply-Side Drug Policy in the Presence of Substitutes: Evidence from the Introduction of Abuse-Deterrent Opioids," American Economic Journal: Economic Policy, American Economic Association, vol. 10(4), pages 1-35, November.
    4. Anca M. Grecu & Dhaval M. Dave & Henry Saffer, 2019. "Mandatory Access Prescription Drug Monitoring Programs and Prescription Drug Abuse," Journal of Policy Analysis and Management, John Wiley & Sons, Ltd., vol. 38(1), pages 181-209, January.
    5. Jeffrey Clemens & Joshua D. Gottlieb, 2014. "Do Physicians' Financial Incentives Affect Medical Treatment and Patient Health?," American Economic Review, American Economic Association, vol. 104(4), pages 1320-1349, April.
    6. Sun, Liyang & Abraham, Sarah, 2021. "Estimating dynamic treatment effects in event studies with heterogeneous treatment effects," Journal of Econometrics, Elsevier, vol. 225(2), pages 175-199.
    7. Angélica Meinhofer, 2018. "Prescription Drug Monitoring Programs: The Role of Asymmetric Information on Drug Availability and Abuse," American Journal of Health Economics, University of Chicago Press, vol. 4(4), pages 504-526, Fall.
    8. Sacks, Daniel W. & Hollingsworth, Alex & Nguyen, Thuy & Simon, Kosali, 2021. "Can policy affect initiation of addictive substance use? Evidence from opioid prescribing," Journal of Health Economics, Elsevier, vol. 76(C).
    9. Nathan W. Chan & Jesse Burkhardt & Matthew Flyr, 2020. "The Effects Of Recreational Marijuana Legalization And Dispensing On Opioid Mortality," Economic Inquiry, Western Economic Association International, vol. 58(2), pages 589-606, April.
    10. Thomas C. Buchmueller & Colleen Carey, 2018. "The Effect of Prescription Drug Monitoring Programs on Opioid Utilization in Medicare," American Economic Journal: Economic Policy, American Economic Association, vol. 10(1), pages 77-112, February.
    11. Birk, Erica G. & Waddell, Glen R., 2017. "The Mitigating Role of Prescription Drug Monitoring Programs in the Abuse of Prescription Drugs," IZA Discussion Papers 10990, Institute of Labor Economics (IZA).
    12. Jill Horwitz & Corey S. Davis & Lynn S. McClelland & Rebecca S. Fordon & Ellen Meara, 2018. "The Problem of Data Quality in Analyses of Opioid Regulation: The Case of Prescription Drug Monitoring Programs," NBER Working Papers 24947, National Bureau of Economic Research, Inc.
    13. Paulozzi, L.J., 2006. "Opioid analgesic involvement in drug abuse deaths in American metropolitan areas," American Journal of Public Health, American Public Health Association, vol. 96(10), pages 1755-1757.
    14. Davis, C.S. & Pierce, M. & Dasgupta, N., 2014. "Evolution and convergence of state laws governing controlled substance prescription monitoring programs, 1998-2011," American Journal of Public Health, American Public Health Association, vol. 104(8), pages 1389-1395.
    15. Angélica Meinhofer, 2018. "Prescription Drug Monitoring Programs: The Role of Asymmetric Information on Drug Availability and Abuse," American Journal of Health Economics, MIT Press, vol. 4(4), pages 504-526, Fall.
    16. Amy Finkelstein, 2007. "The Aggregate Effects of Health Insurance: Evidence from the Introduction of Medicare," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 122(1), pages 1-37.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Simone Balestra & Helge Liebert & Nicole Maestas & Tisamarie B. Sherry, 2021. "Behavioral Responses to Supply-Side Drug Policy During the Opioid Epidemic," NBER Working Papers 29596, National Bureau of Economic Research, Inc.
    2. Lucas Marín Llanes & Hernando Zuleta, 2022. "Myths of drug consumption decriminalization: effects of Portuguese decriminalization on violent and drug use mortality," Documentos CEDE 20328, Universidad de los Andes, Facultad de Economía, CEDE.
    3. Garrouste, Clémentine & Juet, Arthur & Samson, Anne-Laure, 2023. "Direct and crowding-out effects of a Hepatitis B vaccination campaign," Economics & Human Biology, Elsevier, vol. 51(C).
    4. Smart, Rosanna & Powell, David & Pacula, Rosalie Liccardo & Peet, Evan & Abouk, Rahi & Davis, Corey S., 2024. "Investigating the complexity of naloxone distribution: Which policies matter for pharmacies and potential recipients," Journal of Health Economics, Elsevier, vol. 97(C).
    5. Abouk, Rahi & Powell, David, 2021. "Can electronic prescribing mandates reduce opioid-related overdoses?," Economics & Human Biology, Elsevier, vol. 42(C).
    6. Shishir Shakya & Jane E. Ruseski, 2023. "The effect of Prescription Drug Monitoring Programs on county‐level opioid prescribing practices and spillovers," Contemporary Economic Policy, Western Economic Association International, vol. 41(3), pages 435-454, July.
    7. Kaestner, Robert & Ziedan, Engy, 2023. "Effects of prescription opioids on employment, earnings, marriage, disability and mortality: Evidence from state opioid control policies," Labour Economics, Elsevier, vol. 82(C).
    8. Johanna Catherine Maclean & Justine Mallatt & Christopher J. Ruhm & Kosali Simon, 2022. "The Opioid Crisis, Health, Healthcare, and Crime: A Review of Quasi-Experimental Economic Studies," The ANNALS of the American Academy of Political and Social Science, , vol. 703(1), pages 15-49, September.
    9. Denis Agniel & Jonathan H. Cantor & Johanna Catherine Maclean & Kosali I. Simon & Erin Taylor, 2023. "Insurance Coverage and Provision of Opioid Treatment: Evidence from Medicare," NBER Working Papers 31884, National Bureau of Economic Research, Inc.
    10. Buckles, Kasey & Evans, William N. & Lieber, Ethan M.J., 2023. "The drug crisis and the living arrangements of children," Journal of Health Economics, Elsevier, vol. 87(C).
    11. Shishir Shakya & Collin Hodges, 2023. "Must‐access prescription drug monitoring programs and retail opioid sales," Contemporary Economic Policy, Western Economic Association International, vol. 41(1), pages 146-165, January.

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Simone Balestra & Helge Liebert & Nicole Maestas & Tisamarie B. Sherry, 2021. "Behavioral Responses to Supply-Side Drug Policy During the Opioid Epidemic," NBER Working Papers 29596, National Bureau of Economic Research, Inc.
    2. Shishir Shakya & Collin Hodges, 2023. "Must‐access prescription drug monitoring programs and retail opioid sales," Contemporary Economic Policy, Western Economic Association International, vol. 41(1), pages 146-165, January.
    3. Shishir Shakya & Jane E. Ruseski, 2023. "The effect of Prescription Drug Monitoring Programs on county‐level opioid prescribing practices and spillovers," Contemporary Economic Policy, Western Economic Association International, vol. 41(3), pages 435-454, July.
    4. Thomas C. Buchmueller & Colleen M. Carey & Giacomo Meille, 2020. "How well do doctors know their patients? Evidence from a mandatory access prescription drug monitoring program," Health Economics, John Wiley & Sons, Ltd., vol. 29(9), pages 957-974, September.
    5. Kaestner, Robert & Ziedan, Engy, 2023. "Effects of prescription opioids on employment, earnings, marriage, disability and mortality: Evidence from state opioid control policies," Labour Economics, Elsevier, vol. 82(C).
    6. Dhaval Dave & Monica Deza & Brady Horn, 2021. "Prescription drug monitoring programs, opioid abuse, and crime," Southern Economic Journal, John Wiley & Sons, vol. 87(3), pages 808-848, January.
    7. David Cho & Alvaro Mezza & Joshua Montes, 2022. "Choices and Implications when Measuring the Local Supply of Prescription Opioids," Finance and Economics Discussion Series 2022-078, Board of Governors of the Federal Reserve System (U.S.).
    8. David Cho & Daniel I. García & Joshua Montes & Alison E. Weingarden, 2021. "Labor Market Effects of the Oxycodone-Heroin Epidemic," Finance and Economics Discussion Series 2021-025, Board of Governors of the Federal Reserve System (U.S.).
    9. Thuy D. Nguyen & W. David Bradford & Kosali I. Simon, 2019. "How do Opioid Prescribing Restrictions Affect Pharmaceutical Promotion? Lessons from the Mandatory Access Prescription Drug Monitoring Programs," NBER Working Papers 26356, National Bureau of Economic Research, Inc.
    10. Sumedha Gupta & Thuy D. Nguyen & Patricia R. Freeman & Kosali I. Simon, 2020. "Competitive Effects of Federal and State Opioid Restrictions: Evidence from the Controlled Substance Laws," NBER Working Papers 27520, National Bureau of Economic Research, Inc.
    11. Christopher J. Ruhm, 2019. "Shackling the Identification Police?," Southern Economic Journal, John Wiley & Sons, vol. 85(4), pages 1016-1026, April.
    12. Gihleb, Rania & Giuntella, Osea & Zhang, Ning, 2020. "Prescription drug monitoring programs and neonatal outcomes," Regional Science and Urban Economics, Elsevier, vol. 81(C).
    13. Aljoscha Janssen & Xuan Zhang, 2023. "Retail Pharmacies and Drug Diversion during the Opioid Epidemic," American Economic Review, American Economic Association, vol. 113(1), pages 1-33, January.
    14. David Powell & Rosalie Liccardo Pacula, 2021. "The Evolving Consequences of OxyContin Reformulation on Drug Overdoses," American Journal of Health Economics, University of Chicago Press, vol. 7(1), pages 41-67.
    15. Johanna Catherine Maclean & Justine Mallatt & Christopher J. Ruhm & Kosali Simon, 2022. "The Opioid Crisis, Health, Healthcare, and Crime: A Review of Quasi-Experimental Economic Studies," The ANNALS of the American Academy of Political and Social Science, , vol. 703(1), pages 15-49, September.
    16. Daniele, Gianmarco & Le Moglie, Marco & Masera, Federico, 2023. "Pains, guns and moves: The effect of the U.S. opioid epidemic on Mexican migration," Journal of Development Economics, Elsevier, vol. 160(C).
    17. Aparna Soni, 2024. "Estimating price elasticities of demand for pain relief drugs: evidence from Medicare Part D," International Journal of Health Economics and Management, Springer, vol. 24(4), pages 481-515, December.
    18. Eichmeyer, Sarah & Zhang, Jonathan, 2023. "Primary care providers’ influence on opioid use and its adverse consequences," Journal of Public Economics, Elsevier, vol. 217(C).
    19. Lindsey Rose Bullinger & Benjamin C. Ward, 2021. "What about the children? How opioid use affects child well‐being," Contemporary Economic Policy, Western Economic Association International, vol. 39(4), pages 737-759, October.
    20. Lucy Xiaolu Wang, 2021. "The complementarity of drug monitoring programs and health IT for reducing opioid‐related mortality and morbidity," Health Economics, John Wiley & Sons, Ltd., vol. 30(9), pages 2026-2046, September.

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:eee:jhecon:v:75:y:2021:i:c:s0167629620310547. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Catherine Liu (email available below). General contact details of provider: http://www.elsevier.com/locate/inca/505560 .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.