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Competitive effects of federal and state opioid restrictions: Evidence from the controlled substance laws

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  • Gupta, Sumedha
  • Nguyen, Thuy
  • Freeman, Patricia R.
  • Simon, Kosali

Abstract

A significant concern in the policy landscape of the U.S. opioid crisis is whether supply-side controls can reduce opioid prescribing without harmful substitution. We consider an unstudied policy: the federal Controlled Substance Act (CSA) restrictions placed in August 2014 on tramadol, the second most popular opioid medication. This was followed seven weeks later by CSA restrictions for hydrocodone combination products, the leading opioids on the market. Using regression discontinuity design (RDD) models, based on the timing of the (up-)scheduling changes, to explore spillover effects, we find that tightening prescribing restrictions on one opioid reduces its use, but increases prescribing of close competitors, leading to no reduction in total opioid prescriptions.This suggests that supply restrictions are not effective in reducing opioid prescribing the presence of close substitutes that remain unrestricted.

Suggested Citation

  • Gupta, Sumedha & Nguyen, Thuy & Freeman, Patricia R. & Simon, Kosali, 2023. "Competitive effects of federal and state opioid restrictions: Evidence from the controlled substance laws," Journal of Health Economics, Elsevier, vol. 91(C).
    • Handle: RePEc:eee:jhecon:v:91:y:2023:i:c:s0167629623000498
    DOI: 10.1016/j.jhealeco.2023.102772
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    Cited by:

    1. Alexander Ahammer & Analisa Packham, 2024. "Supply-Side Drug Policy, Polydrug Use, and the Economic Effects of Withdrawal Symptoms," NBER Working Papers 32804, National Bureau of Economic Research, Inc.
    2. 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.

    More about this item

    Keywords

    Opioids; Controlled substance act; Prescribing;
    All these keywords.

    JEL classification:

    • I12 - Health, Education, and Welfare - - Health - - - Health Behavior
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health

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