IDEAS home Printed from https://ideas.repec.org/p/nbr/nberwo/30471.html
   My bibliography  Save this paper

What Drives Risky Prescription Opioid Use? Evidence from Migration

Author

Listed:
  • Amy Finkelstein
  • Matthew Gentzkow
  • Dean Li
  • Heidi L. Williams

Abstract

We investigate the role of person- and place-specific factors in the opioid epidemic by developing and estimating a dynamic model of risky prescription opioid use. We estimate the model using the relationship between cross-state migration and risky use among adults receiving federal disability insurance from 2006 to 2015. Event studies suggest that moving to a state with a 3.5 percentage point higher rate of risky use (roughly the difference between the 20th and 80th percentile states) increases the probability of risky use by 1.0 percentage point on-impact, followed by an additional increase of 0.30 percentage points per subsequent year. Model estimates imply large place effects in both the likelihood of transitioning to addiction and the availability of prescription opioids. A one standard deviation reduction in all place effects would have reduced risky use by two-thirds over our study period. Reductions in place effects on addiction have a larger cumulative effect than analogous reductions in place effects on availability. However, their relative efficacy is reversed in the first few years, suggesting a temporal tradeoff among policy options.

Suggested Citation

  • Amy Finkelstein & Matthew Gentzkow & Dean Li & Heidi L. Williams, 2022. "What Drives Risky Prescription Opioid Use? Evidence from Migration," NBER Working Papers 30471, National Bureau of Economic Research, Inc.
    • Handle: RePEc:nbr:nberwo:30471
    Note: AG EH PE
    as

    Download full text from publisher

    File URL: http://www.nber.org/papers/w30471.pdf
    Download Restriction: no
    ---><---

    References listed on IDEAS

    as
    1. Janet M. Currie & W. Bentley MacLeod, 2020. "Understanding Doctor Decision Making: The Case of Depression Treatment," Econometrica, Econometric Society, vol. 88(3), pages 847-878, May.
    2. Clément de Chaisemartin & Xavier D'Haultfœuille, 2020. "Two-Way Fixed Effects Estimators with Heterogeneous Treatment Effects," American Economic Review, American Economic Association, vol. 110(9), pages 2964-2996, September.
    3. Fadlon, Itzik & Van Parys, Jessica, 2020. "Primary care physician practice styles and patient care: Evidence from physician exits in Medicare," Journal of Health Economics, Elsevier, vol. 71(C).
    4. Molly Schnell & Janet Currie, 2018. "Addressing the Opioid Epidemic: Is There a Role for Physician Education?," American Journal of Health Economics, University of Chicago Press, vol. 4(3), pages 383-410, Summer.
    5. Raj Chetty & John N. Friedman & Jonah E. Rockoff, 2014. "Measuring the Impacts of Teachers I: Evaluating Bias in Teacher Value-Added Estimates," American Economic Review, American Economic Association, vol. 104(9), pages 2593-2632, September.
    6. Corredor-Waldron, Adriana & Currie, Janet, 2022. "“Tackling the Substance Use Disorder Crisis: The Role of Access to Treatment Facilities”," Journal of Health Economics, Elsevier, vol. 81(C).
    7. Powell, David & Pacula, Rosalie Liccardo & Taylor, Erin, 2020. "How increasing medical access to opioids contributes to the opioid epidemic: Evidence from Medicare Part D," Journal of Health Economics, Elsevier, vol. 71(C).
    8. David Molitor, 2018. "The Evolution of Physician Practice Styles: Evidence from Cardiologist Migration," American Economic Journal: Economic Policy, American Economic Association, vol. 10(1), pages 326-356, February.
    9. David H. Autor & Mark G. Duggan, 2006. "The Growth in the Social Security Disability Rolls: A Fiscal Crisis Unfolding," Journal of Economic Perspectives, American Economic Association, vol. 20(3), pages 71-96, Summer.
    10. Christopher J. Ruhm, 2018. "Deaths of Despair or Drug Problems?," NBER Working Papers 24188, National Bureau of Economic Research, Inc.
    11. 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.
    12. James J. Heckman & Hidehiko Ichimura & Petra E. Todd, 1997. "Matching As An Econometric Evaluation Estimator: Evidence from Evaluating a Job Training Programme," The Review of Economic Studies, Review of Economic Studies Ltd, vol. 64(4), pages 605-654.
    13. 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.
    14. Carpenter, Christopher S. & McClellan, Chandler B. & Rees, Daniel I., 2017. "Economic conditions, illicit drug use, and substance use disorders in the United States," Journal of Health Economics, Elsevier, vol. 52(C), pages 63-73.
    15. Jessica Van Parys, 2016. "Variation in Physician Practice Styles within and across Emergency Departments," PLOS ONE, Public Library of Science, vol. 11(8), pages 1-19, August.
    16. Daniel I. Rees & Joseph J. Sabia & Laura M. Argys & Dhaval Dave & Joshua Latshaw, 2019. "With a Little Help from My Friends: The Effects of Good Samaritan and Naloxone Access Laws on Opioid-Related Deaths," Journal of Law and Economics, University of Chicago Press, vol. 62(1), pages 1-27.
    17. David M. Cutler & Edward L. Glaeser, 2021. "When Innovation Goes Wrong: Technological Regress and the Opioid Epidemic," Journal of Economic Perspectives, American Economic Association, vol. 35(4), pages 171-196, Fall.
    18. Doleac, Jennifer & Mukherjee, Anita, 2018. "The Moral Hazard of Lifesaving Innovations: Naloxone Access, Opioid Abuse, and Crime," IZA Discussion Papers 11489, Institute of Labor Economics (IZA).
    19. 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.
    20. David M. Cutler & Edward L. Glaeser, 2021. "When Innovation Goes Wrong: Technological Regress and the Opioid Epidemic," NBER Working Papers 28873, National Bureau of Economic Research, Inc.
    21. Alan B. Krueger, 2017. "Where Have All the Workers Gone? An Inquiry into the Decline of the U.S. Labor Force Participation Rate," Brookings Papers on Economic Activity, Economic Studies Program, The Brookings Institution, vol. 48(2 (Fall)), pages 1-87.
    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. 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. Effrosyni Adamopoulou & Jeremy Greenwood & Nezih Guner & Karen Kopecky, 2024. "The Role of Friends in the Opioid Epidemic," NBER Working Papers 32032, National Bureau of Economic Research, Inc.
    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).

    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. Aliprantis, Dionissi & Fee, Kyle & Schweitzer, Mark E., 2023. "Opioids and the labor market," Labour Economics, Elsevier, vol. 85(C).
    2. Claudio Deiana & Ludovica Giua & Roberto Nisticò, 2024. "Opium Price Shocks and Prescription Opioids in the USA," Oxford Bulletin of Economics and Statistics, Department of Economics, University of Oxford, vol. 86(3), pages 449-484, June.
    3. Chen, Chong & Huang, Qianqian & Shi, Chang & Yuan, Tao, 2024. "Opioid epidemic and corporate innovation," Journal of Corporate Finance, Elsevier, vol. 86(C).
    4. Ivan Badinski & Amy Finkelstein & Matthew Gentzkow & Peter Hull, 2023. "Geographic Variation in Healthcare Utilization: The Role of Physicians," NBER Working Papers 31749, National Bureau of Economic Research, Inc.
    5. Christopher J. Ruhm, 2018. "Deaths of Despair or Drug Problems?," NBER Working Papers 24188, National Bureau of Economic Research, Inc.
    6. Deiana Claudio & Giua Ludovica, 2021. "The Intended and Unintended Effects of Opioid Policies on Prescription Opioids and Crime," The B.E. Journal of Economic Analysis & Policy, De Gruyter, vol. 21(2), pages 751-792, April.
    7. 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.
    8. Gal Wettstein, 2019. "Health insurance and opioid deaths: Evidence from the Affordable Care Act young adult provision," Health Economics, John Wiley & Sons, Ltd., vol. 28(5), pages 666-677, May.
    9. Carolina Arteaga Cabrales & Victoria Barone, 2021. "The Opioid Epidemic: Causes and Consequences," Working Papers tecipa-698, University of Toronto, Department of Economics.
    10. 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.
    11. Janet Currie & Hannes Schwandt, 2021. "The Opioid Epidemic Was Not Caused by Economic Distress but by Factors That Could Be More Rapidly Addressed," The ANNALS of the American Academy of Political and Social Science, , vol. 695(1), pages 276-291, May.
    12. Ruhm, Christopher J., 2019. "Drivers of the fatal drug epidemic," Journal of Health Economics, Elsevier, vol. 64(C), pages 25-42.
    13. 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.).
    14. Janet Currie & Hannes Schwandt, 2020. "The Opioid Epidemic Was Not Primarily Caused by Economic Distress But by Other Factors that Can be More Readily Addressed," Working Papers 2020-25, Princeton University. Economics Department..
    15. David Beheshti, 2019. "Adverse health effects of abuse‐deterrent opioids: Evidence from the reformulation of OxyContin," Health Economics, John Wiley & Sons, Ltd., vol. 28(12), pages 1449-1461, December.
    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. Cotti, Chad D. & Gordanier, John M. & Ozturk, Orgul D., 2020. "The relationship of opioid prescriptions and the educational performance of children," Social Science & Medicine, Elsevier, vol. 265(C).
    18. 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.
    19. Eichmeyer, Sarah & Zhang, Jonathan, 2023. "Primary care providers’ influence on opioid use and its adverse consequences," Journal of Public Economics, Elsevier, vol. 217(C).
    20. Packham, Analisa, 2022. "Syringe exchange programs and harm reduction: New evidence in the wake of the opioid epidemic," Journal of Public Economics, Elsevier, vol. 215(C).

    More about this item

    JEL classification:

    • H51 - Public Economics - - National Government Expenditures and Related Policies - - - Government Expenditures and Health
    • I12 - Health, Education, and Welfare - - Health - - - Health Behavior

    NEP fields

    This paper has been announced in the following NEP Reports:

    Statistics

    Access and download statistics

    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:nbr:nberwo:30471. 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: the person in charge (email available below). General contact details of provider: https://edirc.repec.org/data/nberrus.html .

    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.