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

• 成果类型: Article
• 署名作者: Eichmeyer, Sarah; Zhang, Jonathan
• 署名单位: Bocconi University; McMaster University; US Department of Veterans Affairs; Veterans Health Administration (VHA)
• 刊物名称: AMERICAN ECONOMIC JOURNAL-APPLIED ECONOMICS
• ISSN/ISSBN: 1945-7782
• DOI: 10.1257/app.20210048
• 发表日期: 2022
• 页码: 271-+
• 关键词: chronic noncancer pain; c virus-infection; UNITED-STATES; prescribing patterns; risk-factors; polydrug use; health-care; back-pain; drug-use; prescription

摘要

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 sugges-tive evidence of transition into illicit opioids due to prescription opi-oid exposure.