Origins of the Opioid Crisis and its Enduring Impacts*

• 成果类型: Article
• 署名作者: Alpert, Abby; Evans, William N.; Lieber, Ethan M. J.; Powell, David
• 署名单位: University of Pennsylvania; National Bureau of Economic Research; University of Notre Dame; RAND Corporation
• 刊物名称: QUARTERLY JOURNAL OF ECONOMICS
• ISSN/ISSBN: 0033-5533
• DOI: 10.1093/qje/qjab043
• 发表日期: 2022
• 页码: 1139-1179
• 关键词: TRIPLICATE PRESCRIPTION PROGRAM; DRUG-MONITORING PROGRAMS; new-york-state; UNITED-STATES; PAIN MANAGEMENT; ABUSE; mortality; EPIDEMIC; overdose; deaths

摘要

Overdose deaths involving opioids have increased dramatically since the 1990s, leading to the worst drug overdose epidemic in U.S. history, but there is limited empirical evidence about the initial causes. In this article, we examine the role of the 1996 introduction and marketing of OxyContin as a potential leading cause of the opioid crisis. We leverage cross-state variation in exposure to OxyContin's introduction due to a state policy that substantially limited the drug's early entry and marketing in select states. Recently unsealed court documents involving Purdue Pharma show that state-based triplicate prescription programs posed a major obstacle to sales of OxyContin and suggest that less marketing was targeted to states with these programs. We find that OxyContin distribution was more than 50% lower in triplicate states in the years after the drug's launch. Although triplicate states had higher rates of overdose deaths prior to 1996, this relationship flipped shortly after the launch and triplicate states saw substantially slower growth in overdose deaths, continuing even 20 years after OxyContin's introduction. Our results show that the introduction and marketing of OxyContin explain a substantial share of overdose deaths over the past two decades. JEL Codes: I12, I18.