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Title: Origins of the Opioid Crisis and Its Enduring Impacts

Citation Type: Working Paper

Publication Year: 2019

DOI: 10.3386/w26500

Abstract: Overdose deaths involving opioids have increased dramatically since the mid-1990s, leading to the worst drug overdose epidemic in U.S. history, but there is limited empirical evidence on the initial causes. In this paper, 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 OxyContin’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 about 50% lower in “triplicate states” in the years after the launch. While 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 twenty years after OxyContin's introduction. Our results show that the introduction and marketing of OxyContin explain a substantial share of overdose deaths over the last two decades.

Url: https://www.nber.org/papers/w26500

User Submitted?: No

Authors: Alpert, Abby E; Evans, William N; Lieber, Ethan M J; Powell, David

Series Title: NBER Working Paper Series

Publication Number: 26500

Institution: NBER

Pages:

Publisher Location:

Data Collections: IPUMS USA

Topics: Fertility and Mortality, Health, Other

Countries:

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