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What Drives Risky Prescription Opioid Use? Evidence from Migration

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  • 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.

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  • 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
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    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).

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    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

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