Tighter Prescription Regulations Limited the Rise of Opioid Use
Five states that required doctors to fill out triplicate forms and report opioid prescriptions experienced slower growth in OxyContin use.
The opioid epidemic struck with different force in different states. The average per capita usage rate over the last two decades of OxyContin, a widely used prescription opioid that was introduced in 1996, was about 50 percent lower in California, Idaho, Illinois, New York, and Texas than in other states. In Origins of the Opioid Crisis and Its Enduring Impacts (NBER Working Paper 26500),
Abby E. Alpert,
William N. Evans,
Ethan M.J. Lieber, and
David Powell show how regulations in these states influenced the marketing strategy of Purdue Pharma, the maker of OxyContin.
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According to internal company communications that were revealed in court documents, Purdue Pharma decided against mounting a significant marketing effort in the triplicate states after learning from focus groups that providers would be less willing to prescribe OxyContin in these states. To disentangle the impact of the triplicate rules themselves from the reduced marketing of OxyContin, the researchers compared the five triplicate states with two other groups of states that had had similarly stringent prescribing cultures: five non-triplicate states that had the lowest oxycodone prescribing rates in 1991–95; and two states that had dropped triplicate regulations just prior to OxyContin's introduction. In all non-triplicate states as well as both sets of comparison states with similar prescribing cultures, OxyContin use and opioid overdose deaths were substantially higher on average than in the five states that had triplicate policies in place when the drug came on the
— Steve Maas
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