In a recent study, researchers have shown that legitimate prescriptions of opioids as painkillers can significantly contribute to long-term addiction.
The study, conducted by Sarah Eichmeyer of Bocconi’s Department of Economics and Jonathan Zhang of McMaster University in Canada, sheds new light on the pathways into opioid dependence.
The research has been published in two papers: “Pathways into Opioid Dependence: Evidence from Practice Variation in Emergency Departments,” in the American Economic Journal, and
“Primary care providers’ influence on opioid use and its adverse consequences,” in the Journal of Public Economics.
The study comes amid an ongoing opioid crisis in the United States, which originated in the late 1990s when pharmaceutical companies reassured the medical community that patients would not become addicted to opioid painkillers.
Aggressive marketing strategies led to the widespread prescription of these painkillers.
Over time, misuse of both prescription and non-prescription opioids spiraled out of control, resulting in hundreds of thousands of overdose deaths and a significant societal cost.
To understand the factors underlying opioid addiction, the researchers turned to the medical records of about 2 million veterans provided by the US Veterans Health Administration.
This allowed them to perform a statistically robust analysis without conducting ethically questionable clinical tests on vulnerable individuals.
The researchers found wide variability in doctors’ inclination to prescribe opioids, even among those working in emergency departments.
Their study establishes not only a causal relationship between opioid prescriptions and later-stage addiction, but it also quantifies the extent of the impact.
Their findings indicate that an opioid prescription following an emergency department (ED) visit increases the probability of long-term prescription opioid use, opioid addiction, and overdose mortality by 1.2, 0.34, and 0.075 percentage points, respectively.
These numbers mean that out of every 1,400 people receiving an opioid prescription from an ED, one will eventually die of an overdose.
“Our results highlight that long-term opioid use, misuse, and dependence can arise as a consequence of small variations in medical care received in a single medical encounter, at the emergency department,” Sarah Eichmeyer explains.
“We do not find evidence for improved health—measured via improvements in pain—due to use of prescription opioids.”
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The study was published in American Economic Journal: Applied Economics.
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