Overdosing on Regulation: How Government Caused the Opioid Epidemic

20 Pages Posted: 10 Jun 2019

See all articles by Jeffrey Miron

Jeffrey Miron

Cato Institute

Greg Murphy Sollenberger

Casualty Actuarial Society

Laura Nicolae

Harvard University, Students

Date Written: February 14, 2019


Opioid overdose deaths have risen dramatically in the United States over the past two decades. The standard explanation blames expanded prescribing and advertising of opioids beginning in the 1990s.

This “more prescribing, more deaths” explanation has spurred increased legal restrictions on opioid prescribing. Federal and state governments have enacted a variety of policies to curtail prescribing and doctor shopping, and the federal government has raided pain management facilities deemed to be overprescribing. Supporters believe these policies reduce the supply of prescription opioids and thereby decrease overdose deaths.

We find little support for this view. We instead suggest that the opioid epidemic has resulted from too many restrictions on prescribing, not too few. Rather than decreasing opioid overdose deaths, restrictions push users from prescription opioids toward diverted or illicit opioids, which increases the risk of overdose because consumers cannot easily assess drug potency or quality in underground markets. The implication of this “more restrictions, more deaths” explanation is that the United States should scale back restrictions on opioid prescribing, perhaps to the point of legalization.

Keywords: opioid, epidemic, overdose, PDMP

JEL Classification: L65

Suggested Citation

Miron, Jeffrey and Sollenberger, Greg Murphy and Nicolae, Laura, Overdosing on Regulation: How Government Caused the Opioid Epidemic (February 14, 2019). Cato Institute Policy Analysis No. 864, Available at SSRN: https://ssrn.com/abstract=3382352

Jeffrey Miron (Contact Author)

Cato Institute ( email )

1000 Massachusetts Avenue, N.W.
Washington, DC 20001-5403
United States

Greg Murphy Sollenberger

Casualty Actuarial Society ( email )

United States

Laura Nicolae

Harvard University, Students ( email )

Cambridge, MA
United States

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