The Evolving Consequences of Oxycontin Reformulation on Drug Overdoses

41 Pages Posted: 13 Apr 2020 Last revised: 30 Mar 2023

See all articles by David Powell

David Powell

RAND Corporation

Rosalie Liccardo Pacula

University of Southern California - Schaeffer Center for Health Policy and Economics; National Bureau of Economic Research (NBER)

Date Written: April 2020

Abstract

Recent evidence suggests that the short-term transition of the opioid crisis from prescription opioids to heroin can be attributed to the reformulation of OxyContin, which substantially reduced access to abusable prescription opioids. In this paper, we find that over a longer time horizon, reformulation stimulated illicit drug markets to grow and evolve. We compare overdose trajectories in areas more exposed to reformulation, defined as states with higher rates of non-medical OxyContin use before reformulation, to less exposed areas. More exposed areas experienced disproportionate increases in fatal overdoses involving synthetic opioids (fentanyl) and non-opioid substances like cocaine, suggesting that these new epidemics are related to the same factors driving the rise in heroin deaths. Instead of just short-term substitution from prescription opioid to heroin overdoses, the transition to illicit markets spurred by reformulation led to growth in the overall overdose rate to unprecedented levels.

Suggested Citation

Powell, David and Pacula, Rosalie Liccardo, The Evolving Consequences of Oxycontin Reformulation on Drug Overdoses (April 2020). NBER Working Paper No. w26988, Available at SSRN: https://ssrn.com/abstract=3574452

David Powell (Contact Author)

RAND Corporation ( email )

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Rosalie Liccardo Pacula

University of Southern California - Schaeffer Center for Health Policy and Economics ( email )

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Los Angeles, CA 90089-3333
United States

National Bureau of Economic Research (NBER)

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Cambridge, MA 02138
United States

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