Opioid Prescribing Limits and Opioid-Related Mortality

Abstract

The opioid epidemic has led state and local governments to enact legislation in an attempt to curb opioid overuse, addiction, and mortality. Most legislation focuses on preventing the already addicted from accessing opioids that could perpetuate their addiction or lead to overdose. A relatively new piece of legislation, prescribing limits, may instead be more successful in preventing addiction in the first place, which would lead to less overdoses overall. However, like any legislation that restricts access to prescribed opioids, prescribing limits may induce those already addicted to shift to other, un-regulated markets to get their opioids, resulting in more deaths. I use state-by-month level Vital Statistics NHCS’ multiple cause of death data and the roll-out of prescribing limits across states to establish the effect of prescribing limits on deaths rates from different types of opioids. Initial findings suggest that opioid prescribing limits decrease the death rate from heroin overdoses by .13 per 100,000 people per month and semisynthetic opioid overdoses, like from Oxycodone and Hydrocodone, by 0.09 per 100,000 people per month within a year, decreases of about 35% and 45% from the pre-treatment means, respectively. Deaths from synthetic opioids, like Fentanyl, drop by 0.16 per 100,000 people per month within a year as well, a decrease of about 26%, though these results are imprecisely estimated. The results found here are consistent with prescribing limits making people less likely to accidentally overdose from their legitimate prescriptions and making it less likely for people to misuse their opioids and develop a tolerance, and thus addiction.