RAND, Arlington, VA 22202, United States.
University of Southern California, Los Angeles, CA 90089, United States.
J Health Econ. 2020 May;71:102286. doi: 10.1016/j.jhealeco.2019.102286. Epub 2020 Mar 4.
Drug overdoses involving opioid analgesics have increased dramatically since 1999, representing one of the United States' top public health crises. Opioids have legitimate medical functions, but they are often diverted, suggesting a tradeoff between improving medical access and nonmedical abuse. We provide causal estimates of the relationship between the medical opioid supply and drug overdoses using Medicare Part D as a differential shock to the geographic distribution of opioids. Our estimates imply that a 10% increase in opioid medical supply leads to a 7.1% increase in opioid-related deaths among the Medicare-ineligible population, suggesting substantial diversion from medical markets.
自 1999 年以来，涉及阿片类镇痛药的药物过量急剧增加，这是美国最严重的公共卫生危机之一。阿片类药物具有合法的医疗功能，但它们经常被转移，这表明在改善医疗服务获取和非医疗滥用之间存在权衡。我们利用医疗保险处方药计划（Medicare Part D）作为阿片类药物地理分布的差异冲击，提供了医疗用阿片类供应与药物过量之间关系的因果估计。我们的估计表明，医疗用阿片类供应增加 10%，会导致医疗保险不覆盖人群中与阿片类相关的死亡人数增加 7.1%，这表明大量阿片类药物从医疗市场转移。
