The Role of Physician Behavior in the Opioid Epidemic

While reports of pain have remained stable over the last 15 years, the use of prescription opioids in the United States has more than quadrupled since 1999. This dramatic expansion in the clinical use of opioids has led to a new wave of drug addiction in the US, with prescription drug overdoses surpassing auto fatalities as the leading cause of accidental deaths in 2008. In this paper, I design a dynamic, general equilibrium framework of opioids in order to examine the role that physician behavior has played in the current crisis. On the supply side, I model the prescription-writing decision of a utility-maximizing physician, while on the demand side I allow tastes for opioids to vary across locations and over time according to a diffusion model from the epidemiology literature. I estimate my model using detailed, prescriber-level data on all prescriptions written for opioids in the US in each month from 2006-2015. Applying this framework, I identify factors that influence the propensity of physicians to write opioid prescriptions, and examine how heterogeneity in physician behavior impacts the effectiveness of policy interventions. Preliminary results suggest that location-specific policies will be required to effectively curb opioid abuse across the diverse medical environments found in the US.