How the Reformulation of OxyContin Ignited the Heroin Epidemic

William N. Evans, Ethan Lieber, Patrick Power

NBER Working Paper No. 24475
Issued in April 2018
NBER Program(s):Health Care, Health Economics

We attribute the recent quadrupling of heroin death rates to the August, 2010 reformulation of an oft-abused prescription opioid, OxyContin. The new abuse-deterrent formulation led many consumers to substitute to an inexpensive alternative, heroin. Using structural break techniques and variation in substitution risk, we find that opioid consumption stops rising in August, 2010, heroin deaths begin climbing the following month, and growth in heroin deaths was greater in areas with greater pre-reformulation access to heroin and opioids. The reformulation did not generate a reduction in combined heroin and opioid mortality—each prevented opioid death was replaced with a heroin death.

Acknowledgments

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Document Object Identifier (DOI): 10.3386/w24475

Published: William N. Evans & Ethan M. J. Lieber & Patrick Power, 2019. "How the Reformulation of OxyContin Ignited the Heroin Epidemic," The Review of Economics and Statistics, vol 101(1), pages 1-15. citation courtesy of