Work

Regulating quasi-legal markets: Evidence from pain management clinic laws

Year: 2025

Type: article

Abstract: The opioid crisis has often been fueled by its simultaneous interaction with both medical and illicit markets, including "pill mills" that distribute legal substances in inappropriate and quasi-legal ways. Pain management clinic laws (PMCLs) aim to address this property by enforcing stricter regulatory licensing requirements and regulatory oversight on opioid prescribing establishments. Using a difference-in-differences framework and Medicare claims data, we find that PMCLs reduce problematic opioid prescribing and doctor shopping. Drawing on transaction-level information on opioid shipments, we estimate that PMCLs lead to strikingly large reductions in the volume of opioids dispensed directly by practitioners to patients. Studying mortality data, we estimate reductions in overdose death rates involving prescription opioids, with little evidence of substitution to illicit opioid markets. As PMCLs have not been adopted in most states, our results suggest they warrant greater attention from policymakers, even amid the declining role of prescription opioids in the annual death toll of the opioid crisis.

Source: Journal of Public Economics

DOI: 10.1016/j.jpubeco.2025.105515

Authors: Yuji Mizushima, David Powell, Rahi Abouk, Cheryl Damberg

Institutions: RAND Corporation, University of Pennsylvania, William Paterson University

Language: English

Topic: Opioid Use Disorder Treatment

Subfield: Public Health, Environmental and Occupational Health

Field: Medicine

Domain: Health Sciences

SDGs: Good health and well-being, Peace, justice, and strong institutions

Open Access status: hybrid

Estimated APC paid: $4,510