 Primary care providers’ influence on opioid use and its adverse consequencesSarah Eichmeyer and Jonathan Zhang Journal of Public Economics, 2023, vol. 217, issue C Abstract: Primary care is the most frequently utilized health service and is the source of nearly half of all opioids prescribed in the United States. This paper studies the impact of exposure to high prescribing primary care providers (PCP) on opioid use, opioid use disorder, and mental health. Using electronic health records, we exploit within-facility quasi-random assignment of providers, who differ in their opioid prescribing tendency, to 650,000 new patients enrolling in care with the Veterans Health Administration. We find that assignment to a PCP who prescribes opioids at a 2.54 percentage point (pp) higher rate (equivalent to the average difference between a 90th and 10th percentile prescriber within a facility) increases the probability of long-term opioid use by 20% (or 0.43 pp) and development of opioid use disorder by 4% (or 0.035 pp). Veterans’ mental health deteriorates: the three-year likelihood of a depression diagnosis increases by 1.3% (or 0.31 pp). We find that PCPs with more cautious prescribing behavior rely more on non-opioid pain management and adhere more to clinical recommendations on naloxone distribution. Keywords: primary care; opioids; physician behavior; mental health (search for similar items in EconPapers) Downloads: (external link) Related works: Export reference: BibTeX RIS (EndNote, ProCite, RefMan) HTML/Text Persistent link: https://EconPapers.repec.org/RePEc:eee:pubeco:v:217:y:2023:i:c:s0047272722001864 DOI: 10.1016/j.jpubeco.2022.104784 Access Statistics for this article Journal of Public Economics is currently edited by R. Boadway and J. Poterba More articles in Journal of Public Economics from Elsevier |
Is your work missing from RePEc? Here is how to contribute.
Questions or problems? Check the EconPapers FAQ or send mail to .
EconPapers is hosted by the
School of Business at Örebro University.