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What drives prescription opioid abuse? Evidence from migration

We investigate the role of person-specific and place-specific factors in the opioid epidemic by analyzing cross-county migration of disabled Medicare recipients and its relationship with prescription patterns associated with opioid abuse. We find that movement to a county with a 20 percent higher rate of opioid abuse (equivalent to a move from a 25th to 75th percentile county) increases rates of opioid abuse by 6 percent, suggesting that roughly 30 percent of the gap between these areas is due to place-specific factors. These effects are particularly pronounced for prior opioid users, who experience an increase in opioid abuse four times larger than the increase for opioid naives.

Amy Finkelstein
Matthew Gentzkow
Heidi Williams
Publication Date
August, 2018