Pathways into Opioid Dependence: Evidence from Practice Variation in Emergency Departments
利用医生处方差异，研究发现随机分配到高处方量医生的患者，后续长期使用阿片类药物、患上药物滥用障碍和过量死亡的风险显著增加，并提示可能转向非法阿片类药物。
We use practice variation across physicians to uncover the role of medical care in causing opioid dependence. Using health records of 2 million US veterans with emergency department visits, we find that quasi-random assignment to a top (versus bottom) decile prescribing provider significantly increases subsequent opioid use and misuse rates. Instrumental variable results show that opioid prescription receipt leads to a 20 percent increase in the probability of long-term prescription opioid use and sizable increases in the development of opioid use disorder and opioid overdose mortality. We find suggestive evidence of transition into illicit opioids due to prescription opioid exposure.