TY  - RPRT
        AU  - Graham, Francis W.
AU  - New, Sonja C. de
AU  - Nielsen, Suzanne
AU  - Petrie, Dennis
        TI  - Revisiting the OxyContin Reformulation: The Role of Licit Substitutes
        PY  - 2023/Dec/
        PB  - Institute of Labor Economics (IZA)
        CY  - Bonn
        T2  - IZA Discussion Paper
        IS  - 16653
        UR  - https://www.iza.org/index.php/publications/dp16653
        AB  - After the introduction of abuse-deterrent OxyContin in 2010, states with widespread extramedical OxyContin use experienced steep increases in heroin deaths, implying substitution from OxyContin to heroin. Leveraging cross-state variation in initial OxyContin utilization, we show the OxyContin reformulation also induced substitution to a similar prescription opioid product, Opana ER. States with high Opana ER utilization after the OxyContin reformulation experienced continued growth in prescription opioid deaths, and after Opana ER was reformulated 18 months later, an additional wave of substitution to heroin previously solely attributed to OxyContin. Our results highlight underappreciated substitution pathways throughout these pivotal years of the epidemic.
        KW  - opioids
KW  - opioid epidemic
KW  - OxyContin
KW  - Opana ER
KW  - heroin
        ER  -