Ep. 94: Targeted supply-side enforcement in the controlled substance market

Between 1997 and 2011, opioid dispensing in the United States more than tripled, fueling what would become the deadliest drug epidemic in American history. This surge in the supply of opioids was concentrated among a small subset of doctors: roughly 1 percent of the doctors who prescribed opioids accounted for almost 50 percent of all domestic opioid doses prescribed. In a paper in the American Economic Journal: Economic Policy, author Adam Soliman examined what happened when federal authorities cracked down on "rogue" doctors who overprescribed opioids.  He found that removing a single doctor from the opioid supply chain reduced county-level dispensing by 10 percent, with no negating increases in neighboring areas. Yet these interventions came with a trade-off—while overall drug mortality declined, heroin overdoses increased by 50 percent, likely as a result of existing users seeking alternatives.  Soliman recently spoke with Tyler Smith about how he untangled these complex enforcement effects and what his findings mean for combating drug epidemics that begin in the legal pharmaceutical market.