NB19-02: What Drives Prescription Opioid Use by People with Disabilities? Evidence from Migration

Opioid abuse is particularly pronounced among DI recipients, affecting their health and ability to return to work, as well as DI and Medicare program costs. This project will investigate the underlying causes of opioid abuse in this population; an important first step toward designing effective policies to combat it. We will build on prior work using Medicare panel data (Finkelstein et al. 2016) to examine how prescription opioid abuse changes as Medicare recipients with disabilities move across counties with different rates of abuse. These results will be of direct interest and will also lay the groundwork for subsequent projects examining the impact of opioid abuse on DI recipients' rates of work (or exit from DI) and on their overall health and healthcare use. Our work will consist of the following steps:
• Define sample of DI beneficiaries in Medicare claims who move across counties
• Measure opioid abuse in origin and destination counties, relative “size” of change
• Implement econometric specification, probe validity and sensitivity to identifying assumptions