Drug control policy can have unintended consequences by pushing existing users to alternative, possibly more dangerous substances. Policies that target only new users may therefore be especially promising. Using commercial insurance claims data, we provide the first evidence on a set of new policies intended to reduce opioid initiation in the form of limits on initial prescription length. We also provide the first evidence on the impact of must-access prescription drug monitoring programs (MA-PDMPs), laws that do not target new users, on initial opioid use. Although initial limit policies reduce the average length of initial prescriptions, they do so primarily by raising the frequency of short prescriptions, resulting in increases in opioids dispensed to new users. In contrast, we find that MA-PDMPs reduce opioids dispensed to new users, even though they do not explicitly set out to do so. Neither policy significantly affects extreme use such as doctor shopping among new patients, because such behavior is very rare.

药物管制政策可能会迫使现有使用者使用替代的、可能更危险的药物，从而产生意想不到的后果。因此，仅针对新用户的政策可能特别有前途。利用商业保险索赔数据，我们提供了一系列新政策的第一个证据，这些政策旨在以限制初始处方时长的形式减少阿片类药物的使用。我们还提供了第一份证据，证明必须使用的处方药监测计划 (MA-PDMP)（不针对新使用者的法律）对阿片类药物初始使用的影响。尽管初始限制政策减少了初始处方的平均长度，但它们主要是通过提高短期处方的频率来实现的，从而导致向新用户分配的阿片类药物增加。相比之下，我们发现 MA-PDMP 减少了向新用户分配的阿片类药物，即使他们没有明确规定这样做。这两项政策都不会显着影响新患者中的极端使用行为，例如就医，因为这种行为非常罕见。