Recent evidence suggests that the short-term transition of the opioid crisis from prescription opioids to heroin can be attributed to the reformulation of OxyContin, which substantially reduced access to abusable prescription opioids. In this paper, we find that over a longer time horizon, reformulation stimulated illicit drug markets to grow and evolve. We compare overdose trajectories in areas more exposed to reformulation, defined as states with high rates of non-medical OxyContin use before reformulation, to less exposed areas. More exposed areas experienced disproportionate increases in fatal overdoses involving synthetic opioids (fentanyl) and non-opioid substances like cocaine, suggesting that these new epidemics are related to the same factors driving the rise in heroin deaths. Instead of just short-term substitution from prescription opioid to heroin overdoses, the transition to illicit markets spurred by reformulation led to growth in the overall overdose rate to unprecedented levels.

中文翻译：

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奥施康定重新配制对药物过量的演变后果

最近的证据表明，阿片类药物危机从处方阿片类药物到海洛因的短期过渡可归因于奥施康定的重新配制，这大大减少了对可滥用处方阿片类药物的获取。在本文中，我们发现在更长的时间范围内，重新配方刺激了非法药物市场的增长和演变。我们比较了更多暴露于重新配制的区域的过量轨迹，定义为重新配制前非医疗 OxyContin 使用率高的州，与较少暴露的区域。更多的暴露地区经历了涉及合成阿片类药物（芬太尼）和可卡因等非阿片类物质的致命过量服用的不成比例增加，这表明这些新的流行病与推动海洛因死亡人数上升的相同因素有关。