中文摘要
本文估计打击医生违规行为对处方阿片类药物需求量、跨市场替代和跨产品替代的影响。利用行政执法行动在时间和地点上看似外生的变异，我发现，对一名医生采取打击行动会使县级阿片类药物配发量减少10%。这种下降在空间上持续存在，并随时间推移而扩大。此外，海洛因替代现象显著，但药物过量致死率总体下降。这些结果凸显了政策制定者在实施定向打击时应考虑的一项关键权衡：必须在减少新增使用者流入与现有使用者转向更危险药物所造成的危害之间取得平衡。(JEL I11, I12, I18, K42)
Abstract
This paper estimates the impact of doctor crackdowns on the quantity demanded of prescription opioids, across-market substitution, and across-product substitution. Exploiting plausibly exogenous variation in the timing and location of administrative actions, I find cracking down on a single doctor decreases county-level opioid dispensing by 10 percent. This decline persists across space and grows over time. Additionally, significant heroin substitution occurs, yet overall overdose mortality decreases. These results highlight a critical tradeoff policymakers should consider with targeted crackdowns: Reductions in the flow of new users must be balanced against the harm that arises when existing users substitute to more dangerous drugs. (JEL I11, I12, I18, K42)