OxyContin's Reformulation and Substance Use Disorder Treatment: Evidence from Admissions and Facilities

Abstract

I examine how the substance use disorder treatment sector responded to the abuse-deterrent reformulation of OxyContin, which contributed to a shift from prescription opioid misuse to heroin and synthetic opioids in the 2010s. States with higher pre-reformulation rates of OxyContin misuse experienced larger increases in heroin treatment admissions across outpatient and inpatient detoxification settings. Substance use disorder treatment facilities also expanded in higher misuse states, driven entirely by an increase in outpatient facilities. Despite increasing availability of medication-assisted treatment services at substance use disorder treatment facilities in higher misuse states, I find no evidence that heroin treatment admissions receiving medication-assisted treatment at these facilities increased. These results indicate that OxyContin’s reformulation increased opioid treatment admissions, shifted the composition of admissions toward heroin, and spurred expansion of outpatient treatment capacity.