# Measuring the Presence of Opioid Markets in Local Communities and Their Impacts on Harm

> **NIH NIH P50** · RAND CORPORATION · 2021 · $192,498

## Abstract

Project Summary
Prescription opioids have been a primary driver of the opioid epidemic, but more recently, overdoses involving
heroin and fentanyl have increased dramatically. These trends have not been uniform across the country, yet
we have little understanding about the heterogeneous effects of federal and state policies which seek to curb
the overdose rate. Many policies have been implemented to address the rise in opioid-related abuse including
prescription drug monitoring programs (PDMPs), pill mill regulations, and federal encouragement of abuse-
deterrent formulations. Recent research has suggested that these interventions may promote substitution from
non-medical prescription opioid use to abuse of heroin and fentanyl, partially unravelling the benefits of these
policies. This national-level evidence masks significant amounts of local heterogeneity. In this project, we will
explore this heterogeneity to understand which types of communities will be most impacted by certain policies
and which will experience such unintended consequences as individuals substitute to more harmful drugs. This
evidence is critical for predicting the local ramifications of federal and state policies and for providing
information to help mitigate such unintended harms.
Our analysis focuses on two central factors that likely determine local impacts of federal and state policies.
First, we will use a rich array of datasets and outcomes to fully-characterize local markets in terms of access to
prescription opioids for nonmedical use, fentanyl, and heroin. We further develop measures of how
interconnected these markets are as possible determinants of the scope for substitution across drugs. Second,
we will create measures of treatment access. Given a large reduction in the availability of prescription drugs for
misuse, individuals may substitute to other drugs or may seek treatment, and additional treatment availability
could potentially lead individuals to choose treatment instead of substituting to heroin. We will study the cross-
sectional and temporal relationship between local markets for opioids (by type) and treatment access to
understand the responsiveness of access to markets. Finally, we will study the heterogeneous effects of major
opioid-specific policies based on our measures of the maturation of local markets and treatment access. We
will focus on the adoption of “must access” PDMPs, pill mill crackdowns, the reformulation of OxyContin, and
the reformulation of Opana. The estimates will provide evidence about how specific local factors predict
responsiveness to opioid policies.

## Key facts

- **NIH application ID:** 10220923
- **Project number:** 5P50DA046351-04
- **Recipient organization:** RAND CORPORATION
- **Principal Investigator:** David Powell
- **Activity code:** P50 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $192,498
- **Award type:** 5
- **Project period:** 2018-08-15 → 2023-07-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10220923

## Citation

> US National Institutes of Health, RePORTER application 10220923, Measuring the Presence of Opioid Markets in Local Communities and Their Impacts on Harm (5P50DA046351-04). Retrieved via AI Analytics 2026-05-26 from https://api.ai-analytics.org/grant/nih/10220923. Licensed CC0.

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