Investigators: Ilaria Natali


The abuse and misuse of opioid analgesics is a serious public health problem in the US and has recently raised serious concerns in France as well. In this context, the research of effective interventions aimed at limiting the abuse of narcotic medications becomes a topic of primary importance. This paper assesses the impact of laws that restrict access to opioid products and builds on previous studies by showing how local economic conditions, as proxied by the level of poverty, matter for the magnitude of responses to these policies. The empirical investigation is performed by using OpenHealth monthly data on Codeine- product sales for the year 2017 and for the 94 departments composing Metropolitan France. By using a difference in differences (DiD) approach, I first estimate the causal impact of a new regulation that forbids over-the-counter (OTC) sales of Codeine products. I then exploit a triple difference (TD) strategy to evaluate the existence of possible heterogeneous responses across French departments, depending on their economic prosperity. I find that the new law proved effective in reducing Codeine consumption and that departments in eco- nomic disadvantage exhibit smaller decreases in consumption following the new law. Hence, poorer departments are more ‘regulatory-inelastic’. This means that demand-side factors can contribute to amplify or hinder the effect of supply-side interventions. Policy-makers should, therefore, take into account the former when evaluating the impact of the latter. Moreover, results suggests that additional measures, such as intensified pharmacovigilance, healthcare professional education and support services, should be addressed towards the most disadvantaged local communities.