Opioids prescribing restrictions and homelessness: Evidence from hydrocodone rescheduling

Abstract

This paper examines the effect of restricting opioid prescription on homelessness. We assess this relationship by exploiting plausible exogenous variation in prescribed opioid supply derived from an opioid restriction policy: the hydrocodone (i.e., Vicodin, not oxycodone products like Oxycontin) rescheduling. We identified the causal effect of this decrease in the supply of hydrocodone, the most prescribed opioid in the U.S. and comprising 55% of overall use opioid prescription dispensing, by comparing the number of homeless individuals in geographies with higher exposure to Hydrocodone against those in areas with lower exposure, before and after the enactment of the policy. We find that in the quarter following hydrocodone upscheduling, the rate of people experiencing homelessness decreased by almost 56 per 100,000 inhabitants (a 25.4% reduction relative to the pre-policy mean). In addition, results show that hydrocodone prescriptions, drug related deaths, unemployment, and divorce rates decrease following the upscheduling. Taken together, our results suggest that during our study period (2007–2017) the hydrocodone rescheduling reduced homelessness by preventing some household crises.