Promoting Safe Opioid Disposal: Experimental Evidence on Behavioral Messaging With Financial Incentives

Abstract

Some patients prescribed opioid pills fail to properly dispose of their unused pills, posing a risk for others. We report results from a pre-registered field experiment testing whether behaviorally informed reminder cards increase participation in a financial incentive program for returning unused opioid pills among U.S. Veterans. The cards incorporate principles from behavioral economics, including timely reminders, implementation intention prompts, and loss framing. Relative to a cash incentive alone, the reminder cards increase both the likelihood that patients return unused pills (the extensive margin) and the number of pills returned (the intensive margin). The intervention also improves cost-effectiveness, reducing both the cost per pill returned and the cost per participant who returns pills. These findings show that low-cost behavioral messaging can meaningfully enhance the effectiveness of existing financial incentive programs for safe opioid disposal.