“When access to prescription opioids is heavily restricted, people will seek out opioids that are unregulated,” says Grant Victor, an assistant professor in the Rutgers School of Social Work and lead author of the study  in the Journal of Substance Use and Addiction Treatment.

“The opposite may also be true; our findings suggest that restoring easier access to opioid pain medications may protect against fatal overdoses.”

America’s opioid crisis has evolved across several waves, with each increasingly fatal. Wave one, which began in the 1990s, was associated with overdose deaths because of the misuse of opioid medications.

A policy implemented during the initial wave created prescription drug monitoring programs (PDMPs), state-based initiatives that track controlled substance prescribing. While the policy made it more difficult to access prescription opioids and rates of prescribing did decrease, it had the unintended consequence of pushing people toward off-market opioids, raising the risk of accidental death, Victor says.

This led to wave two of the crisis, a surge in heroin-related deaths, beginning around 2010, followed by wave three (which started in 2013), fueled by synthetic opioids such as fentanyl.

To measure trends and sociodemographic disparities in access to buprenorphine—a common treatment for opioid use disorder—and opioid painkillers, the researchers examined toxicology data, death records, and available PDMPs from 2,682 accidental overdose deaths that occurred from 2016 to 2021 in Indianapolis, Indiana.

Read the full article about decreasing overdose deaths by Andrew Smith at Futurity.