Economics faculty research highlights impacts of opioid use on communities, monitoring standards for disabled populations

Economics associate professor Orgul Ozturk, economics clinical associate professor John Gordanier and their co-authors have studied the economic impacts of the ongoing opioid epidemic with two recently published articles; one explores the Prescription Drug Monitoring Programs’ impact on opioid prescriptions for those with formally diagnosed disability conditions that are typically associated with chronic pain. The other concluded that rural counties with an increase in opioid prescription rates show a statistically significant reduction in white student test scores.

Published research:

“Prescription Drug Monitoring Programs and Opioid Prescriptions for Disability Conditions” — Applied Health Economics and Health Policy, May 2021 (Ozturk).

“The relationship of opioid prescriptions and the educational performance of children” — Social Science and Medicine, November 2020 (Gordanier and Ozturk).

Why it matters:

• Prescription Drug Monitoring Programs were created to decrease abuse of opioids and other controlled substances and prevent “doctor shopping” for prescriptions. While the policy is well-intentioned, when it comes to those disabled with chronic pain, physicians and pharmacists were less likely to flag multiple prescriptions for opioids because they can see the full drug-filling patterns for these patients and all the ways they’ve tried to manage their pain.
• From Ozturk and her co-authors’ findings with PDMPs, Ozturk said the main concern is that research is not clear if opioid prescribing for patients with chronic pain conditions are even effective treatments. “In light of evidence that increases in dosage of opioids may not reduce pain, this finding highlights the need for education for prescribers in pain evaluation and targeted management strategies based on the etiology of the pain,” Ozturk added.
• Ozturk and her co-authors’ research on increased opioid prescription rates and a correlating reduction in white student test scores illustrates that the opioid epidemic has been most detrimental to middle-income rural white communities. Given the importance of educational attainment, this reduction in test scores associated with high rates of opioid prescriptions may indicate that there will be long-lasting spillover effects of the opioid crisis. The research team’s research did not find a statistically significant impact on non-white students’ test scores.

Research design for “Prescription Drug Monitoring…”:

• Ozturk and her co-authors used the 2000-14 cohorts of the U.S. Medical Expenditure Panel Survey, which produced a total sample size of 292,940 individuals. They were able to categorize 6,269 individuals, or 2 percent of their total sample size, as being in disability groups, which included diagnosis codes used to fill prescriptions for those with chronic pain.
• Their findings showed the Prescription Drug Monitoring Programs did not significantly decrease opioid incidence, quantity and potency of opioids prescribed for those with chronic pain compared to those without chronic pain conditions.

Research design for “The relationship of opioid…”

• Gordanier, Ozturk and their co-author compared administrative education data from 2006-17 with county-level prescription rates during the same time period.
• They found when the opioid prescription rate increases in a county, there is a statistically significant reduction of white test scores in that county. Their research determined there was no major impact on non-white test scores when opioid rates increased.
• The negative effect is still present even when considering changing county-level economic conditions; student-level poverty measures; county demographic, income and political characteristics; and county level trends. Among white students, the association is strongest among rural students in households that are not receiving government assistance.  

Learn more about Orgul Ozturk's research.

Learn more about John Gordanier's research. 

About Orgul Ozturk:

• Orgul Ozturk joined the Moore School in 2006 and is an associate professor of economics. She is the incoming chair of the economics department.
• Her academic research interests are in applied microeconomic fields, specifically labor economics and health economics. Ozturk has written articles on the effects of labor market regulations and minimum wages on female employment, effectiveness of supported employment programs for the developmentally disabled and the relationship between occupation choice and welfare independence.
• Ozturk teaches classes in microeconomics at the undergraduate level and courses related to econometrics and labor economics at the graduate level.
• She earned her bachelor’s degree in economics and sociology from Koc University in Istanbul. Ozturk also received her master’s and Ph.D. in economics from the University of Wisconsin.

About John Gordanier:

• Gordanier arrived at the Moore School in 2007 and is a clinical associate professor of economics.
• His research focuses on personnel economics, labor economics and industrial organization. Gordanier is currently a member of the advisory panel for the Law Firm’s Working Group, a cross-disciplinary group of researchers studying empirical aspects of law firms.
• Gordanier teaches courses about the principles of microeconomics, labor economics, industrial organization, law and economics and intermediate microeconomics at the undergraduate levels.
• He earned his bachelor’s degree in economics and statistics from the University of Missouri. Gordanier also has a master’s and Ph.D. in economics from the University of Wisconsin.

Gordanier and Ozturk researched “The relationship of opioid prescriptions and the educational performance of children” with Chad Cotti, Oshkosh Corporation Endowed Professor and chair of the Department of Economics at the University of Wisconsin, Oshkosh.

Ozturk researched “Prescription Drug Monitoring Programs and Opioid Prescriptions for Disability Conditions” with Yuan Hong, USC biostatistics Ph.D. candidate (‘XX expected graduation); Suzanne McDermott, Director of the Disability Research and Dissemination Center in the USC Arnold School of Public Health Epidemiology and Biostatistics department; and Margaret Turk, M.D., professor of physical medicine and rehabilitation and pediatrics at the State University of New York Upstate Medical University at Syracuse.

Ongoing research:

Ozturk said her research on increasing opioid rates negatively impacting student test scores and future studies on the subject can demonstrate how opioid use affects non-health outcomes for families.

“Future research on this and how these spillovers might impact the long-term educational attainment, social status and employment outcomes of children residing in high opioid exposure communities will likely be of importance to understand the complete effects of the opioid epidemic,” Ozturk said.