The effect of pill mill legislation on suicides

Abstract

Objective: To examine the effect of pill mill legislation on suicides and drug-related suicides in the United States.

Data sources: We use state-level restricted use mortality data from the National Vital Statistics System for the period 2000-2016, along with state level sociodemographic data from the US Census Bureau and Bureau of Labor Statistics and opioid-related state health policy data from publicly available sources for the analysis.

Study design: The analyses use a difference-in-differences regression approach.

Data collection/extraction methods: Publicly available secondary data were collected and merged with restricted use mortality data files from the National Vital Statistics System for the analysis.

Principal findings: Our results show that pill mill legislation is associated with an 8.5% (p < 0.01) reduction in the drug related suicide rate, a 4.9% (p < 0.05) reduction in suicides among females, and a 4.7% (p < 0.05) reduction in suicides among individuals between age 45 and 64 years.

Conclusions: The findings indicate that pill mill legislation has been effective in reducing total suicides among females in the age group 45-64, and drug-related suicides in the population resulting in 658 fewer drug-related suicides for a given year if pill mill laws are adopted by every state.

Keywords: drug-related suicides; opioids; pill mill legislation; suicide.