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Natl. Acad. Sci. U.S.A."],"published-print":{"date-parts":[[2020,1,28]]},"abstract":"<jats:p>Misuse of prescription opioids is a leading cause of premature death in the United States. We use state government administrative data and machine learning methods to examine whether the risk of future opioid dependence, abuse, or poisoning can be predicted in advance of an initial opioid prescription. Our models accurately predict these outcomes and identify particular prior nonopioid prescriptions, medical history, incarceration, and demographics as strong predictors. Using our estimates, we simulate a hypothetical policy which restricts new opioid prescriptions to only those with low predicted risk. The policy\u2019s potential benefits likely outweigh costs across demographic subgroups, even for lenient definitions of \u201chigh risk.\u201d Our findings suggest new avenues for prevention using state administrative data, which could aid providers in making better, data-informed decisions when weighing the medical benefits of opioid therapy against the risks.<\/jats:p>","DOI":"10.1073\/pnas.1905355117","type":"journal-article","created":{"date-parts":[[2020,1,14]],"date-time":"2020-01-14T17:07:22Z","timestamp":1579021642000},"page":"1917-1923","update-policy":"https:\/\/doi.org\/10.1073\/pnas.cm10313","source":"Crossref","is-referenced-by-count":46,"title":["Predicting high-risk opioid prescriptions before they are given"],"prefix":"10.1073","volume":"117","author":[{"given":"Justine S.","family":"Hastings","sequence":"first","affiliation":[{"name":"Research Improving People\u2019s Lives, Providence, RI 02903;"},{"name":"Watson Institute for International and Public Affairs, Brown University, Providence, RI 02912;"},{"name":"Department of Economics, Brown University, Providence, RI 02912;"},{"name":"National Bureau of Economic Research, Cambridge, MA 02138;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0764-4090","authenticated-orcid":false,"given":"Mark","family":"Howison","sequence":"additional","affiliation":[{"name":"Research Improving People\u2019s Lives, Providence, RI 02903;"},{"name":"Watson Institute for International and Public Affairs, Brown University, Providence, RI 02912;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah E.","family":"Inman","sequence":"additional","affiliation":[{"name":"Research Improving People\u2019s Lives, Providence, RI 02903;"},{"name":"School of International and Public Affairs, Columbia University, New York, NY 10027"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"341","published-online":{"date-parts":[[2020,1,14]]},"reference":[{"key":"e_1_3_4_1_2","unstructured":"S. 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