Published: 07/22/2026 | Author: Courtney Myers

Physician prescribing practices, not just pharmaceutical marketing, played a critical role in fueling the nation’s opioid crisis, according to new research from the University of Notre Dame that adds important context to the ongoing opioid addiction epidemic.

The Opioid Crisis by the Numbers

Economists William Evans and Ethan Lieber, both from Notre Dame’s Department of Economics, analyzed National Ambulatory Medical Care Survey data from 1980 through 2015 and found that opioid prescribing for chronic pain shifted dramatically after 1995.

Before that year, about 7 percent of patient visits for conditions likely to cause chronic pain resulted in an opioid prescription. By 2015, that figure had climbed to 25 percent.

The researchers’ modeling suggests opioid-related deaths in 2015 would have been roughly 43 percent lower had 1995 prescribing levels held steady.

The study, published in the Journal of Human Resources, also found that counties with higher rates of Social Security Disability Insurance enrollment, a marker of higher chronic pain burden in a population, experienced disproportionately severe drug poisoning crises.

What’s Driving the Change

The shift traces back to 1995, when medical experts released a statement encouraging wider use of opioids to treat chronic pain. Physicians responded by prescribing far more aggressively over the following two decades.

Much of the public conversation and opioid litigation in recent years has focused on pharmaceutical marketing, and the researchers say their findings show that prescribing decisions by physicians themselves were also a major factor, separate from advertising campaigns.

According to the CDC, roughly 860,000 people in the United States have died from an opioid overdose since 1999, including nearly 318,000 deaths linked specifically to prescription opioids.

In 2024, opioids were involved in 73.4 percent of drug overdose deaths, and illegally manufactured fentanyl accounted for 65.1 percent of those opioid deaths, reflecting how the crisis has shifted from prescription pills toward illicit fentanyl over time.

Understanding Opioids and Overdose Risk

Opioids include prescription medications like oxycodone and hydrocodone as well as illicit drugs like heroin and fentanyl. All opioids carry overdose risk, which increases sharply when they are combined with other substances or when tolerance drops after a period of abstinence, such as after detox or incarceration.

Naloxone, sold under brand names like Narcan, can reverse an opioid overdose in progress and is available without a prescription in most states.

Harm Reduction and Treatment for Opioid Addiction

Regardless of how someone became dependent on opioids, whether through a legitimate prescription that grew into dependence or through illicit use, medication-assisted treatment with methadone, buprenorphine, or naltrexone remains the most evidence-based path to recovery.

Naloxone access and fentanyl test strips can reduce overdose deaths in the meantime, and NA meetings offer peer support for people at any stage of recovery from opioid or other drug addiction.

Finding Help for Opioid Addiction

Anyone whose opioid use started with a legitimate prescription and grew into something harder to control is not alone, and this pattern is common enough that researchers can trace it in national prescribing data.

Narcotics.com’s meeting directory can help people find NA meetings for peer support, and treatment referral options are available for anyone ready to explore opioid use disorder treatment, including medication-assisted treatment.