Featured Post from Emory University, Goizueta Business School

Expert Research: Mandated Restrictions on Opioid Prescriptions Have Unintended—and Deadly—Consequences

Jun 24, 2024

5 min

New research from Goizueta’s Diwas KC unpacks the dual impact of Prescription Drug Monitoring Programs on opioid prescriptions and heroin overdose deaths.

More than two million individuals in the US are experiencing Opioid Use Disorder (OUD). The CDC defines OUD as “a problematic pattern of opioid use that causes significant impairment or distress.”

Around 130 people die of opioid overdoses every day. Perhaps more startlingly, four million people over the age of 12 have reported using pain medication recreationally, including opioids. Prescription opioids are a highly-regulated class of drug. They interact with the opioid receptors on nerve cells throughout the body, as well as the brain, which reduces the intensity of pain signals to the body.

For many, they are a necessary prescription to get through the pain of surgery or injury, as the body heals itself. Unfortunately, the function of opioids in the body—releasing endorphins and boosting feelings of pleasure, as well as reducing pain—also make them highly addictive.

PDMP: A Successful Federal Mandate

The United States continues to see increases in deaths from opioid overdoses. So, federal and state governments have been working in enact policies that are designed to decrease those fatalities. One of the methods states are using to prevent common abuse patterns like “doctor shopping,” which is the pattern of visiting multiple physicians to obtain prescriptions, is the Prescription Drug Monitoring Program (PDMP), designed to be used in conjunction with Health Information Technology (HIT) programs. PDMP serve two purposes: identifying drug-seeking behaviors in patients, and identifying physicians with patterns of inappropriate prescribing.

Nearly all 50 states have enacted PDMPs of some degree. Some programs require physicians to check the PDMP before prescribing restricted pharmaceuticals, but in others it’s only suggested. Intrastate communication between PDMPs is not always possible, however.

The Unintended Consequences

The use of PDMPs has been shown to reduce the number of opioid prescriptions, the intended outcome of the program. Enter a recently published study by Diwas KC, Goizueta Foundation Term Professor of Information Systems & Operations Management. The research shows that during time the research was conducted, prescriptions for opioids declined by 6.1%.

However, the research also brought to light a very serious and unintended consequence of the implementation of PDMPs. The study concluded that while the implementation of PDMPs did reduce opioid prescriptions, it did not reduce overall numbers of prescription opioid deaths. In fact, it may have contributed to a 50% increase in heroin overdose fatalities.

“The heroin increase was definitely something we were not expecting, it was a total surprise,” says KC.

"It was something that we had hypothesized. You’ve got a bunch of individuals who have used prescription opiates and had presumably been dependent. Now with the passage of this PDMP law, it has become more difficult to obtain prescription opiates. Therefore, some people might be forced to turn to the street version of it."

Diwas KC

“We didn’t expect the effect size it to be as significant as it is,” says KC.

Heroin and commonly prescribed opioids like oxycodone and hydrocodone are very similar on a biochemical level. What’s more, they generate a similar sensation in the body, according to KC. That’s why he and his team had the initial hypothesis that some addicted individuals, when unable to get prescription medication, might turn to street drugs, which are much more dangerous on many levels.

“There are many aspects to this. One has to do with the potency and the toxicity of the things you get on the streets. There are very little checks and balances on those. There’s no control in quality for sure,” KC says. He also notes the lack of checks and balances on the frequency of usage. “So the frequency of usage, the quality of the substances you’re putting inside your body, and possibly the circumstances of acquiring it might also be very risky too.”

A Dual Impact

The research concludes that mandating PDMP use is an example of a successful use of policy for intervention. It does, in fact, decrease the number of opioid prescriptions available to patients. That’s critical information for policy makers and physicians to take in. And it’s a solid reason to keep using and expanding PDMP usage, according to KC.

"I should point out very clearly that the policy did have the intended effect of reducing prescriptions. So, it definitely benefited people who might otherwise have become addicted."

Diwas KC

“By reducing unnecessary prescriptions it might have limited the number of people who would have gotten hooked on the drugs in the first place. So there’s definitely the benefit of that,” says KC. “It’s just that when the policy was implemented, there was also this side effect because of people who were already using it. So, when those people were forced to look for alternatives, that’s when things got bad.”

Research papers like this one show an important side of using data to mark successes and failures of government policies. Taken on the surface, data can show a policy’s impact for the greater good. But a deeper dive into the surrounding data—like the increase in heroin use after the implementation of PDMPs—gives everyone a better idea of the full impact of this mandate.

"Policies have intended as well as unintended consequences. In this case of PDMP it had the desired effect of reducing prescriptions. That probably helped a lot of people not get addicted to opiates in the first place."

Diwas KC

“But sometimes policies also have unintended consequences,” says KC. “Like in the case of people who were already addicted to painkillers suddenly stopping it, causing them to take drastic actions, and that’s what happened for some of the people in the study. Policies need to consider the possibility of unintended consequences and take actions to also mitigate those unintended consequences.”

Interested in knowing more?

Diwas KC is the Goizueta Foundation Term Professor of Information Systems & Operations Management. He is available to talk about this important topic - simply click on his icon now to arrange an interview today

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Diwas KC

John M. and Lucy Cook Chair in Information Strategy

See my website for up-to-date research information: https://diwaskc.com

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Jul 9, 2026

2 min

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As the 2026 Senate races heat up, negative campaign ads are once again dominating the airwaves. David Schweidel, Professor of Marketing and the Roberto C. Goizueta Professor in Business Technology at Emory's Goizueta Business School, has researched political advertising for years and is currently tracking the 2026 Senate races. Asked why negative campaigns tend to outperform positive ones, Schweidel points to what sticks with voters: "It's those negative messages. It's those attack messages," often fear- or anger-based, that he says are "more arousing to us" and "tends to move the needle more so than positive advertising." Where an ad comes from matters too. Schweidel's research looks at whether messaging originates from the candidate directly or from third parties like PACs or political parties, and he's found that candidate-sourced messaging tends to be more believable, "coming from a human brand," in his words, rather than an unfamiliar political organization. His current research pushes this further, into how political advertising shapes what AI chatbots tell voters. Schweidel notes that where news coverage and social media once drove poll movement, more voters are now turning to AI chatbots for candidate information. Using Maine Senate candidate Graham Platner as an example, he explains that recent news coverage and online conversation about a candidate gets absorbed by these chatbots, ultimately shaping what's presented to a voter asking about that candidate. For campaigns and advertisers, Schweidel frames this as a new channel to understand, similar to how companies already monitor social media conversation, and predicts political campaigns will start actively tracking how their candidates are portrayed in AI responses, the same way many companies now treat AI presence the way they once treated search engine optimization: "What a lot of companies are trying to come up with now is what is the playbook to do the same thing for AI." Dr. Schweidel is an expert in marketing technology, AI, social media, political marketing, and customer analytics. He holds a PhD in Marketing from the Wharton School of the University of Pennsylvania and is the author of Social Media Intelligence and Profiting from the Data Economy. His research has appeared in the Journal of Marketing, Journal of Marketing Research, Marketing Science, and Management Science, and he has been recognized as a Marketing Science Institute Young Scholar and named to Poets & Quants' "Top 40 Under 40." Dr. Schweidel is available to discuss: Why are negative campaign ads more effective than positive ads? Why do negative emotions drive people to vote, donate, and campaign, more than positive emotions? The connection between AI and campaign ads How organizations make explicit decisions to exploit these trends Click on the connect button in his profile below.

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1 min

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As the 2026 FIFA World Cup unfolds across North America, Emory University’s Goizueta Business School experts are available to help media explore the business stories behind the world’s biggest sporting event, from the economics of hosting and ticket pricing to global sponsorship, player brands and the psychology of fandom. Goizueta’s World Cup 2026 Business Hub brings together faculty who can provide timely, research-backed commentary on the commercial, cultural and consumer forces shaping the tournament as it moves from match to match, city to city and story to story. Featured Topics The Economics of Hosting Infrastructure investment, tourism revenue, real estate, local labor markets and the broader financial impact of hosting World Cup matches. The Science of Fandom What drives global fan devotion, audience loyalty and engagement across stadiums, broadcasts and digital platforms. Ticket Pricing and Demand Dynamic pricing, hospitality packages, travel costs and how extraordinary demand shapes the fan experience at major global events. Brand Strategy and Global Sponsorship How companies evaluate World Cup sponsorships, build global campaigns and measure the return on major sports partnerships. The Rise of the Player Brand How star footballers build, extend and monetize personal brands that reach far beyond the pitch. Media can visit Goizueta’s World Cup 2026 Business Hub to explore available experts and connect directly with the right source for their story.