REMEMBER LAWS? –
May 19, 2026 – Overprescribing in problematic pain clinics is driven by profit motive, which increases when opioids are both prescribed and dispensed by the provider. Pill mills typically dispense opioids directly or coordinate with a local pharmacy (in return for kickbacks) to fill inappropriate opioid prescriptions. To examine whether the laws reduced this type of arrangement, the team analyzed transaction-level information on opioid shipments. They found that pain management control laws reduced opioid shipment quantities to practitioners by 74%. They also documented “strikingly large” reductions in the volume of opioids dispensed directly by practitioners to patients. The team also found limited evidence that pill mill control laws reduce the number of pain management clinics in states.
Pill mill control laws have not been widely adopted, perhaps because they are often opposed by physician organizations and require resources from law enforcement, state medical boards, and health agencies. The results of this study, however, suggest that policies that target high-risk pain management practices, rather than imposing blanket limits on prescribing, might be more effective at reducing harmful prescribing while also minimizing the risk of substitution into illicit drug use.
