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.