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Objective To examine the association between prescriber workforce exit, long term opioid treatment discontinuation, and clinical outcomes. Design Quasi-experimental difference-in-differences study Setting 20% sample of US Medicare beneficiaries, 2011-18. Participants People receiving long term opioid treatment whose prescriber stopped providing office based patient care or exited the workforce, as in the case of retirement or death (n=48 079), and people whose prescriber did not exit the workforce (n=48 079). Main outcomes Discontinuation from long term opioid treatment, drug overdose, mental health crises, admissions to hospital or emergency department visits, and death. Long term opioid treatment was defined as at least 60 days of opioids per quarter for four consecutive quarters, attributed to the plurality opioid prescriber. A difference-in-differences analysis was used to compare individuals who received long term opioid treatment and who had a prescriber leave the workfor

United statesStanford universityNew yorkSan franciscoAdrienneh sabetyMichaell barnettMarema gayeHannaht neprashMedicaid servicesHarvard universityUniversity of minnesotaRetirement research foundation forCenters for medicareHarvard th chan school of public heathNational institute on agingHarvard th chan school of public health