How do restrictions on opioid prescribing, harm reduction, and treatment coverage policies relate to opioid overdose deaths in the United States in 2013–2020? An application of a new state opioid policy scale

More robust state harm reduction policy scores were associated with reduced overdose risk, adjusting for other policy domains. Harmful associations with opioid prescribing restrictions in 2013–2016 may reflect early unintended consequences of these laws. Medicaid coverage domain findings did not align with experts’ perceptions, though data limitations precluded inclusion of several highly ranked Medicaid policies.