Dr Cohen-Mohliver wins ‘Award for Responsible Research in Management’
Academic article on the US prescription drug crisis is a winner of this year’s Responsible Research in Management Award
The United States is “experiencing the worst drug overdose crisis in its history, with 110,000 people now dying annually” (The National Institute on Drug Abuse), and nearly one million Americans dying from drug overdoses since 1999. What is even more surprising is that over 90 per cent of the pills involved in these deaths were prescribed by physicians.
These astonishing figures led London Business School’s Aharon Cohen-Mohliver, Assistant Professor of Strategy and Entrepreneurship, to collaborate with Victoria (Shu) Zhang, an assistant professor of Management and Human Resources at the Wisconsin School of Business, and Marissa King, Professor of Organizational Behavior at the Yale School of Management to research and write the award-winning 2023 article published in Administrative Science Quarterly “Where Is All the Deviance? Liminal Prescribing and the Social Networks Underlying the Prescription Drug Crisis”.
The article, which has now been named a Winner of the 2024 Award for Responsible Research in Management, finds the US drug epidemic has not been principally caused by law-breaking physicians, and identifies how simple network interventions could be much more effective in combating the crisis. This is a unique award: it was first judged by a panel of academics to assess its quality and rigor and then sent to an independent panel of practicing executives, who found it actionable.
Choosing to apply what he terms “old-school sociology” to study who are the physicians that prescribe controlled drugs, with the potential for such widescale abuse, Dr Mohliver said that he and his co-authors chose the setting of benzodiazepines, rather than opioids.
“Statistically, this [helped] us avoid problems of unobserved marketing efforts by pharma companies and really narrow in on the physicians' practices. That is because ‘benzos’ have been off-patent for years now, so there are no real financial incentives associated with prescribing them (compared to Opioids). Yet, ‘benzos’ are addictive, they contribute to that huge number of deaths cited above. They are still prescribed widely by physicians,” writes Dr Mohliver in a December 14, 2022, LinkedIn piece which accompanied the publication of the Administrative Science Quarterly article.
Dr Mohliver says the most common explanation for overprescribing is the one sensationalised by Netflix dramas and characterised in books. Broadly, it’s the pharma companies and physicians are ‘pushing’ these drugs for financial motives.
But there are other, “less nefarious explanations” which are illuminated in the Administrative Science Quarterly article. “It could be that caring physicians prescribe excessive quantities of these drugs. These physicians are not 'pushing drugs', they are just bending the rules – potentially thinking they’re helping their patients.” This is described in the article as “liminal practice”; “not clearly wrongful but unambiguously violating prescribing guidelines”.
Overall, the article paints a very different picture of the drug crisis. It may be fuelled not by “pill mills” and corrupt physicians, but by well-intending physicians who lack the network ties to learn about the harmful effects of these drugs before they start prescribing them.
