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Long-term opioid therapy (LTOT) is used by millions of Americans for managing chronic pain, though contemporary evidence has established that it has little to no advantage to other non-opioid therapy. Growing recognition o this evidence has contributed to a shifting culture away from opioid prescribing for chronic pain. Many have raised concerns that poor adherence to guideline-suggested tapering may lead to undertreated pain, mental health crises, and suicide. Recent evidence has examined the association between tapering or discontinuation of LTOT and health outcomes, but these studies typically used statistical techniques that only adjust for observable, but not unobservable, differences between LTOT users who taper or discontinue vs. those who do not. We addressed this evidence gap by leveraging prescriber exit from the workforce, a common phenomenon, as an external shock to prescribing patterns. We hypothesized that prescriber market exit would lead to an increase in LTOT discontinuation that was not related to either observed or unobserved patient clinical factors, enabling testing for the independent effect of LTOT discontinuation on patient outcomes.