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Study: Opioid Epidemic Fueled Homicides, Not Just Overdoses

A new study finds that the epidemic of opioid abuse likely made homicide rates worse than they otherwise would have been, particularly among white people and in Appalachia, in the initial years of the opioid epidemic. In a Harry F. Guggenheim Foundation research brief by Joel Wallman, Richard Rosenfeld and Randolph Roth, an analysis of county data between 1999, recognized as the start of the opioid epidemic, and 2015 showed that higher overdose rates were associated with, and arguably caused, elevated homicide rates at a time when homicides in general were on the decline. "Holding constant several other variables known to be associated with homicide rates, we found growth in overdose among Whites in this period was associated with a 9-percent increase in homicide across all counties and a 19-percent increase within Appalachia," the report states. "The equivalent figures for Blacks were 3.5 and 16."

The growth in the illicit drug trade caused more violence, slowing the nationwide homicide decline at that time, the study found. Unlike the crack cocaine epidemic of the 1980s, which caused urban violence concentrated among young Black men, the opioid epidemic "is more evenly spread across age and racial groups and among big cities, suburbs, small towns, and rural areas," the report states. "This more diffuse prevalence is one reason the impact of the opioid crisis on homicide rates may not be as readily apparent as the impact of the crack markets was." That relative obscurity, in turn, means that "the policy response to the opioid crisis, unlike the response to crack cocaine, has not equated opioid use with criminality, at least at the level of the end user, but has instead framed the crisis as a public-health emergency." Although the study did not extend into 2020-21, when both opioid overdoses and homicides spiked nationwide, the authors suggest that it's reasonable to ask if the opioid trade played at least some role in rising rates of violence.


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