Spatiotemporal Analysis Exploring the Effect of Law Enforcement Drug Market Disruptions on Overdose, Indianapolis, Indiana, 2020–2021

Abstract

Objectives. To test the hypothesis that law enforcement efforts to disrupt local drug markets by seizing opioids or stimulants are associated with increased spatiotemporal clustering of overdose events in the surrounding geographic area. Methods. We performed a retrospective (January 1, 2020 to December 31, 2021), population-based cohort study using administrative data from Marion County, Indiana. We compared frequency and characteristics of drug (i.e., opioids and stimulants) seizures with changes in fatal overdose, emergency medical services nonfatal overdose calls for service, and naloxone administration in the geographic area and time following the seizures. Results. Within 7, 14, and 21 days, opioid-related law enforcement drug seizures were significantly associated with increased spatiotemporal clustering of overdoses within radii of 100, 250, and 500 meters. For example, the observed number of fatal overdoses was two-fold higher than expected under the null distribution within 7 days and 500 meters following opioid-related seizures. To a lesser extent, stimulant-related drug seizures were associated with increased spatiotemporal clustering overdose. Conclusions. Supply-side enforcement interventions and drug policies should be further explored to determine whether they exacerbate an ongoing overdose epidemic and negatively affect the nation’s life expectancy. (Am J Public Health. 2023;113(7):750–758. https://doi.org/10.2105/AJPH.2023.307291 )

Estimating changes in overdose death rates from increasing methamphetamine supply in Ohio: Evidence from crime lab data

“…We may be misinterpreting the changes in crime lab data as changes in supply as it could instead reflect the consequences of differential incarceration or decreases in supply that could affect overdose deaths as was found by Ray et al (2023) in Indiana. That is, if the police are arresting many more people with MA, it may have a substantial negative effect on the supply of MA, and, thus, we would interpret the negative correlation of MA in lab tests and death rates as a fall in MA supply leading to a fall in overdose deaths.…”

Shared decision-making and client-reported dose satisfaction in a longitudinal cohort receiving injectable opioid agonist treatment (iOAT)

“…Opioid use disorder (OUD) is a pervasive and chronic health condition which continues to be characterized by comorbid physical and mental health issues and several preventable harms, most of which—including higher risk of fatal and non-fatal overdose—are created or exacerbated by criminalization [ 1 – 3 ]. Evidence-based and compassionate health approaches to treat OUD, and to best support individuals’ multifaceted healthcare needs, are increasingly informed by an emerging approach: person-centered care (PCC) [ 4 ].…”

“…As prohibition drives and incentivizes ever-greater potency and toxicity of the criminalized drug supply [ 1 , 2 ], it also leads users to incarceration, marginalization, and exposure to extralegal violence, while suppressing and restricting efforts to prevent and reverse overdoses [ 3 ]. This has fueled the ongoing drug poisoning crisis which continues to claim the lives of many in North America, including first-time, infrequent, and non-opioid users [ 26 ].…”

Drug supply measures and drug overdose mortality in the era of fentanyl and stimulants

“…Several recent studies have examined associations between seized drug reports and measures of overdose mortality or have developed methods of using seized drug reports to forecast or predict overdose deaths as part of early warning systems. Many of these studies have focused on data from a single state or area (e.g., Hall et al., 2021 ; Mohler et al., 2021 ; Lowder et al., 2022 ; Ray et al., 2023 ; Rosenblum et al., 2020 ; Slavova et al., 2017 ; Tran et al., 2021 ; Zibbell et al., 2019 , 2022 ), while fewer have examined multiple states or the entire US ( Jalal and Burke, 2021 ; Gladden et al., 2016 ; Marks et al., 2021 ; Sumner et al., 2022 ; Zibbell et al., 2023 ; Zoorob et al., 2019 ). These studies have varied in terms of specific drug reports examined (e.g., opioids, stimulants), types of drug overdose mortality outcomes (e.g., drug overdose mortality overall, opioid-involved overdose mortality), and units of analysis (e.g., state-year, county-month).…”