By Joel Wallman, Richard Rosenfeld, Randolph Roth

The twenty-five-year epidemic of opioid misuse in the United States has taken at least 750,000 lives through overdose. We undertook to learn whether this toll might have been accompanied by an increase in violence resulting from growth in the illicit opioid market, which, like most illicit drug markets, includes a risk of violence due to conflicts among sellers and between sellers and buyers. We found that increases in activity in this market were associated with—and arguably caused—increased levels of homicide. Using county opioid overdose rates as a measure of levels of transactions in the illicit market, we looked for an association between those rates and county homicide rates between 1999 and 2015. …Despite this growth in overdose rates during the period, homicide rates declined for both groups and in both Appalachian and non-Appalachian counties. … The finding of another harm wrought by the opioid epidemic provides another reason to pursue vigorous public-health efforts, with a strong emphasis on treatment, to stem the epidemic.   

New York:  The Harry Frank Guggenheim Foundation, 2023. 20p.