Jeffrey A. Singer
Two years ago, I reported on a study published in the American Journal of Public Health that examined data from Marion County, Indiana, covering the period from January 1, 2020, to December 31, 2021, to determine whether changes in the number and types of overdose deaths were associated with areas that experienced increases in drug seizures by law enforcement.
The researchers found, “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.” They concluded: “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.”
Today, the Journal of the American Medical Association released a study reinforcing the evidence that police drug seizures lead to increases in overdose deaths. The study, funded by the National Institute on Drug Abuse and the Centers for Disease Control and Prevention, sought to assess whether patterns of law enforcement drug seizures are geographically linked to opioid-related overdose deaths in San Francisco.
The researchers examined records of overdose deaths, including their locations and times, from the Office of the Chief Medical Examiner, along with crime data from the San Francisco Police Department. They investigated whether drug seizures by law enforcement, based on when and where they occurred between 2020 and 2023, were linked to later opioid overdose deaths. Their analysis covered data from January 2020 through September 2023. The study included 2,653 drug seizure events.
The researchers found:
Within the surrounding 100, 250, and 500 meters, drug seizures were associated with a statistically significant increase in the relative risk for fatal opioid overdoses 1, 2, 3, and 7 days following law enforcement drug seizure events.
They concluded:
The findings of this cross-sectional study suggest that the enforcement of drug distribution laws to increase public safety for residents in San Francisco may be having an unintended negative consequence of increasing opioid overdose mortality. To reduce overdose mortality, it may be better to focus on evidence-based health policies and interventions.
As I speculated about the earlier study of Indiana residents, one potential reason is that after law enforcement conducted drug busts, people who use drugs in those neighborhoods had to turn to unfamiliar and potentially less trustworthy suppliers. Without an established relationship, they couldn’t be certain about the strength or purity of the drugs they purchased. In addition, disruptions caused by the seizures may have compelled dealers to alter their supply chains, leading them to change formulations or adjust doses. Both factors could contribute to an increase in overdoses following drug enforcement actions.
I have written many times about how law enforcement pressure pushes drug trafficking organizations to develop and distribute increasingly potent and dangerous drugs—a pattern drug policy analysts refer to as the “iron law of prohibition.” This places people who use drugs at greater risk of overdose. Now we have new evidence of another way in which law enforcement increases the risk of overdose.
This new evidence raises an unavoidable question: how many more lives must be lost before we abandon enforcement-based approaches that fuel the crisis they claim to fight?