ArticleThe International journal on drug policy2021
Alcohol outlets, drug paraphernalia sales, and neighborhood drug overdose.
Article in The International journal on drug policy, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
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Who cites it
9 citing papers in PubMed.
- ZIP code-level alcohol outlet density and nonfatal overdose among people who inject drugs in 22 US metropolitan statistical areas: a multilevel modeling analysis.Harm reduction journal · 2026Article
- The geography of risk: understanding disparities in nonmedical opioid mortality and the role of socio-built environments in New Jersey.Harm reduction journal · 2026Article
- Exploring modifiable neighborhood risk factors for fatal opioid overdose: a case-control study in two US cities.American journal of epidemiology · 2025Article
- Spatial associations between alcohol detection in opioid overdose deaths and alcohol outlets.Drug and alcohol dependence · 2025Article
- Using Geographic Momentary Assessment to Explore Spatial Environment Influences on Wellbeing in People With HIV.AIDS and behavior · 2025Article
- A place-based spatial analysis of racial inequities in overdose in St. Louis County Missouri, United States.The International journal on drug policy · 2024Article
- Community alcohol sales and opioid poisoning deaths: Alcohol serving space as a harm reduction opportunity.Harm reduction journal · 2024Article
- Development of a systematic social observation tool for monitoring use of harm reduction supplies.The International journal on drug policy · 2023Article
- City streetscapes and neighborhood characteristics of fatal opioid overdoses among people experiencing homelessness who use drugs in New York City, 2017-2019.The International journal on drug policy · 2022Article
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Authors and funding
8 authors.
Funding
Abstract
backgroundAlcohol outlets have been associated with various forms of injury and may contribute to neighborhood disparities in drug overdose. Few studies have examined the associations between alcohol outlets and drug overdose. This study investigated whether alcohol outlets were associated with the neighborhood drug overdose rate and whether the sale of drug paraphernalia contributes to this association.
methodsA cross-sectional ecological spatial analysis was conducted within census block groups in Baltimore City (n = 653). Outcomes were counts of EMS calls for any drug overdose in 2015 (n = 3,856). Exposures of interest were counts of alcohol outlets licensed for off-premise and on-premise consumption and the proportion of off-premise outlets selling drug paraphernalia (e.g., blunt wrappers, baggies, pipes). Negative binomial regression was used to assess the relationship between outlet count and overdose rate, and if paraphernalia sales altered this relationship, controlling for other neighborhood factors. Spatial autocorrelation was assessed and regression inference adjusted accordingly.
resultsEach additional off-premise alcohol outlet was associated with a 16.6% increase in the neighborhood overdose rate (IRR=1.17, 95%CI=(1.11, 1.23)), adjusted for other neighborhood variables. On-premise alcohol outlets were not significantly associated with overdose rate when adjusting for off-premise alcohol outlets (IRR=1.01, 95% CI=(0.97, 1.06)). The proportion of off-premise outlets that sold drug paraphernalia was negatively associated with overdose rate (IRR=0.55, 95% CI=(0.41, 0.74)) and did not alter the relationship between off-premise outlets and overdose.
conclusionThis study provides preliminary public health evidence for informing policy decisions about alcohol outlet licensing and zoning. Alcohol outlets could be potential community partners for harm reduction strategies such as health communication in identifying overdose symptoms or Good Samaritan Laws.
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