Evidence map›Paper›PMID 39389758›Full record

ArticleJournal of epidemiology and community health2025

Overdose as a complex contagion: modelling the community spread of overdose events following law enforcement efforts to disrupt the drug market.

Jamie L Humphrey, Clyde Schwab, Nicholas J Richardson, Barrot H Lambdin, Alex H Kral, Bradley Ray

Abstract read
In one paragraph

Article in Journal of epidemiology and community health, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Socioenvironmental disasters and the dialectics of overdose mortality.The International journal on drug policy · 2026
    Article
  2. Article
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Jamie L HumphreyRTI International, Research Triangle Park, North Carolina, USA jhumphrey@rti.org.ORCID http://orcid.org/0000-0003-2147-5278
Clyde SchwabRTI International, Research Triangle Park, North Carolina, USA.
Nicholas J RichardsonRTI International, Research Triangle Park, North Carolina, USA.
Barrot H LambdinRTI International, Research Triangle Park, North Carolina, USA.
Alex H KralRTI International, Research Triangle Park, North Carolina, USA.
Bradley RayRTI International, Research Triangle Park, North Carolina, USA.ORCID http://orcid.org/0000-0003-3643-775X

Funding

NCIPC CDC HHS R01 CE003362
6 · The paper itself

Abstract

backgroundThe opioid overdose mortality crisis in the USA is an ongoing public health epidemic. Ongoing law enforcement strategies to disrupt local unregulated drug markets can have an iatrogenic effect of increasing overdose by driving consumers towards new suppliers with unpredictable drug products of unknown potency.

methodsCross-sectional study using point-level information on law enforcement opioid-related drug seizures from property room data, opioid-related non-fatal overdose events from emergency medical services and block group-level social determinants of health data from multiple sources. Using an endemic-epidemic spatiotemporal regression model, we estimated the degree to which exposure to drug supply disruptions triggers future overdose events within small space-time distances in Indianapolis, Indiana.

resultsNeighbourhoods with more structural racism, economic deprivation or urban blight were associated with higher rates of non-fatal overdose. Exposure to an opioid-related drug seizure event had a significant and positive effect on the epidemic probability of non-fatal overdose. An opioid seizure that occurred within 250 m and 3 days, 250 m and 7 days, and 250 m and 14 days of an overdose event increased the risk of a new non-fatal overdose by 2.62 (rate ratio (RR)=2.62, 95% CI 1.87 to 3.67), 2.17 (RR=2.17, 95% CI 1.87 to 2.59) and 1.83 (RR=1.83, 95% CI 1.66 to 2.02), respectively. Similar spatiotemporal patterns were observed in a smaller spatial bandwidth.

conclusionsResults demonstrated that overdoses exhibit a community spread process, which is exacerbated following law enforcement strategies to disrupt the unregulated drug market. We discuss decriminalisation and increasing resources that promote safer drug use to combat this public health crisis.

Indexed as

Analgesics, OpioidDrug OverdoseIllicit DrugsLaw EnforcementOpiate OverdoseAdultCross-Sectional StudiesFemaleHumansIndianaMaleAnalgesics, OpioidIllicit DrugsGeographyHealth inequalitiesSpatial analysis

Identifiers

PMID39389758
PMCPMC11729275

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.