"Kicking the Can down the Street": Social Policy, Intimate Partner Violence, and Homicide during the Opioid Crisis.

BACKGROUND: Research has established a strong, positive correlation between homicides and substance use and also between homicides and intimate partner violence (IPV). Additionally, there is a well-known, robust, positive relationship between substance use and IPV. Focusing on the opioid crisis and using county-level panel data, this study investigates the possibility that opioid pill prescription trends, IPV, and homicide are intertwined in a complex, interdependent relationship.
Objectives: With an eye toward integrated social policy, this study explores the relationships among and between opioid pill distribution patterns, IPV arrests, and homicide arrests within the United States between 2006 and 2012.
Methods: Using county-level panel data from several established federal datasets, a series of longitudinal mixed-effects models regress homicide arrests onto the number of pills within each county, IPV arrests, and other relevant controls.
Results: While IPV shares a strong, positive main effect relationship with homicide arrests, opioid pill volume is not significantly related to homicides. However, opioid pill volume within a county significantly attenuates the relationship between IPV and homicide, indicating that pills, IPV, and homicides share a complex, interwoven relationship.
Conclusion: While the non-significant main effect of opioid pills suggests that opioids are not consequential for homicide, the highly significant interaction between pills and IPV indicates the opposite. Acknowledging the interwoven link between opioids, IPV, and homicide may be of importance when attempting to develop individual programs aimed at addressing these social problems. Well intentioned, unidimensional policies aimed at reducing opioids or IPV may be unknowingly impacting other social problems.