Exploring the Influence of Drug Trafficking Gangs on Overdose Deaths in the Largest Narcotics Market in the Eastern United States

Nicole J Johnson,Alyssa K Mendlein,Caterina G Roman,Laura Hendrick,Courtney Harding,Melissa Francis

doi:10.3390/socsci9110202

Nicole J Johnson, Alyssa K Mendlein + Show 4 more

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https://doi.org/10.3390/socsci9110202

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Abstract

Research has found that drug markets tend to cluster in space, potentially because of the profit that can be made when customers are drawn to areas with multiple suppliers. But few studies have examined how these clusters of drug markets—which have been termed “agglomeration economies”—may be related to accidental overdose deaths, and in particular, the spatial distribution of mortality from overdose. Focusing on a large neighborhood in Philadelphia, Pennsylvania, known for its open-air drug markets, this study examines whether deaths from accidental drug overdose are clustered around street corners controlled by drug trafficking gangs. This study incorporates theoretically-informed social and physical environmental characteristics of street corner units into the models predicting overdose deaths. Given a number of environmental changes relevant to drug use locations was taking place in the focal neighborhood during the analysis period, the authors first employ a novel concentration metric—the Rare Event Concentration Coefficient—to assess clustering of overdose deaths annually between 2015 and 2019. The results of these models reveal that overdose deaths became less clustered over time and that the density was considerably lower after 2017. Hence, the predictive models in this study are focused on the two-year period between 2018 and 2019. Results from spatial econometric regression models find strong support for the association between corner drug markets and accidental overdose deaths. In addition, a number of sociostructural factors, such as concentrated disadvantage, and physical environmental factors, particularly blighted housing, are associated with a higher rate of overdose deaths. Implications from this study highlight the need for efforts that strategically coordinate law enforcement, social service provision and reductions in housing blight targeted to particular geographies.

Highlights

Urban areas in the United States, those with high poverty levels, often experience two significant public health concerns: high levels of drug overdose deaths (OD) and gun violence.For some cities, these public health issues are intertwined and rise to epidemic proportions, greatly diminishing quality of life for residents and incurring billions of dollars in economic losses related to addiction treatment, criminal justice involvement, health care, and lost productivity
Because we are interested in where overdoses are taking place, we focus on the overdose event location, and our discussion of OD incidents throughout the paper refers to accidental OD events that took place within the city of Philadelphia, but these events all eventually resulted in a death
Marginal effects can be calculated from the generalized cross-entropy (GCE) coefficients, which can be interpreted as the change in the expected rate of ODs per square foot given a one-unit change in the predictor

Summary

Introduction

Urban areas in the United States, those with high poverty levels, often experience two significant public health concerns: high levels of drug overdose deaths (OD) and gun violence. For some cities, these public health issues are intertwined and rise to epidemic proportions, greatly diminishing quality of life for residents and incurring billions of dollars in economic losses related to addiction treatment, criminal justice involvement, health care, and lost productivity. The Kensington-Fairhill area of Philadelphia has been referred to as the largest open-air heroin market on the East Coast of the United States (Percy 2018) and data from the U.S Federal Bureau of Investigation (FBI) confirm that Philadelphia is a leading regional and multistate supplier for high-grade heroin (Roselli 2018). The extensive reach of the Kensington-Fairhill area DTOs is evidenced by the amount of drugs from Kensington-Fairhill found outside of this area of the city—a three-month snapshot of victims of drug overdose from January through March of 2018 in the four counties surrounding Philadelphia identified fifteen different heroin stamps linked directly to Kensington suppliers (Roselli 2018)

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