Opioid mortality, public health care expenditures, and cross-national homicide rates: findings from 25 OECD countries, 2000-2017.

Abstract

This study assesses the relationship between opioid mortality and homicide rates across 25 member countries of the organization for economic co-operation and development (OECD) over time and investigates the role of country-level public health expenditures in this relationship. Fixed effects linear regression is used to assess the longitudinal association between opioid mortality and cross-national homicide rates in 25 OECD countries between 2000 and 2017. Moderation analyses are conducted to assess the interaction between opioid mortality rates and public health expenditures per capita. Study findings revealed a positive bivariate association between opioid mortality and homicide rates. However, this association became null after controlling for public health expenditures. Moderation analyses revealed that there is a strong positive association between opioid mortality and homicide rates when public health expenditures are low, which becomes gradually weaker at higher levels of health expenditures. This study suggests one consequence of the opioid epidemic may be increased homicide rates, and this association is stronger in countries with lower public health expenditures. These findings highlight the potential role of governments to combat the associated harms of rising opioid use through greater investments in public health care.