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. 2021 Sep:95:103289.
doi: 10.1016/j.drugpo.2021.103289. Epub 2021 May 11.

Alcohol outlets, drug paraphernalia sales, and neighborhood drug overdose

Elizabeth D Nesoff  1 , Adam J Milam  2 , Christopher Morrison  3 , Brian W Weir  4 , Charles C Branas  3 , Debra M Furr-Holden  2 , Amy R Knowlton  4 , Silvia S Martins  3
Affiliations

Alcohol outlets, drug paraphernalia sales, and neighborhood drug overdose

Elizabeth D Nesoff et al. Int J Drug Policy. 2021 Sep.

Abstract

Background: Alcohol 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.

Methods: A 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.

Results: Each 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.

Conclusion: This 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.

Keywords: Alcohol outlets; Drug overdose; Neighborhoods; Paraphernalia.

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Conflict of interest statement

Declarations of Interest The authors have no possible competing interests to declare, including any direct or indirect connections with the alcohol, gambling, tobacco, or pharmaceutical industries.

Figures

Figure 1.
Figure 1.
Maps of (A) off-premise and (B) on-premise alcohol outlets; (C) drug overdoses; (D) proportion of off-premise alcohol outlets with drug paraphernalia sales by census block group, Baltimore City, 2015
See this image and copyright information in PMC

References

    1. Beckett K, Nyrop K, & Pfingst L (2006). Race, drugs, and policing: Understanding disparities in drug delivery arrests. Criminology, 44(1), 105–137. 10.1111/j.1745-9125.2006.00044.x - DOI
    1. Berke EM, Tanski SE, Demidenko E, Alford-Teaster J, Shi X, & Sargent JD (2010). Alcohol retail density and demographic predictors of health disparities: A geographic analysis. American Journal of Public Health, 100(10), 1967–1971. 10.2105/AJPH.2009.170464 - DOI - PMC - PubMed
    1. Bivand RS, Pebesma E, & Gomez-Rubio V (2013). Applied Spatial Data Analysis with R (2nd ed.). Springer.
    1. Branas CC, Elliott MR, Richmond TS, Culhane DP, & Wiebe DJ (2009). Alcohol consumption, alcohol outlets, and the risk of being assaulted with a gun. Alcoholism, Clinical and Experimental Research, 33(5), 906–915. - PMC - PubMed
    1. Branas CC, Richmond TS, Ten Have TR, & Wiebe DJ (2011). Acute alcohol consumption, alcohol outlets, and gun suicide. Substance Use & Misuse, 46(13), 1592–1603. - PMC - PubMed

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