The twenty-five-year epidemic of opioid misuse in the United States, which has taken at least 750,000 lives through overdose, has had another lethal toll: violence associated with the street market for these drugs. In this HFG Research and Policy in Brief, Joel Wallman, Richard Rosenfeld, and Randolph Roth present the results of county-level studies that assessed the association between levels of transactions in the illicit market, measured by overdose rates, and homicide. They found that the growth in opioid abuse, arguably a reflection of growth in the illicit market, exerted upward pressure on homicide rates in both the U.S. Black and White populations, but especially in the latter and especially in Appalachia.

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