A discussion of critical errors in a longitudinal study on the deterrent effect of drug-induced homicide laws on opioid-related mortality across 92 counties and the District of Columbia in the United States

Drug overdose claimed more than 100,000 lives in the United States in 2021. Drug-induced homicide (DIH) laws create specific criminal liability for individuals who provide drugs that cause or contribute to the death of another person. DIH prosecutions in the United States have increased substantially over the past decade despite the absence of meaningful evidence of their individual- or community-level impacts. Recently, Lee et al. analyzed the impact of DIH laws on county-level opioid overdose mortality across 92 counties in 10 states and concluded that DIH laws are associated with significant reductions in rates of opioid overdose death. In this commentary, we present evidence demonstrating that the Lee et al. study is fundamentally flawed. Specifically, the legal data used by Lee et al. to define their treatment condition (the presence or absence of a state-level DIH law) is incorrect in almost every aspect. We also describe significant methodological weaknesses, including flawed sampling strategies that resulted in a biased sample of county overdose rates as well as flawed modeling strategies that cannot effectively evaluate the hypothesis that DIH laws negatively impact opioid overdose mortality. More research on the individual- and community-level impacts of DIH laws is needed. In the meantime, we advise policymakers to strengthen state 911 Good Samaritan laws, as DIH laws appear to erode the efficacy of this proven overdose-prevention strategy.