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In recent years, the United States (U.S.) has been experiencing an unprecedented opioid epidemic characterized by mounting numbers of unintentional opioid-related overdoses and deaths (Jalal et al., 2018). From 1997-2017 nearly 400,000 deaths were attributable to opioid overdoses and opioid-induced mortality is one of the major leading causes of accidental death in the U. S. (Pesarsick et al., 2019; Scholl, Seth, Kariisa, Wilson, & Baldwin, 2019). In particular, from 2000 to 2014 the U.S. saw a 300% increase in opioid overdose events and a 200% increase in opioid overdose deaths (Rudd, Aleshire, Zibbell, & Gladden, 2016). Heroin and fentanyl have had a devastating impact, with fentanyl alone driving the rise in overdoses and overdose deaths since 2013 (Gladden, Martinez, & Seth, 2016). Currently the epidemic shows no signs of slowing down with nearly 50,000 opioid-related deaths in 2019 (Gold, 2021; Scholl et al., 2019).
Whereas the opioid epidemic has swept across the U.S. regardless of urban, suburban, or rural (Peters, Monnat, Hochstetler, & Berg, 2020; Rossen, Khan, & Warner, 2014; Stopka et al., 2019), cities or urban areas in particular account for a much greater percentage of raw opioid-related overdoses and mortalities. During the period of 2000 through 2014, approximately 82% of all overdose deaths involving heroin occurred in large, metropolitan counties (Stewart, Cao, Hsu, Artigiani, & Wish, 2017). In another study researching urban and rural trends of overdoses in the state of Missouri, Coffey, Hunter, Mobley, and Vivolo‐Kantor (2020) found that overdoses display geospatial clustering in metropolitan counties as opposed to rural counties with metropolitan counties accounting for 75% of all fatal opioid overdoses in the state along with death rates two to three times higher than small metro and rural counties.
With respect to the geographical patterns of the opioid crisis within urban communities, latest research has found that different neighborhoods have been unequally affected (Carter, Mohler, & Ray, 2019; Daniel A. Dworkis, Taylor, Peak, & Bearnot, 2017). This observation corroborates a more general notion (or law) about the distribution of crime incidents that criminologists have recently suggested - most criminal activities take place in a very small proportion of microgeographic places (e.g., street segments or face blocks) within the boundary of an urban community (Bernasco & Steenbeek, 2017; Braga, Hureau, & Papachristos, 2011; Gill, Wooditch, & Weisburd, 2017; Weisburd, 2015). Latest studies have observed this same law by examining data on drug-activity and overdoses (Carter et al., 2019; Hibdon & Groff, 2014). For example, studying drug-related 911 calls for service in Seattle, Washington, Hibdon and Groff (2014) found that 50% of all calls concentrated on about 1% of the city’s street segments, while 100% of the calls being found within just 11% of Seattle’s street grids. Moreover, scholars have applied geospatial statistical techniques to identify clustering patterns (spatially and temporally) of opioid overdose incidents and other drug activity. One such study in Cambridge, Massachusetts observed that of those 700 total runs, 362 (or 52.5%) were located within three distinct hot spots (Daniel A Dworkis, Weiner, Liao, Rabickow, & Goldberg, 2018). Likewise, using space-time scan statistics, Linton, Jennings, Latkin, Gomez, and Mehta (2014) identified a number of clusters of narcotic calls for service from 2000 to 2010 across Baltimore, Maryland’s neighborhoods that had significantly high rates of drug activity relative to the entire city as a whole.