Opioid Policy and Intimate Partner Violence

Substance use is a well-established driver of intimate partner violence (IPV), with drug-related incidents posing persistent challenges for both public health and criminal justice systems. We examine how expanding access to substance use treatment (SUT) services affects IPV in the United States by leveraging variation in the opening and closing of treatment facilities at the county level. Using administrative data on IPV incidents from the National Incident-Based Reporting System at the agency level from 1998 to 2019 combined with county-level records on treatment facility information, we implement a continuous difference-in-differences research design. Our results show that adding three SUT facilities—the average annual increase per county over the sample period—reduces drug-involved IPV by about 1.5–1.7 percent. We find no evidence of significant effects on alcohol-related or non-substance-related IPV. Staggered event-study analyses confirm parallel outcome trends, across treated and non-treated counties, prior to net facility openings and lend support to a causal interpretation of the estimates. Related evidence from SUT admissions drawn from the Treatment Episode Data Set (TEDS) shows that new centers significantly raise treatment entry, particularly among men, consistent with reduced perpetration driving the observed decline in IPV exposure. Our findings highlight the role of health services infrastructure in shaping violence-related outcomes and underscore the broader public safety benefits of investment in treatment access.

Substance abuse is a major risk factor for intimate partner violence (IPV). We investigate how a key supply-side intervention – the abuse-deterrent reformulation of a widely-diverted opioid, OxyContin – affected IPV. Our results indicate counties with greater baseline rates of prescription opioid usage experienced relatively larger declines in IPV after OxyContin’s reformulation. The reformulation reduced IPV only in states with smaller illicit drug markets, while states with larger illicit drug markets experienced increased heroin-involved IPV due to substitution towards illicit opioids. Our results underscore the importance of identifying populations at high risk of substitution to illicit opioids and moderating this risk with evidence-based policies.

The opioid crisis generates broader societal harms beyond direct health and economic effects, impacting non-users through adverse spillovers on children, families, and communities. We study the spillover effects of a supply-side policy aimed at reducing overprescription of opioids on women’s well-being by examining its effects on intimate partner violence (IPV) in the United States. Using administrative data on incidents reported to law enforcement, in conjunction with quasi-experimental variation in the adoption of stringent mandatory-access prescription drug monitoring programs, we find that these policies generate a downstream benefit for women by significantly reducing their overall exposure to IPV and IPV-involved injuries by 9 to 10%. The strongest effects are experienced by groups with higher rates of opioid consumption at baseline, including non-Hispanic Whites. Our findings also show a significant increase in heroin-involved IPV incidents, suggesting substitution into illicit drug consumption. However, since heroin-related IPV accounts for less than 1% of all incidents, its increase among highly opioid-dependent individuals does not offset the overall decline in total IPV incidents in affected states. Our results highlight the need to identify high-risk groups prone to switching to illicit opioids and to address this risk through evidence-based policies.