The public health impacts of drug-induced homicide laws: a community-engaged scoping review

Drug-induced homicide (DIH) laws are state laws that confer criminal liability equivalent to homicide or manslaughter for the sale or delivery of drugs subsequently associated with a fatal overdose. We undertook a scoping review of literature on the public health impacts of DIH laws and held focus groups to seek guidance on the interpretation of review results from three directly-impacted community groups: public health and harm reduction professionals; people who use drugs (PWUD); and family members of adult victims of fatal overdose. Eight publications met our inclusion criteria. Three of those publications presented the results of a systematic analysis of DIH laws and/or their effects; the remaining five publication presented exploratory results related to these topics. Six of the eight publications suggest that DIH laws actively deter people from calling 911 to report an overdose. Two publications suggest that DIH laws have small but disruptive impacts on drug market participation. One publication suggests that friends and family of overdose victims constitute about half of all people charged under DIH laws and the conclusion that DIH charges are overwhelmingly brought in response to the death of a white person. Public health and harm reduction professionals and PWUD reported, generally, that these conclusions align with their lived experience and prior understandings of DIH laws. Family members rejected the evidence that DIH laws deter calling 911, asserting that such a relationship makes no sense, often relying on stereotyped understandings of substance use to support that claim. Public health and harm reduction professionals advocated for additional research documenting the negative impacts of DIH laws, with the goal of informing more effective drug policy. Family members advocated for more research on friends and loved ones affected by overdose. Current evidence on the impacts of DIH laws remains limited but consistently indicates negative consequences for public health. Additional research is needed, especially research that addresses the expressed needs and priorities of directly impacted community groups.