Drug use, drug markets, and the risk of being assaulted with a gun

Background. The aim of this study was to examine the relationship between drug use, local drug markets, and the risk of being assaulted with a gun. Method. An incidence density sampled case-control study was conducted in the entire City of Philadelphia from 2003 to 2006. We enrolled 677 cases that had been shot in an assault and 684 population-based controls. The outcome of being assaulted with a gun was modeled as a function of drug use and drug market activity in the surrounding area. Conditional logistic regression was used to adjust for numerous confounding variables. Results. Drug use was associated with a large, statistically significant risk of being shot in an assault. Drug use may generate about the same level of gun assault risk as being in an area where illicit drug markets are highly clustered. However, the risk of gun assault associated with illicit drug markets is significantly reduced by various individual and sociodemographic confounders while the risk of gun assault associated with drug use is not. Conclusions. Drug use and drug market activity substantially increase the risk of being shot. Multilevel strategies that decrease both the supply and demand of illicit drugs are still sorely needed in low-income and minority neighborhoods in major US cities.