Finding crime in a public health crisis: a comparative analysis of opioid news coverage in West Virginia and Vermont.

BACKGROUND: Under what conditions do newspapers reference crime or law enforcement in their coverage of opioids in the United States? This study examines how crime framing varies across political contexts, time periods, and drug types in newspaper coverage of opioids. METHODS: The study analyzed 2,400 newspaper headlines, including 1,200 from Vermont and 1,200 from West Virginia. For each state, half the headlines were identified using the search term "oxycodone" and half using "fentanyl." Headlines were coded for the presence of crime frames. RESULTS: Bivariate analyses showed that West Virginia newspapers were significantly more likely than Vermont newspapers to employ crime frames and that crime framing declined significantly between the early (2011-2016) and late (2017-2025) periods. Oxycodone and fentanyl headlines were equally likely to reference crime overall. However, interaction analyses revealed that these patterns masked important contingencies. State differences in crime framing were driven largely by oxycodone coverage in the early period, when West Virginia headlines were substantially more crime oriented than those in Vermont. By contrast, fentanyl coverage showed little variation between states. Crime framing declined over time for oxycodone but increased for fentanyl in both states. CONCLUSIONS: The findings demonstrate that the effects of state context, historical period, and opioid type on crime framing are interrelated rather than operating independently. Given that crime-oriented narratives may influence public perceptions and shape policy responses to opioid use disorder, identifying the conditions under which such frames emerge is an important area of inquiry.