Chronic Drug Use and Crime

Leaving Their Drugs at the Gate? Exploring Changes in Drug Use From Before to During Incarceration in Norway

As the number of incarcerated persons who use drugs increases in many countries, it is important to understand the nature of drug use in prison by exploring how substance use patterns change from before to during incarceration. In this study, we rely on cross-sectional, self-report data from The Norwegian Offender Mental Health and Addiction (NorMA) study to identify the nature of changes in drug use among incarcerated respondents who reported having used either narcotics, non-prescribed medications, or both, during the 6 months before their incarceration (n = 824). Results show that about 60% (n = 490) stop using drugs. Of the remaining 40% (n = 324), about 86% changed their use patterns. Most commonly, incarcerated people stopped using stimulants and started using opioids; switching from cannabis to stimulants was the least common change. Overall, the study illustrates that the prison context leads most individuals to change their use patterns, some in unanticipated ways.

Multisubstance-Using Probationers and the Odds of Arrest While in the Community

Failed drug tests commonly lead to technical violations and revocation hearings for probationers. The current study extends these observations by examining whether multisubstance-using probationers also have increased odds of arrest in the community. This is important as multisubstance-using probationers may present unique public safety challenges to community corrections agencies and require intensive treatment resources and additional monitoring. Using data from a county-level probation cohort (N = 2,257) from 2009 to 2010, a series of logistic regression analyses estimated the effects of multisubstance use on the odds of being arrested for a new offense while in the community. The findings revealed that multisubstance use and the frequency of multisubstance use increased the odds of arrest while on probation when compared with single-substance users. We discuss how agencies may best supervise multisubstance-using probationers and suggest directions for further examination.

Alcohol Use, Employment, and Arrest: Making Sense of a Convoluted Relationship

The relationships between alcohol use, employment, and arrest are complexed and nuanced. This study examines the possibility of interactions between drinking and employment to evaluate whether the effects of alcohol use and/or employment on offending are contingent upon the other. Data from the 1997 National Longitudinal Survey of Youth (NLSY97) are analyzed using multilevel logistic regressions to examine the possibility of interactions between alcohol use and employment in their impact on offending. Both drinking in general and binge drinking increase the odds of arrest. In contrast, employment reduces the likelihood of arrest. Results from analyses of potential interactions indicate alcohol use and employment interact in their effects on crime. Alcohol use and employment appear to interact such that the effect of alcohol use on arrest depends on how frequently a person works, and the protective effect of employment depends on how often a person consumes alcohol.

Neighborhood crime, disorder and substance use in the Caribbean context: Jamaica National Drug Use Prevalence Survey 2016

The purpose of the study was to examine the role of objective and subjective measures of neighborhood crime and disorder on substance use among a nationally representative sample of 4525 Jamaicans aged 12–65 years. Log-Poisson models with generalized estimating equations were used to estimate relative risks (RR) and 95% confidence intervals (CI). A test of interaction was used to determine presence of effect modification by sex. Approximately 39% of the study population reported past-month alcohol use; 10% past-month tobacco use; and 15% past-month marijuana use. In fully adjusted models, past-month alcohol and tobacco use were associated with perceived neighborhood disorder (p<0.05). The likelihood of alcohol use was 1.12 (95%CI:1.04, 1.20) times greater among participants who perceived higher neighborhood disorder. The likelihood of tobacco use was 1.22 (95%CI: 1.01, 1.46) times greater among participants who perceived higher neighborhood disorder. A significant test for interaction in adjusted models (P<0.2) suggested that the associations between substance use and perceived neighborhood disorder varied by sex. Examination of stratified models indicated that the role of perceived neighborhood disorder on alcohol and tobacco consumption varied among females, but not males. Females who perceived higher levels of neighborhood disorder had an increased likelihood of past-month alcohol and tobacco use (RRa:1.25 95%CI:1,07, 1.45; RRa:1.73 95%CI: 1.10, 2.67). Objective neighborhood crime measures were not associated with alcohol, tobacco, or marijuana use. The study findings provide evidence for the importance of considering subjective and objective neighborhood measures when examining relations with health outcome and demonstrate that perceptions of context and contextual exposures are not uniform across populations within neighborhoods. Interventions focused on building community trust and social cohesion (e.g. neighborhood community watch groups) and greening of blighted or abandoned spaces may help increase the sense of safety and order, reducing stress and maladaptive coping such as substance use.

Attacks Intended to Seriously Harm and Co-occurring Drug Use Among Youth in the United States

BACKGROUND

While it is known that substance use and violence co-occur, less is understood in terms of how this relationship might vary based on the degree of youth involvement in violence.

OBJECTIVES

This study sought to examine the prevalence and degree that substance use disorders (SUD) and related intrapersonal and contextual factors were associated with violent attacks.

METHOD

Repeated cross-sectional data from a population-based study (National Survey on Drug Use and Health) of youth ages 12-17 (n = 216,852) in the United States between 2002 and 2013 were pooled to increase the analytic sample size. Survey multinomial regression was used to examine psychosocial and substance use differences between youth reporting episodic (1-2 times, n = 13,091; 5.84%) and repeated violent attacks (3+ times, n = 1,819; 0.83%) in contrast with youth reporting no attacks. Additional analyses examined the association of sociodemographic, intrapersonal, and contextual factors with SUD among youth reporting violent attacks.

RESULTS

The prevalence of SUD among youth with no attacks was 6% compared to 22% among episodic and 36% among repeatedly violent youth. Violence-involved youth were substantially more likely to experience elevated sensation-seeking, easy drug access, and recent drug offers and less likely to benefit from religiosity and protective substance use beliefs.

CONCLUSIONS/IMPORTANCE

Findings highlight the importance of distinguishing between the various gradations of violence among youth in understanding the relationship between substance use and violence, and shed light on the intrapersonal and contextual factors that can help identify violent youth at greatest risk for substance use problems.

Disaggregating the Relationship Between Drug Misuse and Crime

Studies on the association between drug-misuse and criminal behaviour have tended to be based on either aggregated data (composite forms of drug-misuse or offending) or data on just one or two types of drug-misuse or crime. Such studies can obscure variations in the nature of the relationship between particular drug types and particular offences. The current study uses disaggregated data derived from the NEW-ADAM (New English and Welsh Arrestee Drug Abuse Monitoring) program to investigate both connections and nonconnections between drug-misuse and crime. The results show some variations in the relationship depending on the particular combinations of type of drug-misuse and type of crime. The paper concludes that the use of disaggregated data can help identify both consistencies and variations in the relationship and might help to understand its complexities and inform government policy.

Factors associated with inability to access addiction treatment among people who inject drugs in Vancouver, Canada

BACKGROUND

Addiction treatment is an effective strategy used to reduce drug-related harm. In the wake of recent developments in novel addiction treatment modalities, we conducted a longitudinal data analysis to examine factors associated with inability to access addiction treatment among a prospective cohort of persons who inject drugs (PWID).

METHODS

Data were derived from two prospective cohorts of PWID in Vancouver, Canada, between December 2005 and November 2013. Using multivariate generalized estimating equations, we examined factors associated with reporting an inability to access addiction treatment.

RESULTS

In total, 1142 PWID who had not accessed any addiction treatment during the six months prior to interview were eligible for this study, including 364 women (31.9 %). Overall, 188 (16.5 %) reported having sought but were ultimately unsuccessful in accessing addiction treatment at least once during the study period. In multivariate analysis, factors independently and positively associated with reporting inability to access addiction treatment included: binge drug use (Adjusted Odds Ratio [AOR] = 1.65), being a victim of violence (AOR = 1.77), homelessness (AOR = 1.99), and having ever accessed addiction treatment (AOR = 2.33); while length of time injecting was negatively and independently associated (AOR = 0.98) (all p < 0.05).

CONCLUSIONS

These findings suggest that sub-populations of PWID were more likely to report experiencing difficulty accessing addiction treatment, including those who may be entrenched in severe drug addiction and vulnerable to violence. It is imperative that additional resources go into ensuring treatment options are readily available when requested for these target populations.

Quantifying crime associated with drug use among a large cohort of sanctioned offenders in England and Wales

AIM

To assess the relationship between testing positive for opiates and/or cocaine and prior offending.

METHODS

139,925 persons (107,573 men) identified from a saliva test for opiate and cocaine metabolites following arrest in England and Wales, 1 April 2005-31 March 2009, were case-linked with 2-year recorded offending history. The prior offending rate, accounting for estimated incarceration periods, was calculated by: drug-test outcome; gender; four main crime categories (acquisitive, non-acquisitive, serious acquisitive, and non-serious acquisitive) and 16 sub-categories. Rate ratio (RR) compared opiate and/or cocaine positive to dual-negative testers. Adjusted rate ratio (aRR) controlled for age at drug test.

RESULTS

The relationship between testing positive for opiates and cocaine and prior 2-year offending was greater for women than men (aRR men 1.77; 95% CI: 1.75-1.79: women 3.51; 3.45-3.58). The association was weaker for those testing positive for opiates only (aRR: men: 1.66, 1.64-1.68; women 2.73, 2.66-2.80). Men testing positive for cocaine only had a lower rate of prior offending (aRR: 0.93, 0.92-0.94), women had a higher rate (aRR: 1.69, 1.64-1.74). The strongest associations were for non-serious acquisitive crimes (e.g. dually-positive: prostitution (women-only): aRR 24.9, 20.9-29.7; shoplifting: aRR men 4.05, 3.95-4.16; women 6.16, 5.92-6.41). Testing positive for opiates and cocaine was associated with violent offences among women (aRR: 1.54, 1.40-1.69) but not men (aRR: 0.98, 0.93-1.02).

CONCLUSIONS

Among drug-tested offenders, opiate use is associated with elevated prior offending and the association is stronger for women than men. Cocaine use is associated with prior offending only among women.

Adolescent Pathways to Co-Occurring Problem Behavior: The Effects of Peer Delinquency and Peer Substance Use

Delinquency and substance use are more likely to co-occur in adolescence compared to earlier and later developmental periods. The present study examined developmental pathways to co-occurring problem behavior from 6th-10th grade (N=2,002), testing how peer delinquency and substance use were linked to transitioning between abstaining, delinquency, substance use, and co-occurring problem behavior. Developmentally, most youth transition from abstinence to delinquent behavior, and then escalate to co-occurring problem behavior. Once co-occurring problem behavior onsets, remitting to single problem behavior or abstinence is unlikely. The impact of peers on problem behavior are domain specific when individuals transition from abstaining to a single problem behavior, but are more general with respect to escalation of and desistance from problem behavior.

Dynamics in the costs of criminality among opioid dependent individuals

BACKGROUND

Research into the avoided crime-related costs associated with methadone maintenance treatment (MMT) is sparse. Our objective was to characterize the dynamics in crime-related costs associated with MMT effectiveness among opioid dependent individuals in Vancouver, Canada.

METHODS

We considered individuals enrolled in a prospective study between December, 2011 and May, 2013. Monthly crime-related costs (2013 CAD) were derived from self-reported criminal activity. On the basis of MMT receipt and illicit opioid use, individuals were classified in mutually exclusive health states: (i) MMT high effectiveness; (ii) MMT low effectiveness; (iii) opioid abstinence; or (iv) relapse. We classified individuals as daily, non-daily or non-stimulant users and controlled for demographic and socio-economic characteristics. A two-part multiple regression model was constructed; the first part modeled non-zero cost probability, the second estimated the level of costs. Avoided costs were estimated for each health state and stratified by stimulant use intensity.

RESULTS

Our study included 982 individuals (median age 47, 38% female) for 2232 observations. Individuals on MMT with high effectiveness incurred lower monthly costs of criminality (avoided costs of $6298; 95% C.I. ($1578, $11,017)), as did opioid abstinent individuals ($6563 ($1564, $11,561)). Avoided costs for daily stimulant users were greater than for non-daily users, both for individuals on MMT with high effectiveness ($12,975 vs. $4125) and opioid abstinent ($12,640 vs. $4814).

CONCLUSION

Using longitudinal data on individuals with a history of MMT, we found substantially lower costs of criminality associated with high effect to MMT. Avoided costs were highest among daily stimulant users that were on MMT with high effectiveness or those opioid abstinent.

Some initial findings and policy implications of the Pathways to Desistance Study

Little is known about how adolescents curtail their offending and make positive adjustments to early adulthood. The Pathways to Desistance study follows 1,354 serious adolescent offenders to provide information about these processes. This paper summarizes some initial findings from the study and lays out their potential policy implications. The findings covered include the variability in the sample, the importance of the link between substance use and offending, and the possible implications of institutional care.

Methodological, ethical, and legal considerations in drug court research

Since their inception in the late 1980s, drug courts have become the most prevalent specialty court in the United States. A large body of outcome research conducted over the past two decades has demonstrated that drug courts effectively reduce drug use and criminal recidivism, which has led to the rapid proliferation of these courts. Importantly, drug court research has flourished despite the many challenges faced by researchers when working with a vulnerable population of justice-involved substance users. In this article, we highlight the most common methodological, ethical, and legal challenges encountered in drug court research, and discuss ways in which researchers can overcome these challenges to conduct high-quality research. Drug court research exemplifies how rigorous empirical investigation can be accomplished in the criminal justice system, and it can serve as a useful model for researchers working in other parts of the judicial system.

The association between spending on methamphetamine/amphetamine and cannabis for personal use and earnings from acquisitive crime among police detainees in New Zealand

AIMS

Few studies have examined the statistical association between methamphetamine/amphetamine use and acquisitive crime. Both methamphetamine/amphetamine and cannabis use have been implicated by New Zealand Police as factors in acquisitive offending among active criminal populations. The aim of our study was to examine the statistical association between spending on methamphetamine/amphetamine and cannabis and earnings from acquisitive crime among police detainees in New Zealand.

SETTING

Four police stations in different regions.

PARTICIPANTS

A sample of 2125 police detainees were interviewed about their drug use and acquisitive crime.

DESIGN

Statistical models were developed to predict involvement in acquisitive crime using spending on methamphetamine/amphetamine and cannabis for personal use, and to examine associations between the level of spending on methamphetamine/amphetamine and cannabis for personal use and level of dollar earnings from acquisitive crime.

MEASUREMENTS

Self-reported spending on drug use and self-reported earnings from acquisitive crime in the past 30 days.

FINDINGS

Spending on cannabis and methamphetamine/amphetamine could predict involvement in acquisitive crime. Level of spending on methamphetamine/amphetamine and cannabis was associated positively with the level of earnings from property crime. Level of spending on methamphetamine/amphetamine was also associated positively with level of earnings from drug dealing. There was a largely negative association between level of spending on cannabis and level of earnings from drug dealing.

CONCLUSIONS

High spending on methamphetamine/amphetamine is associated statistically with higher earnings from acquisitive crime among police detainees. Further research into this association, and in particular the causal nature of the association, is required to obtain clear policy recommendations.

Longitudinal analysis of changes in illicit drug use and health services utilization

OBJECTIVE

To analyze the relationships between illicit drug use and three types of health services utilization: emergency room utilization, hospitalization, and medical attention required due to injury(s).

DATA

Waves 1 and 2 (11,253 males and 13,059 females) from the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC).

STUDY DESIGN

We derive benchmark estimates by employing standard cross-sectional data models to pooled waves of NESARC data. To control for potential bias due to time-invariant unobserved individual heterogeneity, we reestimate the relationships with fixed-effects models.

PRINCIPAL FINDINGS

The cross-sectional data models suggest that illicit drug use is positively and significantly related to health services utilization in almost all specifications. Conversely, the only significant (p<.05) relationships in the fixed-effects models are the odds of receiving medical attention for an injury and the number of injuries requiring medical attention for men, and the number of times hospitalized for men and women.

CONCLUSIONS

Failing to control for time-invariant individual heterogeneity could lead to biased coefficients when estimating the effects of illicit drug use on health services utilization. Moreover, it is important to distinguish between types of drug user (casual versus heavy) and estimate gender-specific models.

Does heavy adolescent marijuana use lead to criminal involvement in adulthood? Evidence from a multiwave longitudinal study of urban African Americans

While marijuana use is common during adolescence, it can have adverse long-term consequences, with serious criminal involvement being one of them. In this study, we utilize longitudinal data from the Woodlawn Study of a community cohort of urban African Americans (N=702) to examine the effects of heavy adolescent marijuana use (20 or more times) on adult criminal involvement, including perpetration of drug, property and violent crime, as well as being arrested and incarcerated. Utilizing propensity score matching to take into account the shared risk factors between drug use and crime, regression analyses on the matched samples show that heavy adolescent marijuana use may lead to drug and property crime and criminal justice system interactions, but not violent crime. The significant associations of early heavy marijuana use with school dropout and the progression to cocaine and/or heroin use only partially account for these findings. Results suggest that the prevention of heavy marijuana use among adolescents could potentially reduce the perpetration of drug and property crime in adulthood, as well as the burden on the criminal justice system, but would have little effect on violent crime.

The cost of crime to society: new crime-specific estimates for policy and program evaluation

Estimating the cost to society of individual crimes is essential to the economic evaluation of many social programs, such as substance abuse treatment and community policing. A review of the crime-costing literature reveals multiple sources, including published articles and government reports, which collectively represent the alternative approaches for estimating the economic losses associated with criminal activity. Many of these sources are based upon data that are more than 10 years old, indicating a need for updated figures. This study presents a comprehensive methodology for calculating the cost to society of various criminal acts. Tangible and intangible losses are estimated using the most current data available. The selected approach, which incorporates both the cost-of-illness and the jury compensation methods, yields cost estimates for more than a dozen major crime categories, including several categories not found in previous studies. Updated crime cost estimates can help government agencies and other organizations execute more prudent policy evaluations, particularly benefit-cost analyses of substance abuse treatment or other interventions that reduce crime.

Comparing heroin users and prescription opioid users in a Canadian multi-site population of illicit opioid users

INTRODUCTION AND AIMS

Recent data suggest increasing prescription opioid and decreasing heroin use among street drug users, yet little is known on possible differential use characteristics and outcomes associated with these drugs. [While we recognise that, correctly, these populations would need to be labelled as opioid 'abusers' or 'non-medical users', we rely on the simpler terms 'use' and 'users' for the population under study within the wider context of them being engaged overall in illicit opioid use activities.] This study compared drug use, health, and socio-economic characteristics between heroin (H)-only, prescription opioid (PO)-only and mixed heroin and prescription (PO & H) users in a Canadian multi-site cohort of illicit opioid and other drug users (OPICAN).

DESIGN AND METHODS

Data from the most recent (2005) multi-component assessment of the H-only (n = 94), PO-only (n = 304) and PO & H (n = 86) cohort sub-samples were analysed. Based on bivariate analyses of variables of interest, a multinomial logistic regression analysis (MLRA) model was computed, comparing PO-only and PO & H groups to the H-only reference group, respectively.

RESULTS

H-only users were found in two of the seven study sites. Based on the MLRA, PO-only and PO & H users, compared to H-only users, were more likely to: be older, use benzodiazepines and cocaine, use drop-in shelters and less likely to use walk-in clinics. PO-only users were also more likely to: be white; receive legal income; use drugs by non-injection; have physical health problems; and use private physician services.

DISCUSSION AND CONCLUSIONS

Our study underscores the increasing prevalence of PO compared to heroin use in the study population. Differences between PO-only and H-only users were more pronounced than differences between PO-only and PO & H users. PO-only use may be associated with lowered health risks and social burdens, yet concerns regarding polysubstance use and drug sourcing arise. Challenges for targeted interventions are discussed.

The longitudinal association between substance use and delinquency among high-risk youth

Over the past two decades, studies have provided evidence for the strong link between substance use (SU) and delinquency among adolescents. However, the dynamics of this relationship and its temporal ordering remain unclear. The current study used four waves of data collected from high-risk youth over a 12-month period to examine the temporal association between SU and delinquency. Youth (n=449) were recruited from the Los Angeles juvenile probation system. The majority of the sample was male (87%), with 43% Hispanic, 16% White, 15% African American, and 26% of participants describing themselves as some other ethnicity. We estimated a series of cross-lagged path models using maximum likelihood estimation and controlled for gender, age, ethnicity, and time spent in a controlled environment during the study period. We estimated models examining the cross-lagged association between SU and drug-related crime, interpersonal crime, and property crime. The temporal relationship between SU and delinquency was similar across the three types of crime, thus we estimated a fourth model examining the relationship between SU and a latent delinquency variable indicated by the three crime scales. Findings indicated that the relationship between SU and delinquency was reciprocal at each time point, suggesting that the reciprocal effects of SU and delinquency appear to be fairly stable over time.

Exploring the type-of-crime hypothesis, religiosity, and spirituality in an adult male prison population

This study examined the association between measures of spirituality and religiosity and characteristics of current criminal conviction in a male prison population. Spirituality was operationalized as spiritual well-being and existential well-being. Religiosity was operationalized as frequency of religious service attendance, whether an individual considered himself to be religious, and how strongly an individual believed his religious beliefs influenced his behavior. Inmates whose convictions were property related reported greater spiritual wellbeing, were more likely to consider themselves religious, and to say that religious beliefs influenced their behavior than inmates whose crimes were not property related. Inmates whose convictions were drug related were less likely to consider themselves religious, and inmates whose conviction involved violence were more likely to consider themselves religious but less likely to endorse statements that religious beliefs influenced their behavior. The distinction between religiosity and spirituality is discussed in terms of the type-of-crime hypothesis.

Dangerous to your health: the role of chronic drug use in serious injuries and trauma

OBJECTIVES

This study estimated the differential risks of serious injury or trauma for a community-based sample of chronic drug users (CDUs; n = 926) and a matched group of nondrug users (NDUs; n = 553). The study also estimated whether CDUs and NDUs differed in their utilization of health care services for serious injury or trauma.

MATERIALS AND METHODS

Data were collected in 1996 and 1997 through community outreach activities in Miami-Dade County, Florida. The analysis estimated the effects of drug use on (1) any lifetime serious injury or trauma, (2) any serious injury or trauma during the past 12 months, and (3) utilization of health care services for serious injury or trauma. All analyses were gender specific and the models were also estimated with a measure of problematic alcohol use in addition to CDU. To examine the potential endogeneity of drug use, various specification tests were conducted.

RESULTS

For females, CDUs experienced significantly more serious injury, trauma, or both (both lifetime and past year) than nonusers. Drug use status was not a significant predictor of serious injury or trauma (lifetime and past year) for males. Regardless of gender, conditional on experiencing any serious injury or trauma during the past year, CDUs and NDUs did not differ in their utilization of health care services. Various statistical tests determined that CDU was exogenous in all specifications and the findings were largely unchanged when problematic alcohol use was included in the models.

CONCLUSIONS

The elevated risk for serious injury or trauma for female CDUs renders these persons vulnerable to severe medical problems. Specific training in substance abuse issues may be necessary if health care providers are to identify, engage, knowledgeably serve, and refer CDUs for appropriate services.