The concept of substance-abusing individuals in the justice system varies depending on the research study and different definitions that are used. Often the term substance-abusing offenders refers to individuals with substance use behaviors (i.e., using illicit substances and/or consuming alcohol) that influence offending (i.e., causation for criminal behavior), while others assume that those engaged in criminal behavior use substance abuse as part of their lifestyle (i.e., nondirective influence). Since the drug-crime nexus is very convoluted, it is unclear how substance abuse affects criminal behavior or even how involvement in criminal behavior affects substance use. This entry provides an overview of the concept behind substance-abusing justice involved individuals including a discussion of the criteria for diagnosing substance abuse disorder and the prevalence of substance use disorders in the general population and in the justice system. Finally, this entry examines the relationship between mental illness and drug use.
Overview
Goldstein’s tripartite theory identifies three types of individuals with substance abuse disorder: those with psychopharmacological influences where drugs influence behavior, those who are involved in the business of drugs either for personal use or for monetary gain, and those who are affected by the surrounding environment where drugs are prevalent. While this theory is well-recognized, it suffers from a lack of evidence to indicate a causality between substance use and criminal behavior. To that end, there is a need to identify a typology of substance abusers deriving from theory and empirical knowledge about the relationship between substance abuse and criminal behavior. This typology is needed to ensure that the tautology (i.e., some substances are illicit and therefore this is criminal conduct) does not prevail in defining justice involved individuals with substance abuse issues, but rather the focus is the relationship between the substance use and criminal conduct. According to the Federal Bureau of Investigation (2010), these substance abuse–related crime categories still account for the majority of arrests: 1.6 million arrests for possession of illicit substances and 1.4 million for driving under the influence.
In the criminal justice system, part of the problem is a lack of clear definition as to what is a substance abuser or substance abusing offender. Often the offense the person is arrested for is used as a proxy for the type of substance abuser. That is, an individual who is arrested for possession of drugs may be considered a substance abuser. But the individual arrested for a property offense (even if the goal was to obtain funds for drugs) is not considered a drug offender. Other means of identifying drug offenders is to use a standardized risk and need assessment tool that identifies those who use drugs. It is presumed that the use of substances is linked to criminal behavior. This is in contrast to the clinical definition provided by the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. Substance use is part of a continuum with an increasing number of symptoms (from an identified list of 11 symptoms) to qualify as a substance use disorder. If an individual has greater than six symptoms, then they are considered to have a serious substance use disorder. Moderate substance use disorders are in the 4–6 range.
The severity of the substance abuse does not consider the type of drug of choice or whether it is alcohol or an illicit substance.
Nature of Substance Use Disorders in the General Population and Arrestees
Two major surveys are useful to identify the unique characteristics of individuals who abuse substances among the criminal justice and general population. This distinction is important because it helps assess the degree to which the justice involved substance abuser is similar to or different from the general population. The National Household Survey on Drug Use and Health is an annual survey of 67,000 individuals to monitor the use of illicit substances and health status in the general population; using sampling weights, these statistics are useful for generating national estimates among the general population. This survey has two questions regarding criminal justice status:
One about whether the person was arrested in the last year and one about whether the person was on probation or parole in the last year. The second source of data is the Arrestee Drug Abuse Monitoring System (ADAM-II), a survey of arrestees in five counties—Atlanta, GA (Fulton County); Chicago, IL (Cook County); Denver, CO (Denver County); New York, NY (Borough of Manhattan); and Sacramento, CA (Sacramento County)— including an interview and collection of biological data. It provides an assessment of the characteristics of those who use substances in the justice population. This is in contrast to individual studies which have smaller samples or dated surveys of justice involved populations.
In the 2016 National Household Survey on Drug Use and Health, 28.6 million individuals over 12 years of age report use of an illicit substance in the past 30 days. The majority, 24 million, used marijuana; use of a pain medication was the second highest category (3.3 million). Nearly 137 million report alcohol uses in the past month with 48% reporting binge drinking (i.e., 5 or more drinks on one occasion). About 12% of the individuals report that they are heavy drinkers. Substance use disorders affect 20.1 million people including alcohol (15 million) and drug disorders (7.4 million). Nearly 4 million individuals experience both alcohol and drug use disorders.
In the 2013 ADAM-II survey, arrestees continue to have high rates of substance use. At the time of the arrest, the following are the rates of individuals who reported the presence of at least one drug in their system: Atlanta (63%), Chicago (83%), Sacramento (83%), Denver (74%), and New York (71%). Some offenders had more than one drug in their system, including Atlanta (12%), Chicago (19%), Sacramento (50%), Denver (27%), and New York (22%). The offense for those arrested in these sites varies considerably, illustrating that offense is not necessarily useful in identifying the substance abuse population. In Atlanta, this was the breakdown of the offenses by those arrested: 17.7% violent offenses, 30.4% drug offenses, 24.3% property offenses, and 45.3% other offenses; in Chicago, 23.7% violent offenses, 50.1% drug offenses, 28.2% property offenses, and 17.3% other offenses; in Sacramento, 19.1% violent offenses, 48.1% drug offenses, 12.4% property offenses, and 50.5% other offenses; in Denver, 24.2% violent offenses, 13.6% drug offenses, 14.4% property offenses, and 63.5% other offenses; and, in New York, 18.8% violent offenses, 31.2% drug offenses, 32.5% property offenses, and 32.6% other offenses.
Marijuana
According to the NHSDHU, of the 24 million marijuana users in the general population, 1.8 million are between the ages of 12 and 17 years (6.5% of the overall aged population), 6.8 million (20.8%) are between 18 and 25, and 13.5 million (7.2%) are older than 26. Around 25% or 4.0 million people using marijuana have a disorder based on the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. Marijuana substance abusers are more likely to be 18–25 years old. Of these, 4.0 million, 584,000 (2.3%), 1.7 million (5%), and 1.7 million (.7%) are between 12 and 17, 18 and 25, and older than 26, respectively. The drug use among the general population is similar in that arrestees in the ADAM-II survey report were detected to use marijuana at high rates: Atlanta (34%), Chicago (52%), Sacramento (59%), Denver (48%), and New York (44%).
Heroin
Within the general population, 948,000 (.4%) people reported using heroin within the past year. The majority of the users were older than 26. Approximately 708,000 individuals in the general population have heroin use disorders with the majority being 26 years of age and older. In the ADAM II survey, three jurisdictions had higher percentages of heroin users: Atlanta, Denver, and Sacramento reported increased opiates/heroin use from 2000 to 2014. The rates were 2% in Atlanta, 4% in Denver, and 3% in Sacramento. New York and Chicago saw decreases during this 13-year period including a 36% reduction in 2000 to 14% in 2013 and 20% in 2000 to 8% in 2013, respectively.
Alcohol
Alcohol is the most frequently used substance in the general population and among arrestees. For the general population, the National Household Survey on Drug Use and Health uses three categories to describe alcohol usage within the past month: alcohol use (i.e., having at least one drink), binge drinking (i.e., having five or more drinks in one occasion, once), and heavy drinking (i.e., five or more drinks on one occasion more than once). Overall, 136.7 million (50.7%) used alcohol in the past month, 65.3 million (23%) reported being binge drinkers, and 16.3 million (6.0%) reported being heavy drinkers. Further, 43.6% of those who use alcohol are binge drinkers, 11.7% are heavy drinkers, and 26.8% are heavy drinkers. Among those who use alcohol, 2.3 million (9.2%) are between the ages of 12 and 17, 19.8 million (57.1%) are between 18 and 25, and 114.7 million (54.6%) are older than 26 years of age. Of binge drinkers, 1.7 million (4.9% of the overall aged population) are between the ages of 12 and 17, 13.3 million (36.4%) are between 18 and 25, and 50.9 million (24.2%) are older than 26 years of age. Lastly, for heavy drinkers, 191,000 (1%) are between the ages of 12 and 17, 3.5 million (10.1%) are between 18 and 25, and 12.6 million (6%) are older than 26 years of age.
The ADAM-II survey does not examine alcohol use among arrestees. But the 2004 National Bureau of Justice Statistics’ Survey of Inmates in State and Federal Correctional Facilities found that 32.6% and 18.5% of state and federal prisoners, respectively, reported using alcohol at the time of their offense. Alcohol use was reported for 36.8% of violent offenses, 29.1% of property offenses, 21.4% of drug offenses, 41.2% of public order offenses, and 41% of other offenses for state prisoners. For federal offenders, alcohol use varied with 20.8% for violent offenses, 12.8% for property offenses, 18.5% for drug offenses, 18.3% for public order offenses, and 20.6% for other offenses.
Cocaine
In the general population, 1.9 million (.6%) people report use of cocaine and 432,000 (.1%) report use of crack in the past month. The majority of users were over 26 years old (this includes both cocaine and crack users). Additionally, 867,000 of those who use have a diagnosable cocaine use disorder, with the majority being over 26 years old. The use of cocaine among arrestees is the second most common drug detected in the ADMA-II survey: Atlanta (33%), Chicago (25%), Sacramento (7%), Denver (20%), and New York (33%). Crack seems to make up a higher percentage of the cocaine using arrestee population than powder cocaine with 14% (Atlanta), 8% (Chicago), 3% (Sacramento), 9% (Denver), and 15% (New York) using crack, while 5% (Atlanta), 6% (Chicago), 3% (Sacramento), 7% (Denver), and 5% (New York) using cocaine.
Drug Use and Mental Illness
According to the NSHDUH survey, 44.7 million (16.1%) people over the age of 18 had some type of mental illness but 10.1 million (~4%) had a serious mental illness within the past year. Mental illness affects those who are younger more so than their older counterparts, with higher rates among those ages 18–49. Comparatively, in the ADAM-II sample, only 2.3% had a mental illness within the last month in Atlanta, 5.8% in Chicago, 4.4% in Sacramento, 1.5% in Denver, and 4.7% in New York (these statistics were measured by the percentage of arrestees who were treated in a mental health/psychiatric treatment facility). Among the general population, 7.9 million people have both a mental health disorder and a substance abuse disorder, making up 39.1% of the population with substance abuse disorder and 16.2% of the population with mental illness. The ADAM-II survey does not directly measure comorbidity.
Substance Abusers in the Justice System
The justice involved population has a 4 times greater rate of substance abuse than the general population. As documented by Trevor Bennett, Katy Holloway, and David Farrington in 2008, a meta-analysis of 30 studies on substance use and recidivism assessed the differential outcomes reported in studies that explored recidivism based on drug of choice, with the odds of offending 6 times greater for individuals who used crack (odds ratio [OR] = 6.09) than those who did not, about 3 times greater for those who used heroin (OR = 3.08) as opposed to those who did not, about 2.5 times greater for individuals who used cocaine (OR = 2.56) than those who did not, and about 1.5 times greater for individuals who used marijuana (OR = 1.46) than those who did not. Drug of choice is an important factor in an individual’s further involvement in the justice system. Few studies, including national surveys, define substance abuse disorders according to a clinical disorder. Nor do the studies indicate how comorbid conditions may affect offending behaviors. While individuals involved in the justice system have higher rates of substance abuse than the general population, the relationship between drugs and alcohol and criminal conduct is still poorly understood.
References:
- Bennett, T., Holloway, K., & Farrington, D. (2008). Statistical association between drug misuse and crime: A meta-analysis. Aggression and Violent Behavior, 13(2), 107–118.
- Bureau of Justice Statistics. (2010). Alcohol and crime: Data from 2002 to 2008 [data file]. Retrieved from http://www.bjs.gov/content/acf/29_prisoners_and_ alcoholuse.cfm
- Goldstein, P. J. (1985). Drugs and violent behavior. Journal of Drug Issues, 15, 493–506.
- Office of National Drug Control Policy. (2014). 2013 Annual Report, Arrestee Drug Abuse Monitoring Program II. Washington, DC: Executive Office of the President.
- Substance Abuse and Mental Health Services Administration. (2017). Key substance use and mental health indicators in the United States: Results from the 2016 National Survey on Drug Use and Health (HHS Publication No. SMA 17-5044, NSDUH Series H-52). Rockville, MD: Center for Behavioral Health Statistics and Quality, Substance Abuse and Mental Health Services Administration.
- S. Department of Justice Federal Bureau of Investigation. (2010). Crime in the United States [Data File]. Retrieved from https://www.fbi.gov/ about-us/cjis/ucr/crime-in-the-u.s/2010/crime-in-the-u.s.-2010/tables/10tbl29.xls
- White, H. R., & Gorman, D. M. (2000). Dynamics of the drug-crime relationship. Criminal Justice, 1(15), 1–218.