Elsevier

Drug and Alcohol Dependence

Volume 79, Issue 3, 1 September 2005, Pages 295-302
Drug and Alcohol Dependence

Reductions in criminal convictions after addiction treatment: 5-year follow-up

https://doi.org/10.1016/j.drugalcdep.2005.01.023Get rights and content

Abstract

Changes in criminal convictions were investigated among 1075 clients admitted to 54 drug misuse treatment services across England as part of the National Treatment Outcome Research Study (NTORS). Convictions data during the year prior to treatment, and at 1 year, 2 years, and 5 years after treatment intake were collected from the Home Office Offenders’ Index, a national database of all convictions in adult and youth courts. Clinical data were collected by face-to-face interviews at intake to treatment, and at follow-up 1 year, 2 years, and 4–5 years after admission to treatment. During the year prior to treatment, 34% of the sample had been convicted of at least one offence. Conviction rates at all follow-up points were significantly lower than at intake. During the year prior to the 5-year follow-up, 18% of the sample had been convicted of at least one offence. Statistically significant reductions in the mean number of convicted offences were also found between treatment intake and 5-year follow-up. Reductions in convictions were found for acquisitive, drug selling, and violent crimes. Reductions in crime were associated with reductions in regular heroin use, age, and with stable housing. The results replicate previously reported findings of crime reductions among the NTORS cohort as indicated by self-reported measures of offending behaviour. The observed reductions in crime among drug misusers after treatment represent substantial changes in behaviour and have considerable personal, social and clinical significance. Reduced criminality also provides substantial economic benefits to society.

Introduction

The association between crime and drug misuse has been reported by many studies (Maden et al., 1992, Hall et al., 1993, Spunt et al., 1995; US National Institute of Justice, 1996). This association is often strongest where drug misuse involves the regular and dependent use of drugs such as heroin and cocaine. Many heroin addicts finance their habits largely through acquisitive crime (Jarvis and Parker, 1989) and crimes involving theft have been found to be a common offence among heroin addicts (Ball et al., 1983). Heroin addicts were more likely to be charged with burglary than non-addict criminals (Speckart and Anglin, 1985). The onset of use of addictive drugs has been found to be associated with high levels of criminal behaviour, which continues during periods of addiction (Ball et al., 1983). Involvement in crime and the amount of crime committed during periods of addiction far exceed that committed during periods of non-addiction (McGlothlin et al., 1978, Ball et al., 1983, Nurco et al., 1985, Nurco et al., 1989, Nurco, 1987).

The question of how drug misuse treatment interventions influence criminal behaviour is important both for the implementation and evaluation of treatment programmes and for the development of policies to tackle drug misuse problems. Research into the association between drug use and crime has been a priority issue since at least 1975 in the United States where the reduction of crime is seen as a specific goal of drug misuse treatment (Gerstein and Harwood, 1990). Hubbard et al. (1989) and Ball and Ross (1991) found that treatment was associated with major reductions in the most common forms of income-generating crime such as shoplifting, other forms of theft, burglary, and robbery. Hubbard et al. (1989) found that in both residential and community treatment modalities, the proportion of clients committing property crimes was greatly reduced during and after treatment. Less crime is committed by patients in methadone maintenance treatment than by comparable groups of addicts out of treatment (Hunt et al., 1984). Ball and Ross (1991) reported that the number of offences during methadone maintenance fell to about 20% of pre-treatment levels. Longer periods of stay in methadone treatment have been linked to greater reductions in both heroin use and criminal activity (Flynn et al., 2003a, Flynn et al., 2003b), as have higher methadone doses (Bellin et al., 1999).

Studies of crime among drug misusers have included large-scale national studies (Elliot et al., 1989) as well as observational studies of small groups (Johnson et al., 1985). Also, different measures of crime have been used. Measures have included crime days (Shaffer et al., 1984, Speckart and Anglin, 1986, Bell et al., 1997), type and number of offences (Jarvis and Parker, 1989, Hammersley et al., 1990, Hall et al., 1993, Bell et al., 1997, Kaye et al., 1998), number of arrests (McGlothlin, 1979, Inciardi, 1979, Grapendaal, 1992;), rate or number of convictions (Jarvis and Parker, 1989, Hall et al., 1993, Bell et al., 1997), type of first crime (Inciardi, 1979), and criminal income (Speckart and Anglin, 1986, Hammersley et al., 1990). Data on crime has also been collected by self-report (Inciardi, 1979, Hammersley et al., 1990, Hanlon et al., 1990, Hartnagel, 1997), and official policy records showing arrests, court appearances, convictions, and type of offences (Bennett, 1998, Grapendaal, 1992).

There are problems and weaknesses associated with each of these methodologies and measures (Chaiken and Chaiken, 1982). Self-reported information is less likely than criminal justice records or other agency records to underestimate criminal behaviour (Inciardi, 1979, Chaiken and Chaiken, 1990). On the other hand, the validity of self-reported criminal behaviour may be adversely affected by problems of recall, or by motivated deception involving either exaggeration or concealment of illegal activities. Drug users, like other people, may provide information which is selectively presented or manipulated to serve their own interests. Conversely, data on convictions represent an underestimation of actual criminal behaviour. Inciardi and Pottieger (1998), for instance, showed that there is a very low risk of arrest for income-generating crimes committed by heroin users, and Reuter (1997) suggested that drug selling is much less likely to lead to arrest and imprisonment than offences such as burglary or robbery. Despite this, the availability of an official measure of offending means conviction data is used as a key indicator of performance within the criminal justice system in England and Wales.

The present report is one of a series of investigations which took place as part of the National Treatment Outcome Research Study (NTORS). Previous reports on this study sample described the high rates of self-reported crime prior to treatment (Stewart et al., 2000a), and the reductions in acquisitive and drug dealing crimes that occurred after treatment (Gossop et al., 2000a, Gossop et al., 2000b). This paper presents a further investigation of changes in crime among the NTORS cohort by analysis of officially recorded convictions among these drug misusers subsequent to their entry to drug treatment programmes. In particular, the study investigates whether the reductions in criminal offending behaviour previously reported by the NTORS cohort following treatment entry were also found in terms of reduced levels of recorded criminal convictions.

Section snippets

Subjects and agencies

NTORS uses a longitudinal, prospective cohort design. Clients were recruited on entry to drug misuse treatment programmes during a 5-month period between March and July 1995. The resulting sample consisted of 1075 clients. Their average age was 29.3 years; 74% were men and 91% reported their ethnicity as white/UK. The most common presenting problem was heroin (or opioid) dependence (90%), though multiple substance use was typical with 81% having used two or more drugs in the 3 months prior to

Reductions in convictions at follow-up

From the full sample (n = 1075), a total of 799 of the NTORS clients (74%) were matched to the OI database (i.e. with one or more lifetime convictions). No convictions for any criminal offence were recorded for the remaining 276 clients (26%). During the year prior to treatment intake, one-third (34%) of the sample had been convicted of one or more criminal offences. At 1-year follow-up, the percentage of the sample convicted during that year had fallen to 28%, with further reductions at 5 years

Discussion

Substantial reductions in criminal convictions were found among a cohort of more than a thousand drug misusers after treatment for drug dependence problems. These reductions were found in terms of the proportion of the sample convicted, and in the number of convicted offences, and for all categories of crime (all crimes, acquisitive crimes, drug selling, and violent crimes). High rates of criminality were found during the year prior to treatment, with one-third of the cohort having been

Acknowledgements

The authors wish to thank the staff at the participating agencies without whose active support NTORS would not have been possible, and the clients for agreeing to take part in the project. Funding for the NTORS project was wholly provided by the Department of Health. Funding for the further analyses of convictions reported in this paper was provided by the Home Office. The views expressed in this paper are those of the authors and do not necessarily reflect those of the Department of Health nor

References (56)

  • J. Ball et al.

    The Effectiveness of Methadone Maintenance Treatment

    (1991)
  • J. Ball et al.

    The day-to-day criminality of heroin addicts in Baltimore: a study in the continuity of offence rates

    Drug Alcohol Depend.

    (1983)
  • J. Bell et al.

    Methadone maintenance and drug-related crime

    J. Subs. Abuse

    (1997)
  • E. Bellin et al.

    High dose methadone reduces criminal recidivism in opiate addicts

    Addict. Res.

    (1999)
  • T. Bennett

    Drug Testing Arrestees, Home Office Research Findings 70

    (1998)
  • B. Bowling

    The rise and fall of New York murder: zero tolerance or crack's decline?

    Br. J. Criminol.

    (1999)
  • W.S. Cartwright

    Cost-benefit analysis of drug treatment services: review of the literature

    J. Ment. Health Policy Econ.

    (2000)
  • J.M. Chaiken et al.

    Drugs and predatory crime

  • J.M. Chaiken et al.

    Varieties of Criminal Behaviour: Summary and Policy Implications

    (1982)
  • D.S. Elliot et al.

    Multiple Problem Youth

    (1989)
  • P.M. Flynn et al.

    Looking back on cocaine dependence: reasons for recovery

    Am. J. Addict.

    (2003)
  • P.M. Flynn et al.

    Costs and benefits of methadone treatment in DATOS. Part 1: discharged versus continuing patients

    J. Maintenance Addict.

    (2003)
  • D.M. Fergusson et al.

    Alcohol abuse and crime: a fixed-effects regression analysis

    Addiction

    (2000)
  • C.P. Ferri et al.

    Route of cocaine administration: patterns of use and problems among a Brazilian sample

    Addict. Behav.

    (1999)
  • C. Friendship et al.

    Reconviction: a critique of two main data sources in England and Wales

    Leg. Criminol. Psychol.

    (2001)
  • D.R. Gerstein et al.

    Treating drug problems, vol. 1, A Study of the Evolution, Effectiveness, and Financing of Public and Private Drug Treatment Systems

    (1990)
  • C. Godfrey et al.

    Economic analysis of costs and consequences of the treatment of drug misuse: 2-year outcome data from the National Treatment Outcome Research Study (NTORS)

    Addiction

    (2004)
  • M. Gossop et al.

    The National Treatment Outcome Research Study in the United Kingdom: Six month follow-up outcomes

    Psychol. Addict. Behav.

    (1997)
  • M. Gossop et al.

    Substance use, health and social problems of clients at 54 drug treatment agencies: Intake data from the National Treatment Outcome Research Study (NTORS)

    Br. J. Psychiatry

    (1998)
  • M. Gossop et al.

    Drug selling amongst drug misusers before intake to treatment and at 1-year follow-up: results from the National Treatment Outcome Research Study (NTORS)

    Drug Alcohol Rev.

    (2000)
  • M. Gossop et al.

    Reductions in acquisitive crime and drug use after treatment of addiction problems: 1-year follow-up outcomes

    Drug Alcohol Depend.

    (2000)
  • K. Grapendaal

    Cutting their cost according to their cloth: economic behaviour of Amsterdam opiate users

    Int. J. Addict.

    (1992)
  • W. Hall et al.

    Crime and drug use among applicants for methadone maintenance

    Drug Alcohol Depend.

    (1993)
  • R. Hammersley et al.

    The criminality of new drug users in Glasgow

    Br. J. Addict.

    (1990)
  • T.E. Hanlon et al.

    Trends in criminal activity and drug use over an addiction career

    Am. J. Drug Alcohol Abuse

    (1990)
  • T.F. Hartnagel

    Crime, illegal drug use and social control in the transition from school to work

    Crim. Behav. Ment. Health

    (1997)
  • Y.I. Hser et al.

    A 33-year follow-up of narcotics addicts

    Arch. Gen. Psychiatry

    (2001)
  • R.L. Hubbard et al.

    Drug Abuse Treatment: A National Study of Effectiveness

    (1989)
  • Cited by (108)

    • High drug related mortality rates following prison release: Assessing the acceptance likelihood of a naltrexone injection and related concerns

      2018, Journal of Substance Abuse Treatment
      Citation Excerpt :

      Serving a current sentence for an acquisitive crime compared to a drug misuse, violent, or miscellaneous offence, was the strongest predictor of high NIAL ratings. With acquisitive crimes often committed to support heroin use (Gossop et al., 2005; Stewart et al., 2000), this result may indicate greater willingness in this offender group to accept an intervention which will remove any reason to find money to acquire heroin, compared to the other offender groups. It should be noted that higher post release mortality has previously been reported for this offender group than for other types of offences (Farrell & Marsden, 2005).

    View all citing articles on Scopus
    View full text