Drug use is not just a mental health problem. It’s something that affects every level of society and every walk of life like few other things can. Drugs ruin careers and destroy prospects, but they also make people go to illegal lengths, either to pursue their habit, or to make a living off a multi-billion dollar market. Crime and drug use go down the same rabbit hole, leaving nothing but devastation and misery in their interconnected wake.
Popular and medical understanding of drug abuse has evolved over time. We know more about the mechanics and psychology of addiction than we did even 15 years ago, but what has not changed about drugs is the damage they cause. There are obvious health and wellness issues (physical and mental deterioration, loss of jobs and relationships) that occur because of an addiction, but beyond that, drugs cost money. They cost money to make, money to distribute and money to buy.
Drugs are in high demand, certain drugs are illegal to own, and most drugs make their users act in impulsive, unpredictable and sometimes dangerous ways. Put all these factors together, and the criminal element is just a matter of time.
Crime and Drug Use: Almost Automatic
So intertwined is the relationship that the National Council on Alcoholism and Drug Dependence pulls no punches in declaring that a drug addiction can lead to criminal behavior (the association between the two is “almost automatic,” in the words of a Canadian parliament report on their “complex relationship”
), listing the following felonies as examples:
- Aggravated assault
- Breaking and entering
- Serious motor vehicle offenses
- Hate crimes
The NCADD quotes figures from the Uniform Crime Reporting Program of the FBI that show 80 percent of all prison inmates abuse drugs or alcohol. Almost 50 percent of them fit the criteria for dependence on illicit substances, and around 60 percent of the people who are arrested for “most types of crimes” test positive for drugs at the time of their arrest.
Or, as put by The New York Times in 1998 (and quoting a report released by the National Center on Addiction and Substance Abuse at Columbia University), four out of five inmates are behind bars as the result of the possession or use of illegal drugs or alcohol. Some of them had been high (or under the influence) when they committed their crimes; others had stolen money or goods in order to procure more drugs; and yet more had a history of abusing drugs or alcohol that led them to break the law.
Alcohol and Marijuana
Alcohol, says the Times, was more closely associated with violent crimes (murder, rape, assault, and child and domestic abuse) than any illegal drug.
While only one percent of state prisoners were high on heroin when they committed their crimes, and only three percent had been using cocaine (either crack or powdered), 21 percent of prisoners were using alcohol (or were drunk) when they engaged in their criminal activity.
Alcohol may be the biggest offender here, but other drugs can be just as dangerous. In 2011, researchers writing for the American Journal of Orthopsychiatry found that men who had developed a dependence on methadone were more physically, sexually and psychologically abusive toward their partners.
Furthermore, while alcohol has the closest association to violent crime, the former Director of the Office of National Drug Control Policy said in 2013 that marijuana is the substance that is most often linked to crime. Of adult men arrested for crimes in Sacramento, California, 80 percent of them tested positive for at least one illegal drug, and marijuana was found in 54 percent of them, making it the most commonly detected drug.
While marijuana advocates were quick to criticize the comments, the director of the Justice Policy Center for the Urban Institute called for better preventative and treatment measures to address the root causes of criminal behavior, and not simply the symptoms that result in incarceration. 
For most of those inmates mentioned by the Times and the NCADD, a prison sentence does little to mend the errors of their ways. NCADD says that between 60 and 80 percent of drug abusers commit a new crime after they are released, and that crime is usually drug-driven in nature. A staggering 95 percent of them resume their drug habits following the end of their incarceration. According to The New York Times article mentioned above, fewer than 150,000 out of 840,000 prisoners in 1996 received any kind of mental health or drug counseling before they were released.
But what is a drug-driven crime? The NCADD explains that there are three general definitions for how illicit substances and illegal behavior meet:
Possession or Use
In certain jurisdictions, simply having or using drugs (or even alcohol if under a certain age) is illegal. This definition also extends to the creation or distribution of contraband, even if the person does not use the substances himself.
As an addiction takes hold, a user becomes less interested in their social, professional, or academic lives, and more concerned with spending time with people who can keep their drugs coming (like dealers and other users). This new lifestyle may involve violations of the law, such as trespassing, falling behind on court-mandated payments, or other combinations of the user keeping bad company or being in the wrong place at the wrong time.
The Prescription Problem
While alcohol plays an undeniable role in the execution of crimes (notwithstanding the problems it can cause, alcohol enjoys an almost sacrosanct level of availability in the western hemisphere), it is obviously not the only substance that addicts use when they are compelled to behave in risky and inadvisable ways.
And the substances don’t have to be illegal, either; as Psychology Today warns, “prescription drugs are more deadly than street drugs.” This has given rise to a black market that deals not in cocaine and methamphetamines, but in the kind of painkillers that need nothing more than a prescription to obtain.
The National Drug Law Enforcement Research Fund of Australia also found that people who had pharmaceutical opioids (such as benzodiazepines) tended to lack inhibitions and be aggressive when carrying out such behavior as shoplifting, vandalism, violent acts, dangerous driving, or dealing drugs themselves. Similarly, a study in Scotland found that 33 percent of criminals tested positive for benzodiazepines at the time of their arrest.
The potential for misuse of benzodiazepines is unsurprisingly high. Benzodiazepines are psychoactive drugs that are prescribed for the treatment of stress, anxiety, insomnia and a number of other conditions. According to the Center for Substance Abuse Research, there are so many varieties of benzodiazepines that, combined, they account for the most frequently prescribed drugs in the United States.
However, the journal Drugs warns benzodiazepines are powerful enough that they should not be used for more than two consecutive weeks. Johns Hopkins Medicine warns that more than 33 percent of people who take benzodiazepine for longer than 30 days become addicted to the powerfully sedative and hypnotic effects of the drugs; those characteristics are also why people who don’t medically need benzodiazepines start taking them.
Whatever the reason behind the misuse, excessive and chronic levels of benzodiazepines in a patient’s system can depress certain hormones and induce depression. In 1987, the American Journal of Psychiatry found that of 46 patients who received a type of benzodiazepine, 33 percent of them developed major depression, even though the benzodiazepine was successful in alleviating their panic disorders.
Notwithstanding the positive effects of benzodiazepines, they carry enough risk for the U.S. Drug Enforcement Administration to classify them as a Schedule IV drug. They have a relatively low potential for abuse, but they can still cause physical or psychological dependence in patients.
Benzodiazepine dependence has been known to cause a “fugue state,” where the patient loses her sense of personal identity, literally forgetting who she is. These individuals impulsively wander away from their homes or workplaces, sometimes traveling hundreds of miles away, and possibly committing crimes while in this very confused state of mental health. The journal of Medicine, Science and Law reported the case of a 26-year-old Chinese woman, with a history of benzodiazepine dependence and shoplifting, who committed robbery while in such a fugue state.
Another reason for the regulation over the distribution of benzodiazepine is because, as the Journal of Toxicology reports, benzodiazepines have been used in the facilitation of crimes where the victim is sedated, such as in rape and robbery. When benzodiazepines are used with the intention of sedating a victim, they are typically hidden in an item of food or drink. A January 2006 article in the Journal of Clinical Forensic Medicine presented a case of a man who added one mg of a benzodiazepine called flunitrazepam into a woman’s drink and raped her while she was under the tranquilizing effects of the drug. The victim had no memory of the rape because of the amnesia induced by the benzodiazepine, similar to the fugue state mentioned above.
The Heroin Epidemic
Of course, legal drugs like benzodiazepines tell only one of the many stories of the crime and drug relationship. In the inner cities of metropolises on the East Coast of the United States, health care and social services are overwhelmed by the number of people falling prey to the lure of methamphetamines and heroin. Drugs are shipped up from Central and South America, making landfall in strategically located cities like Atlanta and Baltimore, before moving on to regional centers like New York City and Montreal.
Reporting on how Mexican cartels are targeting American cities, the Washington Post writes that in 2012, the DEA seized 1,394 kilograms of heroin and arrested 3,350 people on heroin charges.
Following the death of actor Philip Seymour Hoffman in 2014, TIME magazine reported that heroin is nonetheless becoming one of the most popular illegal drugs in America. Even as fears rise that heroin has now become the most dangerous drug in the country, some low income and disenfranchised people have nothing else to get them through the day. A BBC report on what is widely being called a “heroin epidemic” mentioned a woman in a county jail who was put there because she stole to fuel her habit. A young man who started smoking heroin at age 18 resorted to skipping classes in order to buy drugs and then shoot up in the bathroom between classes (one of the “lifestyle” definitions of drug-related criminal activity that the National Council on Alcoholism and Drug Dependence mentioned).
Similarly, Missoula, Montana (a city with one of the highest rates of illegal drug use in the country), is experiencing what Forbes magazine called a “[methamphetamine] epidemic.” A detective in Missoula told a local paper that many people claim economic hardship as a reason for turning to distributing, selling or owning meth. As a result, meth-related crimes in the area are on the rise after a five-year lull.
Across the entire United States, incarcerations stemming from drug convictions have soared. In 2007, there were 7.3 million adults in jail as a result of drug charges, says the National Institute of Health. Such offenders are four times more likely to have issues with substance abuse than the general population, but they are still not getting the necessary mental health treatment they need.
Race, Drug Use and Crime
An issue as vast and multifaceted as drug use and crime cannot exist in a vacuum, and one of the factors of the dynamic may be race. A 2009 report from Human Rights Watch found that African Americans are arrested for drug possession thrice as often as Caucasians. This is despite, according to a 2011 survey by the Substance Abuse and Mental Health Services Administration, more white people use cocaine than African Americans and Latinos. Yet, according to the Bureau of Justice Statistics, of the 225,242 inmates in state prisons for drug offenses in 2011, African Americans accounted for 45 percent of them; Caucasians, only 30 percent.
The author of the Human Rights Watch report suggests that the disparity arises from police making arrests in low-income neighborhoods, most of which have a predominantly ethnic minority population. To that effect, Reason.com criticized the comments made by the Director of the Office of National Drug Control Policy (ONDCP) about marijuana being the drug most often linked to crime, concluding that the correlation between drugs and crime is nowhere near as close as the correlation between being poor and getting caught. Citing figures released by the ONDCP, Reason.com explained that most of the arrestees for drug-related crime in 2012 were black, did not finish high school, and/or did not have health insurance. Most did not have a college degree, and most did not own or rent their own homes. A sizeable number (41.8 percent) were unemployed.
In the eyes of Reason.com, the relationship about crime and drug use (what the International Journal of Drug Policy called “a puzzle inside an enigma”) can ultimately be boiled down to poverty. The demographic can be further broken down by gender, showing that women of color tend to face harsher sentences for drug-related crime than men (and may indeed have more risk factors that drive them to drugs than men). Minority women who are connected to drug crimes are usually low income, uneducated and unskilled. They tend to have mental health problems and have suffered physical or sexual abuse, lack familial support, have to raise a family on their own, and are generally convicted for possession of a small quantity of drugs.
Whether or not Reason.com’s verdict of “poverty” is a simplistic reduction of a very complex situation, it is one of the many factors in explaining the dynamic of a problem that grips and affects all levels of society. In attempting to understand why black youths are arrested rates 10 times more than white youths for drug crimes, even though white youths are more likely to abuse drugs than black youths, a professor of psychiatry at Duke University called for more culturally sensitive treatment to help youths from all backgrounds and walks of life deal with the temptation, pressure, and consequences of substance abuse.
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