Risk for Dependency/Abuse and Treatment Experience

An important focus of ADAM is gauging risk for dependency or abuse and previous treatment experience.  This information may be relevant for policies addressing drug usage in Arizona.  For example, Arizona Proposition 200 stipulates that first-time drug offenders be given the opportunity for drug treatment.  For this strategy to be effective in reducing drug use and drug-related crime it is essential that the appropriate offenders be targeted.  That is, those eligible for the program must in fact be using drugs and have drug-related problems.  In addition, for the treatment programs to be effective they must tailor their approach to the specific types of drugs used by eligible arrestees.  To help inform this policy, drug usage and risk for dependency and abuse was examined for drug and non-drug offenders in Maricopa and Pima Counties.  While the data do not permit us to make the distinction between first-time drug offenders and those with previous charges, the broader distinction between drug offenders and non-drug offenders can still shed light on the policy.

Table 4.1 presents positive urinalysis results and self-report drug usage for arrestees with drug and non-drug charges.  It is clear that drug offenders were more likely to have used drugs recently with over 93% of arrestees testing positive in Maricopa County and greater than 84% testing positive in Pima County.  These rates were 23% to 30% higher than arrestees with non-drug charges.  The findings are similar for self-reported drug use activity.  Examining urinalysis results and self-report usage of specific types of drugs reveals the same pattern – arrestees with drug charges are more likely to test positive for drugs than arrestees with non-drug charges.  The single exception is women’s use of marijuana in Pima County.  Both types of offenders had a relatively low usage of marijuana at just over 27%.  For cocaine tests we must rely upon self-reports to distinguish between crack and powder cocaine usage.  Among most offenders in both counties crack was used more often than powder cocaine.  However, males in Pima County seemed to prefer powder cocaine at nearly the same rate as crack cocaine, a rate that is twice as high as males in Maricopa County.

In developing the appropriate types of treatment programs it is informative to distinguish between males and females and counties when looking at the types of drugs used most often by drug offenders.  Male drug offenders in Maricopa County tested positive most often for marijuana (53.6%) followed by methamphetamine (32.7%) with crack use falling between 20% and 40%.  Female drug offenders in Maricopa County were more likely to use methamphetamine (42.2%) followed by marijuana (34.6%) and crack (between 35% and 43%).  In Pima County, male drug offenders were most likely to test positive for marijuana (55.1%) and either crack or powder cocaine (56.5% combined).  Female drug offenders in Pima County were most likely to have used crack cocaine (52.8% self-reported) followed by opiates (28.8%) and marijuana (27.1%).

Table 4.1: Confirmed and Reported Drug Use by Drug Offense and Gender in Maricopa and Pima Counties

Table 4.2: Treatment History and Risk for Dependency/Abuse by Drug Use, Drug Offense, and Gender in Maricopa and Pima Counties

Table 4.2 presents arrestees’ treatment experience and risk for drug abuse or dependency for drug offenders and non-drug offenders.  Risk for drug dependency and abuse is based on items from the DSM-IV published by the American Psychiatric Association.  Arrestees are asked six questions about possible drug-related problems they may have had recently.  Their responses are used to determine if they are at risk for drug abuse or, more seriously, at risk for drug dependency.

Slightly fewer males with drug charges in Maricopa County reported previous inpatient or outpatient drug treatment than males without drug charges.  More females with drug charges in Maricopa County and both males and females in Pima County reported previous drug treatment.

Examining risk for dependency reveals three distinct trends.  First, among all arrestees in both Maricopa and Pima Counties drug offenders were at greater risk for drug dependency than non-drug offenders.  Note that the percentage of male drug offenders at risk for dependency is roughly 50% higher than non-drug offenders in both counties (59% versus 40.4% in Maricopa County and 61.2% versus 41% in Pima County).  However, the difference between drug offenders and non-drug offenders for females in Maricopa County is closer to 65% (70.8% versus 42.8%) and for females in Pima County it is nearly 100% (75% versus 37,9%).  This pattern is more evident when examining only those arrestees who tested positive for any drug.  Males with drug offenses in both counties were only slightly at greater risk for dependency than males with non-drug charges (4.1% in Maricopa County and 6.8% in Pima County).  Females with drug charges were at greater risk for dependency than non-drug offenders in both counties (the difference being 14.1% in Maricopa County and 16.2% in Pima County).  Thus, it appears that the difference in risk for dependency between those with and without drug charges may be greater for women than for men.

A second trend emerges when examining the difference in risk for dependency between all arrestees and those testing positive for any drug.  For both male and female arrestees facing drug charges the percent at risk for dependency only increased slightly when narrowing the sample to those testing positive for any drug.  That is, arrestees with drug charges were at similar levels of risk whether or not they tested positive for any drug.  However, for arrestees with non-drug charges, the percent of arrestees at risk for dependency was much higher for those testing positive for drug use (between 13% and 17%).

A third trend is evident when focusing on specific types of drug use.  In Maricopa County, regardless of drugs used, males with drug charges were only slightly more at risk of dependency than males without drug charges.  The situation is reversed for females facing drug charges in Maricopa County who were at greater risk than non-drug offenders regardless of drugs used.  In Pima County the situations for males was similar with the exception that males with drug charges who tested positive for opiates were at much greater risk for treatment than males without drug charges.

It is also informative to examine which types of users were at greatest risk for drug dependency.  In Maricopa County, males testing positive for opiates were at greatest risk for dependency (79.4% of non-drug offenders and 78.6% of drug offenders).  Females in Maricopa County were at greatest risk for dependency if they tested positive for cocaine/crack or opiates (both just over 83%).  In Pima County male and female drug offenders using opiates were both at greatest risk for dependency (96.5% of males and 93.3% of females).  Cocaine/crack and methamphetamine users were next (around 70% for male drug offenders and 78% for female drug offenders) and marijuana users were the least at-risk for dependency.

Generally, for males, risk for dependency was only slightly higher for drug offenders than for non-drug offenders in both counties.  Additionally, non-drug offenders who tested positive for any drug were at much higher risk for dependency than non-drug offenders who did not test positive for any drug.  This suggests that while Proposition 200 is succeeding in targeting individuals with drug dependency problems, there remain a large number of individuals who are at risk for dependency.  Among males at least, a positive urinalysis appears to be as good an indicator of drug dependency as being charged with a drug offense.

Table 4.3 presents risk for dependency for those arrested on drug charges and whether or not they have previously had drug treatment.  The clearest pattern is that for all types of drug use, arrestees who previously had drug treatment (inpatient or outpatient) were at greater risk for dependency than those without previous treatment.  This points to the enduring difficulty individuals have in reducing their dependency on drugs.  In both Maricopa and Pima counties and regardless of treatment type, arrestees who tested positive for any type of drug were overall at no greater risk for dependency than the whole population of arrestees with drug charges.  Looking at the types of drugs used by those at greatest risk for dependency reveals that opiates and methamphetamine are particularly addictive.  In Maricopa County, drug offenders testing positive for either opiates or methamphetamine had the highest rates of risk for dependency.  In Pima County, the pattern was similar though arrestees with previous inpatient treatment that tested positive for cocaine/crack had very high levels of risk as well.

Table 4.3: Risk for Dependency and Abuse by Previous Drug Treatment Experience and Positive Drug Test (only drug arrests)

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