George Speckart

Consequences and costs of shutting off methadone

In the face of rising fiscal conservatism, many states and localities with sizable addict populations have reduced or eliminated public funding for methadone maintenance (MM) programs and permitted private-fee-for-service programs to replace them. The social and economic costs of these changed funding policies with reference to the California experience were analyzed. A two-and-a-half year follow-up of a sample of San Diego MM clients (195 men, 129 women) terminated from a public subsidized program compared outcome results to clients from publicly funded MM programs in Orange, Riverside and San Bernardino counties (129 men, 131 women). In a secondary analysis, San Diego clients who transferred into private (fee-for-service) treatment programs were compared with those who did not transfer. Major adverse consequences were found for clients unable or unwilling to transfer to private programs: higher crime and dealing rates, more contact with the criminal justice system, and higher rates of illicit drug use were demonstrated by nontransfer clients. Moreover, the savings resulting from a reduction of MM program costs were nearly offset by increased direct costs for incarceration, legal supervision, and other government-funded drug treatment. Indirect costs were not assessed.

Narcotics and Crime: A Causal Modeling Approach

The present study examines the relationships between narcotics use and criminality utilizing a confirmatory structural equation modeling approach. Latentvariable and manifest-variable models are used to represent causal relationships between narcotics use and criminality in both the postaddiction and the pretreatment periods of the addiction career. Latent-variable models include a preexisting deviance construct as an exogenous factor, and manifest-variable models include a measure of drug trafficking, or dealing, as an influencing variable. Both inclusions are made as an attempt to minimize specification error in the models. The results are consistent in showing that, while simultaneous relationships between narcotics and criminality are clearly demonstrable, the prediction of either variable from the other across time cannot be demonstrated. It is concluded that causal relationships between narcotics and criminality are probably not characterized by an appreciable or identifiable time lag. Other theoretical considerations suggested by the modeling results are discussed, such as the role of idiosyncratic approaches to the economics of maintaining addition.

Narcotics Addiction: Related Criminal Careers, Social and Economic Costs

A sample of 279 male heroin addicts admitted to methadone maintenance programs in Southern California, interviewed between 1978 and 1980, reported high rates of drug trafficking and over 250,000 property crime-days, which resulted in 6,251 arrests. Analyses indicate that offense rates and related social and economic costs were at their highest during periods of addiction. The aggregate cost to society, including criminal justice system and drug treatment intervention, is conservatively estimated at

Narcotics use, property crime, and dealing: Structural dynamics across the addiction career

85 million, averaging

The Effect of Parole on Methadone Patient Behavior

20,000 per subject per year. These findings provide an empirical basis against which to evaluate the cost-effectiveness of alternative interventions.

Modeling the Longitudinal Impact of Legal Sanctions on Narcotics Use and Property Crime

Structural-equation modeling is used to test causal relationships between narcotics addiction and the associated cost-support activities of property crime and drug dealing across four critical periods of the addiction career. It is argued that structural-equation methodology yields greater insight into the causal dynamics of such activities than the typical methodologies of comparing means and proportions. Using structural coefficients of longitudinal models to infer causal relationships and stability, it is found that (1) dealing is often a predictor of future narcotics involvement; (2) narcotics use, property crime, and dealing are mutually interrelated during periods of elevated narcotics use and are not related during periods of reduced narcotics use; (3) dealing appears to be the most stable of the three variables, although narcotics use and property crime show appreciable stability as well; and (4) property crime and dealing appear to be inversely related to a moderate extent. The relevance of these findings to the understanding of the economic behavior of addicts during the initiation and cessation of addiction, relapse, and “maturing out” is discussed.

CATEGORIZING SKEWED, LIMITED DEPENDENT VARIABLES Using Multivariate Probit Regression to Evaluate the California Civil Addict Program

A 7-year followup of three male samples of 1971-1973 methadone maintenance admissions was conducted: a random sample of 100; a sample of 136 who had a minimum of 30 months remaining on civil addict parole status at the time of methadone entry; and a matched sample of 136 not on parole. Ninety percent of those not decreased were interviewed. The overall sample spent 58% of the nonincarcerated follow-up interval on methadone. This resulted in a large decline in daily heroin use and associated criminal behavior measures. The addition of parole supervision with urine testing resulted in only marginal improvements in behavior over that attributable to maintenance alone; however, the parole status did significantly reduce the length of intervals of daily heroin use both prior and subsequent to methadone entry.

Narcotics Use and Crime: A Multisample, Multimethod Analysis

Structural equation models are used to confirm the suppressive effects of legal sanctions, e.g., probation and parole, on narcotics use and property crime. Both concurrent and longitudinal effects of legal sanctions are tested within two different models, which together span the entire addiction career. The findings indicate that (1) the suppressive effects of legal sanctions are evident only when legal sanctions are operationalized as parole or probation officer contact where urine monitoring is utilized; (2) only concurrent suppressive effects are statistically significant, and longitudinal suppressive effects are not; (3) both narcotics use and property crime are suppressed by legal sanctions, although the latter is less responsive than the former to intervention by the criminal justice system; and (4) suppressive effects tend to be more pronounced later in the addiction career. The significance of the findings and the implications for criminological theory related to issues regarding surveillance effects are emphasized.

Narcotics and crime: An analysis of existing evidence for a causal relationship

Probit analysis is applied in a situation where analysis of covariance (ANCOVA) would customarily be used. The dichotomous dependent variables arise from dichotomizations of skewed continuous variables recorded as the proportion of time certain activities are observed. The probit approach avoids the biases of ordinary A NCO VA that arise due to skewness (limited variation). To illustrate this, data from 225 experiments and 214 control subjects in a drug treatment program was analyzed. It was found that the probit approach was able to reveal more substantial treatment effects than the ordinary A NCO VA.