John C. Ball

The criminality of narcotic addicts

Recent research conducted by independent investigators concerning the relationship between crime and narcotic (primarily heroin) addiction has revealed a remarkable degree of consistency of findings across studies. The major conclusion supported by the majority of these studies is that narcotic addicts commit a vast amount of crime and that much of this is directly related to the need to purchase drugs. A large proportion of the crimes committed does not consist merely of drug sales or possession, but involves other criminal behaviors including serious crimes. The strongest evidence of a causal relationship between narcotic drug use and crime is derived from longitudinal studies in which the amount of crime committed during periods of active addiction far exceeds that committed during periods of nonaddiction. Much of this crime goes unreported, although addicts, under conditions of strict confidentiality, have provided information that permits realistic estimates of criminal activity. Use of this methodology has permitted the identification of different types of addicts, especially with respect to the amounts and types of crimes in which they are engaged. The implication of these findings is that although addicts as a group commit a great amount of crime, they cannot be regarded as a homogeneous class. Some addicts commit many crimes, regardless of current addiction status, whereas others commit relatively few, and these are obviously related to their need to purchase drugs. There is a discernible impact of treatment on narcotic drug use and criminality. Although the relationships between addict characteristics and treatment response have yet to be fully determined, extensive prior criminal involvement is associated with a negative outcome.

Lifetime Criminality of Heroin Addicts in the United States

A probability-based sample of 243 addicts was selected for study from a Baltimore population of 4,069 male opiate addicts. The sample was interviewed and their criminal history was traced in detail over an 11 year risk period during which they were “on the street”. It was found that these 243 heroin addicts had committed more than 473,000 crimes. As measured by crime-days, the average addict committed over 178 offenses per year and almost 2,000 offenses during his post-onset lifetime. Although the predominant offense committed was theft (as with most populations of criminals), these addicts were also involved in a wide range of other crimes: drug sales, robbery, forgery, pimping, assault, and murder. The implications of these findings are discussed with respect to the impact of arrest and incarceration upon the lifetime criminality of these addicts. These research results provide a means for estimating the extent of criminality among heroin addicts throughout the United States. Our calculations indicate that the 450,000 heroin addicts in the United States commit more than 50,000,000 crimes per year and that their lifetime criminality exceeds 819,000,000 offenses.

A comparison by ethnic group and city of the criminal activities of narcotic addicts

In an effort to update the results of earlier studies concerning the amounts and types of crimes committed by urban, male narcotic addicts, confidential interviews were conducted with addicts attending methadone maintenance clinics in Baltimore and New York. Samples were stratified by ethnic group (black and white in Baltimore; black, white, and Hispanic in New York), and the amounts and types of crimes committed were compared across groups, cities, and narcotic addiction status (actively addicted/not actively addicted) using six different measures all based on the concept of crime-days per year at risk. Consistent with previous findings, addicts were found to engage in a great deal of criminal activity, especially during periods of active addiction to narcotics. Differences in the amounts and types of crimes committed were found among ethnic groups and, to a lesser extent, between cities as well. For the Baltimore sample, comparison of findings with those derived from an earlier (1973-78) data base suggests that the amount of crime committed by addicts has increased in several categories as well as overall. However, minor differences in data collection procedures render this finding suggestive rather than conclusive.

Nonnarcotic drug use over an addiction career—A study of heroin addicts in Baltimore and New York City ☆

Detailed interview data from 250 male narcotic addicts attending methadone maintenance treatment centers in Baltimore and New York City were used to confirm and extend previous findings regarding the frequency of nonnarcotic drug abuse among relevant addict subgroups. Consistent with earlier results, abuse of nonnarcotic drugs in general, and particularly cocaine, was higher during periods of addiction than during periods of nonaddiction. Overall, marijuana and cocaine were the two main drugs of abuse, but variations were present according to addiction status period, city, and ethnic group membership. Relationships between cocaine use and specific types of criminal activity were also examined. It was found that there were high associations between cocaine use and several different kinds of crime.

Admissions to methadone maintenance: comparisons between programs and implications for treatment

Male admissions to six methadone maintenance programs in three cities were interviewed. The characteristics of these patients in the seven Addiction Severity Index (ASI) scales--medical, employment/support, alcohol, drug, legal, family/social and psychiatric--were described. The characterization of drug addicts was not found to be unidimensional. Though the admissions, as a group, had some positive characteristics (e.g., over 50% reported full time employment over the past three years), they also reported severe problems. For the 30 days prior to interview, heroin was the most commonly used drug, followed by cannabis, cocaine, and alcohol. Less than 10% had never been arrested and subjects reported engaging in crime on 6.4 of the past 30 days. The majority of these subjects had never married, but very few lived alone. The most common psychiatric symptoms reported were depression and anxiety. Characteristics were compared between programs and differences were found in race and age as well as two of the seven ASI areas. Thus, despite differences in demographics there was a great commonality in terms of the characteristics of admissions to these programs. The implications of this for the behavioral problems related to drug abuse and for the development of treatments aimed at specific areas (such as measured by the ASI) were discussed.

The Similarity of Crime Rates among Male Heroin Addicts in New York City, Philadelphia and Baltimore

The similarity of crime rates among 617 heroin addicts in New York City, Philadelphia and Baltimore was investigated. It was found that aggregate crime rates, participation rates and frequency of crime among addicts in the three cities were remarkably similar. Thus, when “on the street” and addicted, the mean offense rate for addicts in New York, Philadelphia and Baltimore were, respectively, 603, 631 and 567 offenses per year. Their respective mean crime-days per year at risk were 217, 269 and 227. Similarities and differences between offense rates and lifetime arrest rates were also analyzed.

Medical Services Provided to 2,394 Patients at Methadone Programs in Three States

The type and amount of medical services provided to 2,394 patients in methadone maintenance programs in three states was studied. Data were obtained from on-site confidential interviews with the entire treatment staff at seven programs. It was found that there were marked differences in the number and type of medical staff. Thus, there was ten times more coverage by physicians at some programs than others. In general, there were notable differences in the treatment staff available. Comparable variations among the programs were found with respect to the actual provision of medical services. Thus, the number of patients seen by the medical staff on a weekly basis varied from a high of 185 patients to a low of 36 patients. Similarly, the proportion of each programs patients receiving medical treatment per week varied from 53 to 14 percent. Reasons for those variations in medical services are considered.

The frequency of nonnarcotic drug use and its relationship to criminal activity among narcotic addicts

Abstract Using confidential interview data obtained from 354 male narcotic addicts residing within the Baltimore metropolitan area, both the frequency with which various nonnarcotic drugs were used and the relationship of such use to the commission of different types of crime were investigated. Frequency and type of nonnarcotic drugs used were found to be a joint function of race (Black/White) and current narcotic addiction status (addicted/not addicted). Similarly, the relationship of such use to the commission of different types of crime depended on race and narcotic addiction status. Interestingly, members of both races tended to use more nonnarcotic drugs during periods of active addiction to narcotics than during periods of nonaddiction. Bivariate and multiple correlational analyses provided evidence that higher rates of use of certain nonnarcotic drugs were associated with higher rates of commission of certain types of crime; however, a cause and effect relationship cannot, of course, be proven.

Follow-up Study of 105 Patients Who Left Treatment

Attention is focused in this chapter on 105 patients who left the six methadone maintenance programs after their first interview and who were reinterviewed in the community a year later. Before discussing the findings from this follow-up study, it is pertinent to address the issue of retention in methadone maintenance treatment.

Prevalence and Change in Psychiatric Symptomatology Among Methadone Maintenance Patients

Investigating the prevalence of psychiatric factors among drug abusers has been a subject of study in the United States for more than 50 years.1 Most of the early studies focused on opiate addicts, as they comprised the principal population of drug abusers at risk for hospitalization or imprisonment. Pescor’s study of the clinical records of 1036 addicts hospitalized at Lexington during 1936–1937 referred primarily to opiate abusers.1 Pescor’s analysis was followed by a succession of other studies that also investigated personality factors and psychopathology among opiate abusers.2,3,4