Introduction
The use and abuse of illicit drugs and alcohol are widespread and constitute an important social and public health problem in United States (Danaei et al. 2009) and beyond (Rehm et al. 2006). More than half of arrestees have one or more drugs in their system at the time of arrest, and drug users have some of the highest recidivism, or re-arrest, rates for violent and non-violent crime. In the 1980s, the already well-documented relationship between drugs and crime was thought to be causational and uni-directional (Gropper 1985), with some drugs in particular (e.g., “street heroin”) being directly associated with criminal behavior. Results from this body of research implied that if treatment and education to reduce drug use among the most frequent users was provided, drug-related crime would decline (Gropper 1985). Forty years later, there no doubt that drug use, and drug addiction, is more common among offenders when compared to the general public [for a recent text on this subject, see The Handbook of Drugs and Society (Brownstein 2015)].
Despite the breadth of literature now available on the drug–crime nexus, we have made little progress towards our understanding of the causal processes associated with the link. Emerging conceptualizations of the “addiction” process may be instrumental in expanding our understanding of how the cycle of drugs–crime begins (and, correspondingly, how it can end). Rather than conceptualizing drug use and dependency as a rational choice (Becker and Murphy 1988), the term addiction is now being used to refer to chronic, relapsing brain disease caused by repeated exposures to drugs (Kalivas and Volkow 2005). Under this addiction model—one that has is widely accepted across an inter-disciplinary field of researchers—drugs modify the cellular structure of the brain. As stated by the pioneers in this domain, Kalivas and Volkow (2005), these cellular modifications, “[P]romote the compulsive character of drug seeking in addicts by decreasing the value of natural rewards, diminishing cognitive control (choice), and enhancing glutamatergic drive in response to drug-associated stimuli (1403).”
As a result of this research in neuroscience, drug addiction is now being viewed increasingly as a disease, and crime may be conceptualized as a side effect. This indicates a need for lifelong support for people suffering from addiction, which should indirectly prevent a great deal of drug-related crime. However, despite this advancing knowledge that addiction is less a conscious choice and more a chronic disease, persons suffering from addiction are stigmatized and discriminated against even more so than those suffering from severe mental illnesses (Barry et al. 2014). The public remains skeptical of drug treatment and its effectiveness, thus opposing policies and resource allocation towards treatment for persons suffering from addiction (Barry et al. 2014).
This ongoing public sentiment could indicate that dissemination of recent findings in support of addiction as a chronic disease has been limited. This book represents an attempt to aggregate and disseminate the most recent research on drugs and crime; particularly, how the intersections of biology and social behavior can converge to enhance our understanding of the causal processes associated with addiction and criminal behavior.
The arguments presented in this book are built upon seven guiding principles related to addiction and criminal behavior. Below is a brief description of each principle to provide context for this chapter and the remaining text.
- 1.There is no gene for drug use and crime, but there is a genetic vulnerability that underlies both substance use disorders and antisocial behavior. A number of genes, such as GABRA2, CHRM2, and MAOA (among several others) have been implicated as playing an important role in addiction. Many of these genes overlap with externalizing and antisocial behavior.
- 2.Drugs of abuse hijack the brain’s reward pathways. This leads to compulsive drug-seeking and, in turn, crime. As discussed by Kalivas and Volkow (2005), acute drug use triggers a dopaminergic response, even despite long-term use.
- 3.Addiction alters brain function long-term. These cognitive modifications could explain ongoing criminal behavior. Addiction alters the prefrontal cortex, the brain center responsible for behavioral regulation and decision-making abilities, to over-activate when presented with drug-related stimuli. Rational decision-making becomes limited in the presence of long-term drug-seeking motivation and craving.
- 4.Early manifestation of childhood behavior problems that persist into adulthood could result from a combination of biologic susceptibility and social conditioning. There is no inherent gene that causes delinquent or criminal behavior. However, alleles linked to deficits in neurocognition and antisocial behavior have been identified (Beaver et al. 2009; Vaughn et al. 2009). In the presence of environmental risk factors (e.g., limited parental supervision or peer drug use), life-course-persistent criminal behavior may occur.
- 5.Delayed onset of drug use is critical, as developmental neuroplasticity among adolescents and young adults is easily disrupted by substance use. This could result in long-term harm. If normal development of impulse control and reasoning is impaired, long-term deficiencies in executive function, and corresponding criminogenic impulsive behavior, may persist throughout the life course (Crews et al. 2007).
- 6.Crime and antisocial behavior are asymmetrical. That is, a small subset (approximately 5 %) of individuals account for the lion’s share of offending. Further, many of these chronic offenders have had troublesome histories with psychoactive drugs and, at various points in their criminal careers, possess diagnosable substance-use disorders.
- 7.All substance use and crime-prevention or treatment strategies are inherently overlapping and biosocial. Not all persons suffering from addiction will criminally offend; however, an exceedingly large proportion do. Principles 1 and 2 tell us that prevention and treatment strategies will be unsuccessful if they ignore the biology of addiction or the social context of the person suffering from addiction. Treatment strategies that ignore family, friends, significant others, and pharmacological (or behavioral) treatment of brain disease will be ineffective and result in relapse of either drug use or crime (or, commonly, both).
Drug Abuse, Dependence, Use Disorders, and Addiction
What is the Difference?
Before we can begin to understand how each of these principles relates to crime, a historical review of the terminology surrounding substance use, abuse, dependence and addiction is needed. The (recorded) origins of modern addiction date back to 1641 (Wassenberg 2007), when Calvinist theologians made the first attempts to explain “compulsive” alcohol use as “sinful” behavior. In the 16th century, “addict” was defined by the Oxford English Dictionary as “attached by one’s own inclination, self-addicted to a practice; devoted, given, inclined to.” No reference to drug addiction as a psychiatric condition appeared in the Diagnostic and Statistical Manual of Mental Disorders, 2nd edition; however, “nicotine dependence” emerged in the 3rd edition of the Manual (DSM-III-R). Arguably, inclusion of nicotine dependence in a manual of psychiatric diagnoses was the turning point in recognition of addiction as a disease. On successive iterations of the DSM, the American Psychiatric Association (APA) disagreed on terminology related to addiction. For example, in the DSM-IV (SAMHSA 2004), drug dependence was defined as, “a maladaptive pattern of substance use, leading to clinically significant impairment or distress, as manifested by three (or more) [criteria] occurring at any time in the same 12-month period.” These criteria included tolerance, withdrawal, taking larger amounts [of the drug] or over a longer period than intended, persistent desire or unsuccessful efforts to cut down or control drug use, time spent on activities needed to obtain the drug, giving up recreational, social, or occupational activities because of the substance, and continued use of drug despite knowledge of consequences. If any three of these subjective criteria were met, dependence was diagnosed.
Drug abuse, on the other hand, required meeting only one criterion over a 12-month period. The four manifestations of abuse include: recurrent substance use resulting in a failure to fulfill major obligations, recurrent substance use in hazardous situations, recurrent substance-related legal problems, and continued drug use despite recurrent problems. In other words, drug abuse required a lower threshold of drug-related problems for diagnosis compared to dependenc...