Criminal Behavior in Opioid‐Dependent Patients Before and During Maintenance Therapy: 6‐year Follow‐Up of a Nationally Representative Cohort Sample

Abstract

Lifetime prevalence of opioid dependence is about 0.4% in western countries. Opioid-dependent patients have high morbidity and mortality and a high risk of criminal behavior. Few studies have addressed the long-term impact of opioid maintenance therapy on convictions and criminal behavior. The PREMOS study is a prospective, longitudinal, naturalistic clinical study of a nationally representative sample of 2694 opioid-dependent patients to investigate convictions and criminal behavior at baseline and after 6 years of maintenance treatment. At follow-up, 2284 patients still were eligible (84.7%). A comprehensive assessment including a patient and doctor questionnaire, and the EuropASI was completed at baseline and follow-up. Data on criminality at follow-up had been received for 1147 (70.6%) patients. A large number (84.5%) of them had been charged or convicted at any time before baseline assessment, most frequently with drug-related offenses (66.8%), acquisitive crime (49.1%), or acts of violence (22.0%). Reported charges and convictions had declined to 17.9% for the last 12 months before follow-up, which was also reflected by a significant decrease in the EuropASI subscore "legal problems" from 1.52 at baseline to 0.98 after 6 years. These data indicate a significant and clinically relevant reduction in criminal behavior in opioid-dependent patients in long-term maintenance treatment. Maintenance therapy is effective in the reduction in both narcotics-related and acquisition crime.

Criminality and Sexual Behaviours in Substance Dependents Seeking Treatment

“…These results reinforce findings from other national and international studies (Oliveira and Souza 2013;Paim Kessler et al 2012;Silva et al 2012;Zweig, Yahner, and Rossman 2012). In these studies, the crime rate varied from 23% to 97% according to the profile of the population with substance dependence (for example, different DOCs, different age ranges), the data collection setting, and the types of crime investigated (Carvalho and Seibel 2009;Fernández-Montalvo et al 2013;Johnson et al 2013;Soyka et al 2012).…”

“…Crack use is generally concentrated among disenfranchised young people with crime involvement (Johnson et al 2013;Paim Kessler et al 2012;Rodrigues et al 2012;Soyka et al 2012). However, in the present study, the presence of a severe drug problem increased the likelihood of that person having committed a crime (Volkmann et al 2013) against persons or property.…”

Initiation of drug dealing among a prospective cohort of street-involved youth

“…This includes the need for the development, implementation, and evaluation of effective psycho-social and pharmacological therapies, which have not emerged thus far (32). Improving addiction treatment access and options for youth who use stimulants can be expected to reduce engagement in drug dealing along with other risky income generating activities (33,34). …”

Outcomes of adult heroin users v. abstinent users four years after presenting for heroin detoxification treatment

“…[4,14] Findings from a recent study by Sokya et al [15] show a significant rate of criminal activity and convictions in patients entering opioid-substitution treatment and a decrease in criminal activities over time. Gossop et al [5] also showed that longer periods of stay in methadone treatment were linked to greater reductions in both heroin use and criminal activity.…”