The Relationship Between Drug Use, Drug-related Arrests, and Chronic Pain Among Adults on Probation

Abstract

The intersection between chronic health conditions, drug use, and treatment seeking behavior among adults in the criminal justice system has been largely understudied. This study examined whether chronic pain was associated with opiate use, other illicit drug use, and drug-related arrests in a sample of substance-using probationers. We expected that probationers with chronic pain-related diagnoses would report more opiate use and drug-related arrests. This study used baseline data from 250 adults on probation in Baltimore, Maryland and Dallas, Texas who were participating in a larger clinical trial. Eighteen percent of probationers in this sample reported suffering from chronic pain. In bivariate analyses, probationers with chronic pain reported more drug-related arrests (t=−1.81; p<0.05) than those without chronic pain. Multivariate analyses support the hypothesis that probationers who reported chronic pain were marginally more likely to use opiates (OR=2.37; 95% CI .89–1.05) and non-opiate illicit drugs (OR=3.11; 95% CI 1.03–9.39) compared to offenders without chronic pain. In summary, these findings suggest that adults under probation supervision who suffer from chronic pain may be involved in criminal activity (specifically, drug-related criminal activity) in an effort to self-medicate their physical health condition(s). Screening probationers for chronic pain in the probation setting and referring these adults to pain management treatment may be an important step in advancing public safety.

A Comparison of Marijuana Use Across Different Levels of Justice-Involved Populations

“…Interestingly, once other substance use behaviors were added to the multivariable analysis the associations between justice involvement and marijuana use changed. First, all measures of substance use were significantly associated with marijuana use, a finding that is consistent with prior research that shows a strong correlation between various types of substance use (Reingle Gonzales et al, 2015). Once other substance use behaviors were accounted for there were no longer significant differences in marijuana use between adults with an arrest and those with no justice involvement, as well as adults on probation and those with no history of justice involvement.…”

“…Continuous chronic stressors can then result in negative health outcomes (Massoglia & Pridemore, 2015; Sugie & Turney, 2017). Marijuana may be viewed as a solution for many health conditions (Reingle Gonzales, Walters, Lerch, & Taxman, 2015) such as mental, physical, and social outcomes (World Health Organization, 2020; Office of Disease Prevention and Health Promotion, 2020). Adults suffering from issues from stress (Gurley & Satcher, 2003; Massoglia & Pridemore, 2015; National Institute on Drug Abuse, 2001) and chronic pain (Maruschak & Berzofsky, 2015; Reingle Gonzales et al, 2015) may turn to marijuana as a form of self-treatment, consistent with the self-medication hypothesis (Khantzian, 1997).…”

“…Marijuana may be viewed as a solution for many health conditions (Reingle Gonzales, Walters, Lerch, & Taxman, 2015) such as mental, physical, and social outcomes (World Health Organization, 2020; Office of Disease Prevention and Health Promotion, 2020). Adults suffering from issues from stress (Gurley & Satcher, 2003; Massoglia & Pridemore, 2015; National Institute on Drug Abuse, 2001) and chronic pain (Maruschak & Berzofsky, 2015; Reingle Gonzales et al, 2015) may turn to marijuana as a form of self-treatment, consistent with the self-medication hypothesis (Khantzian, 1997). Co-occurring health problems (mental and physical) are likely among substance users, which is also common among individuals who are involved with the criminal justice system (Chamberlain et al, 2019).…”

Substance use, mental health, chronic medical conditions and criminal justice contact in a nationally representative sample

“…Adults on probation or parole have been found to have high and stable rates of substance use disorders, especially compared to their peers who are not under similar forms of correctional supervision (Fearn et al , 2016). This population of supervised adults is also more likely to experience other medical conditions, such as chronic pain, hypertension and heart disease, which can directly contribute to increased rates of emergency department utilization and hospitalization relative to the general population (Frank et al , 2014; Gonzalez et al , 2015; McConville et al , 2018).…”

Comparison of Pain in Male Drug Rehabilitees with and without Human Immunodeficiency Virus in Yunnan Province, China

“…Pain is one of the most common problems among drug users [ 2 ]. In the United States, the prevalence of pain among drug users is lower in Texas (18%) and higher in Boston (87%) [ 3 , 4 ]. Further, pain intensity in PWUD has been reported to range from mild to severe, and PWUD with greater pain intensity are at a higher risk of being unable to access addiction treatment [ 4 , 5 ].…”