Drug Use, Dependence, and Abuse Among State Prisoners …

1 Department of justice Office of justice Programs bureau of justice statistics JUNE 2017. Special Report NCJ 250546. Drug Use, dependence , and Abuse Among State Prisoners and Jail Inmates, 2007-2009. Jennifer Bronson, , and Jessica Stroop, BJS Statisticians Stephanie Zimmer and Marcus Berzofsky, , RTI International M. ore than half (58%) of State Prisoners and Figure 1. two-thirds (63%) of sentenced jail inmates met Inmates and adult general population who met the criteria the criteria for drug dependence or Abuse , for drug dependence or Abuse , 2007 2009. according to data collected through the 2007 and 2008-09 Percent Abuse National Inmate Surveys (NIS) (figure 1). In comparison, 70. dependence approximately 5% of the total general population age 18 or 60. older met the criteria for drug dependence or Abuse . General 50. population data come from the National Survey of Drug Use and Health (NSDUH) collected from 2007 to 2009 by 40.

2 Substance Abuse and Mental Health Services 30. Administration. Drug dependence and Abuse estimates in 20. both the NIS and NSDUH data collections were based on 10. criteria specified in the Diagnostic and Statistical Manual of 0. State Sentenced Adult general Mental Disorders, Fourth Edition (DSM-IV).1,2 Prisoners ** jail inmates** population*a This report examines patterns of past drug use by different Note: See Methodology for definition of dependence and Abuse based on the periods ( , ever used, at time of offense, month before Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition. See appendix table 1 for standard errors. arrest, and regularly used), demographics, and offense *Comparison group. type. Drug data were grouped into eight categories for **Difference with the comparison group is significant at the 95% confidence level.

3 Analysis: marijuana/hashish, cocaine/crack, heroin/opiates, aGeneral population estimates have been standardized to the State prisoner depressants, stimulants, methamphetamine, hallucinogens, population by sex, race, Hispanic origin, and age. Source: bureau of justice statistics , National Inmate Surveys, 2007 and 2008 09;. 1 Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, text and Substance Abuse and Mental Health Services Administration, National Survey revision (2000). Washington. DC: American Psychiatric Association. on Drug Use and Health, 2007 2009. 2 The fifth edition of the DSM (DSM-V) was published in May 2013. The DSM-IV was current at time of data collection. HIGHLIGHTS. During 2007-09, an estimated 58% of State Prisoners During 2007-09, Prisoners (77%) and jail inmates (78%). and 63% of sentenced jail inmates met the Diagnostic reported having ever used marijuana/hashish, more than and Statistical Manual of Mental Disorders, Fourth Edition any other drug.

4 (DSM-IV) criteria for drug dependence or Abuse . During 2007-09, more females in prison (47%) or jail (60%). Among Prisoners and jail inmates, prevalence estimates used drugs in the month before the current offense than for those who met the criteria for dependence were two to males in prison (38%) or jail (54%). three times higher than for Abuse . More non-Hispanic white than non-Hispanic black The percentage of inmates who met the DSM-IV criteria was Prisoners regularly used cocaine/crack, heroin/opiates, higher for those held for property offenses than those held or methamphetamines. for violent or other public order offenses. Among those who met the criteria for drug dependence or Lifetime drug use Among the incarcerated populations was Abuse , 28% of Prisoners and 22% of jail inmates participated unchanged from 2002 to 2009. in a drug treatment program since admission.

5 And Alcohol and nicotine were excluded from population was divided into three groups that were the analysis. Prevalence estimates are presented for inmates based on self-reported involvement with the criminal who met the DSM-IV criteria for drug dependence or Abuse justice system in the year prior to the interview: (1) no and for those who participated in a drug Abuse treatment involvement, (2) under supervision (probation or parole), program. All NIS data were self-reported, and the analyses or (3) arrested. (See Methodology.). include State Prisoners and sentenced local jail inmates. This report combined data from the addendums of To facilitate comparisons between the inmate and general NIS-1 (2007) and NIS-2 (2008-09). (See Methodology.). population, NSDUH data on the general population were The NIS-3 (2011-12) also collected drug use data, but standardized twice to (1) match the prison population the data were not used because of potential bias.

6 For this and (2) match the jail population by sex, race, Hispanic reason, the 2007-09 data are the most recent data available origin, and age. (See Methodology.) In addition, the general on drug use and drug use disorders Among inmates. 3 Depressants include barbiturates, tranquilizers, and Quaaludes. Stimulants include amphetamine and methamphetamine. Hallucinogens include LSD, PCP, and ecstasy. Measurement of drug dependence and Abuse The National Inmate Survey (NIS) included questions to defined in the DSM-IV as a maladaptive pattern of drug assess the percentage of inmates who met the Diagnostic use leading to clinically significant impairment or distress, and Statistical Manual of Mental Disorders, Fourth Edition as manifested by one or more of the following, occurring (DSM-IV) criteria for drug dependence or Abuse . Inmates at any time in the same 12-month period: who reported having ever used any drug were asked about 1.

7 Recurrent drug use resulting in a failure to fulfill their experiences and symptoms related to their drug major role obligations use in the year prior to admission to the current facility. The DSM-IV criteria are guidelines designed to be used 2. recurrent drug use in which it is physically hazardous with a patient's history and sound clinical judgment in 3. recurrent drug-related legal problems order to make a diagnosis. Data presented in this report are based on inmate self-reports and were not validated 4. continued drug use despite having persistent or or confirmed by a trained clinician or clinical interview. recurrent drug-related social problems. (See Methodology.). For any one drug, a diagnosis of dependence takes The DSM-IV defines drug dependence as a maladaptive precedence over a diagnosis of Abuse for the same drug. pattern of drug use leading to clinically significant This means that a person who meets the dependence impairment or distress as manifested by three or more of criteria for a particular drug cannot meet the Abuse the following occurring at any time in the same 12-month criteria for that same drug.

8 The DSM-IV states that a period: diagnosis of drug dependence can be applied to 10 drug classes: alcohol, amphetamine or similarly acting 1. tolerance sympathomimetics, cannabis, cocaine, hallucinogens, 2. withdrawal symptoms or drug taken to relieve inhalants, nicotine, opioids, phencyclidine (PCP) or withdrawal similarly acting arylcyclohexylamines, and sedatives. The category of drug Abuse can apply to all of these drug 3. drug taken in larger amounts for longer periods than classes, except intended A diagnosis of drug dependence or Abuse should be 4. persistent desire or unsuccessful attempts to cut down drug-specific ( , cocaine dependence or heroin Abuse ). or control drug use and not generally made based on drug use in the past year 5. a lot of time is spent obtaining drugs, using them, or as a whole. However, NIS data do not permit an analysis recovering from its effects of dependence or Abuse symptoms by individual drug type.

9 As such, dependence and Abuse data presented in 6. a reduction in or absence from social, occupational, this report are not drug-specific. or recreational activities 4 The DSM-IV uses the term classes, which is not the same as 7. continued use despite adverse consequences. the schedule of controlled substances established through the 1970 Controlled Substance Act ( 91-513). Unlike the criteria for drug dependence , criteria for drug Abuse do not include tolerance, withdrawal, or a pattern of compulsive use. Instead, the Abuse criteria include only the harmful consequences of repeated use. Abuse is DRUG USE, dependence , AND Abuse Among State Prisoners AND JAIL INMATES, 2007-2009 | JUNE 2017 2. Drug dependence and Abuse Table 1. During 2007-09, more than half of State Prisoners and State Prisoners and sentenced jail inmates who met the criteria for drug dependence or Abuse , 2007 2009.

10 Two-thirds of sentenced jail inmates met the DSM-IV. criteria for drug dependence or Abuse Diagnostic criteria State Prisoners Sentenced jail inmates dependence or Abuse About 58% of State Prisoners and 63% of sentenced jail dependence inmates during 2007-09 met the DSM-IV criteria for drug Abuse dependence or Abuse for any drug (table 1). Among State No dependence or Abuse * Prisoners , 42% met the criteria for drug dependence and Total count 1,265,400 375,700. 17% met the criteria for Abuse . The percentage of State Note: See Methodology for definition of dependence and Abuse based on the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition. See Prisoners who met the criteria for dependence was the same appendix table 2 for standard errors. as those who did not meet the criteria for either dependence *Includes inmates who did not report ever using drugs.