Drugs and Crime: Behavioral Aspects
DRUGS AND CRIME: BEHAVIORAL ASPECTS
For more than a century, there have been differences of opinion regarding the relationship between the use of illegal drugs (specifically narcotics and cocaine) and criminal behavior. While representatives of the criminal justice system, the medical profession, and academia have reflected numerous points of view and have espoused widely differing reasons for their interest in the topic, a detailed and focused analysis of the issues and the literature suggests that a variety of questions need to be addressed. For example, is criminal behavior, first of all, antecedent to addiction; or is the former a phenomenon that appears subsequent to the onset of addiction? More specifically, is crime the result of or response to a special set of life circumstances brought about by the addiction to illegal drugs, or is addiction per se a deviant tendency characteristic of individuals already prone to committing predatory crimes? Secondly, and assuming that criminality may indeed be a pre-addiction phenomenon, does the onset of the chronic use of narcotics, cocaine, and other illicit drugs bring about a change in the intensity and frequency of illegal acts? Does criminal involvement tend to increase or decrease subsequent to addiction? Finally, what kinds of criminal offenses do addicts engage in? Do they tend toward violent acts of aggression; or are their crimes more profit-oriented and limited to thefts and drug sales; or both? One might also ask, Is there any relationship at all between the two phenomena? Whatever the studies may have concluded, can the derived relationships be attributed to differential police behavior, to defects in survey designs, to purposeful or unintended bias, to the structure and functional application of laws circumscribing statuses characteristic of drug-using behaviors, or to a spectrum of changes that have occurred through time? Is our present state of knowledge no more than myth, or too fragmented for a composite picture?
Given these questions, the purpose of this entry is to review and analyze a number of the major research efforts in these areas of inquiry, and to provide a framework for their interpretation. Furthermore, commentary is offered relative to some basic issues that must be addressed when studying drug-taking and drug-seeking behaviors as they may relate to criminal activity.
The criminal model of drug abuse
Although the questions and issues surrounding the professed relationships between drug use and crime did not fully become a public debate until after the passage of the Harrison Act in 1914, a body of attitudes regarding users of narcotics had already evolved many decades prior to the twentieth century.
Opium had been utilized as a general remedy in the United States as early as the settlement of colonial America, but the drug's availability on a large scale did not occur until its inclusion in numerous patent medicines during the nineteenth century. Opium and its derivatives had then become accessible to all levels of society and could be purchased over the counter in drug and grocery stores as well as through the mails. Remedies of this type were consumed for ailments of almost every type, from coughs to diarrhea, and had special favorability for the treatment of "female troubles."
Public concern regarding the "evil effects" attributed to opium contributed to the definition of its chronic use as a social problem. In 1856, for example, Dr. G. B. Wood dramatized the condition of chronic opium intoxication as being "evil," and suggested that indulgence in the use of the drug led to a loss of self-respect, that such usage represented the yielding of an individual to seductive pleasure, and that it was, in fact, a "vice." Other physicians further reiterated this point and estimated that perhaps hundreds of thousands of Americans were exposed to the "evil affects" of opium. In other cases, the affliction described was often viewed in contrast as a "disease." The vast numbers of Civil War veterans, for example, who had become addicted to morphine through its extensive intravenous administration for the relief of pain, were considered as suffering from "army disease." The majority of such individuals were deemed "sick" rather than "deviant" or "criminal," and treatment in the form of medically supervised withdrawal was readily available in the office of one's family doctor.
By the close of the 1880s, however, the notion that addiction was evil seemed to be increasing, even among members of the medical profession. Dr. C. W. Earle, for example, expressed in the Chicago Medical Review the opinion that the opium habit, like the use of alcohol or gluttony, constituted a vice; and similarly, John Shoemaker's 1908 edition of Materia Medica and Therapeutics reflected on "opium-eating" as a moral rather than a medical problem. Medical practitioners who supported the opinion that the user of opium was to be pitied rather than degraded, on the other hand, nevertheless contributed to an encompassing definition of the addict as someone quite divergent from the more "normal" members of society. In 1894, for example, physician Paul Sollier indicated that a neuropathic or psychopathic condition predisposed opiate addiction; and, Wilson and Eshner's American Textbook of Applied Therapeutics (published in 1896) investigated the phenomenon in terms of a disease of both the body and the mind.
In addition to drug dependence instigated through exposure to opium in patent medicines or by injectable morphine, public concern was also mounting relative to the opium-smoking parlors. Although the use of opium was not a crime during this period, the operation of the opium parlors was illegal in New York City and elsewhere, and police closings of these establishments were widely publicized. Furthermore, descriptions of the opium habit and its consequences were dramatized as "evil" in police literature and the behavior under observation was associated with criminality. And finally, by 1896, the term "dope fiend" had made its way into popular slang usage, implying that drug-taking was, or at least resulted in, an evil obsession. By the end of the nineteenth century, cocaine and heroin had been added to the over-the-counter pharmacopeia, creating ever greater concerns about drug "abuse."
The Harrison Act of 1914
It would appear that American drug policy originated from two competing models of addiction. As noted above, the "criminal model" viewed addiction as one more of the many antisocial behaviors manifested by the growing classes of predatory and dangerous criminals. But there also was the "medical model," in which addiction was considered to be a chronic and relapsing disease that should be addressed in the manner of other physical disorders—by the medical and other healing professions.
Many commentators have viewed the Harrison Act of 1914 as the ultimate triumph of the criminal model over the medical view, and as such that single piece of legislation served to shape the direction of drug policy for years to come and generations yet unborn. However, history suggests a somewhat alternative story. Briefly, the Harrison Act required all people who imported, manufactured, produced, compounded, sold, dispensed, or otherwise distributed cocaine and opiate drugs to register with the Treasury Department, pay special taxes, and keep records of all transactions. As such, it was a revenue code designed to exercise some measure of public control over narcotics and other drugs. Certain provisions of the Harrison Act permitted physicians to prescribe, dispense, or administer narcotics to their patients for "legitimate medical purposes" and "in the course of professional practice." But how these two phrases were to be interpreted was another matter entirely.
On the one hand, the medical establishment held that addiction was a disease and that addicts were patients to whom drugs could be prescribed to alleviate the distress of withdrawal. On the other hand, the Treasury Department interpreted the Harrison Act to mean that a doctor's prescription for an addict was unlawful. The United States Supreme Court quickly laid the controversy to rest. In Webb v. U.S., 249 U.S. 96 (1919), the Court held that it was not legal for a physician to prescribe narcotic drugs to an addict-patient for the purpose of maintaining his or her use and comfort. U.S. v. Behrman, 258 U.S. 280 (1922), went one step further by declaring that a narcotic prescription for an addict was unlawful, even if the drugs were prescribed as part of a "cure program." The impact of these decisions combined to make it almost impossible for addicts to obtain drugs legally. In 1925 the Supreme Court emphatically reversed itself in Linder v. U.S., 268 U.S. 5 (1925), disavowing the Behrman opinion and holding that addicts were entitled to medical care like other patients, but the ruling had almost no effect. By that time, physicians were unwilling to treat addicts under any circumstances, and well-developed illegal drug markets were catering to the needs of the addict population.
In retrospect, numerous commentators on the history of drug use in the United States have argued that the Harrison Act snatched addicts from legitimate society and forced them into the underworld. As attorney Rufus King, a well-known chronicler of American narcotics legislation, once described it, "Exit the addict-patient, enter the addict-criminal" (p. 22). However, the Harrison Act did not instantly create a criminal class. Without question, at the beginning of the twentieth century, most users of narcotics were members of legitimate society. In fact, the majority had first encountered the effects of narcotics through their family physician or local pharmacist or grocer. Over-the-counter patent medicines and "home remedies" containing opium, morphine, and even heroin and cocaine had been available for years, and some even for decades. Yet long before the Harrison Act had been passed, or had even been conceived, there were indications that this population of users had begun to shrink. Agitation had existed in both the medical and religious communities against the haphazard use of narcotics, defining much of it as a moral disease. For many, the sheer force of social stigma and pressure served to alter their use of drugs. Similarly, the decline of the patent-medicine industry after the passage of the Pure Food and Drug Act in 1906 was believed to have substantially reduced the number of narcotics and cocaine users. Moreover, by 1912, most state governments had enacted legislative controls over the dispensing and sales of narcotics. Thus, it is plausible to assert that the size of the drug-using population had started to decline years before the Harrison Act had become the subject of Supreme Court interpretation. In addition, there is considerable evidence that the Harrison Act was the culmination of a broad, popularly and professionally based social reform movement. It was not governmental intrusion on an unwilling citizenry, but rather a reflection of then-current progressive social reform.
In addition, there is historical evidence that a well-developed subculture of criminal addicts had emerged many years before the passage of the Harrison Act. The opium den, "dive," or "joint," for example, was not only a place for smoking, but a meeting place, a sanctuary. For members of the underworld it was a place to gather in relative safety, to enjoy a smoke (of opium, hashish, or tobacco) with friends and associates. The autobiographies of pickpockets and other professional thieves from generations ago note that by the turn of the twentieth century, opium, morphine, heroin, and cocaine were in widespread use by criminals of all manner. And it might also be pointed out that the first jail-based program for the treatment of heroin addiction was established in the infamous New York Tombs (Manhattan City Prison), two years before the Harrison Act went into effect. At the time, it was estimated that some 5 percent of the city's arrestees were addicted to narcotics.
Thus, while the Harrison Act contributed to the criminalization of addiction, subcultures of criminal addicts had been accumulating for decades before its passage. Nevertheless, the Harrison Act was the first piece of federal antidrug legislation, and it carried with it the potential for applying the criminal label to addiction in a broader sense. Not only was the possession of the narcotic drugs interpreted as a criminal offense, but the risk of arrest was also expanded in that the drugs became available only through nonlegal sources. During the period shortly after the new drug law was enacted, it was widely held that 25 percent or all crimes were committed by addicts, and that such offenses were due to the alleged "maddening" effects of drugs.
Early research initiatives
Perhaps the first empirical effort in behalf of the drugs/crime linkage was undertaken by C. E. Sandoz, which examined the drug-seeking behaviors of some ninety-seven male and thirty-three female morphinists who passed through the Municipal Court of Boston in 1920. His conclusions suggested that the majority of the subjects studied had become criminal as a result of their addiction, but at the same time, there were others who were criminals first. Less than a half decade later, Dr. Wilson Kolb's analysis of 181 cases suggested that those addicts who were also habitual law violators tended to have been either actual or potential offenders prior to their addiction, and among a quantity of others, the offenses committed were principally for violations of the narcotic laws. Furthermore, an absence of aggressive crimes was generally characteristic of the criminal records of both groups studied.
The analyses of Sandoz and Kolb were the first to offer conclusions based upon concrete data, and in differentiating between the two sets of narcotic addicts with their corresponding patterns of criminality, the authors provided a foundation upon which the crucial issues of the drugs and crime controversy were to evolve. Essentially, these issues involved four general ideologies:
- that addicts ought to be the object of vigorous police activity since the majority are members of a criminal element and drug addiction is simply one of the later phases in their criminal careers;
- that addicts prey upon legitimate society and the effects of their drugs do indeed predispose them to serious criminal transgressions;
- that addicts are essentially law-abiding citizens who are forced to steal in order to adequately support their drug habits; and,
- that addicts are not necessarily criminals, but they are forced to associate with an underworld element that tends to maintain control over the distribution of illicit drugs.
The notion that addicts ought to be the objects of vigorous police activity was a posture that was actively and relentlessly taken by the Federal Bureau of Narcotics and other law enforcement groups. Their argument was fixed on a notion of criminality, since their own observations suggested that the majority of the addicts encountered were members of the underworld and addiction was simply a component of their criminal careers. In support of this view, an early report of the Bureau of Narcotics (1940) highlighted that the overwhelming majority of narcotics users indeed had criminal histories that preceded their careers in addiction by as much as eight to ten years. Furthermore, the records of 119 trafficker-addicts were cited, indicating that 83 percent of the cases had criminal records prior to addiction. The position taken by the bureau was firm and unconditional. Addicts, it emphasized, represented a destructive force confronting the people of America, and whatever the sources of their addiction might be, they were members of a highly subversive and antisocial group in the nation. And the approach of the bureau had some basis in reality. Having been charged with the enforcement of a law that prohibited the possession, sale, and distribution of a commodity that was sought by perhaps millions of the population, the bureau's agents were confronted by addicts only under the most dangerous of circumstances. It was not uncommon for officers to be killed or wounded in an arrest situation, and analyses of the criminal careers of many of the addicts apprehended suggested that the underworld was well represented among them.
While the Bureau of Narcotics (and now the Drug Enforcement Administration) remained silent on this issue in subsequent years, other police agencies continued to stress criminality in addiction. Joseph Coyle, a former commanding officer of the Narcotics Bureau of the New York City Police Department, demonstrated that of the 3,386 narcotic violators arrested in New York City during 1957, 84 percent had arrests for nonnarcotic violations prior to their first narcotic arrest.
In a contrasting perspective, researchers and clinicians offered data suggesting that in the majority of cases, criminal involvement occurs subsequent to the onset of addiction and that offense behavior represents the avenue of supporting one's addiction to drugs. During the 1930s, Bingham Dai found that as many as 81 percent of 1,047 Chicago arrestees became criminal subsequent to addiction, and in the following decade, a study of 1,036 patients at the U.S. Public Health Service Hospital in Lexington, Kentucky, found that 75 percent of the cases were addicts first.
Contemporary drugs and crime research
Among the difficulties reflected in the research from the 1920s through the 1960s was the static frame of reference in which addiction has been repeatedly perceived. For although different types within addict populations were observed as early as the 1920s, a major portion of later efforts failed to adequately address this phenomenon. Sample bias was a major issue, particularly with police agencies that limited their analyses to arrestees. Similar contamination often emerged from data generated by serious researchers as well. Initially, addicts receiving in-patient care—arrestees, probationers, parolees, or inmates—typically represent the more dysfunctional members of the drug-using community in that their involvement is sufficient enough to bring them to official attention. In addition, many samples were exceedingly small, and differences with respect to even the more common variables of age, sex, and ethnicity were not always factored. Furthermore, since the unreliability of official criminal statistics as a measure of the prevalence and incidence of offense behavior has been long since documented, interpretations grounded in arrest data are highly suspect. In an alternative direction, populations have been drawn for study from treatment settings with little account taken for the possibility of changing styles in addiction over time.
To recap, from the 1920s through the close of the 1960s, hundreds of studies of the relationship between crime and addiction were conducted. Invariably, when one analysis would support the medical model, the next would affirm the view that addicts were criminals first, and that their drug use was but one more manifestation of their deviant lifestyles. In retrospect, the difficulty lay in the way the studies had been conducted, with biases and deficiencies in research designs that rendered their findings to be of little value.
Research since the middle of the 1970s with active drug users in the streets of New York, Miami, Baltimore, and elsewhere has demonstrated that, at least with those drug users active in street subcultures, the medical model has little basis in reality. All of these studies of the criminal careers of heroin and other drug users have convincingly documented that while drug use tends to intensify and perpetuate criminal behavior, it usually does not initiate criminal careers. In fact, the evidence suggests that among the majority of street drug users who are involved in crime, their criminal careers were well established prior to the onset of either narcotics or cocaine use. As such, it would appear that the inference of causality, that the high price of drugs on the black market per se causes crime, is simply not supported. On the other hand, these same studies suggest that drugs drive crime in that illicit drug use tends to intensify and perpetuate criminal careers.
The drugs-violence connection
It has been a recurring theme over the years that drugs instigate users to acts of wanton violence. This has especially been the case since the mid-1980s with arguments about cocaine and crack. In early studies of drug users, however, it was clear that most addict criminals were nonviolent, with their offenses focusing primarily on income-generating crimes. Beginning in the 1970s, however, this tendency appeared to be changing. Based on the growing number of studies of "poly-drug abusers"—an emergent cohort of multiple drug users that had evolved from the drug revolution of the 1960s—it became apparent that a new and different breed of heroin user was living on the streets of American cities. They not only used heroin, but other drugs as well. Most importantly, their criminality was "situational" in nature. Rather than repeatedly committing burglaries, they lacked any type of criminal specialization. They engaged in a wide variety of crimes—including assaults, muggings, and armed robberies—selected according to the nuances of situational opportunity.
During the 1980s, Paul J. Goldstein of the University of Illinois conceptualized the whole phenomenon of drugs and violence into a useful theoretical framework encompassing three models of drug-related violence—psychopharmacological, economically compulsive, and systemic. His psychopharmacological model of violence suggests that some individuals, as the result of short-term or long-term ingestion of specific substances, may become excitable, irrational, and exhibit violent behavior. The economically compulsive model of violence holds that some drug users engage in economically oriented violent crime to support costly drug use. The systemic model of violence maintains that violent crime is intrinsic to the very involvement with any illicit substance. As such, systemic violence refers to the traditionally aggressive patterns of interaction within the systems of illegal drug trafficking and distribution.
The early statements attributing violent behavior to drug use generally focused on the psychopharmacological argument. More recently this model has been applied to cocaine, barbiturates, and PCP, with a major focus on the amphetamines, "crank," and crack. In study after study, it was reported that the chronic use of amphetamines produced paranoid thought patterns and delusions that led to homicide and other acts of violence. The same was said about cocaine. The conclusion is a correct one, although it did not apply to every amphetamine and cocaine user. Violence was most typical among the hard-core, chronic users.
Contrary to everything that has been said over the years about the quieting effects of narcotic drugs, recent research has demonstrated that there may be more psychopharmacological violence associated with heroin use than that of any other illegal drug. Goldstein's studies of heroin-using prostitutes in New York City during the 1970s found a link between the effects of the withdrawal syndrome and violent crime. The impatience and irritability caused by withdrawal motivated a number of prostitutes to rob their clients rather than provide them with sexual services. This phenomenon was found to be common in Miami, and not only among prostitutes but with other types of criminals as well. And to these can be added the many incidents of violence precipitated by the irritability and paranoia associated with crack use.
The economically compulsive model of violence best fits the aggressive behavior of contemporary heroin, cocaine, and crack users. Among 573 narcotics users interviewed in Miami, for example, more than a one-third engaged in a total of 5,300 robberies over a one-year period as a source of income. Some of these were "strongarm" robberies or muggings with the victim attacked from the rear and overpowered, while the majority occurred at gunpoint. In fact, over a one-fourth of the respondents in this study used a firearm in the commission of a crime. A similar phenomenon was found among a cohort of 429 nonnarcotics users in Miami, with weapon use most common among those who were primarily cocaine users.
In the systemic model, acts of drug-related violence can occur for a variety of reasons: territorial disputes between rival drug dealers; assaults and homicides committed within dealing and trafficking hierarchies as means of enforcing normative codes; robberies of drug dealers, often followed by unusually violent retaliations; elimination of informers; punishment for selling adulterated, phony, or otherwise "bad" drugs; retribution for failing to pay one's debts; and general disputes over drugs or drug paraphernalia.
Most street drug users report having been either the perpetrator or victim of drug-related violence, and many women drug users reported over the years that they were the victims of rape at the hands of drug dealers.
Violence associated with disputes over drugs has been common to the drug scene probably since its inception. Two friends come to blows because one refuses to give the other a "taste." A husband beats his wife because she raided his "stash." A woman stabs her boyfriend because he did not "cop" enough drugs for her too. A cocaine injector kills another for stealing his only set of "works." In short, systemic violence seems to be endemic to the parallel worlds of drug dealing, drug taking, and drug seeking.
Researchers in the drug field have maintained that narcotics addicts are responsible for tens of millions of crimes each year in the United States. In addition, an unknown and perhaps a greater level of crime is committed by cocaine, crack, and other drug users. Contemporary data and analyses tend to support such contentions. Significant in this behalf are the findings of the Arrestee Drug Abuse Monitoring Program (ADAM).
The Arrestee Drug Abuse Monitoring Program (formerly known as the Drug Use Forecasting program or DUF) was established by the National Institute of Justice to measure the prevalence of drug use among those arrested for serious crimes. Since 1986, the ADAM program has used urinalysis to test a sample of arrestees in selected major cities across the United States to determine recent drug use. Urine specimens are collected from arrestees anonymously and voluntarily, and tested so as to detect the use of ten different drugs, including cocaine, marijuana, PCP, methamphetamine, and heroin. What the ADAM data have consistently demonstrated is that drug use is pervasive among those coming to the attention of the criminal justice system.
In the final analysis, then, are drug users—and particularly cocaine, crack, heroin, and other narcotics users—driven to crime, driven by their enslavement to expensive drugs that can be afforded only through continuous predatory activities? Or is it that drugs drive crime, that careers in drugs intensify already existing criminal careers? Contemporary data tend to support the latter position more than any other explanation.
James A. Inciardi
See also Alcohol and Crime: Behavioral Aspects; Criminalization and Decriminalization; Drugs and Crime: Legal Aspects.
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