A day-by-day investigation of changes in criminal convictions before and after entering and leaving opioid maintenance treatment: a national cohort study (original) (raw)
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Journal of Substance Abuse Treatment, 2011
This study investigates frequency and types of criminal convictions among a national sample of heroin users during a 3-year period prior to opioid maintenance treatment (OMT). All heroin users (N = 3,789) in Norway who applied for and were eligible for OMT (1997)(1998)(1999)(2000)(2001)(2002)(2003) were included. The OMT records were cross-linked to Norwegian crime statistics. During observation, 24,478 convictions were recorded among 60.9% of the sample. Differences of criminal convictions were found within the group; a large proportion (39.1%) had no convictions, whereas 10% of the sample was responsible for 37.8% of all convictions. Convictions for acquisitive crimes and drug crimes were the most common. Variations in the cohort's individual crime sequences were found. The heavy involvement of heroin users with the criminal justice system provides an opportunity to intervene with dependent offenders. Coordination between treatment providers and police or courts can play an important role in improving outcomes through better access to treatment.
BMC medical research methodology, 2014
The reduction of crime is an important outcome of opioid maintenance treatment (OMT). Criminal intensity and treatment regimes vary among OMT patients, but this is rarely adjusted for in statistical analyses, which tend to focus on cohort incidence rates and rate ratios. The purpose of this work was to estimate the relationship between treatment and criminal convictions among OMT patients, adjusting for individual covariate information and timing of events, fitting time-to-event regression models of increasing complexity. National criminal records were cross linked with treatment data on 3221 patients starting OMT in Norway 1997-2003. In addition to calculating cohort incidence rates, criminal convictions was modelled as a recurrent event dependent variable, and treatment a time-dependent covariate, in Cox proportional hazards, Aalen's additive hazards, and semi-parametric additive hazards regression models. Both fixed and dynamic covariates were included. During OMT, the number...
Addiction, 2012
Aims This study investigates changes in criminal involvement among patients in opioid maintenance treatment (OMT) over a 7-year period prior to, during and after treatment, particularly in relation to differences in treatment engagement. Design, setting and participants Treatment data on all patients who started OMT in Norway between 1997 and 2003 (n = 3221) were cross-linked with national criminal records. The period of observation was divided into four phases; pre-treatment, in-treatment, between treatments and post-treatment. Findings During OMT, rates of criminal convictions for the cohort were reduced to fewer than half of waiting-list levels [incidence rate (IR) 0.63 versus 1.57]. Patients in continuous treatment had the fewest convictions (IR 0.47) during treatment. The highest rates were found among patients out of treatment after several treatment episodes (IR 1.52). All groups had significantly fewer criminal convictions during treatment compared to before treatment. Staying in OMT for 2 years or more was associated with significantly reduced rates of convictions during treatment. Younger age and pre-treatment criminal convictions were associated with significantly (P < 0.001) more convictions during treatment. Those who left treatment, permanently or temporarily, relapsed into high levels of convictions outside treatment.
Norsk Epidemiologi, 2011
Background: Reduced criminal activity is an important outcome for opioid maintenance treatment (OMT). Aims: Investigate possible differences in criminal convictions in four health regions in Norway among a national cohort of OMT-patients before, during, and after treatment: also investigate treatment retention and other factors that may be associated with treatment outcome. Design: Official national criminal records were cross linked with all patients who started opioid maintenance treatment in Norway from 1997-2003 (n=3221), including patients from four different health regions in Norway; the Eastern region (n=1717), the Southern region (n=751), the Western region (n=586) and the Central-Northern region (n=167). Patients in each region were divided into separate groups according to whether they were retained or not retained in continuous treatment. Findings: During opioid maintenance treatment, patients in all four treatment regions had a considerable reduction in criminal convictions compared to pre-treatment levels. Criminal convictions during treatment were associated with retention in treatment. Among patients in continuous treatment, significant differences were found in levels of criminal convictions among the four treatment regions during treatment. Compared to patients in the Eastern region, patients in the Southern and the Central-Northern region had respectively 44 and 81 percent less criminal convictions during treatment, and patients in the Western region had 60 percent more convictions. For patients not in continuous treatment, no statistically significant differences were found between the four regions during treatment. Conclusions: Differences in criminal convictions during treatment may be related to regional differences in treatment practice within the national OMT system. In all regions, criminal convictions during OMT were higher for patients dropping out of treatment. It is suggested that clinical staff should offer more support to patients at risk of dropping out of treatment.
Drug and Alcohol Dependence, 2012
I 1 The general term opioids refers to naturally-derived opiates from the opium poppy (morphine and codeine), semi-synthetic derivatives (heroin and buprenorphine) and fully synthetic opioids (methadone and phentanyl). The substances included in the category of opioids are referred to in the general statistics by United Nations Office on Drugs and Crime, UNOCD, and the European Monitoring centre for Drugs and Drug Addiction, EMCDDA. 2 Problem opioid use refers to 'injecting drug use or long duration or regular use of opioids' (EMCDDA, 2014).
Factors associated with ongoing criminal engagement while in opioid maintenance treatment
Journal of substance abuse treatment, 2017
This study examines factors associated with criminal engagement among patients in opioid maintenance treatment (OMT). Questionnaire data recorded annually among 5654 patients in the Norwegian OMT programme between 2005 and 2010 from seven regional treatment centres were available for analyses. Each patient answered approximately 4 times (mean: 4.11, SD: 1.46) generating a total of 18,538 questionnaires. The outcome variable of the study, engagement in criminal activity, was defined as whether a patient had been arrested, put in custody, been charged and/or convicted of a crime within the last 12months prior to the completion of the questionnaire. Three types of covariates were included: demographical, psychosocial and drug use-related. Missing data were imputed using Multivariate Imputation by Chained Equations and regression parameters were estimated by Generalized Estimation Equations to account for correlated measurements. Having a full-time job (aOR: 0.47, CI: 0.34-0.64) or bein...
Explaining the effectiveness of heroin-assisted treatment on crime reductions
Law and Human Behavior, 2009
This study examines the relationship between heroin-assisted treatment versus methadone maintenance and the criminal activity of 1,015 individuals participating in a German model project. The main objective is to investigate how these treatments contribute to a decline of criminal behavior. The analyses are based upon self-reported criminal offence and police data on alleged criminals. Logistic regression is employed to explain the variance in the 12-month prevalence 1 year after program admission. The results clearly show a decline of criminal offences among participants receiving maintenance treatment; this decline was significantly greater in the heroin group with respect to property crimes and drug offences. The multivariate analysis reveals that the effects are due to a decrease of illegal drug use and absence from the drug scene. Keywords Crime Á Heroin-assisted treatment Á Methadone maintenance Á Treatment effectiveness The link between crime and drug addiction is well documented and is supported by a high suspect rate among drug addicts. Police crime statistics in Germany report for 2005 more than 100,000 suspects known to the police as users of hard drugs (heroin, cocaine, amphetamines, and amphetamine derivatives) (Bundeskriminalamt, Police Crime Statistics, 2005). Users of hard drugs commit 10-22% of all robberies, 11% of all burglaries in private homes, and 28% of all aggravated shopliftings. Empirical research repeatedly indicated a correlation between drug consumption and criminal activity (for an overview see MacCoun, Kilmer, & Reuter, 2003; Parker & Auerhahn, 1998; White & Gorman, 2000). Methadone maintenance has become the most frequently used treatment approach for opiate dependence. Experience gained so far showed, however, that not all opiate dependents benefit from this treatment. A residual group of heavy users do not respond to methadone maintenance. They are often still dependent on the drug and involved in high-risk health and crime behaviors (Hser, Anglin, & Powers, 1993). For this reason, some European countries conducted model projects in recent years, where pure heroin is prescribed as a medication administered under medical supervision to the addicts. The health of drug dependents can thus be significantly improved by preventing the use of contaminated heroin, overdoses, infections, and abscesses from dirty syringes, etc. The literature provides some evidence for the relationship between crime and heroin-assisted treatment. Heroinassisted treatment has been the object of criminological research in Switzerland for a number of years (
Drug and Alcohol Dependence, 2007
Objective: To determine the patterns of acquisitive crime during methadone maintenance treatment among chronic, treatment-resistant heroin users eligible for heroin assisted treatment in the Netherlands. Methods: We retrospectively assessed the type and number of illegal activities during 1 month of standard methadone maintenance treatment in 51 patients prior to the start of heroin assisted treatment. Data were collected using a semi-structured interview focussed on crime with special emphasis on property crime. Volume analyses consisted of frequencies and descriptives of mean numbers of offences per day and per type. Results: In a Dutch population of problematic drug users eligible for and prior to commencing heroin assisted treatment, 70% reported criminal activities and 50% reported acquisitive crimes. Offending took place on 20.5 days per month with on average 3.1 offences a day. Acquisitive crime consisted mainly of shoplifting (mean 12.8 days, 2.2 times/day) and theft of bicycles (mean 5.8 days, 2.4 times/day); theft from a vehicle and burglaries were committed less frequently. The majority of these patients (63%) reported to have started offending in order to acquire illicit drugs and alcohol. Conclusion: During methadone maintenance treatment, 50% of criminally active, problematic heroin users eligible for heroin assisted treatment reported acquisitive crime. Shoplifting, thefts and/or other property crimes were committed on average two to three times on a crime day. This study discusses that the detail provided by self-reported crime data can improve cost estimates in economic evaluations of heroin assisted treatment.