*Birendra Kumar Mandal Assistant Professor Department of Forensic Medicine and Toxicology Chitwan Medical College, Bharatpur, Nepal

Drug abuse is when someone is using drugs (e.g. cannabis, amphetamines, inhalants or kava) in a way that causes them harm. It is not just a matter of how much of a drug the person is using, but how their use affects their life and the lives of those around them. The relationship between drug abuse and crime is complex. Simply, it is a crime to use, possess, manufacture, or distribute drugs classified as having a potential for abuse. Not all individuals who use drugs become addicted, nor do they commit violent crime. However, the impact of illicit drugs, crime and violence is highly damaging to local communities as members of those communities have to live in the midst of illicit drug markets, where crime and violence, and the threat of crime and violence, are ever present.

Drugs are blessed discoveries for the safety and well being of members of the society and not to cause any harm to any of its members but it is abused worldwide. Drug means any substance that, when taken into the living organism, may modify one or more of its functions.¹ The Australian Drug Foundation has defined drugs as ‘Any substance which changes the way the body or mind functions’. ²

In common usage, the term often refers specifically to psychoactive drugs, and often, even more specifically, to illicit drugs, of which there is non-medical use in addition to any medical use.³ Drug-taking can be legal or illegal. The caffeine in coffee and tea is a licit drug and is unregulated. Alcohol is licit, as is tobacco, but both are more heavily regulated. Prescription drugs like benzodiazepine (sleeping pills) and steroids are licit when prescribed but illicit if used by someone without a prescription. Cannabis is illicit, although in several states there are expiation schemes which allow those charged with some possession offences to avoid having the conviction placed on their criminal record; thus, payment of a fine ‘expiates’ (atones for) the violation of the law. Heroin, ecstasy, hallucinogens, and others are also illicit drugs.²

Drug abuse arises out of a maladaptive pattern of substance use, manifested by recurrent and significant adverse consequences related to the repeated intake of the substance. These problems must occur recurrently during the same 12 months period. The criteria do not include tolerance, withdrawal, or a pattern of compulsive use, and instead include only the harmful consequences of repeated use.⁴ Drug abuse can lead to drug dependence or addiction. Drug dependence arises out of a maladaptive pattern of substance use, leading to a cluster of behavioral, cognitive and psychological phenomenon that develops after repeated intake. It includes a strong desire to take the drug, difficulties in controlling its use, persisting in its use despite harmful consequences, a higher priority given to drug use than to other activities and obligations, increased tolerance, and sometimes a physical withdrawal state. It includes both the terms “addiction” and “habituation”.⁴ Addiction defined as a chronic, relapsing disorder characterized by compulsion to take a drug (craving) resulting in physical, psychological and social harm, and continued use despite evidence of that harm.⁴ Drug habituation is a condition resulting from the repeated consumption of a drug, in which there is psychological or emotional dependency on the drug.⁴

There are a wide range of reasons why people use drugs. For example, it may help them to cope with problems, while stopping might lead to unpleasant effects. There may also be things happening within the family or community that are contributing to the person’s drug use.⁵ Many cases of drug or alcohol addicts arise after apparent failure in business or professional life.⁶ Some people may not even be sure why they use drugs.

Dopamine receptors within the brain are affected by drug use and dopamine floods the individual with desirable emotions, rewarding for substance use.⁷ Once dopamine’s relationship to reward was discovered, dopamine was thought to be heavily involved as the reason for addiction. Upon initial use of a psychotropic substance, such as amphetamine or cocaine, changes occur within the brain, influencing a cycle of addiction. Cognitive functioning affects whether or not someone initially tries an illicit substance. Once affected by the drug, brain chemistry is altered to perpetuate additional use. There are various cognitive variables that are common to drug abusers, such as poor decision making, high risk taking and lack of self control.⁷

Contrary to the reward hypothesis of dopamine is that even after an addict does not experience the same high as the first initial use, the addict continues in pursuit of the drug. In addition, although many people try various drugs, not all become addicted. If the underlying reason is reward alone, all who experiment should become addicts.

According to incentive sensitization theories, a person may have (affecting internal anticipation of reward from a drug), mixed with the reward potential of their drug of choice. Different drugs have varying potential for addiction and people do not respond to the same drug in the same way. Anticipated reward or cravings can be difficult to control. A person may experience conditioned pleasure reinforcement and have higher cravings for drugs in certain environments or around people with whom they have used drugs before.⁸

According to legal definition, crime is any form of conduct which is declared to be socially harmful in a State and as such forbidden by law under pain of some punishment.⁹

Relationship between drug and crime is multidimensional. Most directly, it is a crime to use, possess, manufacture, or distribute drugs classified as having a potential for abuse such as cocaine, heroin, marijuana, and amphetamines. Drugs are also related to crime through the effects they have on the user’s behavior and by generating violence and other illegal activity in connection with drug trafficking. For example, drug-related homicide can include murders related to drug distribution, murders committed while using drugs, murders committed in the act of a crime to get money for drugs, or murders that simply occur in high-drug-use neighborhoods. However, it is difficult to count offenses of violent behavior resulting from drug effects, stealing to buy drugs, or violence associated with the drug trade as much of what transpires is undocumented.⁸

Thus for the following reasons drug abuse- crime relationship should be interpreted cautiously-

• most crimes result from a variety of factors (personal, situational, cultural, economic), so even when drugs are a cause, they are likely to be only one factor among many

• meaning of “drug-related” varies from study to study; some studies interpret the mere presence of drugs as having causal relevance while other studies interpret the relationship more narrowly

• reports by offenders about their drug use may exaggerate or minimize the relevance of drugs; drug use measures, such as urinalysis that identifies only very recent drug use, are limited.

The following scheme summarizes the various ways that drugs and crime are related¹⁰-

Drug-defined offenses- Violations of laws prohibiting or regulating the possession, distribution, production, manufacture illegal drugs. Eg Drug possession or use, Marijuana cultivation. Methamphetamine production. Cocaine, heroin, or marijuana sales.

Drug-related offences- Offenses in which a drug’s pharmacologic effects contribute; offenses motivated by the user’s need for money to support continued use; and offenses connected to drug distribution itself. Eg.- Violent behavior resulting from drug effects. Stealing to get money to buy drugs. Violence against rival drug dealers.

Drug-using lifestyle- Drug use and crime are common aspects of a deviant lifestyle. The likelihood and frequency of involvement in illegal activity is increased because drug users may not participate in the legitimate economy and are exposed to situations that encourage crime. Eg.- A life orientation with emphasis on short term goals supported by illegal activities. Opportunities to offend resulting from contacts with offenders and illegal markets. Criminal skills learn from other offenders.

Theories that explain the relationship between drug use and crime

There are three basic explanatory models for the relationship between drug use and crime¹¹:

(1) Substance use leads to crime, (2) Crime leads to substance use, and (3) the relationship is either coincidental or explained by a set of common causes.

Substance use leads to crime

One causal model posits that alcohol and drug use lead to crime because of the psychopharmacological properties of drugs, the economic motivation to get drugs, or the systemic violence associated with the illegal drug market.¹²

The psychopharmacological model proposes that the effects of intoxication such as disinhibition, cognitive-perceptual distortions, attention deficits, bad judgment, and neurochemical changes, cause criminal (especially violent) behavior.^13,14 Chronic intoxication, due to factors such as withdrawal, sleep deprivation, nutritional deficits, impairment of neuropsychological functioning, or enhancement of psychopathologic personality disorders, may also contribute to subsequent aggression and crime.¹⁵

This model has gained greater support in the alcohol literature than in literature about other drugs. Numerous biological and neuropsychological mechanisms have been proffered to explain how alcohol use increases the risk of violence.^16-19There is some research to indicate that chronic use of marijuana, opiates, and amphetamines increases the risk of violent behavior.¹⁷ No conclusive evidence supports a direct association between cocaine use and violence.¹⁷ As well, there has been no evidence (except anecdotal and small samples) that acute use of PCP (phencyclidine) and LSD (lysergic acid diethylamide) is associated with violent behavior, except when use enhances already existing psychopathology.^14,17,20 It is also possible that drug and alcohol use may interact to affect violent behavior.²¹

In sum, the psychopharmacological model appears relevant for explaining a potential causal relationship between alcohol and violence among adults but little of the relationship between drugs and crime.

The economic motivation model assumes that drug users need to generate illicit income to support their drug habit. Thus, they engage in crimes such as robbery, burglary, and prostitution to get drugs or the money to buy them. Support for the economic motivation model comes from literature on heroin addicts, which indicates that raising or lowering the frequency of substance use among addicts raises or lowers their frequency of crime, especially property crime.^22-24

Studies in the 1970s found that more female drug users were prostitutes than were drug dealers²⁵, as crack selling became profitable, some women gave up prostitution in favor of dealing²⁶. Still, many women who use crack continue to be heavily involved in prostitution²⁶, and the economic motive is clear²⁵.

The major illegal activity for heroin-cocaine users is drug distribution.²⁷ Studies consistently show that crack users are heavily involved in dealing, but they are also involved in nondrug criminality.^28-29

The systemic model posits that the system of drug distribution and use is inherently connected with violent crime. Systemic types of crimes in relation to drug distribution include fights over organizational and territorial issues, enforcement of rules, punishments of and efforts to protect buyers and sellers, and transaction-related crimes such as robberies of dealers or buyers, assaults to collect debts, and resolution of disputes over quality or amount.¹⁷ Drug markets can create community disorganization, which, in turn, affects the norms and behaviors of individuals who live in the community. Such community disorganization may be associated with increases in crime that are not directly related to drug selling.^30-32

This model probably accounts for most of the current violence related to illicit drug use, especially drug-related homicides.^30,31,33 Goldstein (1997) suggested that at any given time, systemic violence is associated with whatever drug is most popular.³⁴ Overall, the results of these studies suggest that deviant individuals are attracted to drug selling, rather than that drug selling causes individuals to become criminals.

This model is based on the assumption that deviant individuals are more likely than non deviant individuals to select or be pushed into social situations and subcultures in which heavy drinking and drug use are condoned or encouraged.

For example, rather than the need for a drug compelling an individual to commit robbery, the income generated from a robbery might provide the individual with extra money to secure drugs and therefore place the individual in an environment that supports drug use.³⁵ It has also been suggested that several aspects of the professional criminal lifestyle are conducive to heavy drinking and drug use, such as working periodically, partying between jobs, being unmarried, and being geographically mobile.³⁶ In addition, it has been proposed that deviant individuals may use drugs in order to self-medicate³⁷ or to give themselves an excuse to act in a deviant manner.³⁸

It is also possible that both of the above models are correct and that the relationship between substance use and crime is reciprocal. That is, substance use and crime may be causally linked and mutually reinforcing. For example, when an addict has an easy opportunity to commit robbery, he or she will commit it and then buy drugs with the money gained, not out of a compulsion but rather as consumer expenditure. Conversely, when the need for drugs is great, users will commit crimes to get money to buy drugs.^23,39

The common cause model postulates that substance use and crime are related because they share common causes such as genetic or temperamental traits, antisocial personality disorder, parental alcoholism, and poor relations with parents.^40,41

In addition, drug use and crime may have common environmental and situational causes. Research shows, for example, that rates of violent crime and delinquency are high in neighborhoods that are poor, densely populated, racially segregated, and composed of a transient population.^42,43 Social disorganization and lack of social capital appear to be the crucial mechanisms linking these structural characteristics to crime.³²

Thus it is obvious that a single model cannot account for the drug-crime relationship among all people. For some individuals the acute, and possibly chronic, cognitive effects of some drugs, such as alcohol, increase the propensity toward criminal behaviors. For others, involvement in deviant behavior weakens bonds to conventional norms and increases involvement in deviant subcultures that provide opportunities and reinforcement for increased deviant behavior, including drug use. Finally, for others, probably a majority, biopsychological factors (e.g., temperament) and early parent-child interactions, in combination with socioenvironmental factors, increase the risk for involvement in all types of deviant behavior.

Provisional data for 1991 show that among adult respondents (ages 18–49), those who use cannabis (marijuana) or cocaine were much more likely to commit crimes of all types than those who did not use these substances.⁴⁴ Methamphetamine users were significantly more likely than heroin users to have committed violent crime.⁴⁵ Study indicates that in comparison with other drug users, meth users are more likely to be under the influence of either drugs or alcohol at the time of arrest.⁴⁶ In the U.S. several jurisdictions have reported that benzodiazepine misuse by criminal detainees has surpassed that of opiates.⁴⁷

The Columbia Center for Drug Studies estimated that in the 1990s the population of inmates needing drug treatment grew significantly. In 1996, 900,000 inmates in a prison population of 1,300,000 (69%) were in need of some form of drug treatment. The percentage of men who are testing positive for drugs at the time of arrest in various cities ranges from 60% to 80% for any drug in major metropolises. The percentage of women testing positive for drugs at the time of their arrest has been skyrocketing in the last eight years, and has risen to between 60% and 70%. [44] The percentage of juveniles testing positive for drugs at the time of arrest is 60% to 70%. Depending on the location, the most common drug youths test positive for is marijuana (50% to 60%). However, methamphetamine and cocaine continue to gain strength: 4% to 14% of juveniles tested positive for these drugs in 1998 (National Center on Addictions and Substance Abuse 1998).^44,48

The international ADAM (Alcohol and Drug Abuse Monitoring) data reveals that in London over 60% of all arrests were associated with any drug: 10% of these arrests were for amphetamine, 40% for marijuana, close to 20% were for opiates, 10% for cocaine and 8% were for methadone1 (U.S. Department of Justice, National Institute of Justice 1999).^44,49,50

In Brazil, drug-related violence is a particularly serious national challenge that has a negative impact on communities. Of almost 30,000 homicides registered annually, a high proportion are linked to drug abuse and illicit drug trafficking. Street children play an important part in this illicit market, acting as couriers for drug traffickers, and are frequently killed because they know too much, steal too much or are caught in the crossfire between gangs and dealers.⁵¹ Also in Latin America and the Caribbean, a survey conducted by the World Bank on youth gangs and violence indicated that youth gangs involved in drug trafficking generally displayed higher levels of violence than those not involved in such activity.⁵¹

CONSEQUENCES

Scope for crime and violence is enhanced because of the economic opportunities provided to criminal groups by illicit drug markets, as criminals compete for a share of those markets; that, in turn, may have dire consequences for the local community. Rivalries between local drug dealers and traffickers can develop into violent confrontations in and around public places and, as a result, make such places “no-go areas” for the general public. Communities may become dependent on local illicit drug markets that support whole economies. Thus both are unable and unwilling to challenge the status quo. The authorities themselves may also be in no position to challenge violent drug-related crime in certain communities, as they too are at risk of violence or they have been influenced by corruption and are consequently in a state of inertia.

The stress, anxiety and fear generated by exposure to crime and violence, interfere with the daily lives and normal developmental progress of people particularly young people: for example, their ability to trust and have a sense of personal safety; their ability to develop skills to control their emotions; their freedom to explore the local environment; and their ability to form “normal” social relationships.

Thus the social harm caused to communities by the involvement of both adults and young people in drug-related crime and violence is immense. The very fabric of society is challenged by the continued presence in communities of drug-related crime.

Relationship between drug abuse and crime is complex and that relationship destroys our community in small scale and the nation and the world in large scale. The evidence indicates that drug users are more likely than nonusers to commit crimes, that arrestees and inmates were often under the influence of a drug at the time they committed their offense, and that drug trafficking generates violence. Though there are different theories (psychopharmacological, economic motivation, systemic, crime leading to drug abuse and common cause theory) that explain relationship between drug abuse and crime, assessing the nature and extent of the influence of drugs on crime requires that reliable information about the offense and the offender is available, and that definitions be consistent. In face of problematic evidence, it is impossible to say quantitatively how much drugs influence the occurrence of crime.

I am grateful to my wife RITI KAMAT (MANDAL) for her understanding and help whenever I need.

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