PSYCHOACTIVE SUBSTANCES AND VIOLENCE
by Jeffrey A. Roth, Feb. 1994
ISSUES AND FINDINGS
Discussed in the Research in Brief: The current status of research on the
links connecting violence to alcohol and illegal psychoactive drugs, and
evaluations of interventions to prevent violence related to these
Key issues: Correlations between violence and psychoactive substances;
the social, economic, cultural, psycho-social, neurobehavioral, and other
factors that explain the correlations; and prevention strategies for
reducing the violence associated with these substances.
* Research has uncovered strong correlations between violence and psycho-
active substances, including alcohol and illegal drugs, but the underlying
relationships differ by type of drug.
* The links between violence and psychoactive substances involve broad
social and economic forces, the settings in which people obtain and consume
the substances, and biological processes that underlie all human behavior.
These factors interact in chains of events that may extend back from an
intermediate triggering event such as an argument to long-term predisposing
processes that begin in childhood.
* Of all psychoactive substances, alcohol is the only one whose
consumption has been shown to commonly increase aggression. After large
doses of amphetamines, cocaine, LSD, and PCP, certain individuals may
experience violent outbursts, probably because of preexisting psychosis.
Research is needed on the pharmacological effects of crack, which enters
the brain more directly than cocaine used in other forms.
* Alcohol drinking and violence are linked through pharmacological
effects on behavior, through expectations that heavy drinking and violence
go together in certain settings, and through patterns of binge drinking and
fighting that sometimes develop in adolescence.
* The most promising strategies for reducing alcohol-related violence
are to reduce underage drinking through substance abuse preventive
education, taxes, law enforcement, and peer pressure.
* Illegal drugs and violence are linked primarily through drug
marketing: disputes among rival distributors, arguments and robberies
involving buyers and sellers, property crimes committed to raise drug money
and, more speculatively, social and economic interactions between the
illegal markets and the surrounding communities.
* The most promising strategy for reducing violence related to illegal
drugs appears to be reducing the demand that fuels violent illegal markets.
Promising tactics include preventive education, pretrial monitoring of
arrestees through urinalysis and, for convicted violent offenders, in-
prison therapeutic communities integrated with postrelease treatment
* In the future, medications may reduce violence by reducing cocaine
craving and by blocking the aggression-promoting effects of opiate
withdrawal and alcohol consumption.
Target audience: State and local policymakers, court administrators, law
enforcement and juvenile justice practitioners, and drug treatment program
As noted by the Panel on the Understanding and Control of Violent
Behavior, the character of violence presents simultaneous challenges to
understanding and opportunities for prevention. First, violence is
diverse. Acts as different as spontaneous drive-by shootings and met-
iculously planned serial killings, for example, are both included in the
legal and statistical category of murder. Second, the causes of violence
are complex, involving a very wide variety of factors. The panel found it
useful to classify these factors in terms of four levels of analysis at
which they are usually studied:
* Broad social and economic forces (macrosocial).
* Encounters between people in particular settings (microsocial).
* Individual behavioral development from childhood through adulthood
* Neurobehavioral and other biological processes that underlie all human
Factors at these four levels operate and interact in chains of events that
may begin long before the violent event that results. Therefore, the
panel's classification framework also categorized causal factors in terms
of their temporal proximity to the violent event itself: from the immediate
triggering mechanism (for example, a response to an insult), back through
the situation that led up to the triggering event, to predisposing factors
that months or years earlier increased the risk of a future violent event.
This diversity and complexity might at first glance seem to discourage
efforts to prevent violence. In fact, however, they create promising
opportunities. Merely acknowledging the diversity breaks the overall
"violence problem" into separate problems that may be preventable through
interventions by different public agencies. Recognizing the causal
complexity expands the list of options for preventing a particular violence
problem by highlighting all the points at which chains of events leading to
it may be breakable. Problem-solving initiatives--programs that involve
design and evaluation of preventive interventions at various links in these
chains of events, that revise these interventions in light of the
evaluation findings, and that replicate the evaluations--have the potential
to simultaneously reduce violence and increase the understanding of its
Many chains of causal events for violence include links to alcohol or to
illegal psychoactive drugs. The panel found these links worth exploring in
depth for at least three reasons. First, statistics consistently
demonstrate correlations between violent events and involvement with
alcohol and other psychoactive drugs. Second, the variety of potential
causal links between violence and different psychoactive substances--
alcohol, opiates, cocaine in smokable and powdered form, amphetamines,
hallucinogens, and other illegal drugs--presents an especially rich example
of the panel's classification framework. Third, preliminary evidence from
research and evaluations suggests that certain interventions related to
psychoactive substances should be considered in developing strategies for
Correlations between violence and psychoactive substances
Research supported by the National Institute of Justice and other
organizations has repeatedly found strong correlations between violence and
* For at least the last several decades, alcohol drinking--by the
perpetrator of a crime, the victim, or both--has immediately preceded at
least half of all violent events, including murders, in the samples studied
* Chronic drinkers are more likely than other people to have histories
of violent behavior.
* Criminals who use illegal drugs1 commit robberies and assaults more
frequently than do nonuser criminals, and they commit them especially
frequently during periods of heavy drug use.
* In a study of New York City murders in 1988, researchers classified
more than half the homicides (53 percent) as drug-related: 39 percent in
the course of drug distribution, 8 percent through pharmacological effects
on the offender, 2 percent while the offender was obtaining money to buy
drugs, and 4 percent through more than one of these links.2
Data from the National Institute of Justice Drug Use Forecasting (DUF)
program, which tests for drug use among booked arrestees in 24 sites
nationwide, showed the following patterns in 1989:
* Most males and females who were interviewed after arrest for a violent
crime reported drinking alcohol within 72 hours before the crime for which
they were arrested.
* About 60 percent of arrestees booked for violent crimes were confirmed
by laboratory test to have used at least one illegal drug3 in the hours
EXPLAINING THE CORRELATIONS
While these statistical patterns strongly suggest that psychoactive
substances play significant roles in acts of violence, they do not explain
the nature of those relationships. In trying to sort out links between
violence and psychoactive substances, the panel categorized potential links
in terms of the four levels noted above:
* Social and economic forces (macrosocial):
Processes that affect large social units such as nations or communities.
Examples include cultural practices related to alcohol use and, in the
United States, economic and social processes surrounding the illegal
markets in which psychoactive drugs other than alcohol are sold.
* Encounters between people (microsocial):
Characteristics of encounters between people. Examples include group
drinking in settings where violence is expected and socially acceptable;
arguments that are begun or aggravated because the participants are under
the influence of drugs or alcohol; and disputes involving organizations,
buyers, and sellers in illegal drug markets.
* Psychosocial: Influences on individuals' behavior patterns, which
begin developing in early childhood and continue to evolve throughout
adulthood. Examples include patterns of heavy drinking and aggression that
develop during adolescence and psychoses that predispose a few individuals
toward violent psychotic episodes while under the influence of certain
* Neurobehavioral: Processes in the brain that underlie all human
behavior and that may be altered by pharmacological effects of alcohol and
other drugs. Examples include effects of substance abuse during pregnancy
on fetal development, effects of chronic substance abuse on brain
functioning, and temporary neurological effects of being "high" or "blue."
These and other examples of links at all four levels between violence and
alcohol or other drugs are displayed in table 1. Much of the evidence for
specific links is suggestive rather than conclusive. One challenge in
understanding and verifying the links is the complexity of interactions
among factors at different levels. It would be difficult at best to sort
out such interactions. What makes the challenge even greater is that most
studies measure factors at only one or two levels at a time, so that the
full range of interactions is rarely observed in a single study. In
addition, it is difficult to study violent events using methods that yield
generalizable conclusions. Controlled experiments under laboratory
conditions produce the strongest confirmation of factors that influence
behavior, but practical and ethical constraints generally limit those
methods to studies of behaviors that are far milder than the potentially
lethal violence that occurs in homes and communities. At present,
therefore, there are only fragments of scientific evidence providing
partial support for the existence of many causal links between psychoactive
substances and violence. These findings neither explain definitively how
the links interact nor provide a basis for ranking them in order of
importance in explaining variation in violence related to alcohol or other
Research on humans and many animal species suggests there are several
neurobehavioral links between violence and psychoactive substances:
* Expectant mothers' use of psychoactive substances during pregnancy
adversely affects fetal development. The resultant damage causes learning
and communication problems that, in turn, increase the risk of early grade
school failure, a well-documented precursor of violent behavior.
* Alcohol is the only psychoactive drug that in many individuals tends
to increase aggressive behavior temporarily while it is taking effect.
However, factors at other levels--behavior patterns when people are not
drinking, the setting in which people drink, and local drinking customs,
for example--influence the strength of this relationship.
* Among alcohol abusers, those who also abuse other psychoactive
substances, who are diagnosed with antisocial personality disorder, and
whose parents have been diagnosed as alcohol abusers are at especially high
risk of chronic violent behavior. Some researchers have suggested that a
genetic process may contribute to this relatively rare pattern.
* Marijuana and opiates temporarily inhibit violent behavior, but
withdrawal from opiate addiction tends to exaggerate both aggressive and
defensive responses to provocations.
Individual humans and animals deviate widely from these "average"
behaviors. For example, the aggression-promoting effects of alcohol are
strongest in animals having high blood levels of testosterone, the
principal male hormone that distinguishes males from females; humans may or
may not exhibit the same pattern. A study of violent Finnish alcohol
abusers suggests that the alcohol-violence link may be associated with
abnormally low levels of blood sugar (that is, hypoglycemia) and of
metabolites of the brain chemical serotonin. Another study suggests that
the alcohol-violence link is especially strong in people who exhibit
certain abnormal brain wave patterns, both at rest and while responding to
On the other hand, several common assumptions about connections between
drugs and violence are called into question by research findings:
* There is no evidence to support the claim that snorting or injecting
cocaine stimulates violent behavior. However, research is urgently needed
on the behavioral effects of smoking cocaine in crack form, which affects
the brain more directly.
* Anecdotal reports notwithstanding, no research evidence supports the
notion that becoming high on hallucinogens, amphetamines, or PCP stimulates
violent behavior in any systematic manner. The anecdotes usually describe
chronic users with histories of psychosis or antisocial behavior, which may
or may not be related to their chronic use of drugs.
* Occasional anecdotes about " 'roid rages"--violent outbursts by men
who use anabolic steroids to accelerate muscle growth--appear to describe
isolated coincidences rather than any common, systematic effect.
Evidence from research on animals and humans indicates that patterns of
substance abuse and aggressive behavior reinforce each other. It cannot be
said that one "causes" the other. For example, alcohol may trigger violent
episodes in aggressive animals and people, but rarely in submissive ones.
Patterns of aggressive behavior and substance abuse often become
intertwined starting in childhood. Early childhood aggression is a
predictor of later heavy drinking, and the combination is associated with
an above-average risk of adult violent behavior, especially among those who
also abuse other psychoactive drugs.
Research suggests at least four possible explanations for the link between
substance abuse and violent behavior in adolescents. First, adolescents may
chronically use psychoactive substances to help them temporarily escape
from such feelings as rage, guilt, worthlessness, or depression--emotions
that often precede aggressive behavior. Second, repeated family arguments
over teenage substance abuse may eventually take on a violent character.
Next, underlying family problems or socially expected responses may lead
some adolescent males to patterns of heavy drinking and fighting as ways to
demonstrate their masculinity. Last, boys who regularly observe older males
fighting while drinking may learn to expect that violent behavior
accompanies alcohol use. All of these processes may be at work, but their
roles, interactions, and importance as explanations have not yet been
Preexisting psychosis appears to account for occasional violent outbursts
by people who are under the influence of amphetamines or hallucinogens,
especially PCP. While these drugs are well known to cause disorganized,
bizarre behavior, they trigger violence in very few people who are not also
psychotic. In studies of laboratory mice and monkeys, bizarre behavior on
the part of animals under the influence of PCP fairly commonly provokes
violent attacks by others in the group. Anecdotal information and newspaper
accounts report similar attacks on humans using alcohol, amphetamines,
powdered cocaine, or LSD, but this relationship has not been systematically
studied in humans.
ENCOUNTERS BETWEEN PEOPLE
In a variety of ways, alcohol and drugs modify encounters between people
in ways that make these substances greater hazards for violence. In the
case of alcohol, these hazards tend to be related to use, while for illegal
psychoactive drugs they tend to be related to distribution and purchase.
Alcohol use and sexual violence. Some therapists who treat violent sex
offenders have reported that their patients tend to have both histories of
alcohol abuse and high blood levels of testosterone. Without comparisons to
men who are not violent sex offenders, these clinical observations cannot
demonstrate that alcohol abuse or high testosterone levels cause sexual
violence. Studies of many animal species suggest a causal connection--that
alcohol reduces testosterone levels but has stronger aggression-promoting
effects in individual high-testosterone animals. However, that
relationship has not yet been tested in humans. The frequent involvement of
alcohol in acquaintance rapes suggests that social expectations may also be
at work; that is, young men who expect to have sex after drinking may try
to satisfy their expectations, sometimes forcibly if they encounter
Illegal drug markets. Illegal drug markets operate outside the world of
contract law, courts and mediators for resolving disputes, and business
customs that distinguish socially acceptable from unac- ceptable approaches
to buying and selling. Illegal markets often develop substitute mechanisms
that involve the threat or actual use of violence. Examples include:
* Violence by drug distributors in the course of territorial disputes
between rival organizations, threats of violence to make "staff" obey
organizational rules, violent punishment of rulebreakers to keep the
threats credible, battles with police, and protection of sellers or drugs
on the street.
* Violence between buyer and seller during a drug transaction, caused,
for example, by attempted robbery of one or the other, failure to hand over
drugs or money, or "honest" misunderstandings of local rules of the game on
the part of buyers and sellers.
* Violence involving people other than buyers and sellers who are found
around drug markets--third parties such as innocent bystanders and people
operating in related illegal markets for "protection," guns, or
As places where violence tends to occur for the reasons listed above,
illegal drug markets may also serve as "magnets." As such, they attract
valuable drugs and cash, weapons, and people who are accustomed to
violence. The mix of these ingredients creates hazardous conditions for
robberies and other forms of violence that may not be directly related to
Obtaining drug purchase money. In some settings, the need for money to buy
drugs also increases the chance of a violent encounter. A taxi driver
carrying a passenger late at night, for example, is presumably at greater
risk of being robbed if the passenger wants to buy drugs but lacks the cash
to do so. While robbery is still a common way to obtain money to buy drugs,
it has been replaced by drug selling in some large cities.
Using alcohol and drugs. If alcohol caused violence only by making
individuals behave more aggressively, violence would be equally common in
all places where drinking occurs. In fact, however, most drinking places
are rarely scenes of violence. A few acquire reputations as "animal houses"
or "fighting bars," where people expect drinking and violence to go hand in
Just what characteristics of a drinking place make it a hazard for
violence are not precisely known, but there is supporting evidence for
several possible explanations. People who drink in fighting bars may behave
violently in order to "fit in" or to advance socially. People who
experience anger or frustration may seek out such settings, because they
believe that drinking in these types of establishments means social
permission to engage in violent behavior. One study of a group of young men
who were observed during an evening of drinking illustrates this by
suggesting that behavior patterns and situational influences may play off
each other. As the evening progressed, the group began both to behave more
aggressively and to move on to establishments where aggressive behavior was
more socially acceptable.
Connections between drinking and violence have been identified by
researchers in many countries with predominantly European cultures. But
they have not been found in many tribal and folk societies, even where
binge drinking is common. For reasons not yet known, expectations that
violence follows drinking have failed to develop in those cultures.
Finally, it seems likely that substance abuse is indirectly related to
violence in ways that are difficult to identify and count. Examples of
indirect relationships include robberies committed to replace household
money spent on drugs or alcohol, or spouse assaults arising from disputes
over money or time spent away from home drinking or taking drugs.
Violence is related to the distribution, purchase, and use of illegal
drugs or alcohol in a wide variety of human interactions. Unfortunately,
the difficulty of counting such interactions makes it also difficult to
rank them in order of importance. Better counts would help in focusing
violence prevention strategies on the most common interactions in which
drug- and alcohol-related violence occurs.
SOCIAL AND ECONOMIC FORCES
If the patterns of behavior discussed above were the only links between
illegal drug distribution and violence, every city that experienced a crack
epidemic in the 1980's would also have seen a substantial increase in
homicide at the same time. Indeed, policymakers have occasionally claimed
a "uniform, straight line relationship" between illegal drug use and
The reality is more complex. The murder rate increased 350 percent in
Washington, D.C., and by a smaller amount in New York City as their crack
epidemics unfolded. However, during the crack epidemics in Detroit and Los
Angeles these cities experienced decreases in the murder rate. This
suggests that the relationships between illegal drug market activity and
lethal violence are intertwined with social and economic processes in the
What are these processes? Because causal patterns at the social level are
especially difficult to establish, the answers are necessarily speculative.
Fragments of evidence suggest that some or all of the following factors may
influence the relationship between levels of violence and illegal drug
* Stability of drug market control: Situations that produce violent
encounters--fights over territorial allocations or misunderstandings
between buyers and sellers, for example--arose relatively infrequently in
markets controlled by old, stable organizations that had developed
operating rules decades ago and enforced them through a standing threat to
punish violators violently. Where the spread of crack manufacturing
technology encouraged new organizations to enter the markets, the resulting
destabilization may temporarily have increased the frequency of violent
* Community access to legitimate economic opportunities: Where the rise
of crack markets followed the exodus of legitimate economic opportunities
from central cities, economic rewards shifted away from skills valued by
legitimate employers to those valued by crack distribution organizations;
these included the ability to threaten and use violence.
* Strength of informal violence controls: Where the exodus of legitimate
economic opportunities from urban communities took with it many people
committed to legal, nonviolent values, those people were no longer
available for roles in preventing drug-related violence. They were not
available, for example, as nonviolent role models for adolescents, as
passers-by who might discourage drug buyers or intervene in emerging
violent events, or as concerned individuals who might inform parents if
their children began drifting toward involvement in drug markets.
* Social status and moral authority: During crack epidemics in some
communities, successful young drug entrepreneurs either supplanted or
intimidated neighborhood "old heads"--unofficial community leaders who
upheld traditional values and had exercised moral authority in the
neighborhood. Where this occurred, it tended to weaken cultural restraints
against violence in all contexts, including drug markets.
Because such relationships are difficult to verify, evidence supporting
their influence is only suggestive and fragmentary, and new research is
needed to explore them more fully.
A number of intervention strategies for preventing violence related to
psychoactive substances have been proposed:
* Police disruption of illegal drug markets.
* Selectively longer incarceration of violent drug-using criminals.
* Reducing teenagers' access to alcohol.
* Substance abuse prevention.
* Drug abuse treatment.
* Pharmacological therapies to reduce drug craving and aggressive
tendencies associated with alcohol use and heroin addiction.
Some of these strategies have been evaluated to test their effectiveness
in reducing violence. Only a few have demonstrated success under any
conditions; none have shown universal effectiveness. Developing better
interventions will require collaborative problem-solving initiatives that
involve representatives of criminal justice agencies, providers of
substance abuse treatment and other social services, and evaluation
researchers. These initiatives are needed to turn promising ideas into
workable programs, to evaluate the programs, and to refine them in light of
the evaluation results. The findings of evaluations conducted thus far are
summarized in the following sections.
Disrupting illegal drug markets. Police attack illegal drug markets
through a number of tactics: undercover investigations leading to dealers'
arrests; cooperation with community antidrug efforts; and large-scale, high-
visibility crackdowns. Evaluations of these tactics in Birmingham, Alabama;
Lawrence and Lynn, Massachusetts; New York City; Oakland, California;
Philadelphia, Pennsylvania; and Washington, D.C., present a mixed picture.
Perhaps the strongest supportable statement is that their chance of success
is improved by intervening early in emerging markets, by creating a highly
committed police force, and by generating community receptivity and
cooperation in advance. NIJ's Drug Market Analysis (DMA) program is helping
with the first prerequisite--early detection of drug markets. Specific
techniques for creating supportive climates in police departments and the
surrounding communities are less well understood, although many approaches
are now being tested as part of community policing initiatives.
Incarcerating violent drug-using criminals. Researchers have generally
found that compared to other violent offenders, those who use drugs tend to
have higher average frequencies of violent crimes such as robbery and
assault. This finding raises the possibility that sentencing drug-involved
offenders who are convicted of these crimes to longer prison terms might
reduce violence. However, analyses suggest that this strategy of "selective
incapacitation" would reduce violent crime levels very little unless it
were accompanied by massive increases in prison populations.
A related strategy--monitoring pretrial releasees' drug use through
urinalysis--showed rather surprising effects in a Washington, D.C.,
evaluation. Although positive drug test results did not predict
significantly higher pretrial rearrest rates, failure to show up for the
test was a strong predictor of subsequent new crimes leading to rearrest.
Reducing teenagers' access to alcohol. Evidence is fairly clear that
increases in tax rates and other measures that reduce the availability of
alcohol to adolescents (social pressure and enforcement of underage
drinking laws) in turn reduce drinking and certain associated problems such
as death rates due to auto collisions. Therefore, these strategies may also
reduce adolescents' disproportionate share of violence. That conjecture
remains to be tested, however.
Substance abuse prevention. By reducing the demand that fuels violent,
illegal drug markets, substance abuse prevention should, in theory, reduce
violence levels. Many substance abuse prevention programs have been
evaluated, including the Drug Abuse Resistance Education (DARE), which
brings police officers into classrooms as instructors. Evaluations of
prevention programs have generally found them effective in delaying the
onset of tobacco, alcohol, and marijuana use. Evaluations have not
generally found that education succeeds in preventing use of "harder"
drugs, perhaps because use of those drugs was rare even in the control
groups that did not receive preventive education. However, to the extent
that minor drugs are "stepping stones" to the harder ones,5 the programs
may have meaningful, yet delayed, effects for violence reduction.
Prevention may have an especially important role to play for one category
of adolescents--males whose behavior meets diagnostic criteria for
antisocial personality disorder and whose parents abuse alcohol. Research
indicates that these two factors, coupled with both alcohol and drug abuse,
create a high-risk profile for violent behavior in adulthood.
Drug abuse treatment. Successful drug treatment programs reduce criminal
activity among adult clients. For drug abusers who are not in prison, stays
of at least 3 months in therapeutic communities reduce the tendency to
commit crime after discharge. Up to about 18 months, longer stays in the
therapeutic community produce greater reductions.
For drug abusers in prison, treatment usually involves only individual or
group sessions a few times a week with no postrelease followup.
Evaluations of this approach have not found it sufficient to reduce
criminal behavior following release. However, a more intensive approach--
combining inprison therapeutic communities, planning for postrelease
treatment, and postrelease treatment in the community--reduces overall
rearrest rates of inmates who complete the program. At least three programs
have used this approach: Stay 'n Out (in a New York prison), Cornerstone
(in the Oregon State Hospital), and the California Civil Addict Program.
In addition to these beneficial effects of drug treatment on offenders'
behavior, successful treatment may reduce aggregate levels of violence
related to drug markets by lowering the demand that fuels the markets. Such
an effect would, however, be difficult to measure.
Pharmacological interventions. Like other forms of drug treatment,
pharmacological therapies that reduce drug craving may also lower the
demand that supports violent drug markets. For decades, methadone and
related chemicals have been used to reduce craving for heroin. There is no
analogue to methadone for treating addiction to cocaine in powdered or
smokable form. However, using animals as test subjects, researchers have
identified the receptors for certain subtypes of two brain chemicals,
dopamine and norepinephrine, as promising sites to begin developing such
medications. Animal research also suggests neurochemical starting points
for developing medications that reduce violence in other ways: by
disrupting the aggression-promoting effects of alcohol and by preventing
aggression during withdrawal from heroin addiction.
Too few of the links between violence and psychoactive substances have
been established with enough certainty to advocate a comprehensive national
policy for preventing violence related to those substances. Instead, a
program of testing and evaluating tactics for implementing a variety of
promising strategies is called for. Among these strategies, criminal
justice agencies have particular roles in developing and testing tactics to
disrupt illegal drug markets, in monitoring drug use of pretrial releasees,
in establishing drug abuse treatment for convicted criminals, and in
creating effective substance abuse prevention programs. Fulfilling these
roles will require cooperation between the criminal justice system and drug
treatment, prevention, and education authorities. Eventually, efforts to
prevent drug-related violence may be assisted by pharmacological therapies
to reduce the aggression-promoting effects of alcohol and the craving for
other psychoactive drugs.
1. Among studies of this relationship, many group all illegal drugs
together. Those that distinguish among drugs usually list cocaine, heroin,
amphetamines, barbiturates, and hallucinogens other than marijuana. See,
for example, Elliott, D.S., and D. Huizinga, The Relationship Between
Delinquent Behavior and ADM [Alcohol, Drug, and Mental Health] Problems,
National Youth Survey Report No. 26. Boulder, Colorado: Behavioral Research
2. Goldstein, P.J., H.H. Brownstein, P.J. Ryan, and P.A. Bellucci, "Crack
and Homicide in New York City, 1988: A Conceptually Based Event Analysis,"
Contemporary Drug Problems 16 (Winter 1989):651--687.
3. The DUF program uses urinalysis to confirm self-reports. The urine
specimens are tested for cocaine, opiates, marijuana, PCP, methadone,
benzodiazepine (Valium), methaqualone, propoxyphene (Darvon), barbiturates,
and amphetamines. Samples are collected at the time of arrest on a
voluntary basis; an average of 80 percent of arrestees voluntarily
cooperate. Test criteria are set to detect use of most drugs in the
preceding 24 to 48 hours, but marijuana and PCP can be detected in the
urine several weeks after use.
4. Isikoff, M., and K. Sawyer, "Thornburgh Says All Drug Abusers Fuel
Nation's Crisis," Washington Post, August 17, 1990.
5. Until recently, research on developmental pathways consistently found
these drugs to be "gateways" or "stepping stones" to cocaine use.
Preliminary findings, presented after the Panel completed its report,
suggest that since the New York City "crack epidemic" of the early 1980's,
crack-using youth in increasing numbers are skipping the gateway drugs and
starting directly with crack.
Dr. Jeffrey A. Roth served as study director for the Panel on the
Understanding and Control of Violent Behavior and is research director in
the Bethesda, Maryland, office of the Law and Public Policy area of ABT
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