The criminal histories of male non-medical opiate users in the United Kingdom

Sections

Summary
Introduction
The present study
Discussion

Details

Author: Joy MOTT
Pages: 41 to 48
Creation Date: 1975/01/01

The criminal histories of male non-medical opiate users in the United Kingdom

Joy MOTT Senior Research Officer, Home Office Research Unit, London

Summary

Although there is general agreement that there is some association between non-medical opiate use and criminality the nature, extent and significance of the association remains controversial. The most plausible explanation for an association is that crime becomes an economic necessity for the opiate user where there is, as in most countries, a legislative prohibition on licit supplies of the drugs. In the United Kingdom, however, opiate users may be prescribed the drugs and may also qualify for social security benefits. The criminal histories of three series of United Kingdom male non-medical opiate users are described. A somewhat higher proportion of the series had criminal convictions before any admitted drug misuse when compared with that expected from a general population sample. When age and the number of convictions before identification as opiate users were taken into account, there was no consistent evidence that they were more likely than expected to be convicted of further offences during the two-year period following identification. When the proportion found to have been convicted during this period was greater than expectation, it was due to the proportion convicted exclusively of drug offences. The criminal histories showed a decrease in the number of convictions for theft and other offences and an increase in the number of convictions for, and the number of users convicted of, drug offences during the stages of the drug using history, most particularly during the two years following identification as opiate users. The majority of the drug offences during this period involved opiates when most of the users were, or had been, in receipt of prescriptions for these drugs. It was concluded that the pattern of criminality of male non-medical opiate users was related both to the type of national drug control legislation and to their individual criminal histories.

Introduction

There appears to be general agreement that there is some association between the non-medical or non-therapeutic use of opiate drugs and criminality but the nature, extent and significance of the association remains controversial. O'Donnell (1966) found that the explanations for an association included "the release of criminal tendencies" by the drugs, or that criminals were more likely than non-criminals to become opiate users, or that the association was simply a direct result of the type of legislative control of opiates; activities which must preceed non-medical opiate use - the obtaining and possession of supplies of drugs - are criminal offences in many countries.

One of the most plausible explanations of the association is that crime becomes an economic necessity for the opiate user when there is a legislative prohibition on licit supplies of the drugs. A note by the Secretary-General of the United Nations (1972) rejected the suggestion that the pharmacological properties of opiates were responsible for the release of criminal behaviour. Instead, it was suggested that the non-medical opiate user or addict would, because of his craving for the drugs, be ready to do anything to obtain them; and because the drugs must usually be obtained illicitly, the user would have to make contacts with criminals and commit criminal acts in order to obtain and pay for them. The LeDain Commission (1973) found that the majority of North American opiate users who came to the notice of the law enforcement agencies already had a criminal history of non-drug offences before they began to use drugs and their criminal history continued afterwards, but also that criminal activities were often the only means by which many opiate users could find the money to pay the high cost of illicit drugs.

The economic necessity explanation has never been seriously advanced in the United Kingdom. There, from 1920 to 1968, any medical practitioner could prescribe opiates in the course of treating patients whom they considered to be addicted to these drugs. Although the prescribing of heroin (and cocaine) was limited in 1968 to specially licensed doctors (most of whom work in special clinics of National Health Service hospitals), opiate users continue to be treated within the system of medical care and to be prescribed opiates on a maintenance basis if this is considered to be clinically appropriate. As a patient under the National Health Service the opiate user receives all the benefits of the Service, including help with finding accommodation and work. He may also qualify for social security benefits. Thus, opiate users do not need to commit offences in order to be able to supply themselves with these drugs.

There is, however,evidence that some male opiate users in the United Kingdom have histories of criminal convictions both before and after they have been formally identified as addicts. 1Mott and Taylor(1974), in a survey of the recent United Kingdom literature describing variously selected series of opiate users, reported that about half the males were found to have been convicted of criminal offences at some time prior to identification as addicts. The proportions with convictions varied according to the source of the series, and ranged from 77 per cent of the male users in London prisons during 1967 described by James (1969) to 27 per cent of the (mostly male) users located in a provincial town during 1967 (Kosviner et al., 1968).

Mott and Taylor ( op. cit.) examined the relationship between the drug using and criminal histories of a large series of male opiate users seen by one doctor, Dr. P. A. L. Chapple. They found that 30 per cent of the Chapple series had been convicted of offences before any admitted drug use and 70 per cent had been convicted before notification. The criminal histories showed a decrease in the proportion of convictions accounted for by theft and other offences and an increase in the proportion accounted for by drug offences during the stages of the drug using history and, if the users were convicted of offences during the two years following notification, they were more likely to be convicted of offences involving drugs than of any other type of offence.

Prior to 1968 there was no obligation for doctors to inform the Home Office of patients they attended whom they considered to be addicted to opiates although it was the practice of many doctors, social workers and others to do so informally. During this period the Home Office was informed of individuals having prescriptions dispensed for opiates, as a result of police inspection of retail pharmacists' records to ensure that the regulations with regard to these drugs were being followed. Since 1968 doctors have been required to notify the Home Office of their addict patients and these patients are regularly followed-up. There is a broad legal definition of addiction but, in general, it is left to the discretion of the doctor to decide whether his patient falls within this definition and should therefore be notified. The date when individual opiate users first became known to the Home Office is regarded here as the date of formal identification as an addict and, for convenience, is briefly referred to as "notification".

The Chapple series were not selected systematically from the population of male opiate users known to the Home Office at the time but there was no reason to expect it was likely to include an unusual proportion with criminal histories. In order to investigate further the association between opiate use and criminality in the United Kingdom, the criminal histories of the Chapple series are here compared with those of two other series of male opiate users.

The present study

The three series of male opiate users studied were:

  1. 203 cases seen by Dr. Chapple between 1964 and 1968,

  2. A randomly selected, but age representative, sample of 99 cases first notified by hospitals during 1969,

  3. 67 heroin users identified in Crawley between 1966 and 1970. This series represented almost the total population of male heroin users in this town and has been described by de Alarcon (1969), Rathod (1972) and Mott and Rathod (in preparation).

For all three series information on their drug using histories was extracted from their clinical notes. Details of their criminal convictions were obtained from the Criminal Record Office, New Scotland Yard. Information on their notification histories and attendance at hospital clinics was extracted from the Home Office Drugs Branch records. All cases were followed-up for two years after notification.

The criminal histories were analysed in relation to four stages in the drug using history - prior to any admitted drug use, prior to first admitted use of opiates (usually heroin), prior to notification to the Home Office and during the two years following notification. The date of notification to the Home Office is considered to be the most significant in the drug using history because it is the date when the opiate user is formally identified as an addict; it is also the only date which does not depend exclusively on his own report of drug use and which is precisely recorded.

All offences under the various Dangerous Drugs Acts, and offences under other statutes where drugs controlled by these Acts are involved, are called "drug offences"; "non-drug offences" include all other criminal offences.

THE RESULTS

Age at the time of notification

Fifty-two per cent of the Chapple series, 56 per cent of the hospital series and 86 per cent of the Crawley series were aged between 14 and 20 years at the time of notification to the Home Office. Between 93 per cent and 100 per cent of each series were aged 29 years or younger at this time.

Criminal convictions during tile stages of the drug using history

TABLE 1 First conviction and stage in the drug using history (Percentage)

 

First convicted (cumulative percentage)

Series

Number

Prior to any admitted drug use

Prior to first admitted use of opiates

Prior to notification

During two years following notification

Chapple
         
1964 and earlier
65 42 57 74 85
1965 to 1968
138 26 50 62 76
Hospital
         
1969 74a 23 49 74 86
Crawley
         
1966 to 1970
67 33 48 72 87

a Excluding 25 cases with insufficient information on the drug using history.

Between a quarter and a third of each of the later series had been convicted of offences at least once prior to any admitted drug use. Rather more, but not significantly 2so, of the early cases in the Chapple series-those notified during and before 1964-had been convicted of offences at this stage. The proportion with convictions increased to around 50 per cent prior to the first admitted use of opiates, to around 70 per cent prior to notification and to around 85 per cent by the end of the two years following notification.

The expected incidence of delinquency prior to any admitted drug use

Wadsworth (1975) reported that 15 per cent of a national sample of males had been convicted of offences before reaching the age of 21. He suggests this may be an underestimate because of certain exclusions from the sample and because of the method of data collection. However, his figure represents the best available national estimate with which to compare the series of opiate users. In the Chapple series 28 per cent of the early cases had been convicted before any admitted drug use and before the age of 21 compared with 25 per cent of the late cases so that 26 per cent of the total series had been convicted. The comparable proportion in the small Crawley series was 33 per cent. These proportions are significantly higher than that in the national sample.

2 Differences between proportions in groups with specified characteristics have been compared using the chi-squared statistic and values obtained that had a probability of occurring by chance of 5 per cent or less are described as significant.

Conviction during the two years following notification

TABLE 2

Comparison of the observed and expected proportions convicted during the two year follow-up period

 

Observed convicted (percentage)

 

Age

Number of previous convictions

Expected convicted (percentage)

Total

Drug offences only

Drug and non-drug offences

Non drug offences only

Number convicted

Total number

15-20
  15 46 32 6 8 30 65
21-29
0
- -
36 19 5 12 15 42
15.20   29 61 28 15 15 33 54
21.29 1 21 45 13 16 16 14 31
15.20   57 69 21 17 31 68 98
21.29
2+
50 86 28 29 29 56 65

About 40 per cent in each series were not convicted of offences during the two years following notification. The numbers in the various age and number-of-previous conviction groups in each series were small and, as the series did not differ significantly in the proportions convicted within the groups during the follow-up period, they were combined to compare the observed and expected proportions convicted.

Table 2 shows that around a quarter of the males within in each previous conviction group, considering both age groups together, were convicted only of drug offences during the follow-up period. Within each age group the total proportion of those convicted either only of non-drug offences or of both types of offence was associated with the number of previous convictions. When the age groups were combined, the proportions of the total in each previous conviction group who were convicted but not exclusively of drug offences were: no previous convictions 15 per cent, one previous conviction 33 per cent and two or more 52 per cent.

Wadsworth's ( op. cit.) proportion of 15 per cent of males with a conviction before the age of 21 is quoted in table 2 as the expected proportion convicted during the follow-up period for the 15 to 20 age group with no convictions prior to notification. Similar information was not available for the 21 to 29 age group. The expected proportions convicted during the follow-up period for the groups with one or two or more convictions prior to notification were obtained from the large sample of male offenders of all ages and number of previous convictions dealt with for all types of offence described in Part VI of "The Sentence of the Court" (1970).

Three of the differences between the observed and expected proportions convicted were found to be significant. More of the 15 to 20 year olds with no previous convictions were convicted than expected, 46 per cent compared with 15 per cent; of the same age group with one previous conviction, 61 per cent compared with 29 per cent; and of the 21 to 29 age group with two or more previous convictions, 86 per cent compared with 50 per cent. However, when the proportions within each age group who were convicted ( a) only of drug offences, and ( b) of both drug and non-drug offences, were compared with the expected proportions, there were no significant differences between them. It seems that the significantly greater than expected proportions of opiate users who were convicted during the follow-up period can be accounted for by the proportion convicted only of drug offences.

Types of offence during the stages of the drug using history

TABLE 3

Mean number of convictions by type of offence by stage of drug using history for the Chapple (S 1) and the Crawley (S 3) series

 

Prior to any admitted drug use

During non-opiate use

Early opiate use

During two years after notification

Type of offence
S1
S3
S1
S3
S1
S3
S1
S3
Theft
1.03 1.50 0.88 0.73 0.51 0.50 0.44 0.56
Violence against the person
0.11 0.00 0.18 0.07 0.13 0.16 0.07 0.03
Other
0.34 0.41 0.45 0.66 0.49 0.16 0.24 0.19
Drugs
0.00 0.00 0.19 0.27 0.39 0.78 0.69 1.13
No person convicted
63 22 88 15 71 32 123 37
Percentage persons with drug offences
0 0 19 27 39 63 67 78

The table shows for the Chapple (S 1) and the Crawley (S 3) series the marked decline in the mean number of convictions for theft and other offences and the increase both in the mean number of convictions for drug offences and the proportion of individuals convicted of such offences during the stages of the drug using history. The details of the drug using history prior to notification were not available for all the cases in the hospital series but the trend is similar, with the mean number of convictions for theft offences at any time prior to notification being 2.35 compared with 0.79 during the two years following notification and the mean number of convictions for drug offences being 0.39 and 0.66 respectively. The proportion of persons convicted of drug offences increased from 29 per cent to 52 per cent. In each series the mean number of convictions for offences of violence against the person was negligible both before and after notification.

Of the males who were convicted of drug offences during the follow-up period, about 60 per cent of each series were convicted of offences involving opiates.

Opiate using status on the second anniversary of notification

The series varied in the proportions known to be in receipt of prescriptions for opiates at this time. Of the Chapple series 73 per cent of those traced, alive and in the community (74 per cent of the series), 39 per cent of those traced in the hospital series (72 per cent of the series) and 30 per cent of those traced in the Crawley series (82 per cent of the series) were in receipt of prescriptions. There was, however, evidence that 81 per cent of the hospital series and 45 per cent of the Crawley series had been in receipt of prescriptions at some time during the follow-up period.

Discussion

The comparison of the criminal histories of two representative series of male opiate users with the Chapple series confirmed many of the findings reported by Mott and Taylor for that series. A minority in each series, around a quarter to a third, had been convicted of offences before any admitted misuse of drugs, and very similar proportions were found to have been convicted during the various stages of the drug using history.

Although the proportions in both the Chapple and the Crawley series with convictions prior to any admitted misuse of drugs and before reaching the age of 21 were significantly higher than expected for the general male population, only a minority had been convicted - a quarter of the Chapple and a third of the small Crawley series. Similar proportions of the early and late cases in the Chapple series had been convicted by that age. Thus, there is a suggestion that in the United Kingdom, males with criminal convictions before any drug misuse, are somewhat more likely to become opiate users than those without but the likelihood does not appear to have increased during the period between 1960 and 1970.

Opiate use during the two years following notification, that is, after formal identification as an addict, did not consistently increase the re-conviction rates for the users beyond that expected when age and the number of previous convictions were taken into account. When the proportion convicted during this time was significantly in excess of that expected, this was due to the proportions convicted exclusively of drug offences.About 40 per cent in each series were not convicted during the follow-up period.

The present results provide indirect evidence that male opiate users in the United Kingdom do not commit offences for reasons of economic necessity or "steal to support the habit". Instead, their criminal histories showed a descreasing number of convictions for theft offences during the stages of the drug using history accompanied by an increasing number of convictions for drug offences and an increasing number of individuals convicted of such offences.

The majority of the cases who were alive, traced and in the community at the end of the two year period after notification had, at some time, during the period been in receipt of prescriptions for opiates. Despite this about 60 per cent of those who were convicted of drug offences (between 50 per cent and 80 per cent depending on the series) were convicted of offences involving the unauthorized procuring or possession of opiates. This may be because, as McSweeney and Parr (1970) found, many opiate users remain at risk of conviction for such offences because they buy, sell or borrow or lend each other small quantities of drugs as "a matter of common practice and mutual convenience". Hawks (1973) quoted results from two descriptive studies where opiate users receiving prescriptions claimed that they needed more than the amount of opiates prescribed and that they made up the balance from illicit sources, while fewer of the patients who were prescribed the larger amounts of opiates reported using illicitly obtained drugs.

It seems that the pattern of criminality of male non-medical opiate users is closely related both to the nature of the national drug control legislation (and probably also to the social security provisions) and to the individual criminal characteristics of the users. In the United Kingdom where licit supplies of opiates are available under medical supervision together with social security benefits, opiate users continue to be convicted of offences involving these drugs even when they are known to have been in receipt of prescriptions for them. Indeed, such offences predominated in the criminal histories of the present three series of cases during a two year follow-up period. Nevertheless, for the male opiate user, as for the male offender in general, the younger he was at the time of coming to notice and/or the more criminal convictions he had by that time, the more likely he was to be convicted during the follow-up period.

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