Title: Toward a Drugs and Crime Research Agenda for the 21st Century

Series: Special Report

Author: National Institute of Justice

Published: September 2003

Subject: Drugs and crime and drug policy

271 pages

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Toward a Drugs and Crime Research Agenda for the 21st Century



U.S. Department of Justice

Office of Justice Programs

810 Seventh Street N.W.

Washington, DC 20531



John Ashcroft

Attorney General



Deborah J. Daniels

Assistant Attorney General



Sarah V. Hart

Director, National Institute of Justice



This and other publications and products of the U.S. Department of

Justice, Office of Justice Programs, National Institute of Justice can be

found on the World Wide Web at the following site:



Office of Justice Programs

National Institute of Justice

http://www.ojp.usdoj.gov/nij



--------------------------------



July 03



Toward a Drugs and Crime Research Agenda for the 21st Century



NCJ 194616



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Sarah V. Hart

Director



Findings and conclusions of the research reported here are those of the

authors and do not reflect the official position or policies of the U.S.

Department of Justice.



The National Institute of Justice is a component of the Office of Justice

Programs, which also includes the Bureau of Justice Assistance, the

Bureau of Justice Statistics, the Office of Juvenile Justice and Delinquency

Prevention, and the Office for Victims of Crime.



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CONTENTS



Introduction



At the Intersection of Public Health and Criminal Justice Research on

Drugs and Crime



Research on Drugs-Crime Linkages: The Next Generation



The Drugs-Crime Wars: Past, Present, and Future Directions in Theory,

Policy, and Program Interventions



Appendix A: Summary of Proceedings



Appendix B: Forum Agenda



Appendix C: List of Participants



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INTRODUCTION



Henry H. Brownstein with Christine Crossland



For criminal justice practitioners who deal with drugs and crime day in

and day out, the reality of the drugs-crime nexus is indisputable. In a

manual designed to help police chiefs and sheriffs control drug abuse, the

International Association of Chiefs of Police (IACP) stated unequivocally

its belief in "a significant though complex" relationship between drug

abusers and criminal offenders. Change one group, IACP proposed, and

you change the other: "If there is a reduction in the number of people who

abuse drugs in your community, there will be a reduction in the

commission of certain types of crime in your community."[1]



When IACP released its manual more than a decade ago, researchers

already were confirming what practitioners believed and documenting the

relationship between drugs and crime.[2] Public policy and programs were

and continue to be developed on the basis of this knowledge.[3] But

although researchers and practitioners alike knew the relationship existed,

the nature of that relationship eluded them then and continues to elude

them today.[4] 



To shed light on the drugs-crime link requires research, and the first step is

to specify the research topics to be covered. Taking the lead, the National

Institute of Justice (NIJ) and the National Institute on Drug Abuse (NIDA)

brought together academics and other researchers and asked them to

answer three questions: What do we know about drugs and crime, what do

we not know, and, most important, what do we need to know? Both

agencies see this knowledge not as an end in itself but as a means to

accurately define the problem of drugs and crime and promote future

research. The agenda for research was developed under NIJ and NIDA

sponsorship at a forum held in Washington, D.C., in April 2001. The

findings of the Drugs and Crime Research Forum are presented here.



In Pursuit of the Drugs-Crime Link



If we are going to make progress toward solving the problem of drugs and

crime, we need to shed light on the nature of the drugs-crime link by

designing effective responses. Developing a research agenda on drugs and

crime means tackling the central issue of the drugs-crime link. Is the

link a matter of cause and effect or is it something far more complex?



There is no lack of theories. The direct cause model of the drugs-crime

relationship has attracted its share of supporters. It states simply that either

drug use leads to crime or crime leads to drug use. The simplicity is

appealing. Who would not find it tempting to believe that reducing drug

use can lower the crime rate? In fact, some policies and programs have

been developed on the basis of the direct cause model or the belief in a

significant relationship between drugs and crime. As IACP recognized, the

relationship is real enough. And NIJ's Arrestee Drug Abuse Monitoring

program has demonstrated year after year that among people apprehended

and charged with a crime, a large percentage uses drugs.[5]



However, as sociologist Erich Goode has cautioned, "Even the fact that

drugs and crime are frequently found together or correlated does not

demonstrate their causal connection."[6] The consensus among researchers

who study the issue confirms Goode's observation. The evidence for the

direct cause model is just not there.[7]



We seem more willing today to accept the complexity of the drugs-crime

relationship, more open to the notion that "[t]here is considerable

uncertainty . . . about the degree to which drug use causes crime or the

degree to which criminal involvement causes drug use."[8] In a recent

review of the literature, sociologists Helene Raskin White and Dennis M.

Gorman definitively dismissed the direct cause model. They concluded

instead that the drugs-crime link is best explained by the common cause

model, in which any association of drugs and crime has a cluster of

causes.[9]



Those who subscribe to the common cause model believe that to

adequately understand the relationship of drugs to crime requires attention

to many issues, social, cultural, chemical, and biological among them.

What the model means for policy and practice is that any response to drugs

and crime that works in one set of circumstances may not work in another.

For researchers, it means the research agenda is vast. Policy and practice

can be informed by what we know up to this point, but progress in

responding to the drugs-crime problem requires knowing more.



Building on the Past: The Drugs and Crime Research Forum



NIDA and the National Institute of Law Enforcement and Criminal

Justice, NIJ's predecessor organization, were asked by Congress in 1976 to

find out what was known about drugs and crime. The product of the

agencies' collaboration was Drugs and Crime: A Survey and Analysis of

the Literature. Though not strictly a research agenda, the survey was a first

step "to identify where the gaps in our knowledge lie and to direct research

to fill those gaps."[10] It was intended to "set the stage for more focused

future research."[11]



In 2000, NIJ's call for the development of a research agenda was another

step toward meeting that need. The authors of Drugs and Crime noted at

the time that "few if any [studies] directly address the drugs-crime nexus

issue."[12] This report on the development of the research agenda will

demonstrate that although much has been learned in the intervening years

about drugs, drug use, drug abuse, drug markets, and drug law

enforcement, much work is needed to shed light on the complexities of the

drugs-crime link.



Three papers were commissioned for the research forum. Each addressed

the questions of what we know, what we do not know, and what we need

to know about the drugs-crime link. Prepared by experts in epidemiology,

public policy, social work, and allied disciplines, the papers served as

the focal point and framework for discussions by forum participants. (The

forum summary, agenda, and a list of the participants are presented in

appendixes A, B, and C.) After the forum adjourned, NIDA created a

listserv for participants to continue to exchange their thoughts.



The discussions did not all fit the same mold. Roundtables were generated

from one-sentence statements by participants about drugs and crime.

What we do not know about the drugs-crime relationship was treated at

length. The many strands of thought, lines of discussion, and themes came

together when Forum participants addressed the final question: What

future research is most important, and what research is needed most

urgently? Mindful that the next generation of researchers will be tackling

the problem of drugs and crime, Forum participants recommended topics

for research by their graduate students.



Probing Drugs and Crime: Three Perspectives



"At the Intersection of Public Health and Criminal Justice Research on

Drugs and Crime" was commissioned by NIDA from James C. Anthony

with Valerie Forman. Anthony asked such questions as--



o Have we made effective and adequate use of recent developments in

science and technology to advance the study (and hence the understanding)

of the relationship between drugs and crime? Given the vast literature

generated during past decades on this subject, have we adequately,

appropriately, and effectively integrated research from both the public

safety and public health perspectives?



o Are the tensions between the two perspectives greater than our ability to

overcome them? Given what we know now and the current tension

between researchers in public safety and public health, how can we

conceptualize and organize our thinking and research to enhance our

knowledge and understanding of the relationship in the most productive

ways?



o What do we really know about the suspected causal connection between

drugs and crime? In looking at drugs and crime, what is the intersection at

which public health and public safety meet? How can we achieve the goals

of greater understanding and definitive evidence and greater mastery in

design and application in policy, programs, and techniques to prevent and

reduce harmful health and safety consequences of drug use?



o What do we need to do to integrate molecular biology, genetics, and

neuroscience into discussions of drugs and crime? What do we need to

do to place discussions of the drugs-crime nexus in the context of history?

How can we clarify the question of causal inference? How can we use the

notions of scale and rubrics to help understand the relationship between

drugs and crime? 



"Research on Drugs-Crime Linkages: The Next Generation" was

commissioned by NIJ from Robert MacCoun, Beau Kilmer, and Peter

Reuter. Among the questions asked by MacCoun and his colleagues

were--



o Are our conceptualizations of the relationship between drugs and crime

adequate to move forward in our understanding of that nexus? How must

we conceptualize the relationship to be able to address questions not only

of concomitance and statistical correlation, but also of social significance

and causality?



o To the extent that the drugs-crime relationship is causal, to what extent

do we understand the nature of the causal influences? How can we use

Paul Goldstein's tripartite taxonomy to build on work already done, and

how can we move beyond the taxonomy? How can we use notions such as

Bruce Johnson's conduct norm analysis or Alfred Blumstein's drugs-gun

diffusion hypothesis?[13]



o How does the considerable heterogeneity of users, substances,

locations, and situations as well as differences in market dynamics affect

what we need to have and to do to address the drugs-crime nexus? How do

we address the question of causal influences? How will research in the

coming decade deal with the heterogeneity of effects across users,

substances, cities, neighborhoods, and situations?



"The Drugs-Crime Wars: Past, Present, and Future Directions in Theory,

Policy, and Program Interventions" was commissioned by NIJ from Duane

C. McBride, Curtis J. VanderWaal, and Yvonne M. Terry-McElrath. In

this paper, McBride and his colleagues raised the following questions:



o In the past two or three decades, what progress has been made in our

knowledge and understanding of the relationship between drugs and

crime? Does knowledge of the statistical relationship help us understand

the nature of the relationship? What do we know about the nature of the

nexus and what do we need to do now to advance the state of our

knowledge? In the past century, how have we used that knowledge to

guide public policy? Could we do a better job of linking what we think and

what we know about drugs and crime to what we do to address individual

and social problems in the realms of public health and public safety? Do

we know enough about what has been tried (for example, programs and

program evaluations) to know what works?



o How is the idea of social capital important to our understanding of the

drugs-crime nexus? What is the significance of the dynamic tension

between drug policy as it shifts and the drugs-crime connection as policy

changes? What is the value of interventions and treatment when dealing

with drug-using offenders?



What Do We Need to Learn?



It will come as no surprise that the question of what we know about drugs

and crime was eclipsed by that of what we do not know and what we have

yet to learn. The papers and accompanying discussions yielded an

abundance of ideas on research topics for the coming decades. The major

themes included the following:



o Drug-related crime.



o Drug enforcement.



o Drug markets.



o Drug offenders.



o Drug policy.



o Treatment and intervention.



o Drug use and abuse.



o Ethnographic studies.



o Health sciences perspectives.



o Minority research.



o Research methods.



o Victimization studies.



Categorized more broadly, the topics proposed for research are the

drugs-crime nexus, the social contexts of drug use and crime, and refining

study methods and designs.



What Explains the Drugs-Crime Nexus?



We know that drugs and crime are related. We also know something about

the different ways they might be related, and perhaps something about the

ways they may be related in time and space. What we have yet to learn is

how they are related. In other words, we need to probe the underlying

dynamics of the relationship. We do not know, for example, why so many

people who commit crime also use drugs or why some people who use

drugs commit crime but others who use drugs do not commit crime.

Research in this broad area might take several directions.



Find new ways to conceptualize the drugs-crime nexus. Several years ago,

Goldstein proposed a tripartite framework as a way to disentangle the

relationship between drugs and crime, specifically violent crime. Violence

could be the direct outcome of ingesting drugs, the result of a user's

compulsion to obtain drugs or money for drugs, or a product of the

disorganization and violence inherent in the social systems in which drugs

are manufactured and exchanged.[14] Over the years, this framework has

been useful for studying drugs and violent crime but of limited value for

studying drugs and other types of crime. Beyond what has been learned

from this model, how can researchers conceptualize the way or ways drugs

and crime--not just violent crime--are related?



Combine research perspectives. Research on drug use illustrates how

different disciplines can combine forces. Social science research is

beginning to merge with biological research, particularly genetic research.

Questions include the following:



o How can the study of genes, the social environment, and behavior help

us better understand the link between drugs and crime?



o Are there physiological propensities for drug using? If so, what is the

impact of the user's environment?



o Are alcohol and marijuana complements of or substitutes for other

drugs?



o Do different drugs have different effects on groups of people who are

genetically different?



o How can we address the ethical concerns of such research?



Give more attention to minorities. A disproportionate number of the

people arrested, charged, and in custody for drug and other criminal

offending are from minority groups. The reason is unknown but needs to

be probed. What can we learn about the involvement of various ethnic

and racial groups in the drugs-crime link? What can we learn about gender

and the drugs-crime link? Some answers might be found in comparative,

multisite studies of drug use and drug markets in different ethnic

communities. What is the relationship of gender, age, race, and culture to

drug involvement and crime? What is the effect of disparity (in income,

for example), prejudice, and discrimination on the distribution of resources

used for treatment and prevention? How can we explain racial and ethnic

differences in drug use and involvement in crime? Do people view the

drugs-crime link differently because of their race, gender, or age?



From these general research areas on racial and ethnic diversity, it is

possible to derive many specific topics. What can we find out about the

relationship between drugs, crime, and the increase in the number of

women of color who are incarcerated? Have changes in the economy

affected the involvement of disadvantaged black and Hispanic/Latino

males in drugs and crime? If so, how? What is the impact of drug-related

incarceration on families and children or on prospects for education and

employment in minority communities?



What Do We Need to Know About the Social Context of Drugs and

Crime?



It is widely believed that drug use adversely affects users. But drug use and

crime are affected by and in turn affect forces operating in society at large.

Drug users interact with many people: sellers with buyers, buyers with

sellers, criminal offenders with their victims. There is a social context of

drug use.



Social patterns in the drug world. There have been many studies of drug

users and some studies of drug markets. But what do we need to learn

about the social relations and interactions of the people whose lives are

affected by drugs?



The commerce of drugs and crime: drug markets. Theories about and the

operations and institutional arrangements of drug markets are plentiful, but

not enough research has been done to test them. How stable are drug

markets, and how do they change over time? For example, has the

maturation of the crack cocaine market in some cities affected those cities'

crime rates? What is the connection between local market activity and

fluctuations in supply and demand at the national level? What influences

the relationship between sellers and buyers? How and why do new markets

emerge, and what impact do they have on existing markets? How are

prices set in local drug markets, and how are wages set?



Patterns of use and abuse. We know something about the demographics of

drug use, but what do we know about intergenerational patterns? How do

use patterns vary with social or biological differences? How do patterns of

alcohol use compare with patterns of use of other drugs? Can drug use

help explain juvenile involvement in crime or violence? Are patterns of

use of certain drugs, such as club drugs, designer drugs, or inhalants,

different from patterns of use of other drugs? What can we find out about

how and why people start or stop using drugs?



Criminal offending by drug users. There are some studies of drug

offenders, but how much do we know about how or why drug offenders

commit crime? Are some people genetically predisposed to drug use?

Is there a relationship between drug use and social status, and if so, how

might social status in turn be related to involvement in crime? Beyond

using illicit drugs, to what extent are drug users and sellers involved in

other crime? Can we realistically estimate how much other crime is

committed by drug offenders? What risk do these people pose to their own

health and safety? 



Victims of drug users and drug use. Drug users are in some ways their own

victims, but are there other victims? What do we know about other people

with whom drug users relate? How can we define for research and policy

purposes what we mean by "victims of drugs"? How do we define

victimization in this context? Are there indirect victims, such as families

and communities, as well as direct victims?



The public's response to drug use and drug-related crime. Society

considers drug-related crime and illicit drug use as affronts and responds

accordingly. Enforcement strategies are one example. To what extent are

the responses based on a real understanding of these problems? Are the

responses making a difference?



Enforcing drug laws. What is the effect of enforcement policies, programs,

and practices on drug use, drug dealing, and drug-related crime? What is

the relationship between street-level enforcement and street-level drug

market activity, particularly violent activity? What impact do drug

seizures, drug arrests, and asset forfeiture, among other interdictions, have

on drug and drug-related crime? What is the impact of public concern

about racial profiling and police corruption on the ability of law

enforcement to respond to drugs and crime?



Treating drug use and abuse. With so many different drugs and so many

different types of users, what can we say about the efficacy of drug

treatment in addressing drugs and crime? What is the nexus of drug

treatment and criminal justice? For example, what are the results of

treatment in correctional settings and what do evaluations reveal? Do

incentives or disincentives help drug users to succeed in treatment? How

do we define success? How important are aftercare programs and family

interventions? What is the best way to treat drug users who are dually

diagnosed (for example, those who are also mentally ill)? What are the

dropout rates for treatment, and what does it matter? What treatments 

work best with what types of drug use? How do we distinguish users

from abusers? What difference does that distinction make for treatment

planning?



Intervening to prevent drug use or crime. Although relatively little is

known about preventing drug use, the topic receives a great deal of 

attention. To what extent can media campaigns help prevent drug use? Is

the impact of prevention programs the same for all social categories of

users or irrespective of type of drug? How can we educate young people

about the impact that drugs can have on their lives? Should more attention

be paid to problem behavior, norm violations, and rule breaking than to

drug prevention?



Public policy. When we think about public policy on drugs, we typically

do not think about policy in general but rather about specific aspects, such

as interdiction, enforcement, treatment, and prevention. But can we step

back and think broadly and measure the impact of drug policy over the

past decade, or even the past century? Can we learn from policy

simulations that examine past and prospective views of drug use? Can we

learn from comparative studies of different countries? What is the impact

of different directions in drug policy? What policies have worked or not

worked with adult and juvenile drug offenders? Can research examine

drugs, crime, and public policy together? Can we find out from

policymakers and practitioners what decisions they need to make and

what questions they need to answer about drugs and crime? How can we

move drug policy analysis beyond econometrics (supply and demand, for

example) and begin to study drug use from the perspective of politics,

criminal justice, public health, and social work?



Methods of Studying Drugs and Crime



Research methods are dictated by the questions researchers ask. Some of

the questions already explored indicate that certain methodological

concerns might need to be addressed.



Attention to measurement and design. What are the best measures

currently available to study drug use and involvement in drug markets and

drug treatment? How can they be improved? How can we construct

integrated data collection measures? What is the best way to design

measures and procedures to evaluate drug control programs? What are the

best measures for assessing drug treatment outcomes? What is the role of

cost-benefit analysis in drug studies? What can we learn from longitudinal

studies about the long-term effects of drug use and abuse? How can we

introduce randomization to long-term studies of drug treatment? How can

statistical techniques developed by other sciences be adopted by the 

social sciences? How can we encourage multidisciplinary teams of

researchers to work together to study drugs and crime?



Ethnography. There is a long, distinguished tradition of ethnographic

research in the field of drug studies. Ethnographic studies, however, are

almost by definition limited to a single area or a small group of people.

What might we learn by secondary analyses of ethnographic studies?



What might we learn by replicating ethnographic studies in other

communities or among other groups of drug users? How useful might it be

to link ethnographic studies of community structure with studies of drug

users and dealers in their communities? What can we learn from studying

communities of sellers and users? Would it be useful to establish

prospective, qualitative field sites in various communities as a type of

surveillance system to monitor changing drugs and drug-use patterns?



Using available data and studies. How can we make better use of available

data to study drugs and crime? Are there obstacles to making better use of

available data to learn from them what we can? What can we learn from

meta-analyses of previously conducted research studies of drugs and

crime?



What Is In This Report?



Following this introduction are the three papers commissioned for the

forum and appendixes containing a summary of the forum proceedings, the

agenda, and a list of the names and organizational affiliations of the

participants.



Notes



1. International Association of Chiefs of Police, Reducing Crime by

Reducing Drug Abuse: A Manual for Police Chiefs and Sheriffs,

Gaithersburg, MD: International Association of Chiefs of Police,

1989:5.



2. See Tonry, M., and J.Q. Wilson, eds., Drugs and Crime, vol. 13 of

Crime and Justice: A Review of Research, Chicago: University of Chicago

Press, 1990; and R. Weisheit, ed., Drugs, Crime and the Criminal Justice

System, Cincinnati: Anderson Publishing, 1990.



3. See, for example, Forcier, M.W., "Substance Abuse, Crime and

Prison-Based Treatment," Sociological Practice Review 2 (1991):

123-131; Office of National Drug Control Policy, National

Drug Control Strategy--2000 Annual Report, Washington, DC: The White

House, 2000 (and earlier ONDCP annual reports); and Longshore, D., F.

Taxman, S. Turner, A. Harrell, T. Fain, and J. Byrne, "Operation Drug

TEST Evaluation," final report submitted to the National Institute of

Justice, U.S. Department of Justice, 2000 (grant 97-IJ-CX-0041).



4. Examples of studies that explored the nature of the drugs-crime

relationship in that period include Brownstein, H.H., and P.J. Goldstein,

"A Typology of Drug Related Homicides," in Weisheit, ed., Drugs, Crime

and the Criminal Justice System: 171-192; Chaiken, J.M., and M.R.

Chaiken, "Drugs and Predatory Crime," in Tonry and Wilson, eds.,

Drugs and Crime: 203-239; Fagan, J., "Intoxication and Aggression," in

Tonry and Wilson, eds., Drugs and Crime: 241-320; 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 (1989): 651-687; and Johnson, B.D., T. Williams, K.A.

Dei, and H. Sanabria, "Drug Abuse in the Inner City: Impact on Hard-Drug

Users and the Community," in Tonry and Wilson, eds., Drugs and Crime:

9-67. 



5. Arrestee Drug Abuse Monitoring, 1999 Annual Report on Drug Use

Among Adult and Juvenile Arrestees, Washington, DC: U.S. Department

of Justice, National Institute of Justice, June 2000 (NCJ 181426).



6. Goode, E., Between Politics and Reason--The Drug Legalization

Debate, New York: St. Martin's Press, 1997: 119.



7. See, Brownstein, H.H., "What Does 'Drug-Related' Mean? Reflections

on the Problem of Objectification," The Criminologist 18 (1993): 1, 5-7;

Chaiken and Chaiken, "Drugs and Predatory Crime," in Tonry and Wilson,

eds., Drugs and Crime: 203-239; Fagan, J., "Intoxication and Aggression,"

in Tonry and Wilson, eds., Drugs and Crime: 241-320; Goode, E.,

Between Politics and Reason--The Drug Legalization Debate; White,

H.R., and D.M. Gorman, "Dynamics of the Drug-Crime Relationship," in

G. LaFree, ed., The Nature of Crime: Continuity and Change, vol. 1 of

Criminal Justice 2000, Washington, DC: U.S. Department of Justice,

National Institute of Justice, July 2000 (NCJ 182408); and Wilson, J.Q.,

"Drugs and Crime," in Tonry and Wilson, eds., Drugs and Crime: 521-

545.



8. Office of Justice Programs, Office of Justice Programs Fiscal Year 2000

Program Plan: Resources for the Field, Washington, DC: U.S. Department

of Justice, Office of Justice Programs, 2000: 23 (NCJ 182238).



9. White and Gorman, "Dynamics of the Drug-Crime Relationship," in G.

LaFree, ed., The Nature of Crime: Continuity and Change: 193. 



10. Gandossy, R.P., J.R. Williams, J. Cohen, and H.J. Harwood, Drugs

and Crime: A Survey and Analysis of the Literature, Washington, DC:

U.S. Department of Justice, National Institute of Justice, 1980: xi (NCJ

159074).



11. Ibid.: 122. The survey covered five "crucial areas": patterns of drug use

and criminal behavior; "life cycle" characteristics (age of onset of drug use

and crime, for example); "economic issues" (price and supply/demand, for

example); treatment; and methods (sampling, for example).



12. Ibid.: 122.



13. These works are discussed in this report.



14. Goldstein, P., "The Drugs/Violence Nexus: A Tripartite Conceptual

Framework," Journal of Drug Issues 15 (1985): 493-506.



--------------------------------



AT THE INTERSECTION OF PUBLIC HEALTH AND CRIMINAL

JUSTICE RESEARCH ON DRUGS AND CRIME



James C. Anthony with Valerie Forman



About the Authors



James C. Anthony, Ph.D., is a professor in the Department of Mental

Hygiene at Johns Hopkins University. Valerie Forman is a National

Institute of Mental Health predoctoral fellow with the Psychiatric

Epidemiology Training Program at Johns Hopkins University.



Introduction



This paper discusses intersections of public health research and criminal

justice research on the topic of drugs and crime. The drugs of interest

mainly are marijuana, heroin, and other internationally regulated

compounds of illegal origin, and such internationally regulated products of

legal origin as pharmaceutical cocaine hydrochloride, codeine, and

oxycodone, which also may be consumed on an extraordinary basis (i.e.,

outside the bounds of accepted medical practice). An important point of

departure for this paper is a widely held assumption about two goals of

research on this topic. The first goal is to achieve greater understanding

and develop a body of definitive evidence on drugs and crime. The second

goal is to achieve greater mastery of the design and application of policies,

programs, and techniques to improve public health and public safety by

preventing and reducing harmful consequences of drug use. 



The outline for this paper corresponds with assignments delegated at a

planning meeting held at the National Institute of Justice (NIJ) in January

2001. This introductory section provides some background notes on the

literature reviewed for the paper and describes an organizing conceptual

framework that can be used to assess gaps in the current evidence. The

next section identifies some tensions that merit discussion as we try to

forge a new research agenda on drugs and crime. We then address the

central question posed in our planning meeting for the drugs-crime

research forum: "What do we know about the drugs-crime

interrelationship?" We cannot provide a comprehensive answer to this

question in a relatively short paper, but we will offer a starting point for

discussion, focusing on suspected causal relationships between drugs and

crime. We also present a few concluding statements that were designed to

facilitate discussion at the forum on drugs-crime research held at NIJ in

April 2001.



A Burgeoning Literature on a Variety of Fronts



A scholar interested in the topic of drugs and crime has much to read.

Some of the classics of the field include Terry and Pellens's The Opium

Problem (1928); early papers on drug taking and sociopathy by Kolb and

Pescor, who were two of the early clinical leaders in research at the facility

that ultimately became the National Institute on Drug Abuse's (NIDA's)

Intramural Research Program and Addiction Research Center; and work

by Dunham and Lindesmith, whose surprisingly contemporary remarks

and observations started to systematize some of the field's research

questions on the social psychology of the drugs-crime relationship.

Many of the issues that confront the drugs-crime researcher today were

articulated by Terry and Pellens (1928), Kolb (1925), Pescor (1939),

Dunham (Faris and Dunham, 1939), Lindesmith (1938), and their

contemporaries in the first half of the 20th century.



These issues were re-articulated and a new set of themes was clarified in

subsequent research, such as The Road to H investigations led by Chein

(1964), the work of Preble and Casey as described in "Taking Care of

Business--The Heroin User's Life on the Street" (1969), Cohen's

Delinquent Boys (1955), and Robins' Deviant Children Grown Up (1966).

Two of the most important emerging themes from this research offer a

challenge to conventional thinking about the drugs-crime relationship:



o There is no single drugs-crime relationship. Rather, there are

drugs-crime relationships, most of which are complex rather than simple.



o There is no simple solution to the complex challenges faced when

drugs-crime relationships come into play.



By way of illustration, Brownstein and Goldstein offered and refined a

tripartite conceptualization of drugs-crime relationships, which serves as a

useful guide to some of the surrounding issues. Within this tripartite

framework, one set of criminal offenses is described as

psychopharmacologically induced (e.g., responses to intoxication states

after drug taking). A second set of offenses is described as

economic-compulsive in nature (e.g., instrumental income-producing

criminal acts as needed to stave off symptoms of withdrawal states that

appear once drug use has stopped). A third set of offenses is described as

"systemic" and might be understood best as a consequence of a drug user

entering or living within a social context in which extraordinary drug use

is just one of a set of often intercorrelated criminal behaviors. That is,

we do not need an appeal to drug intoxication, drug withdrawal states, or

drug-induced compulsive behavior to account for offenses observed in this

third category (Goldstein, 1985; Brownstein and Goldstein, 1990).



The tripartite framework clarifies three separate types of drugs-crime

relationships, none of which is simple. As for analysis of simple solutions

for these complex problems, a therapeutically oriented drug maintenance

program might reduce the economic-compulsive type of offending without

influencing the occurrence of crimes determined by poor judgment or

other manifestations of intoxication states. A successful supply-side drug

eradication program might reduce both pharmacological and

economic-compulsive types of offending, but not offending of the

systemic variety. Imprisonment of the drug user within a drug-free prison

environment might extinguish today's crimes but might not influence

tomorrow's offending when the prisoner is released back to the home

community. Even if the prisoner remains drug free during the immediate

postrelease period, the history of incarceration and a criminal record

might constrain job opportunities and economic success to the point of

inducing crimes that otherwise would not have been committed if the drug

user never had been incarcerated in the first place.



Illuminated in this manner, the facets of multiple drugs-crime relationships

become more clear; new opportunities for research open up. As these

opportunities have been recognized, there has been a tremendous growth

in scholarship and research activity on the topic of drugs and crime (see

exhibit 1).



Scholars may benefit from an assembled listing or bibliography of this

literature, now available in electronic form as a technical report from the

Electronic Collaboratory for Investigations about Drugs at Johns Hopkins

University (Forman, 2001). Readers interested in a recent comprehensive

review of these publications can turn to the Harrison and

Backenheimer-edited issue of Substance Use & Misuse on the drugs-crime

nexus in the United States, which was published by Stanley Einstein and

Marcel Decker, Inc., in 1998.



A Conceptual Framework for Drugs-Crime Research



Confronting the accumulated body of evidence and new literature, we have

attempted to sort each element of evidence in relation to a conceptual

framework originally devised for the field of psychiatric epidemiology and

epidemiological research in general (Anthony and Van Etten, 1998). This

conceptual framework is used as we train public health scientists for

advanced research on drug dependence and related conditions. The

framework may prove to be useful in the domain of criminal justice

research as well, perhaps with suitable amendments by interested teachers

and scholars.



The rubrics. Early in their public health research training, we ask our

predoctoral and postdoctoral fellows to master the epidemiology of drug

dependence. Here, drug dependence is defined as a syndrome or "running

together" of clinical features, and sometimes is called drug addiction,

especially when the focus is on such clinical features as obsession-like

cravings and compulsion-like repetitive behaviors in which drug

taking is central. The clinical features of the drug dependence syndrome

include pharmacological tolerance, characteristic withdrawal signs and

symptoms, almost obsessional thinking about drugs and drug-related

behavior, and other observable mental, behavioral, and social adaptational

manifestations of neuroadaptational processes that get started and progress

with repeated drug taking.



This epidemiology of drug dependence is a subject matter to be mastered

by the public health research fellows, just as they master the concepts,

principles, and techniques used as methodological tools in the public

health sciences. Mastery of this subject matter begins with study of the

just-mentioned clinical features, the history of diagnostic criteria or case

definitions used in public health research on drug dependence, and what

has been learned about its neuroadaptational and genetic substrates. In

the process, research fellows learn of patterned variation in drug

dependence syndromes, some of which can be understood in relation to the

pharmacology and pharmacokinetics of different drugs, such as cocaine

versus heroin or methamphetamine versus oxycodone. Research fellows

also learn about different measurement techniques used in laboratory,

clinical, and field studies of the drug dependence syndromes. For example,

under certain conditions, an appropriate dose of a narcotic antagonist can

be used as a bioassay to check for the presence of dependence on heroin or

other opioid drugs (e.g., via precipitated withdrawal). Nonetheless, in

general, the measurements of drug dependence rely heavily on self-report

information obtained under specially protected confidential circumstances.

To the extent that subjectively felt experiences such as "craving" and

obsessional thinking about drugs are central clinical features for drug

dependence, we cannot substitute human urine, saliva, or sweat samples

for self-reports (Anthony, Neumark, and Van Etten, 2000).



Once issues of definition and measurement have been mastered, research

fellows move on to what we call the "rubrics" of epidemiology--its main

subheadings and associated research questions. These main rubrics and

primary associated research questions are displayed in exhibit 2.



Successful research fellows learn these rubrics and use them to master not

only the state of currently available evidence on each form of the drug

dependence syndrome, but also the current gaps in evidence and the

research concepts and tools needed to fill the gaps in evidence.



The relationship of each rubric to an associated set of research concepts

and tools sometimes helps to clarify and differentiate the rubrics. Links

between each rubric and corresponding research concepts and tools are

presented in exhibit 3.



Quantity. Under the rubric of quantity, the main associated research

question is How many in the population are becoming affected, have

become affected, and are now affected?" In this context, "becoming

affected" can refer to becoming a drug user, developing drug dependence,

initiating criminal behavior, or some combination thereof (e.g., see

Gfroerer and Brodsky, 1992; Kosterman et al., 2000; Golub and Johnson,

2001a).



As reflected in the published scientific literature and technical reports

made available by NIJ, the Substance Abuse and Mental Health Services

Administration, and other Federal agencies, a substantial fraction of the

Nation's research expenditures on drugs and crime is directed toward the

"report card" function of public health and criminal justice research under

the rubric of quantity. A recent National Research Council report (Manski

et al., 2001) tallied more than 60 Federal agencies with data systems

designed to keep track of estimates on the number of drug users in

households, among school-attending youths, among arrestees, among

patients seen in emergency rooms, and in various other segments of

American life.



On the U.S. Department of Health and Human Services (HHS) side, we

have the National Household Survey on Drug Abuse (NHSDA) with

growing national probability samples of adolescents and adults (now with

a sample size of more than 70,000 subjects per year); the Monitoring the

Future (MTF) study, which started as a way to track drug use among

graduating high school seniors through a national probability sample each

year and now encompasses 8th and 10th graders; and a less intensive but

more massive Centers for Disease Control and Prevention (CDC)

surveillance of drug use and other health risk behaviors of teenagers in

school. On the U.S. Department of Justice side, we have other ambitious

survey operations, such as the Arrestee Drug Abuse Monitoring (ADAM)

program (formerly Drug Use Forecasting [DUF]), which monitors drug

taking among arrestees through both self-reports and bioassay techniques,

and the National Crime Victimization Survey.



Evaluated as part of the public health and criminal justice research

enterprise, these substantial efforts may be understood best as examples of

surveillance operations. The label "surveillance" does not trivialize the

important work of the professionals and scientists whose daily labors, year

in and year out, yield the hard-won surveillance data. In fact, many of our

country's surveillance operations in this domain of inquiry truly are gems

and tend to be regarded as the best of the best in the world. In some

respects, they are the envy of the world. Nonetheless, by definition,

surveillance activities are designed with timeliness and practicality in

mind, sometimes with deliberate decisions to sacrifice validity of

measurement in favor of enhanced survey response rates.



For example, NHSDA, MTF, and the CDC survey all use self-report

methods to measure drug-taking and crime-related behavior (e.g., weapon

carrying). The option of bioassays to confirm self-report data now is

regarded as impractical or too costly for surveys on a mass population

scale, and there has been concern expressed that bioassays might reduce

survey participation rates below acceptable values. NIDA is engaging in

survey research experimentation with bioassays to complement self-report

data to assess practical questions of this type. In the meantime, serious

concerns have been expressed about the capacities of these data systems to

provide evidence for policy evaluation (see, e.g., Manski et al., 2001).

Nevertheless, evaluated from the standpoint of original plans for the data,

these criticisms are somewhat impertinent as surveillance indicators. The

criticisms are asking the surveillance operations to do far more than they

originally were designed to offer.



The first rubric of epidemiology also encompasses studies of birth cohorts

that are intended to estimate risks of adversity, plot trajectories of

normative development, or quantify important population characteristics

such as rates of officially recognized offending. The concept of a cohort

study is familiar to criminal justice researchers and public health scientists

alike. Prominent examples in the criminal justice research arena include

Robins' classic nonconcurrent cohort study of children seen by child

guidance workers in the early 20th century (1966), and the work of Tracy,

Wolfgang, and Figlio entitled Delinquency Careers in Two Birth

Cohorts (1990).



The fact that the rubric of quantity is mentioned first does not mean that

research under this rubric is easy or a methodological snap. Not at all.

From the standpoint of data gathering, those of us who have recruited,

trained, and supervised teams of 60 or more field worker-interviewers and

quality control staff for data entry, documentation, and management can

appreciate the operational challenges in surveillance work. From a

statistical vantage point, the nature of the surveillance operations often

includes interdependent observations within samples (e.g., sampled

students within samples of schools; sampled household residents within

neighborhoods; multiple respondents within sampled households,

emergency rooms, or criminal justice facilities). These interdependencies

motivate solutions that call on the calculus (e.g., in Taylor series

linearization for variance estimation). In some estimation applications,

there is a need for Bayesian statistics not yet taught widely in graduate

research training programs.



As to the importance of these "counting" operations, we may turn to a

recent research contribution by Cohen, who incorporated values from

these surveillance operations in his attempt to estimate the monetary value

of rescuing a high-risk youth from a life of delinquency, crime, and other

socially maladaptive behavior (1998). To complete this work, Cohen had

to turn to an array of previous results from counting operations that

ranged from the National Institute of Mental Health Epidemiologic

Catchment Area surveys we conducted in Baltimore during the early 1980s

with colleagues at four other university-based sites to work that Blumstein

and his group completed to estimate basic parameters of criminal justice

research, e.g., an estimated 6 percent of all boys account for more than half

of all arrests (Blumstein et al., 1986). 



There can be little doubt that investigators in the drugs-crime arena should

be interested in Cohen's conclusions about varying programmatic

investments and the monetary returns from programs to intervene with

high-risk youths. Nevertheless, it is somewhat startling to know that

Cohen had to turn back to counting evidence gathered in the early 1980s

and before to produce estimates to be used for policy and programmatic

decisions almost two decades later. These quantitative estimates are not

Avogadro's number; rather, they are values expected to change over time,

if not from place to place. If we value probing quantitative criminological

research exemplified by Cohen's work, then we must ensure that the

drugs-crime research agenda includes periodic repetition of surveys to

yield the required estimates.



Studying the accumulated evidence on the drugs-crime relationship, we

have been able to sort much of it into the rubric of quantity. Quite clearly,

NIJ and NIDA now make a considerable investment in the basic counting

tasks required to estimate and quantify such parameters as how many

adult arrestees and juvenile offenders are taking drugs each year. Each

repetition of these surveillance operations provides evidence on variation

in the estimates from time to time and from place to place. The study of

this type of variation falls under the second rubric, which is called

location.



Location. Our second rubric is location, and the main associated research

question is "Where in the population are affected individuals more or less

likely to be found, with variation in occurrence and frequency

differentiated by characteristics of time, place, and person?" On occasion,

work under this rubric is guided by theory, but more often the research has

a more descriptive character.



James et al. (2002) provide an illustration of the nature of research and

evidence about location. The research team set out to plot geographic

variation in the occurrence of drug purchase opportunities experienced by

young adults in the United States. In this figure, a "drug purchase

opportunity," a special form of drug-related crime opportunity, is

measured by a survey response to a standardized assessment in interviews

conducted for NHSDA. As depicted in exhibit 4, and substantiated with a

univariate response regression model for description, there is variation in

the occurrence of these drug purchase opportunities across locational

regions of the country and for young men versus young women. In this

context, the statistical methods are not intended to probe the causes of the

observed variation from place to place, nor the observed male-female

differences. Rather, the methods are used simply to help quantify the

uncertainty in the survey-based estimates and substantiate the presence of

variation from place to place and the male-female differences (James et al.,

2002).



This illustration is useful because it reminds us that location refers not

only to geographic variation but also to variation in relation to

individual-level characteristics (e.g., sex, age, socioeconomic status,

ethnicity). For example, Fendrich et al. (1995) studied juvenile and older

murderers to understand varying degrees of drug involvement in murder.

Locational research also plots temporal changes, as illustrated in a recent

NIJ report on the possibility of new marijuana epidemics, to be described

below (Golub and Johnson, 2001b).



Estimates of the consistency of association between drug use and various

arrest and criminal behavior types also serve to illustrate analyses

focused on location within population experience: Crime was found to be

more common among drug users than among nondrug users. As Harrison

and Gfroerer (1992) make clear in their NHSDA analyses on this topic, the

research questions they were trying to answer concerned the number of

drug users, the number of individuals engaged in criminal behavior, and

the overlap in these numbers. With respect to location, their work clarified

the proportion of drug users who were engaged in criminal behavior and

the prevalence of criminal behavior in relation to drug use. As is true in

the work of James et al., these investigators did not draw on the apparatus

of causal inference, matching, or other scientific maneuvers to disentangle

whether the criminal behavior was a response to the drug use or vice versa.

Nonetheless, taking a step beyond studies of officially recognized crimes,

arrestees, and convicted criminals, Harrison and Gfroerer helped confirm

links between drugs and criminal behavior, but they did not seek to

produce definitive evidence about the causes of drug use or criminal

behavior.



Much of our current research enterprise at the interface of drugs and crime

has this type of descriptive character. Substantial HHS investments in the

MTF study and NHSDA already have been mentioned. On the NIJ side,

we call on ADAM to help clarify variation in the occurrence of drug use

among arrestees across multiple jurisdictions, not only in the United States

but also overseas. For the most part, we do not require these investments

to yield definitive evidence that might be central in causal inference.

Nonetheless, the evidence from these studies helps to describe the location

of drug taking, criminal behavior, and the intersections of these behaviors,

and sometimes to describe or predict the co-occurring and separate

patterns of drug use and criminal behavior.



Analyses conducted under this rubric without a special push toward causal

inference can be especially important in identifying hot spots within

geocoded areas as well as health disparities that might differentially fall on

one or another racial or ethnic minority group. Here, it is a predictive as

well as a descriptive purpose that can be achieved. However, when the

task is to predict and not to explain, there is no special calling for the

methods required for firm causal inferences, as depicted in exhibit 3.



Within the drugs-crime arena, there are many different examples of

surveillance operations under the rubric of location, such as we can see

in recent work by Golub and Johnson (2001b) in which they used

DUF/ADAM data as evidence to advance their claims about a new and

possibly expanding epidemic of marijuana use in the United States. True

to the descriptive character of locational research, Golub and Johnson

present evidence of the new and possibly expanding epidemic among

offenders in some areas (e.g., Atlanta) and evidence of no epidemic in

other areas (e.g., Miami), but they do not seek to explain why there should

be an epidemic in one place but not in another. Because these data are

from incarcerated individuals, an important set of complications arises in

their interpretation. One suspects that the observed time trends and

variation from place to place might reflect operations of local police

departments as much or more than it reflects any underlying change in the

dynamics of marijuana epidemiology.



This rubric of location also encompasses studies in which the investigators

may be striving toward causal explanation, but they fall short, often

demonstrated in a shift toward the language of "prediction" and away from

the language of "explanation." Two different hypothetical concluding

statements can illustrate this point. When the research team falls short of

its goal, the researchers may summarize their work by saying something

like "Based on this study's evidence, the level of drug use in early

adolescence predicted later delinquency and criminal behavior in the

young adult years." A different verb is selected for the alternative, stronger

form of concluding statement: "Based on this study's evidence, the levels

of delinquency and criminal behavior in the young adult years depend on

levels of drug use in early adolescence." 



As the focus shifts from description or prediction toward explanation and

causal inference, we move from the rubric of location to the third rubric of

causes. The shift in focus calls into play a new set of research concepts,

principles, and tools, as outlined in exhibit 3.



Many scholars will appreciate that a single study may contribute evidence

under several rubrics at once. For example, the periodic reports of

NHSDA, MTF, and ADAM routinely present evidence that falls under the

rubric of quantity as well as the rubric of location. Rarely, the authors of

these reports seek to make causal inferences from their surveillance data.



The yield of a study often is not clear at the outset or in the stages of study

planning, and the study orientation to theory is not always a discriminating

feature. Some theory-based studies have started as investigations of causes

but have ended up making contributions solely in the domains of

prediction and description. Other atheoretic studies end up making useful

contributions in our studies of cause. Consider the first conclusive study

on the topic of age-related risk of Down syndrome (DS) and associated

mental retardation, completed some 50 years ago. The investigators sought

to plot the risk of DS by the age of the mother at the time of delivery. An

exponential increase in risk after age 40 was clear in the first graphs. We

still do not know what causes the chromosomal trisomies that give rise to

DS, nor do we know why these trisomies and DS are more common when

older mothers give birth. But even in the absence of firm causal theory and

evidence, it has been possible to reduce the occurrence of DS in human

populations by encouraging mothers to bear their children before age 40.

Hence, a strictly descriptive study provoked an effective intervention to

reduce the occurrence of an important genetic condition.



It is regrettable that our studies of disparities affecting racially and

ethnically defined subgroups of the American population generally fall

under the rubric of location, as do our studies of the changing dynamics of

household and family composition in the United States. For example, we

now can say with some certainty that African-American males experience

rates of arrest, prosecution, and incarceration for drug possession offenses

that cannot be explained by their rates of drug taking, but we do not have

good evidence on the causes of this racial disparity. Initial inquiries

suggest differential law enforcement and judicial practices, which

sometimes encompass racial profiling, but rigorous scientific evidence

on these practices is scarce.



With respect to the dynamics of household and family composition, the

phenomena of youthful drug taking and related criminal offending have

links back to the families of origin, now often characterized by absence or

infrequent appearance of the father in many of our population groups.

This is not to say that female-headed households are homogeneous or

uniformly deleterious with respect to socially maladaptive behavior of

young people. It would be a mistake to presume that the traditional

mother-father household always and in all contexts is more protective than

a female-headed household with respect to the risk of youthful drug taking

or delinquent behavior (e.g., see Chilcoat, 1992). Mothers often mobilize

family resources or draw on assets that in some measure may help

compensate for absent fathers (e.g., by involving grandparents, neighbors,

church groups), as described by Kellam, Ensminger, and Turner (1977),

Pearson et al. (1990), and others.



A research agenda on race, ethnicity, and family or household composition

can be motivated by an awareness that the drugs-crime relationships will

depend to some extent on demographic trends. Against the backdrop of

demographic trends such as these, including an increased prominence of

Hispanic children and families in the United States, it will be important to

sustain the research agenda in the domain of locational variations of this

type. Important steps in this direction have been taken in the Federal

agencies responsible for surveillance of drug-related behaviors, including

increased attention to measurement of ethnic self-identification (e.g.,

with respect to Cuban origin, Puerto Rican origin, and other subgroups of

the Hispanic population; with respect to Chinese origin, Samoan origin,

and other subgroups within the Asian-Pacific Islander category). Similar

attention is required in criminal justice research such as ADAM and

I-ADAM (International ADAM) and in administrative statistics compiled

on operations of the criminal justice system in this country.



Whereas the human genome project is challenging conventional views

about "race" as a scientific concept, studies on self-identified

race-ethnicity will have a sustained importance in the NIJ-NIDA research

agenda on the topic of drugs and crime. 



This evaluation of importance can be grounded in an awareness of the

demographic trends described above, but it also draws on an appreciation

of what studies of self-identified race-ethnicity may teach us about the

influence of cultural contexts and socially learned behaviors with respect

to drug taking and criminal behavior. 



Finally, a note on ethnographic studies should be added here. In general,

the sample size and "sample space" characteristics of these studies do not

make ethnography an especially fertile discipline with respect to the first

rubric of quantity, except when the characteristic under study has

extremely limited dispersion. For anyone who looks to ethnographic

studies for quantitative values, there often are some unanswerable

questions about generalizability and precision of the study estimates. In

some respects, ethnography might be characterized as a search for the

boundaries of no variation in a socially shared human characteristic.



This is not to say that ethnography is barren when it comes to quantitative

data. To the contrary, the small scale of ethnographic research makes it

possible for ethnographers to shift directions more quickly than is possible

in ordinary surveillance operations. As a result, ethnographic field workers

helped in the early identification of crack cocaine, methamphetamine, and

oxycodone outbreaks--years before these outbreaks could be identified in

large-sample surveillance data.



Under the rubric of location, ethnographic field workers were among the

first to note inner-city adolescents whose drug taking started with

marijuana rather than with the more normative experiences with alcohol

and tobacco. They also were the first to characterize a growing use of

"blunts"--tobacco cigars hollowed out and filled with marijuana for a

combined tobacco-marijuana intoxication (Golub and Johnson, 1999). In a

recent round of observations, there is a suggestion that for some youths,

the typical "gateway" drugs have been skipped--an example of subgroup

variation in the more typical developmental sequences running through

alcohol, tobacco, and marijuana to drugs such as heroin, stimulants, and

hallucinogens. Large-sample epidemiological surveillance data now seem

to confirm the initial ethnographic observations on this topic (e.g., see

Golub and Johnson, 1999; Golub and Johnson, 2001a).



One of the reasons ethnographic research is important under the rubric of

location is that it can open our eyes to new conceptions of time, place, and

personal characteristics that impinge on the drugs-crime relationship.

These ethnographic studies are especially useful in descriptions of the

cultural context and socially learned behaviors described above. Their

evidence can add depth and insight to otherwise superficially understood

intersections of drug taking and criminal behavior.



Causes. The third rubric of epidemiology pertains to the study of causes

and draws on the research apparatus required for causal inference (exhibit

2). On occasion, this research apparatus can be quite simple in concept.

For example, a relatively small sample of monozygotic (MZ) twins

discordant for an important outcome is sufficient to provide definitive

evidence about environment with respect to the causes of that outcome.

These MZ twins are genetically matched: If they are discordant for

outcome, one may look for gene-environment interactions, but more often

one looks for differences in environmental conditions in utero (e.g.,

dichorionic versus monochorionic sacs), perinatally (e.g., insults at the

time of delivery), or in later development (e.g., head trauma for one twin

but not the other during infancy or childhood). The National Institutes of

Health (NIH) investment in recent twin research to estimate heritability of

different forms of drug use now generally is paying off in two ways:



o Each study is indicating at least some degree of heritability of drug

dependence, and sometimes heritability of drug use, especially legal drug

use (e.g., tobacco). 



o Each study is indicating ample room for gene-environment interaction

or for influence of environmental conditions and processes. 



These results from causal research help substantiate a case for a future

research agenda on the genetic sources of variation and on environmental

modulation of these genetic sources of variation.



Randomized trials with relatively simple structure also can be used to

probe causal hypotheses with definitive results. For example, these trials

may offer our best avenues toward definitive evidence on whether

cessation of illegal drug use is followed by reductions or elimination in

criminal behavior. An alternative is to nest the study of causes within a

more expanded agenda of systems research on drugs-crime relationships

(Manski et al., 2001). To the extent that systems research entails a finely

detailed specification of mechanisms that link events and processes within

a system, this type of research falls more clearly under the rubric of

mechanisms, as described below.



Outside of the simplicity of research on discordant MZ twins and

randomized controlled trials, a complex apparatus of study design and

statistical method is required to extract definitive evidence in research on

drugs-crime relationships. Given the importance of inferences about

causes in the drugs-crime relationship, it may be understandable that

graduate research training programs have become increasingly

methodological in their orientations.



It may be appropriate to discuss the potential contribution of ethnographic

research in relation to the causes of the drugs-crime relationship. To

date, most ethnographic research on drugs and crime has been descriptive

in character. It has provided leads for more probing causal investigations,

but it has not produced definitive evidence on the links between drugs and

crime. In this respect, ethnography's contribution may be most important

under the rubric of location. Before anyone could mobilize large-sample

surveillance operations to study the new drugs-crime phenomena

connected with crack cocaine (e.g., crack and prostitution), it was possible

for ethnographers to move in and make headway. To some extent,

ethnographers have been pioneers in research on methamphetamine and

club drugs such as MDMA (Ecstasy), and we can expect more of the same

in relation to our first new drugs-crime outbreaks of the 21st century,

which involve sustained release oxycodone.



An NIJ-NIDA investment in ethnographic research on drugs-crime

relationships of this type will continue to be important--if only to help us

begin to understand the unusually circumscribed geographic distributions

of methamphetamine and oxycodone use in the United States and the

patterns of criminal behavior associated with use of these drugs.

Ethnography can be used to produce a catalog of causal explanations for

methamphetamine's emergence as a threat to public health and public

safety in rural sectors of the American Midwest and for oxycodone's

emergence in small cities and towns of the Appalachian mountain range,

especially from West Virginia southward. It is not clear that ethnography

or any other scientific field will be capable of producing definitive

evidence about specific explanations in this catalog of causes.

Nonetheless, there is value and importance in the attempt to do so, and

ethnographers can bring rigor and scientific discipline to this process of

investigating these causes. The alternative seems to be to leave these

investigations to the field of journalism.



Mechanisms. Within epidemiology generally, mechanisms refer to

linkages of states and processes that lead toward expressions in clinical

features of health and illness or disease. As applied to the drugs-crime

relationship, one might ask about the mechanisms of linked states and

processes leading to or away from an association between illegal drug use

and criminal behavior.



For an illustration of these mechanisms, one may turn to the coercive

process and deviancy training models introduced in the work of Patterson

and Dishion. Their Oregon Boys study has provided longitudinal evidence

on what surely must be central linkages in the mechanisms underlying

drugs-crime relationships (e.g., see Patterson, Dishion, and Yoerger 2000).

For example, studying these school-based samples of boys through ages

17-18, and using standardized coding of a 30-minute free

discussion-interaction between best friends, they found substantial

over-time correlation of deviant friendship process (e.g., duration of

rule-breaking talk bouts as coded from videotape). Dishion also has

reported on a link from initial drug use to increased affiliation with deviant

peers and onward to initiation of criminal behavior that is more consistent

with the delinquency-to-drugs link that emerged in the longitudinal

research of Johnston and colleagues based on MTF analyses published

more than 20 years ago (Dishion et al., 1996; Johnston, O'Malley, and

Eveland, 1978), as well as on more recent studies (e.g., Elliott and

Huizinga, 1989).



The use of multiwave longitudinal study designs to probe into suspected

causal mechanisms is well known in both public health and criminal

justice research circles. The Alcohol, Drug Abuse, and Mental Health

Administration (the precursor to SAMHSA), and more recently NIH and

OJJDP have maintained support for a series of important longitudinal

studies over the years (e.g., see the work of Jessor and Jessor, Kellam and

Ensminger, Block and Block, McCord, Bachman, Kandel, Robins,

Elliott and Huizinga, Hawkins and Catalano, and many other studies of

this type, as listed in compendiums such as Verdonik and Sherrod, 1984).

Advantages of long-term investment in these longitudinal studies can be

seen in the research articles from many of the research projects with

multiwave assessments, for example, the Pittsburgh Youth Study (e.g.,

Loeber et al., 1998), the Denver Youth Study, and the Rochester Youth

Development Study (Loeber et al., 1999); and the research groups led by

the Brooks, Newcomb, and Bentler (e.g., see Brook et al., 1996, Brook et

al., 2000; Newcomb and Bentler, 1988; Newcomb 1992).



One of the questions in the design of an agenda for future research on

drugs and crime is how the evidence from large- and medium-sized

samples from longitudinal studies of this type might be linked with

evidence from the generally much smaller intensive studies of cases. Until

there is consensus about effective interventions to disrupt the drugs-crime

relationship, possibilities for a linkage exist through the concept of natural

history.



In the history of medicine and medical research, the first natural historians

of disease were clinicians and clinically oriented observers who made

careful observations at the bedside of patients, in the absence of effective

interventions. They watched, measured as best they could (e.g., body

temperature), and described change in relation to the passage of time from

the first recognition of clinical features. Within the realm of drugs and

crime research, ethnographers and social scientists generally have taken

over the responsibilities of careful clinical observers in relation to illegal

drug use and criminal behavior. During the last 50 years, thanks to the

work of Robins (1966), Winick (1962), Preble and Casey (1969), Agar

(1973), Waldorf (1998), Nurco (Nurco et al., 1975, 1996; Nurco, 1998),

and their successors, we have learned much about the natural history of

drug use, drug dependence, and associated criminal behavior through

ethnographic and social science research. 



The natural history of a disease proves to be an important element under

the rubric of mechanisms. In the past, a careful description of a disease's

natural history often has guided investigators toward underlying causal

mechanisms.



In the years before effective drug treatments, Winick and others drew

attention to the maturing out process for drug addicts, and there is a

parallel literature on maturing out with respect to criminal behavior in

general (Winick, 1963). The maturing out process continues to be an

important locus for new research on the drugs-crime relationship.



Other clues about causal mechanisms are being produced in observational

and longitudinal studies of individual cases or families characterized by

some feature of the drugs-crime relationship. For example, we have

Dunlap's intensive studies of families in which one of the members is a

crack cocaine dealer (Dunlap and Johnson, 1996; Dunlap, Johnson, and

Manwar, 1994); research such as Spunt's study of adolescent offenders

with a history of violent crime (Spunt et al., 1990), Longshore's linkage of

DUF and California Bureau of Criminal Statistics data (Longshore 2000),

and the earlier related studies started by Hser, Anglin, and McGlothlin

(1987); and investigations led by Inciardi, Johnson, and Goldstein or

members of their research groups (e.g., see Inciardi and Russe, 1977;

Inciardi 1990; Inciardi and Pottieger, 1998; Johnson, Dunlap, and Maher,

1998; Goldstein 1998; Spunt et al., 1990, 1994, 1995).



Several interesting elaborations of these intensive case studies have

developed in the realm of criminal justice research. For example, Logan

(2001) has added bioassays for metabolites of the neurotransmitter

serotonin as well as testosterone assays as part of his intensive followup

studies of crack users. This example serves to illustrate a potential

intersection of public health and criminal justice research that should be

explored in more depth as we work through a future agenda for research

on drugs and crime.



A conceptual shuttling back and forth between these intensive smaller

sample studies and the generally larger sample longitudinal studies would

seem to have advantages for investigators who work in one or another of

these arenas, and there are a few investigators who conduct both types of

studies (e.g., see Dishion and Loeber, 1985; Dishion, Patterson, and Reid,

1988; Dishion et al., 1996). This type of bridgework between the

microsocial and ethnographic research traditions and large-scale

longitudinal sample research deserves to be a deliberate focal point on the

future drugs-crime research agenda. This focal point is important because

the study of causal mechanisms and processes can draw attention to

potentially vulnerable links where new interventions might be directed.



In epidemiology generally, the focus of research on causal mechanisms is

shifting to genes and encoded gene products, as displayed in our most

recently emerging subspecialties of genetic epidemiology and molecular

epidemiology. To some extent, Elliott has a head start in a potential

cross-fertilization between criminal justice research, genetic epidemiology,

and molecular epidemiology. He already has introduced harvesting of

DNA samples in the context of his national longitudinal study (Elliott,

2001). Opportunities for case-control studies and other genetically

informative designs, including whole genome scans nested in a

case-cohort study design, will become possible as this research evolves.

Eventually, this type of work should lead us toward more definitive

evidence on causal mechanisms underlying the drugs-crime relationship,

including gene-environment interactions.



It is possible to make a forecast of likely integrations of genetic research,

cognitive sciences, and the more traditional disciplines of behavioral and

social sciences for a future agenda for NIJ and NIDA research on

drugs-crime relationships. For example, exhibits 5-7 represent an

elaboration of conceptual models our research group has developed as an

aid to our study of transitions from drug use to drug dependence. Exhibit 5

expresses a suspected causal influence of drug use on criminal behavior. It

also expresses a separate influence of drug dependence on criminal

behavior. These two specifications are consistent with the

Goldstein-Brownstein distinctions between drug-related crimes that

might arise from acute drug intoxication states versus crimes that are

rooted in the economic-compulsive behavior of an individual who suffers

withdrawal states as a result of sustained drug use and neuroadaptation.

There are many law-abiding drug dependent individuals who do not

commit crimes, even when they are suffering from withdrawal pains.

Hence, exhibit 5 includes a speculative causal pathway that runs directly

from withdrawal to the occurrence of criminal behavior, over and above

the separately specified role of the drug dependence syndrome for which

withdrawal serves as a manifest indicator.



We speculate that an individual's genome can contribute to the

drugs-crime relationship in different ways. Exhibit 5 concentrates on a

possibility that some genetic polymorphisms or mutations may be

intercorrelated manifestations of an underlying diathesis or vulnerability to

make the transition into drug dependence from a state of nondependent

drug taking, as reflected in pathway 1. It also specifies a possibility that a

specific polymorphism (or mutation) has an additional influence on this

transition, as reflected in pathway 2. As indicated by pathway 3, we may

hope for development of effective intervention techniques that can disrupt

what otherwise might be an expression of the diathesis. If effective, these

interventions will slow or disrupt the natural history of drug dependence at

a step in the process that links nondependent drug taking and the

subsequent transition into drug dependence. This effect of intervention, by

itself, may be sufficient to alter the drugs-crime relationships depicted to

the right of the exhibit.



The potential role of the cognitive sciences is expressed in the

intermediate pathways that link nondependent drug taking and drug

dependence to later criminal behavior. Here, aggression may be

conceptualized in a generic sense as rowdy misbehavior or social

maladaptation secondary to drug taking, which can occur with or without

criminal behavior. Executive dysfunction refers to impairments in the

cognitive processes that subserve human capacity to plan, direct, and

control one's future behavior within adaptational boundaries and may

encompass more generalized planning behavior (e.g., see Tolman,

Edleson, and Fendrich, 1996).



As depicted in exhibit 5, during states of acute drug intoxication, there

may be a release of aggressive behavior and a disruption of regulatory

executive functions. As levels of drug dependence increase, levels of

aggressive behavior can change in an upward or downward direction and

executive dysfunctions can occur. The complexity of interrelationships

between aggression and executive dysfunction is reflected in the reciprocal

causal paths between these two constructs. Increased executive

dysfunction translates as inept decisionmaking about aggression and the

subjective utility functions that govern decisions about whether to commit

a crime. As part of generally adaptive fight-flight responses and

modulation of monoamine neurotransmitter signaling pathways during

bouts of aggression, there can be a cascade of executive dysfunctions:

Mere rowdiness can be transformed into aggravated assault.



To be sure, exhibit 5 is only a model that represents little more than an

oversimplified representation of the complexities that link an individual's

genome with cognition and behavior. Models by definition are

oversimplified representations. It is fair to ask whether the model requires

additional specifications, such as the possibility that religious convictions

might tend to modulate the relationship between drug taking and

aggression or criminal behavior. In this oversimplification, exhibit 5 does

not convey all such possibilities. These possibilities for elaboration of the

longitudinal model should help the reader understand some of the

complexities faced in observational studies of causal mechanisms that

account for observed drugs-crime relationships.



Exhibit 6 presents even more simplification to sharpen focus on the

drugs-crime relationship specifically. The genetically based diathesis and

other covariates of exhibit 5 are set into the background (i.e., presumed to

exist but not explicitly depicted). In exhibit 6, we see a readily appreciated

reciprocity between the level of drug taking and the level of drug

dependence: (a) the more drug taking, the more we find increased drug

dependence levels, and (b) the more drug dependence, the more we find

increased levels of drug taking. We also see the level of criminal behavior

expressed as a function of levels of drug taking and drug dependence, as

shown in exhibit 5. An additional elaboration involves the longitudinality

of this model. We have levels of criminal behavior at one point in time

influencing levels of criminal behavior at future points in time, but in

exhibit 6, we do not specify a link from levels of criminal behavior to

subsequent drug taking or drug dependence levels. At least in theory, and

in some prior suggestive evidence, this omission represents a potentially

important misspecification of our model for the drugs-crime relationship

(e.g., see Johnson et al., 1995).



Exhibit 7 adds a level of complexity to the model depicted in exhibit 6 and

poses a substantive question for the agenda of action research: "How

might an intervention lead to change in this system of interrelationships?"

We introduce the possibility that social status (e.g., status in the

community, socioeconomic status, lawful income) depends on criminal

behavior and also on the level of drug dependence, and that criminal

behavior influences the subsequent level of drug dependence by its

intermediate influence on social status. The model depicted in this exhibit

also provides for a plausible link from the level of drug dependence to

subsequent criminal behavior. Namely, as drug dependence increases and

social status (e.g., lawful income) falls short, criminal behavior may

increase (as in the Goldstein-Brownstein tripartite model). In addition,

subsequent levels of drug dependence may be influenced by the changes in

social status, either upward or downward.



The model in exhibit 7 also introduces a conglomerate concept of

"assortative peering," expressing a well-known truism: "birds of a feather

flock together." The occurrence of drug taking is linked to later formation

of peer group relationships, as is the occurrence of criminal behavior. To

some extent, we can say that past drug use and past criminal behavior

influence current peer group affiliations, and to some extent, we can say

that past peer group affiliations influence future drug use and future

criminal behavior. These complexities are expressed by hypothesized

causal paths in exhibit 7.



Conceptual models of this type are incomplete representations of the

causal mechanisms that lie beneath observed drugs-crime relationships, yet

they are elaborations of the Goldstein-Brownstein tripartite model.

Nonetheless, most readers will agree that these representations are

oversimplified. If they have value, it is to highlight some future directions

for the joint NIJ-NIDA research agenda on drugs-crime relationships. 



We do not yet have a longitudinal research program to investigate the

relatively simple model of interrelationships between levels of drug use,

drug dependence, and criminal behavior as depicted in exhibit 6, let alone

the more complex model of exhibit 7, with its sociological construct of

social status and the social-psychological construct of affiliation with

behaviorally similar peers (assortative peering, homophily, etc.).

Fortunately, there already is a cadre of criminologists and drug researchers

who are trained in sociology and social psychology and can readily

incorporate the biomedical and clinical concepts of drug dependence into

their research plans, if supported to do so.



It will be more difficult to forge a research agenda that integrates the

genetics research and cognitive sciences constructs depicted in exhibit 5.

For the most part, genetics and cognitive sciences are unknown territories

for most NIJ and NIDA investigators who have made important

contributions in past research on the drugs-crime relationships. For most

drugs-crime researchers, it would not be difficult to integrate concepts and

measurements of aggressive behavior and the clinical syndrome of drug

dependence within their existing research plans. Far more difficulty will

be encountered during the process of integrating genetics and the

neuropsychological and neurophysiological measurements of the cognitive

sciences. 



We can learn a lot about the drugs-crime relationship simply by replicating

and refining important longitudinal research on drugs-crime relationships

that was initiated during the second half of the 20th century. Many of these

longitudinal studies have cohorts that still are intact, and followup studies

are now underway to learn more as these cohorts mature into adolescence

and make the transitions into young and middle adulthood. There are

mountains of data from 20th-century studies that have not yet been fully

exploited through careful analysis.



Nonetheless, as we look forward through the next decades of research, the

NIJ-NIDA agenda must go beyond what has developed as the best

20th-century research on the drugs-crime relationship. Ten decades from

now, if we are to leave the 21st century with an enhanced understanding of

the drugs-crime relationship and with a greater capacity for effective

action to improve public health and safety in this domain, we cannot

continue to work within the narrow paradigms and methodologies of the

traditional scientific disciplines mastered by drugs-crime investigators

of the 20th century. If we are successful, then in a few decades, the

biomedical, genetic, and cognitive science substrates of the drugs-crime

relationship will no longer be a matter of mere speculation, as depicted in

exhibits 5 and 7. There will be definitive evidence, solid understanding,

and effective action-plans based on what we learn from the pioneers who

move into that now-unexplored territory.



Prevention and control. The long-term value of research on causal

mechanisms depends on identifying potentially vulnerable linkages in the

sequence of states and processes that lead to illegal drug use and criminal

behavior. It may go without saying that increasingly definitive evidence

about causes and causal mechanisms will help us achieve our goals in the

domain of effective prevention and control. Nonetheless, a reminder may

be useful with respect to a dynamic interrelationship between etiological

studies (of causes) and the emergence of effective interventions. As

illustrated in the circumstance of DS and maternal age, with limited

evidence on the underlying causal mechanisms of DS, by manipulating

maternal age we have a very effective instrument to prevent and reduce the

risk of DS. As explained in our original paper on the rubrics of

epidemiology, many effective public health preventive interventions

emerged before firm knowledge about causes and causal mechanisms

became available (Anthony and Van Etten, 1998).



A related concept involves the use of randomized preventive trials to

provide increasingly definitive evidence about suspected causal

relationships. Some readers of this paper will know of work that Kellam

and our Johns Hopkins research team have completed, using randomized

field trials to probe the interrelationship between early aggressive and

rule-breaking behavior and later drug involvement among boys (e.g.,

Kellam and Anthony, 1998). In essence, we decided that more

observational research on the link from early aggression or deviance and

later drug use would be less important than an experimental test. Within

the framework of a randomized field trial, we tried to and succeeded

in reducing aggressive and deviant behavior of first-graders using an

experimental intervention assigned at random. For the boys assigned to

experimental intervention, we have found later reduced occurrence of drug

involvement, and we have replicated these results in a second cohort of

first graders (Kellam and Anthony, 1998). More replications along these

lines are needed before anyone can claim that early aggression or deviance

is a "cause" of later drug use, but this experimentation illustrates how

experimental research in the domain of prevention and control can yield

benefits in the form of improved evidence to test causal theories. This idea

is not new. Hawkins, Catalano, Offord, and others have noted it as well

(e.g., Hawkins, Von Cleve, and Catalano, 1991; Hawkins, Catalano, and

Miller, 1992; Jones and Offord, 1989). But it is an idea that often is

overlooked by investigators more interested in theory testing and who

orient themselves toward goal 1, described in this paper's first paragraph.

Under the fifth rubric, we try to orient the research to serve both goal 1

and goal 2.



Because elements of this rubric of prevention and control are being

covered in the companion papers that accompany this working manuscript,

I will close this section more quickly than might be customary. Before

doing so, I would like to mention the contributions of operations research

and systems research in this domain, which often have been neglected in

epidemiology. Over the years, the thoughtful and quantitatively sharp

work of Blumstein and colleagues has continued to inspire an important

line of research on prevention and control that is pertinent to the

drugs-crime relationship. Although I am not confident about all of the data

or assumptions of the underlying analysis approaches, I have been

especially impressed by the directions taken by Blumstein colleagues

Caulkins and Cohen in this regard.



For example, Cohen (1998) discusses potential synergy of programs and

distinguishes the aggregate benefits of programs designed to reduce

crime versus the sum of the benefits of individual programs. It is possible

that no single program would help city residents feel safe enough to derive

lifestyle-related expenditure benefits (e.g., walking a mile through a rough

neighborhood versus taking a taxicab because of concerns about safety).

Combinations of programs might do so. This distinction ties into the

concept of marginal costs versus average costs associated with drug-using

and delinquent youths or criminals, where the marginal costs exclude fear

of crime and private security expenditures because these costs are largely

unaffected by any one criminal's actions.



Caulkins and his colleagues developed a challenging line of systems

research that can ultimately yield new ideas and evidence about policy

instruments in relation to the drugs-crime relationship. The evolution of

this work toward selection of policies and programmatic instruments at

different stages of a drug-taking epidemic is especially important

(Caulkins, Crawford, and Reuter, 1993; Behrens et al., 1999). 



A Selective Overview of Tensions Faced in Research on Drugs and Crime



Numerous tensions are faced at the intersection of public health and

criminal justice research on the drugs-crime relationship. This section

identifies and describes a selection of these tensions, and in some

instances recommendations are offered for NIJ and NIDA action to help

resolve the tensions.



Tensions in Theoretical Perspectives, Concept, and Definition



Heterogeneity at the intersections of public health and criminal justice

research is not limited to differences of opinions and judgment about

empirical observations, the inferences we can draw from these

observations, and the uses to which we apply the observations (e.g., cost

analyses of alternative programs). There are some fundamental tensions

within and across theoretical perspectives and also approach.



The concept of scale. Ecologists work with a concept of scale that may

help us understand some of the tensions mentioned above and may serve

as an axis of orientation as we turn to future directions for research (e.g.,

see Brown, 1995; Wiens et al., 1986). As a concept, scale resonates with

what educational researchers and behavioral and social scientists often

have termed multilevel or hierarchical models, as in Ennett's and the

Duncans' research with young people nested within ecological niches of

higher order such as classrooms, schools, or families (e.g., see Ennett

et al., 1997; Duncan et al., 1997; Duncan, Duncan, and Hops, 1998) and

our own research group's nesting of individual drug users and collections

of drug users in their neighborhoods of residence (e.g., Bobashev and

Anthony, 1998; Petronis and Anthony, 2000). Parker and Toth (1990) also

have appealed to related macro versus micro concepts in their research on

alcohol and homicide, as have Patterson and colleagues in their research

on peer groups (Patterson, Dishion, and Yoerger, 2000). Bronfenbrenner's

ecological systems theory for human developmental research slices scale

into macro, meso, and micro divisions that many investigators have found

useful (Bronfenbrenner, 1979, 1986).



Although not with any direct reference to a formal ecological concept of

scale, we can see resonance of this concept in Markowitz and Grossman's

studies of taxes and regulations on alcohol and their hypothesized effects

on criminal behavior (Markowitz and Grossman, 2000), the research of

Caulkins and colleagues on national drug policy and programmatic

initiatives (e.g., Behrens et al., 2001), and Holder's research on preventive

interventions directed toward communities in the United States (Holder

1993, 2001; Holder et al., 1999, 2000). Scale is worked outward from the

individual organism in the direction of larger social groups, organizations,

and geopolitical units. In public health and criminal justice research, we

often refer to pre-established institutional or geopolitical boundaries

(schools, census tracts, nations) when we work at higher scale. In ecology,

mathematical models and methods such as advanced wavelet analysis are

used to allow the empirical data to inform scale--as in research on

landscape ecology (Anthony and Bradshaw, 2001).



Some tensions arise in research when investigators ignore scale in their

theoretical perspectives or empirical research reports. For example, most

of us work within a conceptual framework that leads us to comprehend

estimates of the drugs-crime relationship without reference to scale.

However, one should expect the drugs-crime relationship to be of one

order of magnitude when we are investigating individuals who all reside in

the same local area (e.g., as in much of the ethnographic research on the

drugs-crime nexus), a different order of magnitude when we work with

individuals and data from multiple neighborhoods, but with matching on

neighborhood in the analysis, and a different order of magnitude when our

data are from individuals across the Nation, with no analytical attention to

who lives near whom, except perhaps during the process of estimating

variances for confidence limits and standard errors (e.g., see Bobashev and

Anthony, 1998). 



Although not clearly within the scope of the original ecological concept of

scale, an investigator may work inward from the boundaries of the whole

organism toward subunits, ultimately leading to the signaling pathways

between neurons, messenger systems originating from genetic material,

and the simplest proteins and the encoding genes themselves. This

elaboration of the concept of scale creates yet another tension, in part

because the concepts of genetics and signaling pathways for

neurotransmission are more familiar in the public health research

community but are not yet in the mainstream of graduate or postdoctoral

research training in the criminal justice research community. To illustrate,

when I have talked with my criminal justice research colleagues about

Elliott's inclusion of DNA assays in the most recent waves of his National

Youth Survey, many of them have asked, "Why?" To be sure, some

skeptical behavioral genetics colleagues also have asked, "Why?" but this

is an instance in which the same verbal behavior has origins in

substantially different theoretical models. My point is that tension can

arise when concepts of scale are not made explicit.



Some of the work at the intersections of public health and criminal justice

research will be to make our concepts of scale explicit. In some respects,

this will be more readily accomplished as we work from the whole

organism outward, and the task may be more difficult as we try to integrate

molecular biology, genetics, and neuroscience into our discussions.

Nonetheless, this hard work will be essential as we make a 21st-century

science of drugs-crime relationships.



Orienting definitions and constructs. The literature also displays

considerable heterogeneity in orienting definitions and constructs. On the

public health side, there often has been an orientation toward drug use and

drug dependence or addiction as useful constructs in their own right. One

orientation often has been called the "medical model," but it amounts to

little more than an analysis of empirical syndromes (i.e., co-occurring

manifestations of the neuroadaptational processes that get started when

drug use begins, followed by a cascade of secondary and tertiary

adaptations, some of them occurring in the domain of social adaptational

roles and responsibilities). In a later section of this paper, I will return to

this syndrome concept. On the criminal justice side, drug use and the drug

problems associated with drug use often are treated as if they are not

interesting in their own right but are something akin to interchangeable

observable manifestations of something else that is more fundamental,

such as the "problem behavior syndrome" construct first elucidated by

Jessor and Jessor (1977) some 30 years ago. A more recent version of this

concept is a general deviance construct used by Scheier, Botvin, and others

in empirical studies (e.g., see Scheier and Botvin, 1996), and there also is a

recent respecification of the Jessor and Jessor model, with elaborations

that encompass the epidemiological concepts of risk factors and protective

factors (Jessor, 1998).



The literature also shows heterogeneity in the typologies of criminal

behavior or social maladaptation. Notions of childhood conduct disorder

followed by Antisocial Personality Disorder appear prominently in some

formulations, but are absent elsewhere (Loeber and Schmaling, 1985;

Stevens, Kaplan, and Bauer, 2001; Langbehn and Cadoret, 2001).



These definitions and constructs in our theoretical perspectives demand

work at the intersection of public health and criminal justice research. If

we cannot bridge these different approaches or marry them to produce

adaptive offspring, they will prove to be an unending source of unresolved

tension with implications for research progress. Unresolved tensions slow

down our progress in research that depends on a peer review process,

whether the peer review occurs at the stage of reviewing proposals or of

vetting journal articles.



At NIJ and NIDA, an important part of the research agenda can be a series

of meetings or technical workshops. The charge to workshop participants

is to bridge these orienting concepts and definitions across disciplines or

create an articulation between concepts that will accelerate research 

progress on drugs-crime relationships rather than slow it down.



Orienting conceptual frameworks and theories. The originating biomedical

branches of public health research sometimes take theory as a given or

work with theory in the background when there are emergent problems of

human suffering and disease to be solved. For example, the important

20th-century line of investigations required to identify lung cancer as an

adverse consequence of tobacco smoking was guided more by implicit 

concepts of carcinogenesis secondary to tobacco smoking. Strongly

articulated, explicit theories, if any, would have been mis-specified and

incomplete in that they could not possibly have incorporated the

postsmoking DNA adducts, protein adducts, and gene-encoded

metabolizing enzymes now prominent in the models of carcinogenesis. In

criminal justice research, true to its origins in the social and behavioral

sciences, the theoretical underpinnings are made more explicit (e.g., see

Thornberry, 1997; Kaplan, 1995). One might say that without explicit

theory, the research in this domain stands little chance in peer review, no

matter how important the empirical contribution.



This is another source of tension at the intersections of and sometimes

within the domains of public health and criminal justice research. In

Public Health Service study sections, I have seen study section members

be less than enthusiastic about proposed epidemiological research on drug

use and Antisocial Personality Disorder because the applicants had not

oriented themselves to the major theories of deviance well known in

criminal justice circles: "inadequate conceptual model" is the phrase that

comes to mind. I also have observed major differences of opinion about

scientific priority among experts in the criminal justice and social science

world, some of whom are comfortable with "psychologizing" constructs

within their theories (e.g., the self-derogation models developed by

Kaplan), and others who are more focused on constructs with a behavior

analytic origin (e.g., coercive process and deviancy training models

developed by Patterson, Dishion, and their research groups in Oregon).



Tension in relation to theoretical models has been readily apparent in this

NIJ-NIDA collaboration, which has offered a chance to step back and look

over a broad expanse of scientific progress in public health and criminal

justice research on the drugs-crime association. This broad perspective

creates germs of ideas that might be useful in a synthesis or integration of

various theoretical perspectives that range from the disciplines of

molecular or behavioral genetics to those of econometrics and the other

social sciences. However, there clearly is diversity and tension even within

fields as narrow as behavior genetics, where some work is oriented toward

developmental family processes (e.g., as advanced in the recent work of

Neiderhiser and colleagues), and other work is not (e.g., see Neiderhiser et

al., 1998, 1999; Neiderhiser, 2001; Brennan, Mednick, and Jacobsen,

1996; Tehrani et al., 1998; Kotler et al., 1999).



These tensions surface most clearly in debate and discussion of an

intersection of genetics research and studies of the drugs-crime

relationship. Many investigators from social science backgrounds are

hesitant to take part in discussions of genetics, gene expression, and

mechanisms of inheritance that might account for covariation of

drug-taking behavior and criminal offending. This hesitation can be traced

in part back to serious and important concerns about ethical issues,

eugenics, and the like. Some of the hesitation can be traced back to a gap

in graduate education: Graduates of social science training programs often

have not mastered the basics of human biology and genetics.



Looking from a different perspective, an observer can see other sources of

tension in relation to conceptual framework and theories. Graduates of

human biology and genetics programs often have not mastered the basics

of behavioral and social sciences research.



The intersection of the Human Genome Project, gene expression, and

proteomics with research on drugs-crime relationships merits close

attention at NIDA and NIJ. To some extent, this intersection can be

cultivated in a gradual process of shaping new investigators. NIDA's peer

review of its portfolio of research training programs and individual career

development awards can specify requirements for cross-discipline mastery.

On one side, new social science investigators can be required to master the

basics of human biology and genetics. On the other side, new human

biology and genetics investigators can be required to master the basics of

behavioral and social sciences.



NIDA already is sponsoring a series of training workshops for new

investigators to expose them to the different disciplines that now

contribute to its research mission. The initial workshops have focused on

epidemiology, pharmacology, and neuroscience and introduced

participants to those fields. Future workshops are planned, with a broad

agenda that cuts across the behavioral and social sciences, including

ethnography and behavior genetics, as well as domains of medical sciences

such as proteomics, drug development, and NIDA's clinical trials network.



Sustained investment in research education of these types will be needed at

NIJ and NIDA. Without attention to pharmacology, neuroscience, and

pharmacogenetics, it will be difficult for future investigators to develop a

fundamental understanding of the pharmacological and

economic-compulsive categories of offending in the Goldstein-Brownstein

tripartite conceptual framework. Without grounding in the social sciences,

it will be difficult for them to develop a fundamental understanding of the

systemic categories.



There now are investigators who can bridge the gaps that appear as

canyons between disciplines. Elliott's attempt to articulate his work with

the NIH human genetics initiative provides one example. In a primate lab

run by Steve Suomi at NIH, research on gene-environment interactions as

substrates of aggressive behavior, social maladaptation, and drug use

provides another example. This research is especially useful because the

environmental conditions experimentally manipulated in this lab have

conceptual linkages back to the deviancy training, inept parenting, and

parent-infant relationship models developed by Patterson, Dishion, Brook,

and others (Higley et al., 1996a, 1996b; Higley, Suomi, and Linnoila,

1996a, 1996b; Patterson, Dishion, and Yoerger, 2000; Dishion et al., 1996;

Brook et al., 1996; Brook, Tseng, and Cohen, 1996).



More examples of this type of bridgework are emerging from the work of

the research pioneers who try to keep pace with evolving contributions

from the NIH Human Genome Project. The NIJ-NIDA research agenda

can be enriched by a technical report series that brings examples of this

type to the community of investigators and research trainees.



Tension That Involves Approach or Methods



Review of the drugs-crime literature creates an opportunity for developing

new insights about the sometimes different approaches and methods that

have been developed in public health and criminal justice research work

groups. For example, ethnography with small groups has expanded to

almost large-sample ethnographic research that bears some resemblance to

large-sample survey research, but in many ways is different. To an

outsider, this expansion is a puzzle to be solved and has not yet been

grasped. In the public health research domain, the original role of an

ethnographer bore some resemblance to the role of the medical practitioner

as a student of the natural history of disease. The original natural history

studies were intensive case studies, with the doctor at the bedside of

individual sick patients making careful systematic observations about this

individual case and then that individual case, in the days when there might

have been symptom palliation (e.g., cold cloths for fever), but no effective

curative interventions to change the clinical course of disease. This has

some resonance with Agar's concepts of the ethnographer's attention to the

details of behavior and verbal expression and of writing the narrative and

taking down the stories of drug users in their own words (Agar, 1973). The

link from this role of the ethnographer to large-sample ethnography

remains unclear.



Measurement methods pioneered in behavioral sciences research and

introduced to studies of drug taking by Larson, Kaplan, and Schiffman

have started to surface in criminal justice research as well. Experience

Sampling Methods (ESM), originally developed to study the daily lives of

high school students, have now been introduced in research on drug use

(e.g., see Csikzentmihalyi and Larson, 1987, 1992). Their ESM procedure

requires study participants to wear an electronic pager device that beeps at

randomly scheduled intervals, signaling the participant to record some

predetermined aspects of his or her present feelings, activities, and/or

surrounding environmental conditions. Usually, dozens of self-reports are

collected over a week or more to capture as much of participants' daily

living as possible. One advantage of this method is the ability of the

researcher to examine drug use specific to each individual, given the

assessment of his or her baseline characteristics for comparison. An

additional benefit is the possibility of taking into account measured social

context of the behavior (e.g., see Farnworth, 2000). ESM also creates new

opportunities to investigate the determinants of drug-taking behavior that

might be unique to each individual and each situation (e.g., see Kaplan and

Lambert, 1995). 



These evolving ESM procedures require a number of conditions if

reliability and validity are to be enhanced. Kaplan and Lambert (1995)

identified the following prerequisites: having a favorable and trusting

relationship between study participants and researchers, ensuring complete

confidentiality of responses, meeting labor or equipment and programming

costs associated with beeping the participants several times per day, and

addressing difficulties faced when the participants are illiterate or

challenged by technology. 



Several recent studies of delinquent and antisocial behavior may help

clarify the utility of ESM procedures in research on the drugs-crime

relationship. For example, Farnworth (2000) studied a group of young

Australian offenders on probation and found that these respondents were

engaged in such productive activities as employment or education an

estimated 10 percent of the time. Compared with reference norms for

Australian adolescents, offenders spent 30 percent more time on passive

leisure activities. An estimated 42 percent of the time, offenders on

probation reported being bored, while 62 percent of the time they were

involved in unchallenging activities. The use of ESM to integrate studies

of drug-taking and criminal behaviors will provide new and important

evidence on relationships that generally have been studied via

retrospective reconstruction of behavior over long spans of developmental

time.



On another measurement front, there is a related tension that involves the

use of bioassay methods to study recent and past drug taking. Wish has

been a pioneer in the use of these methods for research on arrestees, and

recent studies by Harrison and Fendrich are extending this reach into

general household population samples of the type surveyed for the

National Household Survey on Drug Abuse (Wish, 1988; Yacoubian,

Wish, and Perez, 2001; Fendrich, 2001; Harrison, 2001). In future

research, one may anticipate these differences in approach to sustain a

tension until a general consensus has evolved.



With respect to approach in the domain of statistical methodology,

computational advances have contributed to an acceleration of innovation.

There is a resulting air of optimism for what might be accomplished, as in

the domains of longitudinal latent transition modeling, multilevel or nested

models, approaches to nonignorable missing data, and alternative methods

of research on directed acyclic pathways with mediation versus cyclical

pathways with reciprocities. At the same time, there is a tension because

these new statistical approaches have not become integrated in most

research training programs, and there remains certain skepticism about

heavily modeled data. 



Limitations on numeracy keep many of us from probing the assumptions

of complex models, whether these are models of behavior in individual

studies, econometric models, or operations and systems research models to

probe alternative program and policy decisions. Tension may be inevitable

in the face of such complexities.



Tension Involving Research Ethics



NIJ can play an important role in relation to investigations that probe

drugs-crime relationships. At present, a good part of the NIJ role has been

ceded to HHS and its new Office of Human Research Protections (OHRP).

True to its origins in NIH, OHRP is oriented toward the standards of

experimental medical intervention research (e.g., randomized trials to test

safety and efficacy of new drugs). OHRP specifications for informed

consent procedures and disclosure statements share this orientation.



Many behavioral and social sciences researchers have expressed concern

that the standards and specifications of experimental medical research

are not appropriate for studies of the drugs-crime relationship. For

example, in ethnographic and observational survey research, different

specifications for informed consent procedures and disclosure statements

are required. 



NIJ officials can initiate a useful dialogue with OHRP on this important

research topic. Perhaps more than any other government agency, NIJ can

help to stimulate a dialogue and negotiate a reorientation of current

practices in a manner that fosters new and creative research on the

drugs-crime relationship without a lapse in research ethics or slippage in

the protection of human subjects in this research.



Outside the Federal Government, researchers now face increasingly thorny

challenges in the protection of their research participants and the assurance

of confidentiality in relation to research data. For example, research that

includes assessments of tobacco smoking now requires special handling as

a result of legal action by the tobacco industry. These requirements

apparently extend to criminal justice research in which tobacco smoking is

approached as a self-reported indicator of deviance. The integration of

molecular biology and genetics into these research agendas, and even the

introduction of experience sampling methods or bioassays for drug testing,

raise new questions in the domain of research ethics, some of which have

been scrutinized in randomized experimental designs. These challenges

deserve the close attention of these research communities, with OHRP and

its NIJ counterpart in suitable roles.



Does Drug Use Cause Crime? A Focal Point



Each author of working papers for the drugs-crime research forum was

asked to identify a circumscribed set of research issues and probe what we

really know about them. Mindful of other sections to be written, we have

been able to organize these research issues in relation to a single focal

point, expressed in the question, "Does drug use cause crime?" One

advantage of this specific focal point is that it has a broad range and can

encompass many different strands of evidence developed in public health

and criminal justice research. Another advantage is that it is a crucial open

question for research on crime and drugs. As characterized by Harrison

and Backenheimer (1998), "Research has not been able to validate a causal

link between drug use and criminal behavior."



When confronted with an etiological research question such as "Does drug

use cause crime?," a public health scientist typically might turn to a

20th-century elaboration of the 19th century Henle-Koch postulates or

conditions for judging whether a specific disease might be caused by

specific bacteria. For a time, this 20th-century elaboration was known as

Hill's postulates (after Sir Austin Bradford Hill, a medical statistician)

and also as Evans's postulates (after A.S. Evans, an epidemiologist; Evans,

1976; Hill, 1965). Today, students of epidemiology learn them as criteria

for judging whether an association is causal or guidelines for evaluating

the evidence of a causal relationship, together with an analysis of the

relative strengths and weaknesses of evidence from randomized trials,

prospective and longitudinal studies, retrospective studies, and

case-control comparisons. Exhibit 8 presents these criteria and guidelines.



Before reviewing these criteria, four clarifications may be in order. First,

the criteria for evaluating causal significance of observed associations

represent standards of scientific evidence that are substantially different

from the standards used to judge causal evidence in civil and criminal

proceedings. For some segments of this paper's readership, the question,

"Does drug use cause crime?" may sound silly: "Of course drug use causes

crime. My grandmother could tell you that." (This was the type of reaction

TV/radio personality Rush Limbaugh gave to some of the early work that

Howard Chilcoat, Tom Dishion, and I published on the topic of whether

inner-city mothers and fathers might be able to help protect their children

against risk of early-onset drug use if they maintained levels of parental

vigilance generally associated with good parental supervision and

monitoring.)



Our response to these gentle readers is to beg forbearance. Of course, some

of what our grandparents learned to be true is not true, and the analysis of

responsibility for negligent or criminal acts in the individual case (as in a

court of law) necessarily has a different set of standards of evidence. For

example, evidence beyond a reasonable doubt is not the same as the

definitive evidence referenced in the first paragraph of this paper.



Our second clarification is that we acknowledge a possibility that

delinquent or criminal behavior might be a cause of drug use, the

chicken-egg problem referenced by Inciardi and advanced with evidence

by others. This possibility surfaces when one considers earlier sociological

models of deviance (e.g., Sutherland, Matza) or later sociopsychological

developmental models for youthful deviance, antisocial behavior, and

delinquency, such as the coercive interaction and deviancy training models

introduced by Patterson, Dishion, and colleagues; Coie and his colleagues

at Duke; and Kaplan at Texas A&M University (e.g., see Patterson, Reid,

and Dishion, 1992; Patterson, Dishion, and Yoerger, 2000; Dishion et al.,

1996; Coie and Lenox, 1994; Sandstrom and Coie, 1999; Bagwell et al.,

2000; Hubbard et al., 2001; Kaplan, 1995). For example, minor rule

violations in early childhood, well before the years of starting drug use,

might be followed by general peer rejection, differential association or

affiliation with other rejected and deviant peers, and subsequent

group-fostered delinquency and norm violations, including illegal drug

use. We note that this possibility, and the more advanced idea of

reciprocities between drug use and criminal behavior, do not necessarily

undermine inferences about drug use as a cause of crime. We face a

problem of slightly different conformation in our research on drug

dependence: The use of a drug is an absolutely necessary but not sufficient

condition for development of clinical syndromes of drug dependence, but

once the drug dependence process has started, the drug dependence takes

on a life of its own and becomes a determining influence for subsequent

drug use (i.e., drug use causes drug dependence, and then drug dependence

causes drug use).



Our third clarification is to ask first whether it is plausible that there is no

association between drug use and crime or criminal behavior or whether

there might be an inverse association (the more crime, the less drug use).

In our review of available evidence, we must acknowledge the possibility

that in some subsegments of human experience, there well may be a

negative association between drug use and criminal behavior (e.g., in the

highly disciplined and controlled environments of industrial espionage),

just as we must acknowledge the fact that some 90-year-olds have smoked

a pack or more of tobacco cigarettes virtually each day of adult life and

have not developed lung cancer. We also acknowledge the high probability

that in certain times and places or in certain subsegments of population

experience, there is no association between drug use and criminal behavior

(e.g., see Blum and Associates' studies of clinicians and professionals who

used LSD before it was regulated by the Food and Drug Administration;

Blum and Associates, 1964).



Notwithstanding these exceptional circumstances, there is a generally

consistent overall pattern of positive and sometimes quite strong

associations between illegal drug use and criminal behavior of other types.

These associations are observed not only in samples of offenders in the

criminal justice system (e.g., DUF and ADAM), but also in general

household population samples. This evidence has some vulnerability due

to constraints on methods (e.g., refusals by study participants to give

informed consent for participation), but recent consistent evidence from

general population surveys indicates that the observed association extends

beyond officially recognized crimes and does not suffer the transition bias

that is present in DUF, ADAM, and other criminal justice samples (e.g.,

perhaps the arrested or incarcerated offenders were caught because of

impairments from drug use, or the drug use of an offender is a

manifestation of a more general characteristic of carelessness that might

lead more readily to apprehension by the authorities).



Fourth, a "cloud of confusion" sometimes descends when people begin

talking about causes and causation. We will try to be clear. Although we

are asking whether drug use causes crime, we are not saying that there are

no other causes of crime. This issue sometimes is subject to

misinterpretation. For this reason, it might be more sensible to express the

question in a different way: "Under what conditions, if any, does criminal

behavior, as a response variable, depend in any substantive way on drug

use, such that we might be able to shape criminal behavior by shaping

drug use?" This question is not as pithy as, "Does drug use cause crime?"

but it might help us escape the cloud of confusion when we try to review

available evidence pertinent to this issue of causal inference.



Criterion/Guideline 1: Temporal Relationship



If illegal drug use is believed to be a cause of criminal behavior, then we

require evidence that illegal drug use has preceded the onset of that

criminal behavior. Judgments about this criterion or guideline can become

difficult when there are potential reciprocities. For example, when

sustained medicinal use of phenacetin and acetaminophen compounds

(e.g., Tylenol, Datril) was being investigated as a cause of interstitial

nephritis and end-stage renal disease (ESRD), one of the complications

was the possibility that the earliest clinical features of ESRD include

headaches. Of course, headaches can promote the sustained use of

pain-relieving medicines, including the acetaminophen compounds.



The drugs-crime relationship presents this type of temporal complexity, as

was seen in exhibits 6 and 7. Earlier aggression, conduct problems, and

criminal behavior may function as a direct cause of illegal drug use (e.g.,

see Kellam and Anthony, 1998), and possibly as an indirect cause (e.g., by

promoting affiliation with other delinquent and drug-using peers). Earlier

drug use also may function to promote later growth of conduct problems

or criminal behavior (e.g., see Johnson et al., 1995).



Criterion/Guideline 2: Biological or Other Theoretical Plausibility



Carrying books of matches is associated with the risk of developing lung

cancer, tends to precede rather than follow the onset of lung cancer, and

has at least a moderately strong association with lung cancer. However,

except with respect to the associated characteristic of tobacco smoking, we

have no biological or other theoretical plausibility to link carrying matches

per se with the etiology of lung cancer. Even if the matches-cancer

association were to withstand the challenges posed by the other criteria for

evaluating causal significance of an association, we would be inclined to

ask about the underlying theory and its plausibility and coherence in

relation to known relationships and facts.



The tripartite model for the drugs-crime nexus represents a substantiation

of plausible causal links from illegal drug use to criminal behavior. Other

related strands in the fabric of plausibility have been mentioned (e.g.,

differential crime opportunity, differential association).



The plausibility of a link between drug use and aggressive or violent

crimes rests to some extent on neuroscience theory and observed

clinico-pathological associations, as in contemporary thinking about

cocaine's influence on limbic-hypothalamic substrates of aggression

(Davis, 1996). In addition, there is a line of preclinical and clinical

laboratory experiments that has helped to solidify the plausibility of a

link from drug use to aggressive or violent behavior, and possibly to the

types of norm violations associated with nonviolent crime. The evidence

on links from the use of psychostimulant drugs (e.g., methamphetamine,

cocaine) and aggression is noteworthy in this respect. Administration of

cocaine to hamsters during adolescence increased the number of bites and

attacks indicative of a surge of offensive aggression (Harrison et al.,

2000). Moore and Thompson (1978), studying pigeons, found that high

doses of cocaine elicited aggressive behavior. In some species, increased

levels of aggression also have been observed with the administration of

amphetamine stimulant drug--not only when a large single dose (e.g.,

Melega et al., 1997), but also after sustained lower doses (Haber, Barchas,

and Barchas, 1981) are administered. These psychostimulants also may

increase the risk of self-directed aggression (e.g., see Peffer-Smith et. al.,

1983).



Experimental laboratory research with human subjects also has produced

supportive evidence along these lines, often with computerized

point-subtraction methods used to evoke aggression after the drug has

been administered and under control (no drug) conditions. For example,

Licata et al. (1993) administered a high dose, low dose, and no dose of

cocaine and found that subjects in the high-dose group expressed

significantly