Criminal activity appears reduced during opiate maintenance treatment
MedWire News: Opiate maintenance treatment (OMT) reduces criminal activity among heroin addicts, suggest results from a Norwegian study.
"Heroin users are found to have high levels of criminal activity, especially related to income-generating crime," write Anne Bukten (University of Oslo) and team in Addiction. "The reduction or elimination of crime is an important aspect of OMT, and observational studies have shown that maintenance treatment reduces levels of criminal activity among heroin users."
In this study, the researchers investigated the changes in criminal involvement over 7 years that encompassed four treatment phases: pretreatment, in-treatment, between treatments, and post-treatment.
Data from 3221 patients (67.6% men and 32.4% women) starting OMT between 1998 and 2003 were analyzed in terms of criminal records.
The criminal records included in this analysis were only those that resulted in formal conviction in a court of law.
A total of 4222 convictions were identified among 717 patients during the pretreatment period of the cohort, the majority of which were for acquisitive crime (54.2%) and for the sale and distribution of narcotics (23.5%). Of these patients with convictions, 72 were in the 'high-conviction group' as they had 11.5 to 57.0 convictions per person-year, and the remaining 645 were in the 'medium-conviction group' (0.2 to 11.4 convictions per person-year).
The researchers found that the rate of criminal convictions during treatment (incidence rate [IR]=0.63) was less than half that of pretreatment levels (IR=1.57).
Patients in continuous treatment had the fewest convictions (IR=0.47) and patients with the highest conviction rates (IR=1.52) were those who were out of treatment after several treatment episodes. Staying in OMT for 2 years or more was associated with significantly reduced rates of convictions during treatment.
Bukten and colleagues say that past investigations into the financial savings associated with OMT "found clear economic benefits of treating drug users," which could mainly be attributed to the reduced crime and reduced victim cost of crime.
"The considerable reduction in criminal convictions following OMT in Norway is of significance and provides immediate benefits to society… It is important to both identify and to have a particular focus on patients in risk of dropping out of treatment," conclude the researchers.
By Chloe McIvor