Types of Criminal Legal System Exposure and Polysubstance Use: Prevalence and Correlates among U.S. Adults in the National Survey on Drug Use and Health, 2015-2019

• Published in: Drug and alcohol dependence 2022-08, Vol.237, p.109511-109511, Article 109511
• Main Authors: Ford, Jason A., Ortiz, Kasim, Schepis, Ty S., McCabe, Sean Esteban
• Format: Article
• Language: English
• Subjects: Adult; Adults; arrest; Arrests; Crime; criminal legal system exposure; Criminals; Demography; Drug abuse; Drug Overdose; Drug use; Epidemiology; Ethnicity; Exposure; Health risks; Heterogeneity; Humans; Legal system; Marital status; Mental health; Multiple drugs; Overdose; Overdoses; Parole; Parole & probation; Polls & surveys; polysubstance use; Prevalence; Prisoners; probation; Probation service; Substance use; Substance use disorder; Substance-Related Disorders - epidemiology; Suicidal ideation; Suicide; Surveys
• ISSN: 0376-8716; 1879-0046
• DOI: 10.1016/j.drugalcdep.2022.109511

Criminal legal system (CLS) exposed adults experience higher rates of substance use, substance use disorder (SUD), and overdose. As most CLS exposed adults are not incarcerated, it is important to focus on CLS exposure across the carceral continuum. This research used pooled data from adult respondents (N=206,314) in the National Survey on Drug Use and Health (2015-2019). Survey weighted descriptive statistics and Poisson regression were used to estimate prevalence of polysubstance use (i.e., concurrent use) across CLS exposure types (i.e., arrest, probation, parole), identifying relevant correlates. The prevalence of polysubstance use was higher among CLS exposed adults, and nearly two-thirds of CLS exposed adults who used multiple types of substances indicated having an SUD. Comparing CLS exposure types, polysubstance use was less likely among adults on probation (IRR=0.89, 95%CI=0.84,0.94) or parole (IRR=0.82, 95%CI=0.76,0.87) compared to those arrested. Polysubstance use was also more likely among adults on probation (IRR=1.09, 95%CI =1.01,1.17) compared to those on parole. While some characteristics (i.e., age, ethnicity, SUD) were consistently associated with polysubstance use across types of CLS exposure, other characteristics (i.e., sexual identity, marital status, suicidal ideation) were not. There is heterogeneity in health risks as a function of CLS exposure type. Further research is needed to identify causal mechanisms and differences based on demographic characteristics. Given high levels of polysubstance use across CLS exposure types, a shift towards a more comprehensive approach in substance use epidemiology may facilitate building an evidence-base to maximize treatment related interventions to reduce polysubstance-involved overdoses. •Polysubstance use is common among justice-involved adults.•Multiple substance use disorders are more common among justice-involved adults.•Adults with a past-year arrest have the highest rates of polysubstance use.•Adults on parole have the highest rates of multiple substance use disorders.•Age, sexual identity, and marital status are associated with polysubstance use.