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The rapid rise in opioid use has recently contributed to several pressing concerns, including an unprecedented number of fatal overdoses, a marked increase in treatment admissions, a spike in emergency department visits, and a significant proportion of adults who test positive for opioids at the time of arrest. The majority of arrestees who test positive for opioids after being booked into jail also report prior engagement with a substance use treatment program, highlighting the need to address posttreatment substance use and involvement in the criminal justice system. The current study was conducted to untangle the posttreatment substance use–arrest relationship and better understand how one may influence the other. Analyses conducted with 396 adults, drawn from a nationwide sample of patients seeking treatment for opioid use disorder, demonstrated that posttreatment arrest increased the likelihood of substance use, but the evidence suggested that this relationship was not reciprocal. These results have significant implications for criminal justice practices with regard to using alternatives to arrest as methods to minimize posttreatment substance use.

Despite the value of accurately identifying inmates with substance use disorders, little attention has been given to response bias in routine screening. Although individuals with likely substance use disorders are contributing to overcrowding and increased incarceration costs in correctional systems, a lack of accurate routine screening precludes the efficient implementation of programs to address these conditions and thereby reduce criminal recidivism. This study explored the accuracy of inmates' responses on an addiction screen used during standard classification procedures in a county jail. The UNCOPE screen for addictions, validated on arrestee and prison populations, was used to determine risk for substance dependence. Results indicated that inmates significantly underreported their substance use issues on the addiction screen when administered by a correctional officer, but were much more candid when interviewed by an individual not identified as a law enforcement or correctional officer. Recommendations for accurate routine screening are provided.

The link between drug use and crime has been broadly described, but little detail is known about the contributions of alcohol and drug dependence to different types of offending. Data were drawn from the 2010 Arrestee Drug Abuse Monitoring II (ADAM II) program to examine the relationships between dependence, offense type, and severity among recent male arrestees ( N = 3,006). A substantial proportion (ranging from 15% to 39%) of arrestees across all offense types and severity levels endorsed drug-dependent items. Smaller proportions (between 5% and 16%) of arrestees endorsed alcohol-dependent items. Drug dependence was associated with higher odds of receiving felony charges and higher probability of being charged with a substance-related offense. Alcohol dependence was associated with lower odds of felony charges, but greater probability of being charged with a violent offense. Assessment and treatment provisions need to be systematically implemented to reduce these types of offenses.