Effects of Pharmacotherapies for Opioid Dependence on Participants' Criminal Behaviour and Expenditure on Illicit Drugs: An Australian National Evaluation (NEPOD)

Data regarding criminal behaviour and expenditure on illicit drugs by 300 methadone patients and 997 heroin users who participated in the Australian National Evaluation of Pharmacotherapies for Opioid Dependence (NEPOD) were analysed to measure the effects of pharmacotherapy and to identify predictor variables. At baseline, more heroin users than methadone patients reported recent involvement in any crime (39%, 13% respectively), and in each of four subtypes of crime (property, drug dealing, fraud, violence). Heroin users spent more on heroin than methadone patients (means of $3148, $617 in the past month, respectively). Younger age at first use of heroin was associated with higher reported levels of all four crime types, males reported more drug dealing and violent crime than females, lower employment status was associated with more property crime and drug dealing, lower educational status was associated with more property crime, and younger participants reported more violent crime. For participants who were heroin users at baseline and who were still in treatment at 3 months, mean monthly expenditure on heroin dropped from $2345 to $230. Involvement in any crime dropped from 39% to 20%, and also dropped in three of the four crime subtypes. There were no significant differences between the effects of methadone, buprenorphine, LAAM, and naltrexone treatment on criminal behaviour or expenditure on most types of illicit drug, although the pharmacotherapies did differ in terms of their effects on heroin expenditure. Improving treatment retention and expanding treatment availability to increase participation by heroin users would be likely to reduce drug-related crime, and would be a good social investment.

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