Effects of drug substitution programs on offending among drug-addicts

Abstract

Drug abusers are generally more involved in crime, in particular property crime, than people who are not drug abusers. Substitution programs have been developed in order to improve drug users’ quality of life and to decrease their criminal involvement. Several evaluations, but not all, have reported crime reductions following substitution therapies based on heroin and methadone prescription. Objectives: This systematic review is aimed at gaining an overall picture on the respective effects of prescription of methadone vs. heroin and other substances. Search strategy: Six databases (Medline, Campbell Crime and Justice Group, National Criminal Justice Reference Service, National Treatment Agency for Substance Misuse, JSTOR and Criminal Justice Abstracts) as well as relevant journals and websites (Harm reduction Journal, Journal of Substance Abuse Treatment, Drug and Alcohol Dependence, Drug and Alcohol Review, Drug and Therapeutics Bulletin, International Journal of Drug Policy, Journal of Clinical Psychopharmacology, Déviance et Société, Criminal Justice and Behavior, Criminologie, www.heroinstudie.de and www.drugscope.org.uk) have been searched for relevant studies meeting the inclusion criteria. Conclusion: Heroin maintenance has been found to significantly reduce criminal involvement among treated subjects, and it is more effective in crime reduction than methadone maintenance. Methadone maintenance greatly reduces criminal involvement, but apparently not significantly more so than other interventions. Buprenorphine and Naltrexone have been found to be promising, although few studies have been identified using these substances in maintenance treatment.