Epidemiology of drug arrests in the United States: Evidence from the national survey on drug use and health, 2015–2019

• Published in: Preventive medicine Vol. 185; p. 108058
• Main Authors: Rouhani, Saba, Luo, Lingzi, Byregowda, Himani, Weaver, Nicholas, Park, Ju Nyeong
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.08.2024
• Subjects: Adolescent; Adult; Arrest; Cross-Sectional Studies; Drug Users - statistics & numerical data; Female; Health Surveys; Humans; Illicit drug use; Illicit Drugs; Law Enforcement; Male; Middle Aged; Overdose; Policing; Prevalence; Racial disparities; Substance-Related Disorders - epidemiology; United States - epidemiology; Young Adult; United States; Policing; Illicit drug use; Overdose; Arrest; Racial disparities
• ISSN: 0091-7435; 1096-0260; 1096-0260
• DOI: 10.1016/j.ypmed.2024.108058

Following changes to drug criminalization policies, we re-examine the epidemiology of drug arrests among people who use drugs (PWUD) in the U.S. Serial cross-sectional data from the National Survey on Drug Use and Health (2015–2019) were utilized. Past-year illicit drug use (excluding cannabis) and drug arrests were described by year, area of residence, drug use characteristics and participant demographics. Adjusted associations between race and drug arrest were estimated using multivariable logistic regression. Past-year illicit drug use remained consistent over time and was highest among non-Hispanic (NH) white respondents. Of those reporting past-year illicit drug use (n = 25,429), prevalence of drug arrests remained stable over time overall and in metro areas while increasing in non-metro areas. Arrests were elevated among NH Black participants and those with lower income, unemployment, housing transience, non-metro area residence, polysubstance use, history of drug injection, substance use dependence and past-year drug selling. Adjusted odds of drug arrest remained significantly higher among NH Black individuals [aOR 1.92, 95% CI 1.30, 2.84]. Despite recent shifts away from punitive drug policies, we detected no reduction in drug arrests nationally and increasing prevalence in non-metro areas. Despite reporting the lowest level of illicit substance use and drug selling, NH Black individuals had significantly increased odds of arrest across years. Findings highlight the need for further examination of policy implementation and policing practices in different settings, with more research focused non-metro areas, to address enduring structural racism in drug enforcement and its consequences for health. •Arresting people who use drugs exacerbates health risks and racial disparities.•Several policies have been implemented to prevent low-level drug arrests in the US.•We re-examine the epidemiology of drug arrests using nationally representative data.•We observed no overall reductions and persisting racial disparities in arrest.•Findings show enduring structural racism in drug enforcement, despite policy reforms.