The goal of the study was to extend the use of
arrestee urinalysis results in community planning by examining the
relationships among arrestee drug tests and drug-related emergency
room episodes, drug overdose deaths, crimes, and child abuse and
neglect cases. The conceptual framework that was developed addressed
the issue of temporal relationships among indicators by considering
how the diffusion of new patterns of drug abuse and the course of
individual drug careers would cumulatively affect different
indicators. This required an elaboration of assumptions about how drug
abuse spreads, its effects on individuals over time, and the resulting
cumulative effects on the community over time. The product was a
three-stage public health model of drug diffusion and the influence
drug diffusion might be expected to have on various community drug
indicators when they are viewed as aggregate measures of individual
drug use careers. Stage 1 of the model is the initiation of a new drug
use pattern, Stage 2 is spreading drug use, and Stage 3 is drug use
stabilization or decline.
Selection of study sites and community indicators
were determined by data availability. The first criterion was monthly
data on results of urinalysis of arrestees at booking, available for
almost all detained arrestees in Washington, DC, since April 1984. The
additional data on drug-related emergency room episodes, drug overdose
deaths, reported crimes, and reported cases of child abuse and neglect
formed the basis for initial model testing. To examine the extent to
which Washington, DC, might generalize to other communities, Portland,
Oregon, was chosen as a comparison site with similar initial booking
tests of arrestees on a continuous monthly basis and community
indicators similar to those available in Washington, DC. Emergency
room episode data comparable to that in Washington, DC, was not
available for Portland.
Washington, DC: All drug-use arrestees, drug-related
emergency room episodes, drug overdose deaths, violent and property
crimes, and child abuse and neglect cases. Portland, Oregon: All
drug-use arrestees, drug overdose deaths, violent and property crimes,
and child neglect, abuse, and endangerment cases.
Months (Washington, DC: 78 cases/April
1984-September 1990. Portland, Oregon: 33 cases/January
1988-September 1990).
agency files from Washington, DC, and Multnomah County,
Portland, and Gresham, Oregon
administrative records data
Part 1 data (Washington, DC) were broken into five
sections: Arrestee Drug Test Results (cocaine, opiates, methadone,
amphetamines, and PCP), Drug-Related Emergency Room Episodes, Drug
Overdose Deaths, Crimes Reported (violent crimes such as murder, rape,
robbery, and assault, and property crimes, including burglary,
larceny, auto theft, and arson), and Child Maltreatment (abuse,
neglect, and other). Part 2 data (Portland, OR) consisted of the same
sections with the exception of Drug-Related Emergency Room Episodes.
Not applicable.
None