1. Linn Gjersing & Anne Line Bretteville-Jensen
Rates and reasons for incarceration and the possible influence of drug policy liberalization among a cohort of street- and low threshold service recruited polysubstance users
Linn Gjersing & Anne Line Bretteville-Jensen

2. Background The societal burden of drug-related crime is high
Argument for drug policy liberalization
Recent drug policy changes are expected to reduce crime rates

3. Aims
In a cohort of 884 street- and low threshold service recruited polysubstance users
Estimate
Incarceration rate and total number of incarceration episodes
Examine
The associations with self-reported demographics, income and substances used
Investigate and categorize reasons for incarcerations
The potential changes in rates and reasons for incarcerations following a drug policy liberalization

4. Methods A prospective and retrospective cohort study
884 illegal opioid and/or stimulant users
Recruited September and November 2013
Low threshold services, housing facilities, street magasines, street
Norwegian Correctional Service Registry
Incarceration dates (in/out) and reason for incarceration

5. Results 42% incarcerated 610 incarceration episodes 42.8 39.8No
n=511
Yes
n=373
OR (95% CI)
Mean age
42.8
39.8
0.97 [0.96,0.98]***
Male
69%
82%
2.06 [1.49,2.86]***
Homeless or shelter user
22%
37%
2.09 [1.56,2.81]***
Overdose experience
17%
25%
1.69 [1.22,2.35]**
In OST
41%
40%
0.99 [0.75,1.30]

6. Incarceration and income sourcesNo
n=511
Yes
n=373
OR (95% CI)
Work
12% 9%
0.77 [0.49,1.20]
Social benefits
87%
84%
0.76 [0.52,1.12]
Other
26%
24%
0.89 [0.65,1.21]
Prostitution 2%
0.80 [0.31,2.04]
Theft 8%
16%
2.27 [1.48,3.49]***
Dealing
22%
37%
2.09 [1.55,2.82]***

7. Incarceration and substance useNo
n=511
Yes
n=373
OR (95% CI)
Mean no of substances injected
1.9
2.2
1.33 [1.20,1.49]***
Injected one or more substance
75%
87%
2.20 [1.54,3.15]***
Injected heroin
35%
50%
1.83 [1.39,2.40]***
Injected amphetamine
53%
70%
2.07 [1.56,2.75]***
Injected prescription drugs
23%
29%
1.40 [1.03,1.90]*
Injected cocaine 3% 8%
3.00 [1.59,5.64]***
Cannabis (≥4 days a week)
30%
38%
1.43 [1.08,1.89]*

8. Reasons for 610 incarcerations

9. Income-generating
n=211
Theft
75%
Robbery
10%
Handling stolen goods 8%
Fraud 2%
Forgery
Embezzlement 1%
Other acquisitive crime
0.1%
Counterfeit money

10. Less serious drug law violation* 95% Serious drug law violation** 3%
Reasons
Drugs and dealing
n=147
Less serious drug law violation*
95%
Serious drug law violation** 3%
Act of Medicinal Products
*Max 2 yrs
**Max 21 yrs

11. Violence n=108 Bodily harm 25% Threats 19% 17% Assault
Crime towards public servant 6%
Murder 5%
Vandalism 4%
Crimes against personal freedom 3%
Violation of the Firearms Act 2%
Murder-negligent
Sexual offence
Rape 1%

12. Other n=39 Driving under the influence 25% 19% Disturbing public order
17%
Failure to report to jail
Immigration Act 6%
Negligent handling of weapon or explosives 5%
Road Traffic Act 4%

13. Unpaid fines 105 unpaid fines
In Norway, fines are the primary reaction to use and possession of small quantities of illegal substances (Act of Medicinal products §31.2)

14. 3 Drug Policy Scenarios Decriminalisation Legalization A
Use and possession of all psychoactive substances are decriminalised
No legal sanctions for use and possession in terms of fines or incarceration
No specification of any alternative non-legal reactions
Legalization A
Use and possession as well as production and sales of all psychoactive substances are no longer punishable under the criminal law
We assume that users’ drug expenditure (including drug prices and their drug consumption) will remain the same due to policy measures such as taxation, regulations on sale etc.
Legalization B
Same as Legalization A, but with a 50% reduction in users’ illegal income-generating activities due to lower drug prices
We assume that the level of drug consumption remain the same

15. Original setting
Scenario 1:
Decriminalisation
Scenario 2:
Legalization A
Scenario 3:
Legalization B
Reduction in incarcerations
109 (-18%)
252 (-41%)
357 (-59%)
Incarceration episodes
610
501
358
253
Income-generating
211
106
Act of Medicinal Products 4
Drug law violation*
143
Violence
108
Unpaid fines
105
Other 39
Reduction in incarcerated individuals
55 (-15%)
142 (-38%)
236 (-63%)
Total no of individuals incarcerated
373
318
231
137

16. Conclusion Incarceration was common Those incarcerated
Theft, less serious drug law violations and unpaid fines
Those incarcerated
Younger, male, unstable living situation, theft and dealing as an income source and more serious drug use behaviours
Our three drug policy scenarios imply that
A radical change in drug policy is required if the incarceration rates in street- and low threshold facility populations of drug users should be largely affected