Factors related to correctional facility incarceration among active injection drug users in Baltimore, MD

We investigated the moderating effect of impulse control on the association between drug use and incarceration among active injection drug users (IDU).

The study sample consisted of 282 IDUs aged 15-50 years from the Baltimore metropolitan region who reported injection drug use within the past 6 months and indicated that heroin or speedball was their drug of choice. Impulse control was measured using commission error standardized scores from the Test of Variables of Attention (TOVA). Incarceration was obtained using self-reported lifetime history of incarceration in correctional facilities.

Findings indicated that impulse control moderated the association between years of injection drug use and incarceration in correctional facilities adjusting for ethnicity, gender, estimated pre-morbid intelligence, and age of first injection use. Specifically, among individuals who were intact in impulse control, four or more years of injection drug use was associated with incarceration (AOR=4.97, 95% CI: 2.02-12.23). This finding was not observed among individuals with impaired impulse control (AOR=0.57, 95% CI: 0.10-3.23). Furthermore, impulse control moderated the association between regular cocaine use and incarceration. Among individuals who had a history of cocaine use, individuals with low impulse control but not impaired were more likely to have reported time in a correctional facility (AOR=6.28, 95% CI: 1.68-23.60). There was no association among individuals with impaired or intact impulse control.

Results highlight the importance of considering cognitive measures of impulse control in addressing negative outcomes associated with drug use.