Pharmacological interventions for drug-using offenders

Area of Science:

• Pharmacology
• Criminology
• Public Health

Background:

• This review examines pharmacological interventions for illicit drug-using offenders.
• It is part of a series focusing on various interventions for this population.

Purpose of the Study:

• To assess the effectiveness of pharmacological interventions in reducing drug use and/or criminal activity in drug-using offenders.

Main Methods:

• Searched 14 electronic databases and 5 web resources up to May 2014.
• Included randomized controlled trials (RCTs) of pharmacological interventions for drug-using offenders.
• Assessed intervention efficacy, cost, and cost-effectiveness.

Main Results:

• 14 trials with 2647 participants were included. Methodological quality was often poorly described, with high risk of bias.
• Agonist treatments showed low-quality evidence of ineffectiveness in reducing drug use or criminal activity compared to non-pharmacological interventions.
• Antagonist treatments showed moderate-quality evidence of significantly reducing criminal activity but not drug use.

Conclusions:

• Agonist treatments were not effective compared to non-pharmacological options. Antagonist treatments reduced criminal activity but not drug use.
• No significant differences were found when comparing individual pharmacological drugs (methadone, buprenorphine, diamorphine, naltrexone).
• Findings should be interpreted cautiously due to small trial numbers, high risk of bias, and limited generalizability, primarily to male adult offenders.