Risk factors for criminal recidivism – a prospective follow-up study in prisoners with substance abuse

A cohort of prisoners with substance use problems (N？=？4,152) were assessed with the Addiction Severity Index (ASI) in the Swedish criminal justice system. Clients were followed for an average of 2.7？years. Criminal recidivism was defined as any return to the criminal justice system.During follow-up, 69 percent (n？=？2,862) returned to the criminal justice system. Recidivism was associated with amphetamine and heroin use, with an additive risk for injectors, and with polysubstance use. Also, recidivism was negatively associated with alcohol, other opioids than heroin/methadone and with hallucinogenic drugs, and positively associated with previous psychiatric in-patient treatment, violent behaviour, and with a shorter index sentence. Associations remained when controlling for type of crime.Even when controlling for type and severity of crime, and for psychiatric problems, risk of criminal relapse was increased by substance use variables, including amphetamine, heroin and polysubstance use, and an additional risk was shown for injection drug users. These findings have implications for the need for substance abuse treatment after release from prison.Substance abuse and criminal behaviour are closely related, and a large proportion of substance users commit crimes [1,2]. While some part of criminal behaviour is likely to occur in order to finance drug use [3], substance use is also clearly associated with violent crime [4].Also, criminal behaviour is generally more common among mentally ill [5], and a very large proportion of criminal justice clients suffer from alcohol or drug dependence or other mental disorders, including high rates of personality disorders [6,7].There is a growing amount of literature addressing risk factors for criminal recidivism [8-13]. A history of substance use repeatedly has been reported as a predictor of committing new offenses [8,10], and in a large meta-analysis [8], other predictors of general criminal recidivism were previous criminal his