Substance Abuse Treatment Dramatically Reduces Criminal Behavior

Kenneth A. Lucas, CSAC, CADAC

For decades, the relationship between substance abuse and criminal behavior has been suspected but never proven. Thanks to a recently-completed, five-year study by the Center for Substance Abuse Treatment (CSAT) which involved thousands of clients in hundreds of alcohol and drug treatment centers, is it now known that treatment dramatically reduced their criminal behavior; reduced arrests by nearly two-thirds; and cut illicit and risky sexual behaviors in half.


The National Treatment Improvement Evaluation Study (NTIES) measured treatment outcomes primarily through a self-reporting method known as a "before/after" or "pre/post" panel design. Clients were interviewed at admission to treatment, when they left treatment and then at follow-up 12 months after the end of treatment. More than 82% of the recruited sample completed the follow-up interview, and 4,411 of those are included in the outcome analysis.

Treatment Reduces Crime

The NTIES study compares criminal behavior for the entire NTIES sample during the 12 months before and the 12 months after entering federally funded treatment. This finding relates to all clients, including those who completed an intake interview and returned for at least a single visit. The study showed that,

Selling drugs declined by 78%.
Shoplifting or arrests for shoplifting declined by 82%.
"Beating someone up" was reported by almost half of the NTIES clients before treatment. Following treatment, that number declined to 11%, a 78% decrease.
Arrests for drug possession declined 51%.
Arrests for any crime declined by 64%.
Those who reported largely supporting themselves through illegal activity declined by nearly half.

Treatment Reduces Risky Sexual Behavior

The NTIES study also revealed that those who were treated for alcohol and other drug use also evidenced marked and significant reductions in risky and illicit sexual behavior. These activities have implications and strong correlates to criminal behavior and costs to society. The study showed that,

Having sex for drugs or money declined by 59%.
Offering drugs or money for sex declined by 58%.
Having sex with an IV needle user declined by 54%.

Findings Related to Type of Treatment

The NTIES also sampled clients in a number of treatment modalities including methadone detoxification, methadone maintenance, short-term residential treatment, long-term residential treatment and treatment provided in a correctional (criminal justice) setting. Clients in methadone detoxification exhibited smaller percentage changes in all categories, while those in methadone maintenance had somewhat larger changes in criminal behavior compared to other types of treatment. It was also noted that clients in non-methadone outpatient facilities had a lower incidence of illegal support than those in residential treatment.

The study also showed that those in correctional service units had much higher incidence of multiple arrests (89%) than the other groups. After treatment, their past year arrest rates and criminal activities were very much like those in all other units (substantially reduced.)


Crime is one of society’s most vexing problems and one that is firmly linked to substance abuse in a variety of ways. It is also a cause of deep concern and anxiety to many Americans. Against this background, the data on the reduction of criminal behavior shown in the NTIES study are encouraging. Overall changes in criminal behavior for clients in drug treatment, with large and significant reductions in key measures of criminal activity, should benefit the public interest by decreasing crime and placing fewer Americans at risk to criminal behavior.

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