The Arrestee Drug Abuse Monitoring (ADAM) project is a national study that generates extensive and timely data on drug use within the arrestee population. Anchorage has participated in the program for several years. Changes to the research instrument in 2000 have greatly expanded the scope of the information collected. It is anticipated that the redesign and the additional data collected will be more relevant to local communities. This article compares drug use prevalence from 1999 and 2000 and examines the spatial distribution of drug use among the arrested population from 2000.
The Sample and 1999/2000 Comparisons
Arrestee participation in the ADAM study is strictly voluntary. Four times a year (once every quarter) the Justice Center collects data for a two-week period in both Anchorage booking facilities, Cook Inlet Pretrial and Sixth Avenue Correctional Center. The Justice Center and the Alaska Department of Corrections have worked together to administer a secure confidential collection procedure. The only criteria for inclusion in the study are that inmates must not have been in custody for more than forty-eight hours and that they are not federal prisoners, Immigration and Naturalization Service detainees, or transfers from another facility. Once identified as eligible, the inmate is asked to participate in a two-pronged study protocol. The first part is an interview with a professionally trained interviewer. The main content of the interview focuses on current and prior drug use, and additional questions deal with criminal histories, drug treatment, educational background, desire for treatment, and demographics. The second part of the ADAM protocol involves the collection of an interviewee urine sample to corroborate the information given in the interview. The specimen is shipped to a lab where it undergoes testing for the presence of ten different drugs.
The inmate has the right to refuse to answer any question asked or terminate the interview at any time. The urine sample is also voluntary, and the interviewee may refuse to provide a specimen despite participating in the self-report interview. The sample is only collected if the inmate has completed the interview. All of the information obtained during the interview process is confidential; individual results cannot be made available to any law enforcement, prosecutorial, or correctional agency. Strict measures are taken to ensure that the interviewer does not know the names of the persons being interviewed, and the survey instrument and urine sample are not marked in any way that could be traced back to the individual.
At the end of data collection the questionnaires are sent to Washington, D.C. for analysis; aggregate data are later returned for further study.
During the 2000 data collection period, 225 adult females were approached for participation in the study. Sixty-four percent (N=144) agreed to participate in the study and, of that number, 83 percent (N=119) provided a urine specimen. The male response rate was even higher. ADAM staff approached 810 male arrestees; 3 out of every 4 of those approached agreed to be interviewed (N=607), although 6 of these cases were later deemed ineligible because they were arrested more than 48 hours prior to being interviewed. Of those male arrestees interviewed, 81 percent (N=492) provided a urine sample.
One of the benefits of the ADAM data collection effort is its ability to provide objective measures of drug use among the arrested population through the collection of urine specimens from study participants. The statistics presented in this section reflect results based only on those arrestees participating in the survey and providing a urine specimen. The results for adult ADAM males presented in Table 1 show a decrease in the percentage of arrestees testing positive for cocaine from 1999 to 2000. With the exception of the one arrestee classified in the other/multiracial category, the pattern persists across most age and racial groupings. A similar pattern appears for females. The percentage of adult female arrestees testing positive for cocaine use drops, although the decrease is not uniform across all age and racial groups. The results of the testing also reaffirm what was already known about drug use in Anchorage—marijuana and cocaine are the most commonly used drugs among arrestees while opiates and methamphetamine use are much less common.
Spatial Distribution of Drug Use
As part of the ADAM protocol, data on area of residence are collected. Because of privacy guarantees, precise addresses are not collected; however, the zip code of residence is collected for each arrestee. This residence location allows researchers to conduct various types of descriptive analyses involving the spatial location of arrestees and drug markets. An orienting map of Anchorage zip codes is depicted in Figure 1, and other maps produced using the zip code variable are included.
For several reasons, caution must be taken when examining both Figures 2 and 3. First, the maps are based on the zip code of residence. They do not represent where the crime was committed nor do they represent where the individual was arrested. Likewise, they do not illustrate where drugs were purchased or used. Second, no information is available which allows ADAM staff to determine how much time a resident spends in the given zip code. Many arrestees were homeless or otherwise transient. For example, some arrestees listed Brother Francis Shelter as their home residence, yet they may or may not spend a majority of their time within that zip code. Further, a zip code might have been listed as the place of residence despite the fact that the arrestee regularly resided elsewhere. Third, the spatial distribution depicted is limited to those arrestees indicating an Anchorage home zip code — the vast majority of all arrestees in the ADAM sample. Finally, the number of arrestees for several of the zip codes is relatively small. Consider the Elmendorf and Fort Richardson areas: depending upon the nature of the analyses being conducted, each zip code included four or fewer arrestees. In sum, these maps are only for descriptive purposes and should be assessed with some degree of caution. Generalizations about the arrestees in the area may be unwarranted and/or incorrect.
The ADAM lab tests urine specimens for the presence of ten drugs including marijuana, cocaine, and heroin. Figure 2 presents the number of all year 2000 adult male arrestees providing urine specimens who tested positive for any drug. Once again, the data are depicted according to the zip code of residence of the arrestee, and only those respondents who reported an Anchorage zip code are included in the map. The map shows that the area east of downtown (N=46) and the downtown area (N=48) itself have the highest number of arrestees testing positive for any drug. In contrast, the C Street/Arctic Boulevard area south of midtown, Eagle River, Chugiak, Elmendorf, Fort Richardson, and south Anchorage have a low incidence of drug use among the arrested population. Again, the sample sizes need to be taken into account. Only four arrestees came from the Elmendorf area while only eight resided in the C Street/Arctic area between the Tudor Road and Dimond Boulevard areas.
Figure 3 examines the prevalence of drug use among the arrested population. The results exhibit a different spatial pattern. For example, although the Turnagain area had a low volume of arrestees testing positive for drug use, four out of five arrestees from the area did test positive (80% prevalence). Similarly, 15 of 21 arrestees from south Anchorage (99515 zip code) tested positive for any drug (71.4%). Therefore, it appears likely that the high volume of positive test results in the areas depicted in Figure 2 are partially a product of the volume of arrests; prevalence rate maps do not produce the same spatial pattern.
Figures 2 and 3 present the spatial distribution of drug use incidence and prevalence but do not distinguish between the type of drugs used. Table 2 presents the prevalence of drug use among the adult male arrested population for each of the ten drugs for which the ADAM program tests. The results are displayed according the zip code of residence of the arrestee. Clearly, marijuana and cocaine use are the most prevalent across each of the fourteen Anchorage zip codes. However, prevalence varies across zip codes when examining specific drugs. For example, marijuana use is most prevalent among arrestees residing in south Anchorage (57.1%) and Eagle River (45.5%) while least prevalent in west Anchorage (27.3%) and Chugiak (28.6%).
Once again, caution is advised in examining drug use prevalence; the distinction between incidence and prevalence must be stressed. Several examples illustrate this distinction. First, the prevalence of marijuana use among arrestees in south Anchorage is nearly double that of arrestees residing in downtown. However, the incidence, or volume, of arrestees testing positive in downtown (N=28) is nearly three times that of south Anchorage (N=11). Second, zero percent of the arrestees from Fort Richardson tested positive for marijuana, but only one arrestee was tested. Compare this sample size to the Rogers Park/University and downtown areas where 87 and 89 arrestees were tested, respectively. The ability of these numbers to accurately describe drug use prevalence in a zip code must be examined in light of the sample size. Obviously, the accuracy of the statistics is enhanced with a larger sample size.
The expanded ADAM instrument now produces data on drug markets, dependence and abuse, and other areas. Two new sections, in particular, are potentially valuable to local practitioners—those concerning dependence/abuse and drug markets. Each of these sections will be briefly described below.
While earlier versions of the ADAM survey examined the presence of illicit substances in the urine and included self-report measures of drug use, researchers have indicated that frequency of use alone is not entirely accurate as an indicator of abuse and dependence. In light of this, the redesigned ADAM instrument includes measures of abuse and dependence constructed from responses to six items. These items ask respondents to indicate whether, during the past year, they drank more than they intended; neglected some of their responsibilities because of alcohol or drug use; tried to cut down on their alcohol or drug use; had others object to their alcohol or drug use; frequently thought about drinking; or used alcohol to relieve feelings such as sadness, anger, or boredom.
The drug market section is another major addition to the ADAM instrument. The information is intended to provide local law enforcement with an understanding of drug markets, including their type and circumstances. This section generates information on price and quantity of drugs purchased, location of purchase, contacting methods, methods of use, and other local market conditions.
The Justice Center plans to conduct additional analyses on these data over the next several months, focusing in particular on the new sections of the ADAM instrument. Year 2001 data, which will be available early in the new year, will be examined and compared with year 2000 data. The Center will examine a variety of issues including whether the nature of drug markets varies depending upon the drug examined. The Center will continue to monitor changes in other areas such as drug cost, drug use, and dependence and abuse. The potential of this information is just beginning to be realized.
Matthew Giblin is a research associate with the Justice Center.