1. Socialization and Change: A Journey through Crime, Drugs and Recovery David A. Deitch, PhD Professor of Clinical Psychiatry University of California, San Diego Addiction Training Center

2. Overview A picture of current problems A brief look at what’s coming How we develop crime & drug taking Types of substance abusing offenders

3. Economic Costs Of the $620 billion total the states spent, $81.3 billion (13.1%) - was used to deal with substance abuse and addiction The states spend 113 times as much to clean up the devastation substance abuse and addiction visit on children as they do to prevent and treat it Each American paid $277 per year in state taxes to deal with the burden of substance abuse and addiction in their social programs and only $10 a year for prevention and treatment Of the $453.5 billion states spent in the 16 budget categories of public programs, $81.3 billion—(17.9%) percent--was linked to substance abuse and addiction The National Center of Addiction and Substance Abuse, 2000

4. Type of Offense (June, 1997)

5. The Number of Inmates Released Federal and States Prisons 1995 2001 473,300 635,000 Bureau of Justice Statistics, 2001

6. Drug Arrests By Decade (FBI Crime Reports)

7. The Search For Causes Natural Innate Drives Inherited Parts of Physical and Psychological Well-being Hunger Thirst Shelter Sex ( Physical Survival ) Altered Consciousness

8. The Search For Causes Disease Concept of Alcoholism  Know Etiology  Know Progression  Know Outcome Genetic Model  Adoption and Twin Studies  Receptor Genes  Son of Alcoholics and Tolerance  Twin Studies

9. Psychological Models  Addictive Personality  Psychological Vulnerability  Self Medicating  Personality Issues (anti-social, C.D., etc..)  Self Esteem  Risk Taking Psychoanalytic Models  Oral  Oral Longing  Maternal-Depravation  Sexual Adequacy  Sexual Identity  Structural Deficit in Object Relations

10. Defective Stimulus Barriers (Krystal-Raskin)  Inability to Desomatise Emotions Mal-adaptive Narcissism (Wursmer)  Defense Against Overwhelming Feelings of Rage and Loneliness Impoverished Self Esteem (Khamtzian)  Lack of Capacity for Self Care and Poor Emotional Regulation

11. Tension and Stress Reduction Model  Low Tolerance for Tension  Stimulus Augmenting  Drugs (CNS, D)) Reduce Tension = People Use it and Get this Response = Reinforcement Socio-Cultural Models  Cultural Circumstances - Tension  Attitude Toward Drug Taking  Cultural; Substitutes as Means of Satisfaction  Alienation – Anomie Neurotransmitters Brain Pleasure Centers  Dopamine  Re uptake  Inhibition

12. Number of Juvenile Arrests Nationwide 1996 1.9 Million juvenile arrests, up 35.4% from 1987 93,000 Juveniles arrested for FBI Violent Index Crimes, up 59.9% from 1987 murder, rape, robbery, aggravated assault 480,000 Juveniles arrested for FBI Property Index Crimes, up 7.9% from 1987 burglary, larceny-theft, motor vehicle theft, arson Source: FBI Crime in the United States, 1996 – Table 32

13. Impact of Drugs on Criminality Age 7 13 18 28 Normal bell curve If drugs come into play

14. Role of Biology and Environment Crime / Antisocial Behavior Non Antisocial Parent/ Psychological Illness or Antisocial Environment Criminal Parent/ Non Criminal Adoptee Non Criminal Parent/ Non Criminal Adoptee Antisocial Parent/ Antisocial Adoptive Environment R.J. Cadoret, 1978, Archives of General Psychiatry

15. Birth Complications & Maternal Rejection % Violence A. Raine, 1994, Archives of General Psychiatry N=1750N=256 N=2064 N=191

16. Risk Factors Psychiatric Abusive/violent family Abusive/violent family Drug use environment Drug use environment Socialization Factors Socialization Factors Episodic Symptoms Episodic Symptoms Neuro/Limbic dysfunction Neuro/Limbic dysfunction Cognitive impairments Cognitive impairments External Vulnerabilities Inherent Vulnerabilities

17. How We Develop: Risk Factors Cascading Across Domains of Development &Time Age <1Difficult to soothe infant Age 2Coercive parent-child relationship Age 3Poor self-regulation & control Age 4Child rejected by pro-social peers Age 5 Child rejected by teacher Age 6 Child bonds to other rejected peers Age 7Poor school bonding

18. How We Develop Risk Factors Cascading Across Domains of Development & Time Age 8Poor academic achievement Age 9Minor infractions: lying, petty stealing Age 10Cigarette smoking Age 11Alcohol use Age 12Marihuana use, arrests Age 13 Risky sexual behavior Age 14Crack cocaine

19. How We Develop Remember: Social bonding is –Attachment to others in social unit –Investment in lines of action consistent with social unit –Belief in values of the unit

20. Bonding & Environment For example: –Abandonment –Foster care –Group homes –Juvenile detention –Prison How We Develop

21. Bonding & Environment All advance an education A sense of social definition… Their notion of the world and how to handle it -- “might is right” -- etc.

22. How We Develop  Integration  Inner Voices / Conscience  Culture, atmosphere & reference points become deeply integrated  It is our definition of self  These become our inner voices  These voices influence our attitudes and behavior

23. Behavior & Attitude PRO-SOCIAL OR ANTI-SOCIAL  Depends on predominant behaviors  Values & norms of those to whom we are bonded

24. Psychopaths Criminal Personality Prototypes ASPDs Perpetrators with criminal records Sociopaths All perpetrators of illegal, criminal and destructive acts Henry Richards, PhD, U Wash

25. Now What? The person who comes to us bonded, attached and has powerful inner voices.

26. Types of Substance Abusing Offenders  Substance abusing offenders are not a homogenous group.  A classification model: The Early Stage Substance Abuser The Addict The Dually Diagnosed Substance Abuser The Criminogenic Substance Abuser

27. The Early Stage Substance Abuser Early stage refers to experimental and recreational substance abusers whose crimes result from impaired judgment or disinhibition while under the influence of drugs and/or alcohol

28. The Addict Addicts are those for whom daily life is dedicated to drug-seeking behavior. Petty crime has become their primary means to support their addiction. Serious or violent crime is less prevalent in this group than in the criminogenic substance abuser.

29. The Dually Diagnosed Substance Abuser The mentally ill substance abuser, often referred to as dually diagnosed, has a concurrent mental illness and substance abuse problem.

30. The Criminogenic Substance Abuser Criminogenic substance abusers are those who do not wish to be part of mainstream society and have chosen to be members of outlaw subcultures. Their substance abuse is incidental to their criminal behavior.