RESEARCH REPORT

U.S. Department of Justice

Office of Justice Programs

National Institute of Justice

I–ADAM IN

EIGHT COUNTRIES

APPROACHES AND

CHALLENGES
U.S. Department of Justice

Office of Justice Programs

810 Seventh Street N.W.

Washington, DC 20531

John Ashcroft

Attorney General

Deborah J. Daniels

Assistant Attorney General

Sarah V. Hart

Director, National Institute of Justice

Office of Justice Programs National Institute of Justice

World Wide Web Site World Wide Web Site 

http://www.ojp.usdoj.gov http://www.ojp.usdoj.gov/nij
I–ADAM IN EIGHT COUNTRIES

Approaches and Challenges

Editor

Bruce Taylor

Contributing Authors 

Vicknasingam Balasingam, Trevor Bennett, Henry H. Brownstein, Luis Caris, Willemijn Garnier, 

Doug Johnson, Peter Klerks, D. Locke, Antoinette Louw, Toni Makkai, Neil McKeganey, Visweswaran

Navaratnam, Hilal Hj. Othman, Charles Parry, Janine Plaisier, Andreas Plüddemann, Bruce Taylor, 

Elna van Niekerk, and Gina Weir-Smith

May 2002

NCJ 189768
Points of view or opinions stated in this document are those of the authors and do not represent the official position or

policies of the U.S. Department of Justice.

National Institute of Justice

Sarah V. Hart

Director

The National Institute of Justice is a component of the Office of Justice Programs, which also includes the Bureau

of Justice Assistance, the Bureau of Justice Statistics, the Office of Juvenile Justice and Delinquency Prevention,

and the Office for Victims of Crime.
iii

FOREWORD

James O. Finckenauer

James O. Finckenauer is director of the International Center of the National Institute of Justice. He is on leave from the

Rutgers University School of Criminal Justice, where he is a professor of criminal justice.

The International Arrestee Drug Abuse Monitoring (I–ADAM) program began just over 2 years

ago. I–ADAM in Eight Countries: Approaches and Challenges is the first look at the general results

of this international experiment. The compendium provides an update—a kind of status

report—on the state of I–ADAM’s implementation. 

It also provides an opportunity to address the broader subject of international comparative

research. Research purporting to examine crime and justice issues across national boundaries,

while occasionally lauded, has been relatively rare. This rarity is attributable in part to the great

difficulties faced by any would-be comparativists; some of these difficulties are of sufficient

gravity to call into question the very worth of any such undertakings.

Skeptical questions often raised about comparative research include: What is its value? What are

its contributions to our body of knowledge about crime and criminals? What are its pitfalls?

And perhaps most important, are those pitfalls so potentially damaging to research credibility as

to render any findings and conclusions from international comparative studies meaningless?

Although this initial and modest effort by the I–ADAM program can serve as a useful case

example, it will obviously not definitively answer the criticisms and questions. It will, however,

permit us to begin to address a number of issues subsumed within some of the questions.

Before turning to cross-national research in general and the I–ADAM studies in particular, let us

first consider the issue of the overall worth of any research information that is “comparative.”

Findings and results of research can be grouped into three types of information: descriptive, comparative, and explanatory. Although any research results must begin with descriptive information, mere descriptions, by themselves, tell us very little. For example, let us say we find that 30

percent of arrested drug users recidivate. What are we to make of this isolated piece of information? Is that figure high, low, or average? Is it increasing or decreasing? Without some basis for

comparison, we do not know. Thus, we see the need for comparative information—literally, an

answer to the question, “Compared with what?” Before/after studies, multisite studies, and experimental/control studies, for instance, all introduce a comparative frame of reference. Of the three

information types, explanatory information is of the highest order in facilitating understanding.

But to obtain explanatory information, one must have rigorous research designs that enable
iv

I–ADAM in Eight Countries: Approaches and Challenges

testing causal assumptions so as to actually explain the phenomenon in question. Such designs

are quite expensive and difficult to maintain in criminological studies.

As the above discussion implies, comparative research can occur in many forms. Only one of

these—albeit the one most thought of as “comparative research”—involves cross-national work.

Cross-national comparative studies introduce cultural and national diversity into the research

design. They enable us to address questions about the universality of crime and criminal behavior,

the criminal justice system response, the offender and community reactions to that system response,

and the universality of the interactions among these factors. With respect to drug abuse, the focus

of the research reported here, we can ask about differences across countries in drugs, drug use

markets and prices, or the age and gender of users. We can further ask about differences in the

relationship between drug use and criminal offending, the type of crimes committed, and, again,

offender age and gender. As the introduction to this compendium points out, comparing the prevalence of drug use among arrestees in different countries is valuable to help identify invariant

factors that predict drug use across countries and general patterns of human behavior that are

not culturally specific.

I–ADAM has considerable potential for creating a research-based policy platform. The value in

having answers to questions such as those just mentioned lies in finding cross-national differences

that lend themselves to policy interventions. For example, if specific criminal justice responses or

prevention strategies are shown to be effective in particular instances, they can be replicated and

tested in other jurisdictions, which is one of the motives behind the I–ADAM initiative.

Pitfalls of Comparative Research

Some words about a few of the pitfalls in cross-national work, alluded to earlier, are in order. A major

barrier to be overcome is that of language. Except where research sites share a common language,

translation is necessary. Written instruments require not only translation from the original into

the second language, but also translation back to the original to verify accuracy. Despite the utmost

efforts of the researchers, differences in meaning often creep in that can change the results. Because

roughly half of the countries in the I–ADAM project are English speaking, this was not a problem.

Nevertheless, it was an issue for the sites in Chile, Malaysia, and the Netherlands. For example, the Chilean report indicates that the interview schedule was translated into Spanish and then

given “minor edits and adaptation to the Chilean idiom.” It is this kind of adaptation that can

introduce imprecision and differences in responses. Language will become an even greater problem

if and when countries such as Russia and Ukraine are added as sites, as planned.

Cultural differences in research traditions and methods also have to be reconciled in cross-national

studies. The scientific method does not govern everywhere. Sampling can mean different things in

different countries. The same is true of access to data, protection of human subjects, and policies

with respect to publication of research findings. The Chile report is again a case in point. Referring

to the questionnaire, the report says “it was deemed necessary to add as well as remove a few

questions on the basis of cultural applicability.” Similarly, Australia’s report indicates that “changes
v

Foreword

were made to the instrument based on feedback from local sites, interviewers, and interviewees”—

in part because “terminology did not translate.” Introducing differences also introduces variability

that can threaten validity.

Comparative research is also made difficult by the variation in data reliability and validity across

countries. Crimes and criminal justice practices (such as arrests, prosecutions, and convictions)

are defined and recorded differently. These difficulties both challenge and discourage researchers and lead to skepticism with respect to the credibility of cross-national research.

These potential problems confronted the I–ADAM project and required the existence, at the outset,

of a very compelling argument and rationale for the program, which is stated quite succinctly in

the Introduction and Overview chapter. Drug use and the crimes attendant to drug use are global

problems. They infect both developed and developing countries. Drugs devastate individual

abusers and their families. Drug money feeds transnational organized crime, corrupts governments, and finances civil wars and terrorism. To develop effective policies for confronting these

problems, we obviously need to know and learn as much as possible about them. Unfortunately,

for many of the reasons outlined earlier, existing drug research makes cross-country comparison

difficult or impossible. In many cases, no research existed. The report from Malaysia indicates,

for example, that there had never been a study conducted in that country to determine the level

of drug and alcohol use among the arrestee population. It was hoped that the ADAM method

and protocols could help fill the gaps and overcome incomparability.

Method and Protocols

I–ADAM has systematically attempted to deal with the host of potential problems that are common to comparative research and to ensure uniformity in its approach. The research in the

eight countries has proceeded in a parallel way to avoid any history effects. As with the original ADAM, I–ADAM employs two data collection methods: individual interviews and urinalyses. One of the first issues for comparability is the uniformity of the sampling procedure for

choosing those subjects from whom to collect data. In accordance with ADAM practice, arrestee

participation must be voluntary. Adult male and female arrestees (individuals booked and

processed by the police) who are detained long enough to be interviewed, but less than 48 hours,

make up the pool from which the sample of volunteers is to be drawn. Sites use probability

sampling methods, or if the population is small enough, they interview the entire universe.

Alternatively, some sites use convenient sampling methods to reduce the cost of data collection.

A second comparability issue is the need for uniformity with respect to the interviewers and

the interview environment. The ADAM protocol stipulates that interviewers should not be law

enforcement personnel to avoid any coercion or biasing of responses. All interviewers are carefully trained in the administration of the interview schedule. The interviews themselves are

conducted in private or semiprivate settings to encourage confidentiality.

A major issue for uniformity is the interview schedule itself. Dropping and adding questions

obviously works against uniformity. The effect of changes is not itself uniform, however. Because all
vi

I–ADAM in Eight Countries: Approaches and Challenges

questions in the schedule are not created equal, as long as “core” questions are retained and

changes are on the margins, a condition of relative uniformity can be maintained. One effect of

alterations in questions is to limit the comparative analyses to just those items that appear in the

same manner in all forms.

With respect to urinalysis, many comparability problems are avoided. Assuming the sample has

been properly chosen, there is less room for human variation and error in collecting and analyzing

urine samples than in conducting the interviews. Five common drugs are tested for all I–ADAM

sites: marijuana, cocaine, opiates, amphetamines, and benzodiazepines. Drug testing is a highly

reliable method of ascertaining whether a subject has recently used drugs and what drug (or

drugs) has been used.

With this background, but also with the reminder that I–ADAM is both limited and in its early

stages, we can make some observations about the experiences to date. These observations are, of

necessity, impressionistic and suggestive.

Assessment and Observations

The I–ADAM effort described in these pages represents a rare and, in some senses, unique

research effort. Because it was adapted from the ADAM foundation, it starts with a tried-andtrue methodology. It is also relatively narrowly focused and well defined, thus reducing the risk

of incomparability. Unlike other comparative research projects, no considerable time needed to

be spent in designing the research (e.g., formulating research questions, sample designs, or data

collection and analysis strategies). With the research design already in place, individual country

projects could begin as soon as such practical issues as funding and political support were

addressed.

The first observation deals with the samples in the different countries. These samples, including

those in the U.S., tend to be regarded and even treated as nation specific, when this is clearly not the

case. As is pointed out in the U.S. chapter, within-country variability makes any assumptions

about population homogeneity untenable. It is generally accepted that due to the variability among

and between the 35 sites in the United States, results cannot be generalized to any larger population. This is even a greater problem when results are compared across international borders. Thus,

any results will need to be specific and treated with caution.

Considering the sample limitations and variations in the interview schedule, the report from the

Netherlands takes what is perhaps the most appropriate perspective on the comparability of data

collection at this stage. The Dutch say that “comparisons with I–ADAM data from other countries

should perhaps be restricted to hypothesis-forming impressions and should not be used to form

conclusions about the drug situation in the Netherlands.” This is wise advice. The value of using

these reports to develop testable hypotheses and glean other heuristic effects should not be dismissed or downplayed.
vii

Foreword

There are numerous possibilities to be explored here. For example, South African data show

that nearly 80 percent of the offenders arrested for housebreaking tested positively for drugs.

Furthermore, the number of housebreakers in South African sites using cocaine was four times

that of those committing other crimes. In Australia, the strongest correlation with respect to

drug use and offending was between property offenses and opiate use. Scotland found relatively

high levels of opiate use among the arrestees tested but much more so among females than

males. The U.K. found that many of the measures of drug use correlate strongly with many of

the measures of crime. What might be made of all these findings? What are the general patterns

of relations between drug use and offending? What is the particular connection here between

drugs and housebreaking, and opiates and property offending? Why the gender distinction in

Scotland? What are the differences in these respects across countries? These and other questions

are stimulated by the current research.

This compendium illustrates that a reasonable beginning has been made. There are problems

and there are corrections to be made. Nevertheless, the potential value is clear. The report from

England/Wales sums up rather nicely the ultimate value of I–ADAM. Pointing out that these

data add to our fundamental knowledge about drug abuse and crime and the way they are

linked, the report says, “The data generated by the I–ADAM partnership can be used to compare

international trends in drug misuse. The program allows for monitoring changes in drug misuse

across countries and over time. This evidence can then be used to inform national and international drug policies.”
ix

TABLE OF CONTENTS

Foreword . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . iii

James O. Finckenauer, National Institute of Justice, Washington, DC, USA

Executive Summary . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . xi

Introduction and Overview. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

Bruce Taylor, National Institute of Justice, Washington, DC, USA

Australia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9

Toni Makkai, Australian Institute of Criminology, Canberra, Australia

Doug Johnson, Australian Institute of Criminology, Canberra, Australia

Chile. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29

Luis Caris, Chief, Alcohol, Tobacco, and Drug Unit, Ministry of Health, Santiago, Chile

Bruce Taylor, National Institute of Justice, Washington, DC, USA

England and Wales. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 47

Trevor Bennett, Institute of Criminology, University of Cambridge, Cambridge, England

Malaysia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 63

Visweswaran Navaratnam, National Centre for Drug Abuse Research, Universiti Sains Malaysia

Vicknasingam Balasingam, National Centre for Drug Abuse Research, Universiti Sains Malaysia

Hilal Hj. Othman, National Centre for Drug Abuse Research, Universiti Sains Malaysia

The Netherlands . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 75

Peter Klerks, Dutch Police Academy

Janine Plaisier, WODC, Ministry of Justice, The Hague, the Netherlands 

Willemijn Garnier, Ministry of Justice, The Hague, the Netherlands

Scotland. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 97

Neil McKeganey, University of Glasgow Centre for Drug Misuse Research, Glasgow, Scotland

Clare Connelly, University of Glasgow School of Law, Glasgow, Scotland

John Norrie, University of Glasgow Robinson Centre for Biostatistics, Glasgow, Scotland

Janusz Knepil, Department of Biochemistry, Gartnavel General Hospital, Glasgow, Scotland
x

I–ADAM in Eight Countries: Approaches and Challenges

South Africa. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 117

Elna van Niekerk, CSIR, Division of Roads and Transport Technology, Pretoria, South Africa

Charles Parry, Medical Research Council, Cape Town, South Africa

Andreas Plüddemann, Medical Research Council, Cape Town, South Africa

Antoinette Louw, Institute for Security Studies, Pretoria, South Africa

Gina Weir-Smith, Human Sciences Research Council, Pretoria, South Africa 

D. Locke, Crime Information Analysis Centre, Pretoria, South Africa

United States . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 139

Bruce Taylor, National Institute of Justice, Washington, DC, USA

Concluding Thoughts. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 167

Henry H. Brownstein, National Institute of Justice, Washington, DC, USA

Appendix A: Model I–ADAM Survey Instrument. . . . . . . . . . . . . . . . . . . . . . . . . . . . 173

Appendix B: Demographic, Economic, and Drug 

Information by Country. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 181
xi

EXECUTIVE SUMMARY

This publication is primarily a progress report on the implementation of the International Arrestee

Drug Abuse Monitoring (I–ADAM) program in eight countries and on the challenges they faced.

Those countries are Australia, Chile, England, Malaysia, Netherlands, Scotland, South Africa,

and the United States. Although some research findings are presented, the principal purpose of

this report is to describe the experiences of the countries as they engaged in the process of launching I–ADAM.

Providing the first review of the early stages and status of I–ADAM in participating nations, this

volume attempts to identify common problems in developing an I–ADAM site and approaches to

surmounting implementation barriers. As noted toward the end of the Introduction and Overview

chapter, the sequence of subtopics in each of the eight country chapters is the same, ranging from

general information to such issues as obtaining funding, creating a survey instrument, developing research methods, and training.

This report documents that, overall, reasonable progress has been made in implementing the

I–ADAM experiment. Problems remain; some adjustments are needed. I–ADAM’s impressive

potential, however, is undiminished.

International ADAM Program in Brief

I–ADAM is an outgrowth and extension of the Arrestee Drug Abuse Monitoring (ADAM) program, developed and operated by the National Institute of Justice, U.S. Department of Justice. Its

origin dating back to the mid-1980s, ADAM tracks trends in the prevalence and types of hardcore drug use—such as cocaine, heroin, marijuana, and methamphetamine—among booked

arrestees in 35 sites across the United States. Obtained through a standardized methodology and

protocol governing arrestee interviews and urine specimen testing, ADAM provides a series of

localized assessments about the U.S. drug abuse problem in the arrestee population that are a

central component in studying links between drug use and crime and other social problems.

Aspects of ADAM can be customized to address specific needs at the community level. Thus,

data collected through ADAM can also provide a fundamental research and evaluation tool that

local analysts, policymakers, and practitioners can use to target drug-related issues of particular

interest to the locality, such as evaluations of drug treatment and pretrial diversion programs.

In 1998, the ADAM concept began expanding internationally as the I–ADAM program, envisioned as a research partnership among criminal justice organizations worldwide. Like its

namesake, I–ADAM serves the twin functions of research and policy guidance. The program’s

major goal is to develop a standardized international drug surveillance system—similar survey

instruments, sampling, training, and other protocols—that facilitates cross-country comparisons
xii

I–ADAM in Eight Countries: Approaches and Challenges

of the prevalence of drug use among arrestees and permits an assessment of the consequences

of drug abuse within and across national boundaries.

To the extent that its data identify similar drug problems across national borders, I–ADAM can

promote a standard basis for nations to coordinate drug control policies and resources and to

improve multilateral cooperation. I–ADAM identification of a growing substance abuse problem

in a country’s arrestee population can help forecast a potential hot spot for international drug

trafficking.

Researchers may also use I–ADAM data in some cases to develop such estimates as the following:

the relationship between drugs and crime, sources of illegal income for arrestees, drug dependency, use of substance abuse treatment, drug market dynamics, and certain public health-related

consequences of drug abuse. I–ADAM can address topics of local interest (e.g., domestic violence)

and international concern (e.g., drug prices).

Comparing Drug Use Across Countries

I–ADAM is a network of researchers from various nations working together to address problems

in each of their countries that are unique in some ways yet common in others. One of the themes

that emerges from I–ADAM data is that drugs are a global issue. All eight countries have problems. Marijuana in one form or another is the drug that is most commonly used by arrestees

throughout the world. In Australia, 50 to 66 percent of all arrestees tested positive for cannabis. In

Chile, 30 percent of arrestees tested positive. In South Africa, 36 to 44 percent tested positive. 

But some drug problems are unique to particular countries. In South Africa, for example, 19 to 25

percent of arrestees tested positive for mandrax, a blend of methaqualone and antihistamine that

is rarely, if ever, found being used by arrestees in other nations. 

The most serious problem in each country differs: England and Thailand report that opiates are

the main problem. Scotland has a serious problem with injection drugs. 

In addition to the similarities and differences in drug use among nations, the nations also report

similarities and differences in terms of the problems they have in implementing I–ADAM. For

example, in all countries people commit crimes and are arrested and booked daily, night and day.

Yet in all countries, it is not possible to conduct interviews 24 hours every day. 

The researchers report that in those nations where I–ADAM programs have been implemented or

planned, policymakers and practitioners in criminal justice and public health generally express

high levels of interest in the program. At the same time, most are experiencing problems identifying and securing adequate funding to support an ongoing program. All must deal with collecting

data in a hectic environment, and all must work with local law enforcement and correctional officials to ensure that the program operates in a way that benefits the community without disrupting the ongoing operation of the local jail. 

Ultimately, I–ADAM is a fragile multinational network of people who share a common interest in

the problems of drugs and are trying to work together to do something about it. 
1

INTRODUCTION AND

OVERVIEW

Bruce Taylor, National Institute of Justice

Nations are increasingly recognizing a shared interest in better understanding the causes of crime

and drug problems. The problem of drug use and related crime is a global phenomenon. No

longer can the drug/crime problem be thought of in isolation or strictly in national terms. The

drug trade affects most nations of the world, and the problems that arise because of drugs can

be quite severe. In both developing and industrialized countries, problems related to drug abuse

include crime, sexually transmitted diseases, accidents, deaths, poverty, unemployment, and

decreased productivity. Illicit drugs can be devastating not only at the individual level; they can

also corrupt governments and undermine international relations. Despite the growing nature

and globalization of the drug problem, the quality and extent of research on this subject has not

kept pace. Most drug abuse research to date has been done independently by dozens of countries

using different research methods. Unfortunately, the results have not been comparable across

countries.

In response to this dearth of international comparative drug research, the National Institute of

Justice (NIJ) launched the International Arrestee Drug Abuse Monitoring (I–ADAM) program

in 1998, with the first annual I–ADAM conference in Miami. I–ADAM was designed to provide

an international research platform to study the relationship between drugs and crime and other

social problems. By attempting to identify invariant factors that predict drug use across countries,

I–ADAM has the potential to broaden the research community’s understanding of the nature of

the drug epidemic. More important, I–ADAM is designed to provide a data-driven framework

for informing and coordinating global drug control policy. Many recommendations that are

made regarding global drug control policy are made without the benefit of empirical research.

A fundamental element in designing and planning effective drug control strategies is the presence of extensive and reliable data, which are not available in many countries around the world.

I–ADAM is being designed to meet the needs of policymakers by providing a base from which

data-driven policy recommendations can be generated. I–ADAM data should make it easier for

drug control policies to be coordinated across nations, and improved coordination of drug-control

policies could improve the international community’s ability to combat the pernicious effects of

the global drug trade.
2

I–ADAM in Eight Countries: Approaches and Challenges

One of the most significant barriers to drug policy research has been funding. Most countries do

not have the resources to collect data that are representative of their entire population. However,

I–ADAM is an established monitoring system for focusing on the areas of a nation with the worst

drug problems (the largest cities), and where people using the most drugs (arrestees) can be found.

Also, I–ADAM can provide prevalence estimates for low-base-rate drugs not typically used in the

general population (e.g., heroin and cocaine). Finally, the drug use patterns of arrestees are often a

good indication of future problems. For example, the U.S. program documented high prevalence

rates for cocaine long before the epidemic was detected by drug treatment centers.

Historical Background

In 1987, NIJ created the Drug Use Forecasting (DUF) program to serve as one of the U.S.

Government’s primary sources of information on drug use among arrestees in cities. DUF

became one of the primary research tools on drug use, crime, and related social indicators. In

1997, the DUF program was redesigned and renamed ADAM (Arrestee Drug Abuse Monitoring)

to reflect the geographic expansion and increased methodological rigor of the program and its

development as both a research and policy platform and a system for locally initiated research on

topics identified by sites. At its core, however, the ADAM program preserves DUF’s simple concept: interviewing and drug testing arrestees. A component of the new ADAM program was the

development of an international drug surveillance system among arrestees. The international

element to NIJ’s work is relatively new; in the past, NIJ has worked mostly with U.S. Federal,

State, and local officials. In 1997, the NIJ International Center was launched as the central organizing body of NIJ’s international efforts. Its mission is to stimulate, facilitate, evaluate, and disseminate national and international criminal justice research and information.

With the transition from DUF to ADAM, the development of the I–ADAM program became an

important goal. Prior to the formal launching of the I–ADAM program, two countries—Chile

and England—started collecting ADAM-like data in 1996. 

In April 1998 in Miami, I–ADAM held its first annual conference for representatives from eight

nations (Australia, Chile, England, the Netherlands, Panama, Scotland, South Africa, and

Uruguay), two international organizations (The Organization of American States and the United

Nations International Drug Control Programme), experts in the field of drug surveillance systems, NIJ staff, and other U.S. Federal representatives (the Drug Enforcement Administration

and the National Institute on Alcohol Abuse and Alcoholism).

In July 1998, officials from England’s Home Office announced the second phase of development

for the New England/Wales ADAM program (named NEW–ADAM), which added several new

sites and began a time-series design in revisited sites. The second wave of NEW–ADAM data

collection began in August 1998; two locations were surveyed in that year (South Norwood in

London and Copy Lane in Liverpool). 

With the exception of England (1996) and Australia (March 1998), most countries represented at

the first I–ADAM meeting in Miami did not have funding for I–ADAM work. In August 1998,
3

Introduction and Overview

Chile and Scotland secured funds for I–ADAM data collection, and in November 1998, South

Africa secured funds for I–ADAM work.

Also during 1998, NIJ began conducting field assessments (in Scotland and England in September

1998, Australia in October 1998, Chile in December 1998, and South Africa in January 1999) and

training for interviewer staff (in Australia in January 1999 and Chile in January 1999). In the fall

of 1998, the infrastructure for I–ADAM started to take shape, with the development of the core

survey and an I–ADAM training program.

At the beginning of 1999, Chile and Australia started data collection; I–ADAM held its second

strategic planning meeting in April in Chicago. In addition to those who attended the first meeting,

representatives from Malaysia and Taiwan were present at this meeting. In April 1999, NIJ

released Comparing Drug Use Rates of Detained Arrestees in the United States and England,1 which

represented the first comparative analysis of arrestee drug use rates across two countries and the

first publication of the I–ADAM Program.

In mid-1999, three more sites started collecting data (the Netherlands, Scotland, and South Africa),

and another country (Spain) contacted NIJ and expressed interest in I–ADAM. NIJ visited Madrid

in October 1999 and participated in the Seminarios Internacionales Complutenses. NIJ also participated in an international meeting held by the World Health Organization in Vancouver,

Canada, in December 1999 to generate interest in I–ADAM.

In November 1999, NIJ met with other Federal agencies involved in drug policy work, research,

treatment, and law enforcement. The dual purposes of the meeting were to inform interested

parties about the status, goals and objectives, costs, and future rollout plans for I–ADAM and to

start a dialogue among potential Federal or international funding partners and NIJ. One important

issue discussed at the meeting was the wisdom of expanding I–ADAM from the eight self-funded

countries currently involved to a second generation of I–ADAM sites. At the end of the meeting,

a number of representatives expressed interest in I–ADAM on behalf of their organizations and

their desire to collaborate with NIJ on developing a program.

In December 1999, the Medical Research Council of South Africa released its first I–ADAM

report containing data from three metropolitan sites, and in 2000, a number of countries began

publishing the results of their I–ADAM work. Australia released two I–ADAM publications in

January and two more in March. Additional publications were released by the Medical Research

Council of South Africa in May. Scotland released its first publication in June, and England

released its second program publication in July.

Early in 2000, a number of innovative developments occurred in I–ADAM. In February 2000, the

first international comparison study of two drug testing kits was completed. This study demonstrated the similarity in results between different drug testing kits; the fact that England is using

a different urinalysis kit than the United States does not appear to affect results. In March, data

collection for the first-ever national probability sample of arrestees started in South Africa, and

the program’s first Asian country (Malaysia) began collecting I–ADAM pilot data in May. In

early to mid-2000, a number of important I–ADAM-related meetings were held. First, an

I–ADAM section was added to the U.S. ADAM annual meeting, and the third annual I–ADAM

conference was held in September in Washington, D.C. The third conference was the largest
I–ADAM meeting to date (double the size of the second conference); its more than 50 attendees

included 15 representatives from 11 countries (Australia, Chile, England, Malaysia, Russia,

Scotland, South Africa, Taiwan, Thailand, Ukraine, and the United States), more than a dozen

officials from other U.S. Federal agencies, and researchers and policymakers from a variety of

other organizations.

The year 2000 also contained some setbacks. In June, the Netherlands I–ADAM group stopped

collecting I–ADAM data.

Early 2001 involved a fair amount of I–ADAM activity. In Australia, three reports were released,

and additional funding was approved.1 In announcing funding of $1.8 million to continue the

Australian I–ADAM program, known as DUMA, for a further 2 years, the Honorable Chris

Ellison, Minister for Justice and Customs, said: “DUMA testing for the first time provides the

criminal justice system with quality data on the drugs-crime link and demonstrates the

Government’s commitment to evidence-based policy making.”

In England, a summary report on the NEW–ADAM program covering July 1999 and April 2000

data collection was issued.2 The Honorable Bob Ainsworth, Home Office Minister responsible for

coordinating the Drugs Strategy, welcomed the publication of the study by saying: “The

NEW–ADAM research reveals that the first point in the criminal justice system is picking up a

group of particularly prolific drug using offenders. In 1999–2000, this group represented 15 percent of arrestees. Our target is to reduce the size of this group by one quarter in 2005 and by

a half in 2008.” The summary report presents results of drug use and offending among adult

arrestees in eight locations in England and Wales. It sets baselines for the “Communities”

component of the national antidrug strategy.

In South Africa, the I–ADAM group published a report on the third phase of data collection for

their Three Metros Study, and held a workshop to discuss ADAM findings and implications for

policy3. A panel of South African experts from justice, corrections, drug research, social services

department, offender rehabilitation and police was invited to the workshop to give their views

on the drug-crime situation and what was learned from the data. 

In the United States, the first release of data collected under the new ADAM sampling scheme

and revised survey instrument was made publically available, and ADAM published the

“Methodology Guide” and “Data Analytic Guide” by posting the reports on the ADAM Web

site. Also, a number of international participants attended the 2001 ADAM Annual Conference

held in Miami in June 2001. 

Data collection has also proceeded as scheduled in the other I–ADAM participating countries. In

2001, a few other countries (Barbados, Nigeria, and Venezuela) expressed interest in joining the

I–ADAM effort. Representatives from Thailand who attended the third I–ADAM annual meeting

began preparations to collect I–ADAM data in late 2001 in Chiang Mai city. The three studies are:

1. Makkai, T., and K. McGregor, “Drug Use Monitoring in Australia (DUMA): Annual Report

for 2000,” Research and Public Policy Series, No. 37, Canberra: Australian Institute of Criminology, 2001; Johnson, D. “Age of Illicit Drug Initiation,” Trends and Issues in Crime and

Criminal Justice, No. 201, Canberra: Australian Institute of Criminology, 2001; Makkai, T.,

4

I–ADAM in Eight Countries: Approaches and Challenges
5

Introduction and Overview

“Drug Use Amongst Police Detainees: Some Comparative Data Testing,” Trends and Issues in

Crime and Criminal Justice, No. 191, Canberra: Australian Institute of Criminology, 2001. 

2. Bennett, T., K. Holloway, and T. Williams, “Drug Use and Offending: Summary Results From

the First Year of the NEW–ADAM Research Programme.” Home Office Research,

Development and Statistics Directorate Research Findings 148. London: Home Office, 2001.

3. Parry, C., A. Louw, and A. Plüddemann, “Drugs and Crime in South Africa: The MRC/ISS 3

Metros Arrestee Study (Phase 3).” Research Brief. Pretoria: Medical Research Council and

Institute for Security Studies.

Description of Program

The I–ADAM Program is an international partnership of government-sponsored research organizations. All participating countries/jurisdictions are being operated through local/national funds.

Countries participate in I–ADAM to stay current on the latest scientific methods of arrestee drug

surveillance survey work, take part in comparative data analytic projects on cross-national differences in drug use, and receive technical assistance on the basic operation of a data collection

system.

I–ADAM’s development is important because the existing drug surveillance systems around the

globe, in many cases, are not compatible. Therefore, post-hoc comparisons across countries with

independently designed systems are very difficult. The existing general population household

surveys found in some countries use very different measures of drug use and were not designed

for multinational comparisons. From its inception, I–ADAM has been designed to be a standardized

international surveillance system (with similar instruments, sampling, training, and other protocols).

I–ADAM serves two functions: research and policy guidance. Research might show, for example,

that certain market conditions must exist for particular drug epidemics to thrive. The findings

could then be used by countries that are not experiencing the epidemic to plan prevention efforts.

It is hoped that, in the future, I–ADAM can help form a standard basis for nations to coordinate

drug control policies. A growing substance abuse problem in a country’s arrestee population

can help forecast a potential hot spot for international drug trafficking. Through development of

addendums, I–ADAM can be used to help estimate the characteristics of drug markets around

the world; such data should prove useful for coordinating international drug control efforts.

I–ADAM is a standardized international drug surveillance system that for the first time provides

researchers with a platform to compare the prevalence of drug use among arrestees in different

nations and allow them to assess the consequences of drug abuse within and across national

boundaries. I–ADAM has three main components: voluntary, anonymous, and confidential

interviewing; similar data collection methods; and standardized measures.
6

I–ADAM in Eight Countries: Approaches and Challenges

Voluntary, anonymous, and confidential interviewing

At I–ADAM data collection sites, trained interviewers (who are not in law enforcement) conduct

individual interviews with detained arrestees and collect voluntary and anonymous urine specimens

from interviewees. Every I–ADAM site provides a private or semiprivate interview environment

that is conducive to open, valid, and reliable responses by participants.

Similar data collection methods

Each I–ADAM site uses similar eligibility criteria for selecting study participants. Site staff collect

data from male and female booked/processed arrestees detained long enough to be interviewed

(but less than 48 hours). Study participants are generally interviewed before they have seen a

magistrate or judge, but they have access to legal counsel if they wish to ask about the voluntary

nature of the study.

Data collection from juvenile males and females is optional. Each I–ADAM site attempts to obtain

a sample size large enough to provide a reasonable level of statistical precision where all the main

age and gender groups are represented in sufficient numbers. Typically, the site schedules about 2

to 3 weeks of quarterly interviewing at the jail/lockup. Most I–ADAM sites collect data from 150

adult male and 75 adult female arrestees each quarter to reach a total of 900 arrestees annually.

I–ADAM sites aim to use a definable study/catchment area and to understand the representativeness

of their data. Ultimately, probability-based sampling methods will be adopted at each I–ADAM

site. At I–ADAM sites in England and Scotland, the entire universe of eligible arrestees is interviewed at selected study sites during a selected time period. When the universe of cases is interviewed, the problem of complicated sampling schemes is avoided, but the cost of data collection

increases dramatically. The sites that have adopted population-based data collection schemes

have used this method because of the small number of arrests made in their jurisdictions. By interviewing all of the eligible cases, these sites are able to maximize the number of interviews that can

be conducted in the shortest period of time, thereby reducing the burden of data collection to a few

weeks per quarter.

Standardized measures

In collaboration with NIJ, international sites determine the type and number of drugs in the drug

test panel. Currently, at least five common drugs (marijuana, cocaine, heroin/opiates, amphetamines,

and benzodiazepines) are being tested by all the I–ADAM sites. Also, NIJ has developed a core

I–ADAM survey instrument in consultation with the other I–ADAM sites, and the agreed-on

core survey is being implemented by all the active sites. The development of a revised core

I–ADAM survey, which might include such new topical areas as drug dependency, criminal history, and drug markets, is under consideration. At a later point, common addendum surveys will

be developed for special topical areas (e.g., domestic violence).
7

Introduction and Overview

Organization of This Compendium

The chapters in this report provide a review of the developmental stages of I–ADAM in participating countries, barriers to development, national stakeholders involved in the development of

I–ADAM, research methods used in I–ADAM, and analytic results (if data are available). This

report does not involve direct statistical testing of differences across countries; instead, it is intended

to be descriptive. The report attempts to identify common problems across countries in developing

an I–ADAM site and approaches to resolving those problems. Each country provides a summary

of its I–ADAM results and likely policy implications or applications of its data. Also, site description tables covering sociodemographic characteristics, economic information, and drug use

data are included in the appendix for each I–ADAM country.

All country chapters follow the same basic outline. The first three sections of each chapter provide some broad information about the participating countries. Here, the attempt was made to

provide some context for I–ADAM work in terms of the general sociodemographic conditions

present in each country, the basic operation of the criminal justice system within which I–ADAM

needs to fit, and the status of drug control policy. Section I covers national census information on

each country. A basic demographic profile is provided, including statistics on population size;

geographic size; ethnic, gender, and age distribution; unemployment, poverty, and literacy rates;

income; gross national product; percent living in urban conditions; birth rate; life expectancy;

population growth; mortality rates; and gender composition. Section II provides a description of

the country’s criminal justice system, the arrest process, and the detention system. Prior research

with DUF (and now ADAM) has shown that the study of arrestees is important because they

typically represent the hardcore population of drug users and are the group consuming the

majority of illicit drugs.

Section III examines the general policies in place to deal with drugs in each participating country. A fair amount of variability exists within I–ADAM on the issue of drug control policy. For

example, the Netherlands has a policy of harm reduction, or a medical model. Therefore, consumption of certain small amounts of drugs is tolerated by law enforcement in the Netherlands.

Malaysia, however, has a strict zero-tolerance policy for drugs, and the death penalty exists for certain drug offenses. The overview of a country’s drug control policy helps to explain the drug use of

its population.

Section IV covers the developmental history of I–ADAM in each country. For most participating

countries, this history is fairly recent—beginning around 1998—and the programs have developed

quite rapidly. Section V examines the goals and objectives of I–ADAM. It is important to understand

the local/national focus of I–ADAM and that, without the achievement of local goals, little room

for international work exists. Most participating countries have not formally stated their goals

and objectives, but the authors identify at least some of the broad aims of the program. Section

VI documents the difficult work of getting an I–ADAM site operational and is meant to help

interested countries start a program. Issues reviewed in this section include:

• Obtaining funding.

• Deciding to conduct in-house research or to contract it out.

• Negotiating access to the lockup facilities where arrestees are held.
8

I–ADAM in Eight Countries: Approaches and Challenges

• Learning about the catchment area for the project and how arrestees are processed therein.

• Handling urine specimens.

• Creating a survey instrument that is culturally applicable for the local arrestee population.

• Designing a survey that conforms to I–ADAM core standards but retains its utility for

local purposes.

Section VII reviews the numerous barriers that exist to conducting this type of work, such as

obtaining adequate funding and obtaining a large enough sample to allow sufficient statistical

precision. Given the importance of securing political support for I–ADAM to sustain the program,

section VIII discusses the national stakeholders involved. Section IX reviews the site-specific

research methods used in the program. This section pays special attention to detailing the sampling

scheme and related data collection protocols. Section X reviews training issues. NIJ has developed

a training curriculum and related materials and made it available to all participating I–ADAM

jurisdictions. NIJ and its contractors have also visited each of the countries to assist and/or participate in the development of local training programs. This section identifies difficulties that have been

encountered in training I–ADAM interviewers and areas that need to be focused on in the future.

The final sections review the main data analytic results of I–ADAM in each country (Malaysia did

not have findings at the time this compendium was written), the policy implications of I–ADAM,

and various examples of I–ADAM data applications.

Note

1. Taylor, B., and T. Bennett, Comparing Drug Use Rates of Detained Arrestees in the United States

and England, Washington, DC: U.S. Department of Justice, National Institute of Justice, 1999,

NCJ 175052.
9

AUSTRALIA

Toni Makkai

Doug Johnson

Toni Makkai is director of research at the Australian Institute of Criminology and program director of the

Drug Use Monitoring in Australia (DUMA) project. She has held university teaching and research appointments in England and Australia. Doug Johnson is currently a project officer with the Commonwealth

Attorney General. Prior to this, he was a member of the DUMA project team at the Australian Institute of

Criminology.

DUMA is funded under a 3-year grant from the Commonwealth’s National Illicit Drug Strategy. The data

used here were collected for the Australian Institute of Criminology’s Drug Use Monitoring in Australia

project by the National Drug Research Institute at the Curtin University of Technology, Hauritz & Associates

Pty Ltd, and Forsythe Consultants Pty Ltd, with the assistance of the Queensland, New South Wales, and

Western Australian Police Services. Neither the collectors nor the police services bear any responsibility for

the analyses or interpretations presented here.

The opinions expressed here are those of the authors and do not necessarily reflect those of the Australian

Institute of Criminology.
10

I–ADAM in Eight Countries: Approaches and Challenges

I. Overview of Demographic Profile of Nation

Australia has one of the most stable and conservative democracies in the world. The official Head

of State, the Queen of England, and the Westminster style of government are evidence of its British

heritage. Parliament consists of two chambers, the House of Representatives and the Senate.

Voting is along party lines, and the party that captures a majority of seats in the House of

Representatives—or that can assemble a coalition with a majority of seats—is given the opportunity to form a government. The majority party’s leader becomes the Prime Minister. The

Australian political system is a federal system in which the States have significant power relative to the Commonwealth Government. The country comprises six States and two Territories.

Each State has its own Parliament and Premier, and each guards its sovereignty jealously. The

Territories also have their own Parliaments and Chief Ministers, but they have less sovereignty

over their own internal affairs.

Australia is at once one of the world’s most sparsely populated countries and one of its most

urbanized. A population of 19.1 million, 1/14th that of the United States, occupies a landmass

of 7,692,030 square kilometers, nearly the size of the United States. At the same time, 80 percent

of Australia’s population is clustered in a few large coastal cities at the edge of an otherwise virtually uninhabited continent. Characteristics of the population, including population growth, life

expectancy, birth and death rates, and literacy (see exhibit 1) are in keeping with those of other

industrialized, Western countries.1 Australia’s population enjoys a high standard of living, as

shown in exhibit 2.

Besides its geographic distribution, the other distinguishing feature of Australia’s population

is the role that immigration has played in its growth. Although Australian-born individuals contributed two-thirds of the increase in population between 1901 and 1998, by June 1999, 24 percent

of the population was born overseas. Moreover, although the population is still heavily AngloCeltic in background, the sources of immigration have diversified since World War II.

Drug and Crime Statistics

The primary sources of drug statistics in Australia are the National Drug Strategy Household

Survey on Drug Use, school-based surveys, and the annual Illicit Drug Reporting System (IDRS),

which includes surveys of injecting drug users (IDUs). The household and school surveys are

random samples conducted every 2–3 years and are based on self-report data.2 The most recent

surveys show upward trends in the use of illicit drugs. As shown in the drug arrest statistics

(see exhibit 3), cannabis remains the most popular illicit drug, followed by heroin and amphetamines.

IDRS is conducted annually; IDU surveys are convenience samples that use self-report data. The

IDU surveys show that heroin and amphetamines are the most popular illicit drugs among IDUs.

The Australian Bureau of Criminal Intelligence collects annual data on drug-related issues

(exhibit 3), price, and purity. The average drug purity in 1998–99 was 65 percent for heroin,

51 percent for cocaine, and 17 percent for methamphetamines.3 Prices vary across jurisdictions. In

January–March 1999, the price of a cap (0.1–0.3 g) of heroin was estimated to range from $A25 in

parts of New South Wales to $A1004 in the Northern Territory.
11

Australia

Geographic area 7,692,030 km2

Estimated population 19.1 million

Population by place of origin (1996–99)* 24% overseas born, 73.9% Australian born/nonindigenous, 

2.1% indigenous

Gender distribution† 50.2% female; 49.8% male

Age distribution‡ 0–9 years, 13.7 %; 10–14 years, 6.9%; 15–19 years, 7.0%; 

20–29 years, 15.0 %; 30–39 years, 15.3%; 40–54 years, 

20.9%; 55–64 years, 8.8%; ≥65 years, 12.3%

Life expectancy (at birth for 1996–98 cohort)§ Male, 75.2 years; female, 81.9 years

Population growth rate** 1.1%

Total fertility rate 1.8%

Death rate 5.89 per 1,000

Literacy rate†† Level 1, 17%; level 2, 28%; level 3, 38%;0 levels 4 and 5, 17%

Political subdivisions 6 States: Queensland, Victoria, New South Wales, Western 

Australia, South Australia, Tasmania; 2 Territories: Northern 

Territory, Australian Capital Territory

*As of June 1999. In 1947, 81 percent of overseas-born Australians were from the main English-speaking countries (United Kingdom, Ireland,

New Zealand, South Africa, Canada, and the United States); by 1998, the percentage of overseas-born Australians from these countries had dropped

to 39 percent. In addition, the 1996 census shows that 27 percent of persons born in Australia had at least one parent born overseas. Australian

Bureau of Statistics, Migration, Australia 1998–99, Canberra: Australian Bureau of Statistics, 2000. ABS 3412.0; and Australian Bureau of Statistics,

Year Book Australia 2001, Canberra: Australian Bureau of Statistics, 2001, ABS 1301.0, tables 5.34 and 5.35.

†

Australian Bureau of Statistics, Australian Demographic Statistics, Canberra: Australian Bureau of Statistics, March quarter 2000, ABS 3101.0.

‡

Australian Bureau of Statistics, Population by Age and Sex, Australian States and Territories, Canberra: Australian Bureau of Statistics, 1999,

ABS 3201.0.

§

Australian Bureau of Statistics, Year Book Australia 2001, Canberra: Australian Bureau of Statistics, 2001, ABS 1301.0, graph 5.25 and 

table 5.26; and Australian Bureau of Statistics, Deaths: Australia 1998, Canberra: Australian Bureau of Statistics, 1998, ABS 3302.0.

**For the year ending March 2000. Australian Bureau of Statistics, Australian Demographic Statistics, Canberra: Australian Bureau of Statistics,

March quarter 2000: ABS 3101.0.

††These figures come from a literacy survey conducted by the Australian Bureau of Statistics in 1996 for the second phase of the International

Adult Literacy Survey jointly sponsored by the Organisation for Economic Cooperation and Development and Statistics Canada. See Organisation

for Economic Cooperation and Development, Education at a Glance, Paris: Organisation for Economic Cooperation and Development, 2000, table

A2.3a. Generally, levels 1 and 2 represent very poor and poor literacy; level 3 represents the minimum level for functioning in an advanced society

(high school graduate or college-entry level); and levels 4 and 5 represent command of higher order information processing skills. For a more

detailed discussion of the five levels of literacy, see Organisation for Economic Cooperation and Development and Statistics Canada, Literacy in the

Information Age: Final Report of the International Adult Literacy Survey, Paris: Organisation for Economic Cooperation and Development, and Ottawa:

Minister of Industry, Canada, 2000. For more specific information about the Australian survey, see Australian Bureau of Statistics, Aspects of

Literacy: Profiles and Perceptions, Australia, 1996, Canberra: Australian Bureau of Statistics, 1997; and Australian Bureau of Statistics, Aspects of

Literacy: Assessed Skill Levels, Australia, 1996, Canberra: Australian Bureau of Statistics, 1997.

Exhibit 1. General Demographic Information for Australia

The last national crime victimization survey was undertaken in 1998. Data from this collection found

that the prevalence rate for all offenses against households was 9.0 percent and for all offenses against

persons was 4.8 percent. The most common crime was breaking and entering, with a prevalence rate

of 7.6 percent. The survey found that those who were assaulted during a 12-month period were more

likely to be repeat victims than were victims of other crimes. Forty-six percent of assault victims had

experienced two or more assaults during the previous 12 months.

Since 1993, national crime statistics have been collected on seven major crimes recorded by police

in Australia: homicide, assault, sexual assault, robbery, unlawful entry with intent, motor vehicle
12

I–ADAM in Eight Countries: Approaches and Challenges

Gross domestic product (GDP) (March quarter 2001) $159.0 billion

GDP growth rate (December 2000–March 2001) 0.2% trend, 1.1% seasonally adjusted

GDP growth rate (March 2000–March 2001) 1.6% trend, 2.1% seasonally adjusted

Average weekly earnings (February 2001) $A655.30, all employees, $A844.70, full-time adult 

total earnings

Growth in average weekly earnings 0.8% all employees, 0.6% full-time adult total earnings

(November 2000–February 2001)

Growth in average weekly earnings 5.0% all employees, 4.0% full-time adult total earnings

(February 2000–February 2001)

After-housing poverty rate (1989–90)* 13.0%

Unemployment rate (April 2001) 6.8%

*See Saunders, Peter, “Poverty and Deprivation in Australia,” in Year Book Australia 1996, Canberra: Australian Bureau of Statistics, 1996.

According to statistics cited by the Australian Council on Social Service, the after-housing poverty rate in Australia increased from 8.2 percent

in 1973 to 11.5 percent in 1996. See King, A., “Income Poverty Since the Early 1970s,” in Australian Poverty Then and Now, ed. R. Fincher and J.

Nieuwenhuysen, Melbourne: Melbourne University Press, 1998, cited in Australian Council of Social Service, “ACOSS Submission to the Reference

Group on Review of the Welfare System,” paper 103, Strawberry Hills, Australia: Australian Council of Social Service, 1999: 4.

Sources: Australian Bureau of Statistics, Australian National Accounts: National Income, Expenditure, and Production, Canberra: Australian

Bureau of Statistics, 2001: ABS 5206.0; Australian Bureau of Statistics, Average Weekly Earnings: States and Australia, Canberra: Australian

Bureau of Statistics, 2001: ABS 6302.0; and Australian Bureau of Statistics, Labour Force—Unemployment Rate—Australia—Monthly, Canberra:

Australian Bureau of Statistics, 2001, ABS 6291.0.40.001, table 91.

Exhibit 2. Economic Information for Australia

Total drug arrests 83,5241*

Male 68,193

Female 14,212

Consumers 65,836

Providers 17,688

Percentage of arrests by type of drug

Cannabis 69.6%

Heroin 17.2%

Amphetamines 7.9%

Cocaine 0.7%

Hallucinogens 0.7%

Steroids 0.1%

Other 3.8%

*Male and female arrests do not equal total drug arrests because some data are missing.

Source: Australian Bureau of Criminal Intelligence, Australian Illicit Drug Report 1998–99, Canberra: Australia Bureau of Criminal Intelligence,

2000, tables 11.1 and 11.16.

Exhibit 3. Drug Arrests in Australia, 1998–99
13

Australia

theft, and other theft. The most common crime recorded by police is “other theft,” which includes

pickpocketing, bag snatching, and stock stealing. This category accounts for slightly less than half

of the total recorded crimes. The rates of assaults increased from 1993 to 2000. The rates of property

offenses and robberies also increased from 1993 to 1998, decreased in 1999, and appear to have

increased again in 2000. In 1999, 342 murders were recorded, which represented a rate of 18 per

1 million population; murders decreased by 12 percent in 2000 to 302.5

II. Description of Criminal Justice System, 

Arrest Process, and Detention System

Australia’s federal system of government has implications for its criminal justice system. The States

and Territories administer criminal justice, but “the components and processes of criminal justice

are essentially the same across Australia.”6 Australia is served by eight police forces: one in each State

and the Northern Territory, and the Australian Federal Police, which also polices the Australian

Capital Territory. The Drug Use Monitoring in Australia (DUMA) project operates in three States:

Queensland, Western Australia, and New South Wales.

Exhibit 4 illustrates the usual arrest process for offenders. Once an offense comes to the attention 

of the police, the officer can decide whether to investigate further. If the officer proceeds with 

the investigation, three options are open: The suspect can be issued a “notice to attend” or its

equivalent, given a summons, or arrested. A notice to attend is usually given for relatively minor

offenses. A summons is given for civil offenses such as traffic incidents or tax matters. In both these

Exhibit 4. Arrest Process and DUMA Access

Offense Comes to 

Attention of Police

Charged, given a notice

to attend, released

Brought to a

police station

No further action taken

or a caution given

No charge laid

Returned to 

police cell

Remanded

into custody

Charged/held

for court

Released

on bail

Released

on bail

Charged

DUMA

interviewers
14

I–ADAM in Eight Countries: Approaches and Challenges

instances, the offender is usually not brought to the police station. If the matter is more serious, the

officer can either arrest the suspect immediately and bring him or her to the police station or ask the

suspect to accompany him or her to the station for further investigation. Once at the police station,

the arresting officer can decide to continue with a formal charging process or release the suspect

from custody. If the suspect is charged, the seriousness of the charge will determine whether the

suspect is to be held in custody for a magistrate’s hearing. If the charge is not serious, the suspect is

released on bail following completion of formal charges. In the magistrate’s court, the suspect can

either be given bail and released or refused bail and remanded into custody.

DUMA staff cannot interview a detainee until the arrest process is complete. In some sites, if the

offender is refused bail, he or she is then transferred to corrective services. DUMA personnel

must interview the detainee before the transfer. Some sites also have a maximum detention time.

In New South Wales, the police can detain a suspect for up to 4 hours for investigative purposes

(an application can be made for another 8 hours). After that time, the suspect must be charged or

released. DUMA staff must gain access to the detainee before this deadline. There is a last window

of opportunity to interview those people charged and then remanded into custody by the court;

if remand is within 48 hours after arrest, then data collection can proceed.

Australia has State and Federal courts. Seventy-nine percent of court hearings in 1996–97 were for

criminal matters, which State and Territory magistrates’ courts usually handle. These courts have

no jury and normally cannot impose a sentence longer than 2 years. Most defendants in the

magistrates’ courts are found guilty; the majority of defendants are male. The district or higher

court hears more serious criminal matters.

Defendants who cannot afford their own solicitors can apply for legal assistance, but they have no

constitutional right to representation. On conviction, the courts can impose a range of measures,

including a fine, suspended sentence, community-based supervision order, home detention, periodic

detention, and incarceration. In 1997–98, 74,810 persons were sentenced in Australia. Of these, 25

percent were placed in a community corrections program, 25 percent were given a prison sentence,

and 2 percent were given periodic detention.7 The rate of imprisonment in Australia of persons older

than age 16 has increased significantly in the past two decades, rising 52 percent from 91.6 per 100,000

population in 1983 to 139.2 per 100,000 population in 1998.

III. Status of National Drug Policy

The drug of choice in Australian society is alcohol, and, although the country’s temperance movement was active in the late 19th and early 20th centuries, alcohol was never prohibited.8 Before

Federation in 1901, opium and cocaine were legal and as widely available as alcohol and tobacco.

At the turn of the 20th century, considerable concern grew about the use of opium, particularly

by ethnic Chinese. A combination of factors caused the States to introduce legislation to ban

opium use. During the early 1900s, laws were passed to ban over-the-counter medications,

including heroin. Those drugs no longer could be sold without a doctor’s prescription. A policy

of drug maintenance under the control of general practitioners continued until the early 1950s.

Concurrently, an international outcry about high levels of legal heroin use led to a Federal ban

on the importation of heroin, and Australian States banned the manufacture of heroin within

their jurisdictions.
15

Australia

By the early 1980s, the first cases of AIDS were diagnosed, civil liberties were increasingly being

eroded, the profits from organized crime were growing exponentially, and public officials were

being corrupted by large sums of money from the drug trade. In 1983, the Federal Government

introduced a national harm minimization strategy that was most clearly defined in the 1993–97

National Drug Strategic Plan:

Harm minimization is an approach that aims to reduce the adverse health, social, and

economic consequences of alcohol and other drugs by minimizing or limiting the harms

and hazards of drug use for both the community and the individual without necessarily

eliminating use.9

Successive governments have continued to endorse this policy, but at first, law enforcement was

not supportive. By the 1990s, law enforcement agencies were committed to harm minimization,

at least at the policy level. Throughout the 1990s, a range of drug and crime indicators suggested

that illicit drug use and related criminal activity were increasing. The Federal Government

responded in 1996 with the launch of the National Illicit Drug Strategy (NIDS), which allocated

more money to both supply and demand reduction strategies.

IV. Background History to DUMA

Throughout the 1990s in Australia, deaths due to opioid overdose increased at an alarming rate;

illicit drugs, particularly heroin, were widely available; and open drug markets started to

appear in some cities. Crime, particularly property crime, was increasing. In 1997, the Federal

Government reinvigorated its commitment to a national drug policy by allocating more money

for law enforcement, treatment, and education. Given the severity of the problem and the link

between illicit drugs and crime, the Australian Institute of Criminology (AIC) successfully

applied for funds to conduct the Drug Use Monitoring in Australia (DUMA) pilot project.

The project began collecting data in January 1999 and continued under current funding arrangements until December 2001.

V. Goals and Objectives of DUMA

As a pilot study, DUMA’s primary purpose is to apply the U.S. Arrestee Drug Abuse Monitoring

(ADAM) methodology and questionnaire to Australia; its secondary purpose is to begin collecting credible data on drugs and crime. The project specifically aims to determine whether the

ADAM methodology can provide the following:

• Reliable drug prevalence data on detainees.

• Aggregated data to local and national law enforcement and treatment agencies for monitoring,

evaluation, and assessment purposes.

• Timely and high-quality data to inform policy on drugs and crime.10
16

I–ADAM in Eight Countries: Approaches and Challenges

VI. Getting Started

A. Obtaining Funding

NIDS provided new funds for drug policy, half of which was directed toward supply interdiction efforts. AIC obtained $1.6 million in funding for DUMA over 3 years from NIDS’s supplyside funds, which represents 0.76 percent of the total money allocated to supply-side

intervention strategies.

B. Contracting for Data Collection

AIC does not collect DUMA data itself. Instead, a partnership with local police and local universities or research companies operates at each site. Memorandums of understanding govern the

working relationship between AIC and the data collectors. Each site has its own advisory or

steering committee that deals with local strategic issues. Participating State police services are

well represented on the local committees.

C. Facility Access

Facility access must be obtained at two levels. At the higher level, the State police commissioner

in the relevant jurisdiction must give permission for access. At the second level, local watchhouse

personnel must cooperate with the data collection team. Interviews take place at each site usually

over a 3-week period every 3 months. Fieldwork began in January 1999 at the Queensland

(Southport watchhouse) and Western Australia (East Perth lockup) sites and in the third quarter

of 1999 at the two New South Wales sites in Sydney (Bankstown and Parramatta). Exhibit 5

shows the periods when fieldwork was undertaken. Start dates at each site varied according to

local conditions, but they were generally within a few weeks of each other. The collection of data

at the two New South Wales sites—one after the other rather than at the same time—complicated

matters.

Only adult males were interviewed in the first quarter of 1999 in the Queensland and Western

Australia sites. Collection was expanded to include adult females in Queensland in the second

quarter of 1999 and in Western Australia in the third quarter of 1999. In New South Wales, adult

males, adult females, and juveniles were interviewed from the start. The legal definition of an

adult is age 17 in Queensland and age 18 in Western Australia and New South Wales.

DUMA interviewers cannot be law enforcement officers or court personnel. Given Australia’s

size, interviewers must be recruited locally. Thirty-one interviewers were used across all sites in

1999. The average age of interviewers was 33. Twenty of the 31 interviewers were female, and

23 were Australian born. Interviewers were often postgraduate students enrolled in psychology,

drug research, or criminal justice programs. All interviewers were required to undergo training

before each data collection. As part of the training, they engaged in role playing and discussed

their error reports from the previous collection.
17

Australia

After police processing, DUMA interviewers approached detainees and asked them to participate in a confidential and voluntary research project. Detainees were shown a statement describing the study; interviewers read the statement to those with reading difficulties. Interviewers

pointed out that the detainees did not have to take part in the interview if they did not want to,

they did not have to answer any questions that they did not want to, and they could stop the

interview and leave at any time. Detainees were then asked whether they agreed to take part in

the study.

In 1999, seven people started the interview and chose not to complete it. Detainees could also

choose to complete the interview but not provide a urine specimen. Three hundred and fifty

detainees (25 percent) who completed interviews in 1999 chose not to provide urine specimens;

another 66 (5 percent) tried to produce a specimen but could not. At some sites, detainees were

offered food or coffee or tea to thank them for taking part.

D. Knowing the Catchment Area

Although the sites are referred to by the name of the area where the site is located, the catchment

area may not necessarily reflect the city boundaries. A number of differences were observed

among the four sites. The size of the population in the catchment areas varies greatly (see exhibit 6).

This reflects the nature of each site. The East Perth site is a large, old facility designed to take

detainees from a large portion of the city. Many police stations in the city have the capacity to

handle only a few detainees; the East Perth facility accommodates detainees who are to be held

Hours Number Number Specimens 

Quarter Site Period in facility approached interviewed collected

Q1 Western Australia 01/18/99–01/31/99 248.0 138 116 76

Queensland 01/15/99–02/07/99 160.5 99 93 80

Q2 Western Australia 04/07/99–04/25/99 258.0 162 134 82

Queensland 04/15/99–05/12/99 168.5 170 158 133

Q3 New South Wales* 06/28/99–07/16/99 246.0 108 91 45

(Bankstown)

Western Australia 07/02/99–07/25/99 416.0 158 124 78

New South Wales* 06/07/99–06/27/99 312.0 110 94 43

(Parramatta)

Queensland 07/15/99–08/11/99 193.0 131 131 106

Q4 New South Wales* 10/11/99–11/01/99 298.5 104 87 52

(Bankstown)

Western Australia 11/08/99–11/28/99 344.0 139 105 69

New South Wales* 11/01/99–11/21/99 257.5 137 107 74

(Parramatta)

Queensland 10/08/99–11/04/99 183.3 185 162 140

Total All sites 1999 3,085.3 1,641 1,402 978

* Numbers for the New South Wales sites include juveniles.

Exhibit 5. Fieldwork Information for DUMA Pilot Data Collection
18

I–ADAM in Eight Countries: Approaches and Challenges

overnight if a local police station is not open 24 hours a day or does not have a holding cell available. Sydney has no large central facility for detainees. Local police stations handle their own

detainees and take them from other parts of the city only in emergencies. It is rare for detainees

to be held for longer than 4 hours in these facilities; if they are to be held overnight, they are

transferred to Corrective Services. The Southport watchhouse caters to the entire southeastern

region of Queensland. It is a modern facility with the capacity to hold detainees overnight and

serves the local magistrate’s court.

Police districts do not always overlap with census districts, so it is difficult to determine the precise

characteristics of the catchment areas using census data. Postal codes and local census districts

were used to match the police districts as closely as possible. Exhibit 6 provides basic census data

on each catchment area. East Perth, Bankstown, and Parramatta differ little in terms of the mean

age of the population, the percentage of males, and the percentage of Australian-born people.

The catchment population in Southport has a slightly smaller proportion of people with jobs, and

both Bankstown and Southport have a higher percentage of people who left school at age 14 or

younger. The percentage who have never married ranges from 28 to 32 at all sites.

E. Drug Testing Issues

All drug testing for the DUMA project was conducted at Pacific Laboratory Medical Services,

Northern Sydney Area Health Service, in Sydney. The laboratory is accredited to the Australian

Standards AS3408–1995, and it consistently seeks to improve the sensitivity of its tests. In 2000,

the EMITTM (enzyme multiplied immunoassay testing) assay for methadone and amphetamines

will be changed to CEDIA®. CEDIA shows fewer false positives due to proprietary medications,

and its reagent is more sensitive to MDMA (Ecstasy or XTC) and methylamphetamine.

Urine is routinely tested for six classes of drugs: cannabis, opiates, methadone, cocaine, amphetamines,

and benzodiazepines. A test is deemed positive when the drug or its metabolites are detected at the

cutoff levels prescribed in Australian Standard AS3408–1995.11 Confirmatory tests are undertaken

when a sample tests positive for opiates, amphetamines, or benzodiazepines.

Western New South Wales New South Wales

Criterion Queensland Australia (Bankstown) (Parramatta)

Number of people in catchment area 332,952 294,957 158,358 58,962

Mean age of population (years) 39 38 37 36

Male (%) 49 48 49 50

Australian born (%) 69 62 63 61

Employed (%) 86 92 95 91

Left school at age 14 or younger (%) 16 12 20 11

Never married (%) 28 32 29 28

Source: Australian Bureau of Statistics, 1996 Census, Canberra: Australian Bureau of Statistics, 1997.

Exhibit 6. Profile of Geographical Areas Surrounding DUMA Sites
19

Australia

F. Instrument Issues

Cultural applicability

DUMA has attempted to keep the core questionnaire as close as possible to the U.S. ADAM questionnaire. Throughout 1999, however, changes were made to the instrument based on feedback

from local sites, interviewers, and interviewees. In some cases, terminology did not translate or

distinctions (i.e., summary/indictable) were not appropriate for some sites. As a result of interviewer complaints about the length of the drug grid, it was broken down into separate grids. In

addition, interviewers reported that they were skeptical about detainees’ responses to questions

related to money earned from illegal activities. As a result, these questions have been moved toward

the end of the questionnaire in the hope that initial doubts about the confidentiality of the process

will recede as rapport develops between the interviewer and the interviewee.

Standardization versus local utility

Each site has local concerns, and the pressure to include other questions is always present. The

means of overcoming this pressure is to encourage sites to develop local addenda that can be

used in their jurisdictions to answer specific policy questions.

VII. Barriers to Developing DUMA

Although AIC secured money for the DUMA pilot project, ongoing funding is by no means certain.

The five potential barriers to the long-term development of DUMA are—

• Securing ongoing funding and cultivating greater support at the policy level.

• Further promoting cooperation and dedication of resources by police at the local site. 

• Maintaining a well-trained interview team when the work is intermittent.

• Recognizing and solving ethical problems when dealing with a vulnerable population.

• Addressing legal issues in which neither the interviewer nor the detainee has protections such 

as those provided by the statutory and regulatory confidentiality requirements stipulated 

under U.S. legislation.12

VIII. National Stakeholders Involved in the

Development of DUMA

DUMA is a partnership among AIC, local police, and researchers. Exhibit 7 indicates the general

arrangements by which the DUMA project is overseen. The project has been funded by NIDS to

run pilot sites in three jurisdictions (Queensland, Western Australia, and New South Wales)

over 3 years. It is affiliated with the International Arrestee Drug Abuse Monitoring (I–ADAM)

program and has a scientific advisory committee with whom AIC consults concerning technical

and methodological issues.
20

I–ADAM in Eight Countries: Approaches and Challenges

Each site has a local steering or advisory committee that supports local data collectors, monitors

the local progress of the study, suggests ways of improving the project, and ensures that information is disseminated to relevant local agencies. The committees are made up of a cross-section

of people that includes representatives from local law enforcement and researchers.

IX. Research Methods

No attempt was made to sample within the available pool of detainees. The selected sites were

regarded as having a high volume of detainees relative to other possible sites. Even these sites,

however, processed considerably fewer detainees than comparable U.S. sites. Maintaining 24-

hour coverage would not have significantly increased the number of detainees interviewed and

would have been prohibitively expensive. Interviewers entered the sites when the number of

detainees was expected to be highest.

The major eligibility criterion was that the detainee had not been held in custody for more than

48 hours. Approximately 10 percent of detainees were deemed ineligible by local police, usually

due to an assessment that there was a risk to the interviewer. Thus, the sample was not a random

sample of all detainees brought to the police station or of all persons detained by the local police. 

In all three jurisdictions—Queensland, Western Australia, and New South Wales—police are increasingly using notices to attend court or the equivalent that are issued on the spot rather than bringing

Exhibit 7. Sponsoring Organizations, Participants, and Stakeholders in DUMA

Funded by National 

Illicit Drug Strategy

Scientific

Advisory Board I–ADAM

Local site

manager/coordinator

AIC

Local steering or advisory committee

(AIC, local representatives, local law enforcement, and researchers)

Watchhouse

(local law enforcement) Arrestee

Local 

interviewers
21

Australia

people to the police station for questioning. Normally, these notices are for minor offenses when the

person has no prior criminal record. DUMA has no access to these people.

Because the study is anonymous, interview subjects cannot be tracked across interview periods.

Given that a substantial number of detainees self-reported that they had been arrested in the

previous 12 months, it is likely that some detainees appeared in more than one quarter of interviews. Strictly speaking, the sample is one of detentions rather than detainees.

X. Training Issues

AIC has developed a training protocol manual for each site based on the U.S. National Institute

of Justice protocols for the ADAM program and adapted to local conditions. Sites are required to

train staff before each data collection. In addition, AIC produces a report for each site that details

question-by-question errors by the interviewers to assist in the training process.

XI. National Data Analytic Results

The data represent four quarters of interviews for the Queensland and Western Australian sites

and two quarters for the two New South Wales sites.13 As a result, the total sample size for 1999

was much smaller for the New South Wales sites than for the other two sites (see exhibit 8). In

2000, each site was monitored every quarter. Because fewer women than men are detained by

the police, the sample size for women was considerably smaller, which should be borne in mind

when examining the data for females.

In 1999, the program interviewed 1,402 detainees, 1,366 of whom were defined as adults in their

relevant jurisdiction. Urine specimens were collected from 978 adult and juvenile detainees. Both

the interview and the provision of a urine specimen were voluntary; detainees could choose to

complete the interview and not provide a specimen. Approximately 70 percent of both men and

women who agreed to an interview also provided a urine sample. Only data from adults are presented in this section.

Western New South Wales New South Wales 

Queensland Australia (Bankstown) (Parramatta)

Sample size* 544 479 157 183

Females 15 12 18 14

Males 85 88 82 86

*Gender was not recorded for one person in Western Australia and two people in Bankstown, New South Wales.

Source: Australian Institute of Criminology, DUMA collection 1999 (computer file).

Exhibit 8. Gender Profile of Adult Detainees (%)
22

I–ADAM in Eight Countries: Approaches and Challenges

Across all four sites, detainees of both sexes were usually younger than age 30. The largest concentration by age tended to be in the 21- to 25-year-old group, as shown in exhibit 9.

Detainees were asked if they had been arrested (excluding their current arrest) and if they had

spent time in prison in the previous 12 months. These data are presented in exhibit 10. The pattern is similar across the four sites: approximately half of detainees reported at least one prior

arrest in the previous 12 months, and more than 15 percent had spent time in prison during the

previous 12 months. Parramatta had a slightly higher rate of prior imprisonment for males than

the other sites, and it had the highest percentage of detainees self-reporting a prior arrest in the

previous 12 months. These data indicate that many detainees are cycling through the system and

that interventions are needed to break this cycle.

During the DUMA pilot project, all detainees were interviewed regardless of the charge. Exhibit 11

shows what was determined to be the most serious charge at arrest for the detainees interviewed.

The most serious charge was not always obvious from the charge sheet; interviewers recorded up

to three charges. Information from all three charges was considered when determining the most

serious charge: Violent offenses were assigned the most serious charge, followed by property, then

drug, then traffic (including drunk driving) offenses. All remaining offenses were classified in the

“other” category.

The charge profiles varied among the sites. Southport had the lowest percentage of adult male

detainees charged with a violent offense and the highest proportion charged for traffic offenses

(many for drunk driving). Almost half of the adult male detainees in Parramatta were charged

with property offenses, as were approximately three-quarters of adult female detainees. Drug

arrests across the four sites varied for adult males from 7 percent in Parramatta to 15 percent in

Bankstown. East Perth had the highest percentage of “other” charges, many for outstanding warrants.

Age (years) (%)

Sample size* 17/18†–20 21–25 26–30 31–35 36+

Males

Queensland 464 17 27 23 13 19

Western Australia 422 23 26 20 13 18

New South Wales (Bankstown) 129 22 30 22 12 15

New South Wales (Parramatta) 158 14 26 23 13 24

Females

Queensland 80 25 31 20 5 19

Western Australia 56 20 32 21 7 20

New South Wales (Bankstown) 28 18 32 18 14 18

New South Wales (Parramatta) 25 20 36 24 8 12

*Sample size adds up only to 1,363 because gender was not recorded for one person in Western Australia and two people in Bankstown,

New South Wales.

†

Age of adult is 17 years in Queensland and 18 years in Western Australia; Bankstown, New South Wales; and Parramatta, New South Wales.

Source: Australian Institute of Criminology, DUMA collection 1999 (computer file).

Exhibit 9. Age of Adult Detainees
Violent Property Drug Traffic Other

offense offense offense offense offense

Queensland

Male (n = 459) 14 21 10 37 18

Female (n = 80) 8 32 15 33 13

Western Australia

Male (n = 416) 19 22 9 14 36

Female (n = 55) 16 40 9 7 27

New South Wales (Bankstown)

Male (n = 120) 21 26 15 19 19

Female (n = 27) 11 30 22 26 11

New South Wales (Parramatta)

Male (n = 150) 17 47 7 13 16

Female (n = 25) 12 72 4 8 4

Source: Australian Institute of Criminology, DUMA collection 1999 (computer file).

Sample Arrested in Sample Imprisoned in 

size previous year (%) size previous year (%)

Males

Queensland 464 44 464 15

Western Australia 421 53 420 16

New South Wales (Bankstown) 126 49 128 14

New South Wales (Parramatta) 155 54 155 26

Females

Queensland 80 39 79 19

Western Australia 56 64 56 21

New South Wales (Bankstown) 27 63 28 14

New South Wales (Parramatta) 25 56 24 14

Source: Australian Institute of Criminology, DUMA collection 1999 (computer file).

23

Australia

Exhibit 12 shows the percentage of detainees who tested positive for drugs by gender and site.

Drug use among detainees was common among the sites; approximately three-quarters of adult

male detainees across all sites tested positive for any drug. There were, however, significant variations among the sites for individual drugs. A higher percentage of both male and female detainees

tested positive for cannabis in Southport and East Perth than in the two Sydney sites. By contrast, a

much higher percentage of detainees in the two Sydney sites tested positive for opiates; the rates

for adult males in Sydney were almost double those in East Perth and triple those in Southport.

Virtually no detainees tested positive for cocaine, except in Bankstown, where 12 percent of adult

females tested positive for the drug. Only 4 percent of adult males tested positive for amphetamines in Bankstown, compared with between 12 and 14 percent in the other three sites. Multiple

Exhibit 10. Prior Arrest or Imprisonment of Adult Detainees

Exhibit 11. Most Serious Charge at Arrest (%)
Multiple 

Any drug* Cannabis Opiates Cocaine Amphetamines drugs*

Males

Queensland (n = 389) 73 65 13 1 12 18

Western Australia (n = 270) 74 61 22 <1 14 22

New South Wales

(Bankstown) (n = 71) 78 52 45 3 4 27

New South Wales

(Parramatta) (n = 91) 70 56 39 1 12 35

Females

Queensland (n = 68) 65 59 25 2 10 28

Western Australia (n = 34) 77 59 44 0 27 47

New South Wales

(Bankstown) (n = 17) 70 47 65 12 6 35

New South Wales

(Parramatta) (n = 17) 71 47 59 0 6 35

*Any drug is defined as testing positive for cannabis, opiates, cocaine, or amphetamines. Multiple drugs is defined as testing positive for two or

more of these drugs.

Source: Australian Institute of Criminology, DUMA collection 1999 (computer file).

Exhibit 12. Percentage of Adult Detainees Testing Positive for Any Drugs, by Sex

24

I–ADAM in Eight Countries: Approaches and Challenges

drug use is common. It was highest overall among arrestees in Bankstown and Parramatta—the

two sites with the highest rates of opiate use—although the single group with the highest prevalence rate was female arrestees in East Perth, 47 percent of whom used more than one drug.

Exhibit 13 shows that, consistently across all sites, adult male detainees tested positive for a

range of drugs regardless of the charge for which they were detained. Males detained for minor

offenses up to the most serious violent offenses tested positive for cannabis, opiates, and amphetamines. The positive test rates for cannabis were higher than for other drugs, in part because the

test could detect cannabis use for up to 30 days, whereas it could detect use of opiates and

amphetamines only within the previous 2 to 4 days.

Opiates were detected in similar and significant proportions across all offense categories in all

sites except Southport. In Southport, 32 percent of property offenders tested positive for opiates,

but among those charged with other offenses, relatively few (less than 12 percent) tested positive

for opiates. In the other three sites, a significant percentage of detainees charged with a range of

offenses tested positive for opiates; 23 percent of violent offenders in East Perth, 46 percent of

those charged with “other” offenses in Bankstown, and 46 percent of those charged with traffic

offenses in Parramatta. The strongest correlation in all sites was found between property crimes

and the use of opiates. It was particularly strong in Bankstown, where 78 percent of property

offenders tested positive for opiates.

As with opiate use, amphetamine use occurred across all offense categories. This applied less to

the Sydney sites, which had a relatively small pool of detainees who tested positive for amphetamines. The correlation between violent offending and amphetamine use was nowhere near as
25

Australia

Sample size* Cannabis (%) Opiates (%) Amphetamines (%)

Queensland

Violent offense 57 56 9 11

Property offense 84 71 32 17

Drug offense 35 89 11 17

Traffic offense 143 64 6 12

Other offense 67 57 8 6

Western Australia

Violent offense 52 60 23 15

Property offense 57 68 42 12

Drug offense 22 60 23 23

Traffic offense 38 63 16 16

Other offense 95 57 14 13

New South Wales (Bankstown)

Violent offense 15 67 33 0

Property offense 18 50 78 6

Drug offense 9 67 33 11

Traffic offense 13 39 23 0

Other offense 13 46 46 8

New South Wales (Parramatta)

Violent offense 13 54 23 15

Property offense 42 57 52 12

Drug offense 5 100 20 0

Traffic offense 13 31 46 15

Other offense 11 64 18 0

*Sample size equals number of adult male detainees who tested positive for any drug.

Source: Australian Institute of Criminology, DUMA collection 1999 (computer file). 

Exhibit 13. Percentage of Adult Male Detainees Testing Positive, by Most

Serious Charge

strong as that found between opiates and property offending. In Bankstown, none of the violent

offenders tested positive for amphetamines, but the sample size was small (15 offenders charged

with a violent crime). At the other three sites, from 11 to 15 percent of those charged with violent

offenses tested positive for amphetamines.

XII. Policy Implications and Applications of Data

A key goal of policing is to reduce crime. Given that certain criminal activities are closely associated with illicit drug use, monitoring the use of drugs by detainees is of key importance to law

enforcement. DUMA provides for the first time a reasonable and independent indicator of drugrelated crime in specific areas in Australia.
26

I–ADAM in Eight Countries: Approaches and Challenges

Australian law enforcement has not had a systematic monitoring system to track drug use among

people who come into contact with criminal justice agencies. Much of the discussion on the links

between drugs and crime has been based on anecdotal evidence or localized studies. More rigorous

national collections are required for evidence-based policymaking. DUMA’s goal is to overcome

a significant limitation in Australia’s national surveillance of illicit drug use by undertaking

ongoing monitoring of detainees’ involvement in drugs and crime.

Law enforcement concerns itself with both the demand for and the supply of illicit drugs. To

enact successful policies to intervene in illicit drug markets, long-term monitoring of these markets

is required. As with all commercial markets for major products, local markets are inextricably

tied to global markets; one cannot be understood without the other. To understand supply, one

must understand where, how, and when demand occurs and changes.

The purpose of DUMA is to improve understanding of the supply and demand for illicit drugs

among detainees at the local level while providing comparable data across sites to facilitate the

aggregation of national data. DUMA represents a research platform in the criminal justice system

that can enable monitoring of supply and demand for illicit drugs at the local, national, and

international levels.

DUMA data are now being used in three ways. First, local watchhouse personnel use the data

to ensure a high standard of care for detainees. Appreciation of the types and amounts of drugs

used by those coming into the watchhouse helps watchhouse staff better prepare for any medical

situations they might face. Second, strategic law enforcement analysts at the State and local levels

use the data to improve their understanding of drug consumption patterns and related criminal

activities. Finally, local health agencies use the data to plan new drug treatment options.

Notes

1. Australia’s literacy rate compares favorably with those of the United States and the United

Kingdom. According to the International Adult Literacy Survey, 17 percent of Australian adults

ages 16–65 are at the lowest level of literacy, compared with 23 percent in the United Kingdom

and 24 percent in the United States. In contrast, 17 percent of Australian adults ages 16–65 are

at the highest level of literacy, compared with 19 percent in both the United Kingdom and the

United States. Organisation for Economic Cooperation and Development, Education at a Glance

2000, Paris: Organisation for Economic Cooperation and Development, 2000: table A2.3a.

2. Makkai, Toni, Linking Drugs and Criminal Activity: Developing an Integrated Monitoring System,

Trends and Issues in Crime and Criminal Justice Series No. 109, Canberra: Australian Institute

of Criminology, 1999.

3. Purity levels are calculated only on those seizures that have been analyzed at a forensic laboratory. See Australian Bureau of Criminal Intelligence, Australian Illicit Drug Report 1998–99,

Canberra: Australian Bureau of Criminal Intelligence, 2000: tables 11.11, 11.13, and 11.14.

4. Ibid., tables 11.11, 11.13, and 11.19.
27

Australia

5. Australian Bureau of Statistics, National Crime Statistics/Recorded Crime, Australia, 1993–2000,

Canberra: Australian Bureau of Statistics, 1994–2001, ABS 4510.0. 

6. Wimshurst, Kerry, and Arch Harrison, “The Australian Criminal Justice System: Issues and

Prospects,” in Crime and the Criminal Justice System in Australia: 2000 and Beyond, ed. Duncan

Chappell and Paul Wilson, Sydney: Butterworths, 2000.

7. For more detailed information, see Makkai, Toni, “Crime in Australia,” in Sociology of

Australian Society, ed. Jake Najman and John Western, Melbourne: Macmillan Publishers, 2000.

8. Makkai, Toni, “Harm Reduction in Australia: Politics, Policy, and Public Opinion,” in Harm

Reduction: National and International Perspectives, ed. James A. Inciardi and Lana D. Harrison,

Thousand Oaks, California: Sage Publications, 2000: 171–192.

9. Ministerial Council on Drug Strategy, National Drug Strategic Plan 1993–1997, Canberra:

Australian Government Printing Service, 1993: 4.

10. A more detailed outline of DUMA is provided in Makkai, Toni, Drug Use Monitoring in

Australia (DUMA): A Brief Description, Research and Public Policy Series No. 21, Canberra:

Australian Institute of Criminology, 1999.

11. More detailed information on urinalysis testing is provided in Australian Institute of

Criminology, DUMA: Drug Detection Testing, Research in Public Policy Series No. 25, Canberra:

Australian Institute of Criminology, 2000.

12. 42 U.S. Code 3789g and 28 Code of Federal Regulations Part 22.

13. This section of the chapter draws from data presented in Australian Institute of Criminology,

DUMA: 1999 Annual Report, Research in Public Policy Series No. 26, Canberra: Australian

Institute of Criminology, 2000.
29

CHILE

Luis Caris 

Bruce Taylor

Luis Caris is a psychiatrist and professor at the School of Public Health, University of Chile, where he directs the drug

prevention program. He also is chief of the Alcohol, Tobacco, and Drug Unit, Ministry of Health; a short-term consultant to

the Pan American Health Organization; and a consultant to the Organization of American States–CICAD. Bruce Taylor is

the deputy director of the Arrestee Drug Abuse Monitoring (ADAM) Program at the National Institute of Justice (NIJ). 

I. Overview of Demographic Profile of Nation

Chile is a long, thin country in the extreme southwest of South America. Its closest neighbors are

Argentina to the east and Bolivia and Peru to the north. Chile is more than 2,650 miles long but

only about 300 miles wide at its widest point. Chile is as geographically isolated as it is diverse.

To the south, it reaches into the Antarctic zone; to the west, the Pacific Ocean; to the north, the

Atacama Desert; and to the east, the Andes.

Chile exhibits many of the traits that characterize Latin American countries. Its colonization by

Spain began in the 16th century. The culture that evolved was largely Spanish; the influence of the

aborigines is negligible. The country has a relatively homogenous, primarily mestizo population

with a strong cultural unity (see exhibit 1 for demographic information). Chile has no sizable

minority groups. During its history, a small elite has controlled most of the land, wealth, and political life. Chile did not depend as heavily on agriculture and mining as other Latin American countries; it also developed a manufacturing economy. Chile is one of the more urbanized Latin

American countries, with a substantial middle class. More than 85 percent of the total population 

is urban; the metropolitan area of Santiago, the capital, has a population of more than 5 million.

The Republic of Chile was established in 1821. It is divided politically into 13 regions (Regions

I–XII and the Santiago Municipal Region), 51 provinces, and 300 municipalities. Chile has a

long history of representative democratic government and political freedom, with only a few 

short-lived exceptions. From September 1973 to March 1990, a military junta headed by General

Augusto Pinochet Ugarte presided over the longest period of authoritarian rule in the country’s

history. Chile is governed in accordance with the Constitution of 1980,1 approved by a plebiscite

called by General Pinochet to change the Constitution of 1925. The 1980 Constitution places state

administration in the hands of the President, who appoints the state ministers. The regions are
30

I–ADAM in Eight Countries: Approaches and Challenges

headed by an intendente (intendant), provinces are headed by a gobernador (governor), and

municipalities are headed by an alcalde (mayor). In towns with fewer than 10,000 inhabitants,

the mayor is appointed by the municipal council; in towns and cities with more than 10,000

inhabitants, the mayor is appointed by the President of the Republic.2

Chile is one of Latin America’s most economically developed countries, with a diversified freemarket economy characterized by a high level of foreign trade (see exhibit 2). According to the

human development index, Chile leads all Latin American countries in terms of development

and is categorized as having high development in a world context, ranking 38th overall.3

Although Chile’s crime rates in the early 1990s remained far below those of the United States,

the notion that common crime was rare in Chile until the 1970s and 1980s is a myth. Chile’s

rural areas were plagued with outlaw gangs in the early 19th century. Attempting to analyze

the crime situation under the military regime in the 1970s and 1980s is confusing because the

government and media tended to lump ordinary criminal behavior together with dissident violence. Figures on crime and criminals released by the Instituto Nacional de Estad‘ísticas

(National Statistics Institute—INE) are not enlightening as to the true prevalence of crime in the

country. Neither juvenile nor adult crime rates are broken down by gender, and no statistics are

provided on prison populations. Few, if any, published sources provide general crime statistics,

Exhibit 1. General Demographic Information for Chile

Geographic area 756,950 km2 (+ 1,249,675 km2 Chilean Antarctic Territory*)

Estimated population 15,153,797

Population by ethnic origin 95% white/white-Amerindian, 3% Amerindian, 2% other

Religious affiliation 89% Roman Catholic, 11% Protestant, <1% Jewish

Gender distribution 50.5% female, 49.5% male

Age distribution 0–14 years, 28%; 15–64 years, 65%; ≥65 years, 7% 

Life expectancy (at birth for 2000 cohort) Average, 75.74 years; male, 72.43 years; female, 79.22 years

Population growth rate 1.17%

Birth rate 17.19 per 1,000

Total fertility rate 2.2 children per woman

Death rate 5.52 per 1,000

Literacy rate (age 15 and older) Total, 95.2%; male, 95.4%; female, 95.0% 

Language Spanish

Urbanization rate 85.4%

Political subdivisions 13 regions (I–XII and Santiago Municipal Region), 51 provinces,

300 municipalities

Note: Demographic information is as of 2000, except for the literacy rate, which is estimated as of 1995.

*The United States does not recognize Chile’s claim to the Chilean Antarctic Territory. Chile’s territorial claim in Antarctica partially overlaps

British and Argentine claims. 

Sources: Central Intelligence Agency, The World Factbook—Chile, Washington, DC: Central Intelligence Agency, 2000, retrieved August 15,

2001, from the World Wide Web; http://www.odci.gov/cia/publications/factbook/geos/ci.html; Hudson, Rex A., Chile—A Country Study,

Washington, DC: Library of Congress, Federal Research Division, 1994, retrieved October 24, 2000, from the World Wide Web: http://lcweb.loc.

gov/frd/cs/cltoc.html.
31

Chile

with the main exception of figures for arrests, which are readily available in INE’s Compendio

Estadístico.4 Chile’s reported crime rate of about 1,300 crimes per 100,000 people is low compared

with the reported U.S. rate of about 4,615 crimes per 100,000 people.5

Chile long remained relatively unaffected by either drug trafficking or extensive drug abuse. Small

increases in both occurred during the late 1960s and early 1970s, reflecting an international trend.6

By the early 1970s, Chile had become an important regional center for cocaine processing. Drug

trafficking has been growing in Chile since the early 1980s, not only because of its geographic

configuration and location bordering on the world s two leading producers of coca—Peru and

Bolivia—but also because of its economic stability. With its open-market economy and bank secrecy

laws, Chile is an attractive haven for money laundering. By 1992, Chile’s most serious drug-related

problem involved illicit drug transit along the northern corridor to Africa. In early 1993, a new

cocaine/cocaine paste drug route reportedly came from Bolivia through the Azapa Valley. 

After 1989, drug-related crime increased dramatically, particularly in the north of the country.

In 1990, the police estimated that 20 percent of Africa’s population aged 15 to 34 were habitual

drug users. Of 385 homicides (0.3 per 10,000) in Chile during 1990, nearly 77 (20 percent) were

classified as drug related.

Exhibit 2. Economic Information for Chile

Gross domestic product (GDP) (1999 est.) $185.1 billion

GDP growth rate (1999 est.) –1%

GDP per capita (1999 est.) $12,400

GDP composition by sector (1999 est.) Services, 61%; industry, 33%; agriculture 6%

Major export partners (1998) European Union, 27%; United States, 16%

Japan, 14%; Brazil, 6%; Argentina, 5%

Major export commodities Copper, fish, fruits, paper, pulp, and chemicals

Labor force (1999 est.) 5.8 million

Labor force composition by sector (1997 est.) Services, 59%; industry, 27%; agriculture, 14%

Poverty rate (1998 est.) 22%

Unemployment rate (1999 est.) 9%

Human development index (1998) 0.836

Note: The human development index measures a country’s average achievement in three basic dimensions of human development: a long and

healthy life, knowledge, and a decent standard of living. The index is a composite index of three variables: life expectancy at birth; educational

attainment (adult literacy and the combined primary, secondary, and tertiary enrollment ratio); and per capita Gross Domestic Product (measured

as purchasing power parity in U.S. dollars). Countries are grouped into three categories: high human development (≥0.800 on a scale of

0–1.000), medium human development (0.500–0.799), and low human development (<0.500) (United Nations Development Programme, 

Human Development Report 2000, New York: Oxford University Press, 2000, retrieved July 13, 2001, from the World Wide Web:

http://www.undp.org/hdr2000).

Sources: Central Intelligence Agency, The World Factbook—Chile, Washington, DC: Central Intelligence Agency, 2000, retrieved August 15,

2001, from the World Wide Web: http://www.odci.gov/cia/publications/factbook/geos/ci.html; United Nations Development Programme, 

Human Development Report 2000, New York: Oxford University Press, 2000, retrieved July 13, 2001, from the World Wide Web:

http://www.undp.org/hdr2000.
32

I–ADAM in Eight Countries: Approaches and Challenges

II. Description of the Criminal Justice System,

Arrest Process, and Detention System

Criminal Code

The Criminal Code of Chile, first drafted in 1870 after two unsuccessful attempts, was promulgated

in 1874 and modified in 1928 and again in 1930. Its models were the criminal codes of Austria,

Belgium, France, and Spain. The death penalty, abolished in 1930, was reinstated for certain crimes

in 1937 and abolished again in 2001. 

The Criminal Code is divided into general and special sections. The general section enumerates

general principles of criminal law relating to jurisdiction, the concept of crime, attempted crime,

second-party participation in the commission of crime, habitual criminals, penalties, and circumstances that exclude or extinguish criminal responsibility. The special section defines specific

offenses and their appropriate penalties. The courts are charged with ensuring that the penalty is

appropriate not only to the crime but also to the criminal’s culpability.7

Classification of Crimes

Crimes are divided into three basic categories: crímenes (serious crimes), delitos (minor

crimes), and faltas (misdemeanors). A crime is defined as a voluntary act or omission for

which the law imposes punishment. Criminal responsibility is specifically excluded in cases 

in which the defendant is insane or younger than 10. Minors 10 to 16 years old are not held

criminally responsible unless it can be proven that they acted with full understanding of their

acts. Criminal responsibility is also excluded for violent acts committed in the defense of one’s

own person, property, or rights; those of one’s spouse; or those of a third party. Other excluded violent acts are those committed—

• Accidentally in the exercise of a legal act.

• In the exercise of public duty.

• Under duress or fear.

• Resulting in the killing or wounding of the accomplice of an adulterous spouse.

Criminal responsibility is also excluded for crimes of omission owing to a legal or irresistible

cause. Suicide and attempted suicide are specifically decriminalized.8

Arrest Procedure

The Chilean Constitution states that no one may be arrested or detained unless on the order 

of a public official empowered by law. The police may detain someone caught in the act of

committing a crime or based on suspicion. On detention, an arrestee must be brought before a

competent judge within 24 hours. The Constitution allows civilian and military courts to order

detention for up to 5 days without arraignment and to extend the detention of suspected ter-
33

Chile

rorists for up to 10 days. The law affords detainees 30 minutes of immediate and subsequent

daily access to a lawyer and to a doctor to verify their physical condition. The law does not

permit a judge to deny such access. The Constitution allows judges to set bail.9 Trial by jury 

is not provided for, and heavy reliance is placed on police evidence in criminal cases. 

The Courts

The founders of Chile drew from the example of the United States in designing the institutions 

of government, and from Roman law and Spanish and French traditions, particularly the

Napoleonic Code, in designing the judicial system. The 1925 Constitution introduced reforms

aimed at depoliticizing and improving the judicial system by guaranteeing judicial independence.

The organization and jurisdiction of Chile’s courts were established in the Organic Code of the

Tribunals (Law 7,241), adopted in 1943. This law has been modified on several occasions, mostly

recently by Organic Constitutional Law 18,969 of March 10, 1990, and Law 19,124 of February 2,

1992. Chile’s ordinary courts consist of juzgados de letras (local courts), major claims courts, the

cortes de apelación (appellate courts), and the Supreme Court. There is also a series of special

courts, such as the juvenile courts, labor courts, and military courts in peacetime. The local courts

consist of one or more tribunals specifically assigned to each of the country’s communes, Chile’s

smallest administrative units. In larger jurisdictions, the local courts may specialize in criminal or

civil cases, as defined by law. Chile’s 16 appellate courts each has jurisdiction over 1 or more

provinces.10

The Penal System

Chile’s penal system has been standardized since 1930, coming under the jurisdiction of the

Minister of Justice. The system emphasizes rehabilitation of the offender. The degree of confinement is reduced progressively throughout the prisoner’s sentence and ends, subject to good

behavior, in conditional release for periods up to 50 percent of the total sentence. Chile has

approximately 140 penal institutions with a total capacity of approximately 15,000 inmates;

in 1990, however, the estimated number of prisoners was larger than 25,000. During the third

quarter of 1990, for example, Santiago’s San Bernardo Prison, designed to hold 800 prisoners,

housed 3,300 inmates.11

III. Status of National Drug Policy

In 1999, a comprehensive revision of Chile’s 1995 counternarcotics law was undertaken and 

proposed strengthening changes were drafted. The changes focus on authorizing flexibility in

sentencing (currently, the minimum sentence is 5 years regardless of severity of the offense),

combating money laundering through mandatory reporting of transactions and creation of a

financial intelligence unit, and harmonizing the drug code with Chile’s ongoing legal reform.12

The Chilean Government’s coordinating body for drug policy and demand reduction activities 

is the Consejo Nacional para el Control de Estupefacientes (National Drug Control Council—

CONACE). CONACE’s 2001 annual budget of approximately $15.2 million represents a real
34

I–ADAM in Eight Countries: Approaches and Challenges

increase of more than 30 percent from its 2000 budget. Of CONACE’s 2001 budget, $8.2 million 

is earmarked for demand reduction programs—$3.1 million for community-based prevention

programs, $2.6 million for prevention targeted at schools, and $2.5 million for drug treatment.

Resources to be channeled to school- and community-based programs will double under the

2002 budget.13

In a major drug policy initiative in 1998, CONACE decentralized its national project bank for

drug prevention, education, and rehabilitation. As a result of the decentralization, regional councils and local municipalities gained more input in projects that account for approximately 

90 percent of the national project bank’s funds. Individual projects also can be proposed and

implemented by nongovernmental organizations, local governments, universities, and other

institutions.14

Chile is not considered a center of production of illegal drugs. Partly because of its geographic

isolation, it has until recently avoided many of the problems created by illegal narcotics in other

South American countries.15 As a consequence of the expansion of drug trafficking and narcotics

abuse during the late 1960s and early 1970s, Chile’s first antinarcotics law had been passed by

1973. Later, the Government formed a special narcotics unit and began a highly effective crackdown, bringing the narcotics problem under control within a year. Government antidrug forces

also pioneered a youth education program against narcotics. The dismantling of a large drugtrafficking and money-laundering ring in May 1998 demonstrates the Government’s continued

efforts to counter drug smuggling and related criminal activity.16

Chile is a party to the 1988 United Nations Drug Convention. Government and private organizations support drug-abuse prevention and rehabilitation programs. Chile continues to play a

leading role in the Organization of American States’ Comisión Interamericana para el Control

del Abuso de Drogas (Inter-American Drug Abuse Control Commission—CICAD), including

its efforts to create a multilateral evaluation mechanism to combat illegal drug trafficking and

abuse. Chile worked closely with CICAD in the area of money laundering in 1998 and sponsored

public- and private-sector seminars on the topic.17 Chile has joined the Grupo de Acción Financiera

de Sudamérica Contra el Lavado de Activos (South American Financial Action Task Force on

Money Laundering—GAFISUD), created in December 2000. In addition, in August 2000, the

U.S. and Chile signed an umbrella agreement to share information, strategies, and resources

to continue joint efforts against narcotics.18

Chile has several ongoing data collection systems that help inform drug policy. I—ADAM will

serve as another indicator of drug use in Chile. Currently, the Chilean Government conducts a

door-to-door household drug survey of a representative sample of the population every 2 years,

a school-based drug survey, a study of emergency rooms similar to the Drug Abuse Warning

Network program in the United States,19 and various treatment facility surveys.
35

Chile

IV. Background History of the I–ADAM Program 

in Chile

In 1994, the Ministry of Health set up an alcohol and drug surveillance/monitoring system aimed

at assessing alcohol and drug abuse in Chile. Monitoring was conducted in several cities and data

were gathered on drug type, drug and alcohol abuse, and health outcomes. Public school students

and people entering hospital emergency rooms, jail detention centers, and treatment centers

answered self-administered questionnaires about the health risks associated with alcohol and/or

drug use, protective behaviors, prevention, and consumption. Data were analyzed to assess the

magnitude of alcohol and drug abuse, and an early warning system against the use of alcohol

and/or drugs was set up. As previously mentioned above, the Government conducts a door-todoor drug survey of a representative sample of the population every 2 years. Although research

has been done in Chile on the relationship between health and drugs/alcohol, the relationship

between drugs and crime has yet to be explored. In 1998, Chile implemented an I–ADAM project

to explore this relationship and to serve as an indicator of drug use in the country. 

As a precursor to its participation in the I–ADAM project, Chilean health authorities conducted

a 10-day study of drug abuse among detained arrestees in March 1997. Five hundred forty-nine

arrestees (499 men and 50 women) from six police stations in the Santiago municipal region participated in the research. The police stations were located in Santiago city, Renca, Nuñoa,

Peñalolén, San Miguel, and Conchalí. Chilean police bring all persons arrested for nontraffic

offenses to the police stations for booking. During this 10-day period, researchers attempted to

interview all arrestees: 75 percent of the arrestees approached by the research staff agreed to

take part in the study, and 75 percent of those who participated agreed to provide a urine specimen. Because of budget restrictions, urine testing was done only for cocaine and marijuana. The

study instrument and a report of this study are available only in Spanish.

V. Goals and Objectives of I–ADAM in Chile

The primary aim of I–ADAM in Chile is to generate drug abuse surveillance/monitoring data.

Program objectives include the following:

• Testing the applicability of the I–ADAM research methodology.

• Assessing the applicability of the I–ADAM instrument.

• Describing the types and forms of drug use in detention centers.

• Generating information concerning the magnitude of substance abuse in the arrestee 

population.
36

I–ADAM in Eight Countries: Approaches and Challenges

VI. Getting Started

A. Obtaining Funding

The Ministerio de Salud (Ministry of Health) funds and operates the I–ADAM program in Chile.

The Ministry of Health has five divisions, one of which is the División de Salud de las Personas

(Division of the People’s Health). This division has three components: the Departamento de

Programas de Las Personas (People’s Health Program), Departamento de Epidemiología

(Department of Epidemiology), and Departamento Odontológico (Department of Odontology).

I–ADAM in Chile is operated as a research program of the People’s Health Program; its name is

Vigilencia Epidemiologica Drogas en Chile (Drug Epidemiological Surveillance in Chile).

Because Chile’s I–ADAM program is administered by employees of the Ministry of Health, nearly all the costs associated with this research are absorbed as part of employees’ salaries. The only

extra costs incurred by the I–ADAM program are for the laboratory costs of urine testing and

overtime pay for the field site director and the team of interviewers to conduct the research interviews. I–ADAM management aimed for two data collection points per year at each site. Funds

were allocated for one data collection point in 1998 and for two data collection points in 1999.

Efforts are under way to seek funding from the Ministries of Health and Justice and from foreign

and multinational agencies and foundations operating in Chile.

B. Contracting for Data Collection

As indicated above, this project was conducted in house by staff of the Ministry of Health. Hiring

a contractor to conduct this work was considered cost prohibitive.

C. Facility Access

Access to the lockup facilities was secured through a partnership between the Ministry of Health

and the Carabineros (the national uniformed police). The mayors (commanders) of the comisarías

(police stations) gave research staff written permission to conduct the study and gain access to

the jails. Because police were not accustomed to having research conducted in their jails, they

were briefed in detail about the scope of the project.

D. Knowing the Catchment Area

The 1999 I–ADAM study was conducted in select comisarías in three municipalities of the capital

city of Santiago: the First Police Station of Santiago, the Fifth Police Station of Conchalí in the

northern part of the city, and Lo Espejo in the southern part of the city. Data collection sites were

selected based on their case flow and neighborhood characteristics. One site is in the heart of a

thriving downtown commercial area that has arrestees from all socioeconomic levels; another

site is an active drug-trafficking area; the third site has many drug addicts. Future research sites
37

Chile

will include police detention centers in either Valparaiso or Inquinque. Collaboration among the

Ministry of Health, the director general of the Carabineros, and police station commanders made

access to selected research sites easier.

E. Drug Testing Issues

Because of the relative scarcity of high-volume drug-testing equipment in Chile, drug testing is

expensive in the country. After a search, it was determined that PharmChem, the U.S. laboratory

that conducts the U.S. ADAM drug testing, offered the most affordable option for the I–ADAM

group in Chile. PharmChem used the EMITTM (enzyme multiplied immunoassay testing) system—the same system used by the U.S. ADAM program—to screen for the presence of drugs in

urine. Samples were tested for alcohol, amphetamines, barbiturates, benzodiazepines, cocaine,

marijuana, methadone, methaqualone, opiates, PCP, and propoxyphene.

F. Instrument Issues

The questionnaire used in the I–ADAM Chile study was based on the early Drug Use

Forecasting (DUF) questionnaire.20 The National Institute of Justice (NIJ) translated the DUF

questionnaire and sent it to the Chilean research team for review. Minor edits and adaptation

to the Chilean idiom were made, and it was deemed necessary to add as well as remove a few

questions on the basis of cultural applicability. Several drug market questions were dropped,

and the list of drugs to be queried on the drug grid was revised. The self-report survey

includes the following drugs: alcohol, marijuana, coca paste, crack cocaine, powder cocaine,

heroin/opiates/dilaudid, amphetamines, methamphetamines, inhalants, and tranquilizers.

Some housing questions, illegal income questions, and the ethnicity question were removed.

Cultural applicability

Spanish is the official language of Chile, and virtually everyone is conversant in Spanish.

Therefore, it was decided to use only one questionnaire designed in Spanish. Arrestees who

could not speak Spanish were deemed ineligible and were excluded from the survey.

Standardization versus local utility

The same questionnaire is used across all sites in Chile. It was not found necessary to adjust the

questions for local cultural differences. Because cultural standardization is particularly relevant

when making comparisons across countries, the I–ADAM Chile survey includes a series of core

questions that are used in the ADAM surveys in the United States and other I–ADAM participating countries.
38

I–ADAM in Eight Countries: Approaches and Challenges

VII. Barriers to Developing I–ADAM

To date, the development of the Vigilencia Epidemiologica Drogas en Chile has run smoothly.

Nonetheless, barriers arose at the onset of the program. The primary barrier to establishing

I–ADAM in Chile has been obtaining funding and establishing the legitimacy of the research.

Full government support and funding is needed to implement the program. Although the

Ministry of Health earmarked funds for the program in 1999, 2000, and 2001, long-term funding

has not yet been obtained. As noted earlier, program managers are soliciting the Ministry of

Health, the Ministry of Justice, and foreign sources of funds such as CICAD, the United Nations

Drug Control Programme, and the American Embassy in Chile.

VIII. National Stakeholders Involved in the

Development of I–ADAM

The key players involved in developing and implementing I–ADAM in Chile are the Ministry of

Health (the minister and undersecretary), the Ministry of Justice (the Ministry’s representative to

CONACE, the acting undersecretary, and the division directors), and the Carabineros (the director

of the Departamento Control Drogas y Prevención Delictual—Department of Drug Control and

Crime Prevention).

A cooperative relationship has been established among representatives of these Government

agencies. The Ministries of Health and Justice have expressed an interest in ADAM as a platform

for developing policy-relevant research pertaining to drug control activities and the health consequences associated with drug use. The director of the Department of Drug Control and Crime

Prevention has expressed a special interest in international research, especially the potential for

comparative data applications.

IX. Research Methods

The I–ADAM program in Chile has two fundamental components: a questionnaire administered

in a booking facility by a trained interviewer to an arrestee within 48 hours of the arrest and a

urine specimen collected from the respondent that is used to corroborate statements about recent

drug use.

Each of Santiago’s 49 municipalities has its own police force. Chile has a uniformed police force

(Carabineros) and a nonuniformed police force (Policia de Investigaciones) similar to the U.S.

Federal Bureau of Investigation. Nonuniformed officers work at the federal level and deal with

national issues. A judicial order must be issued before nonuniformed officers can initiate an

investigation. Uniformed officers staff comisarías and make arrests. Only persons arrested by

uniformed officers are eligible for inclusion in the I–ADAM study.
39

Chile

Anyone arrested for a crime, including the least serious nontraffic offense, is brought to the

municipal police station for at least 1 hour. The arrest information is entered in a logbook and

recorded electronically. All persons arrested are eligible to be interviewed by I–ADAM research

staff. Using the police station’s computer, a list of all cases for any time period can be easily 

reproduced and used for sampling.

Given that the 1999 I–ADAM Chile study was a pilot test, the main purpose of which was to

resolve implementation issues, nonprobability-based sampling methods were used. The three

sites were selected intentionally because of their locations and neighborhood characteristics; they

do not represent the population of arrestees in the nation or in Santiago. As mentioned earlier,

some effort was made to choose a varying group of catchment areas. At the site level, all cases

that met the study eligibility criteria were interviewed. Interviews were done from 8 a.m. to 10

p.m.; no provision was made to compare cases that were not sampled from 10:01 p.m. to 7:59 a.m.

The eligibility criteria for I–ADAM in Chile are the same as in the other I–ADAM participating

countries. Data were collected from adult booked/processed arrestees detained long enough to

be interviewed (but less than 48 hours). Study participants generally were interviewed before

they saw a magistrate or judge, but they had access to legal counsel to ask about the voluntary

and confidential nature of the study. Arrestees who did not speak Spanish or who were deemed

too intoxicated, violent, or mentally unstable did not participate. The 1999 Chile pilot study

included only men.

X. Training Issues

The goal of the I–ADAM training in Chile is to convey to a team of interviewers the practices

and procedures required to conduct scientific research surveys. The training curriculum for the

Chilean I–ADAM data collection team was based largely on the U.S. ADAM training manual.

The development of the curriculum was a joint effort between NIJ and the Chilean Ministry of

Health. Each Chilean interviewer received training using a standard curriculum and manual

that addressed basic and advanced interview skills and site operating procedures. Training was

conducted 2 to 3 days before actual data collection. The training curriculum covered the roles

and responsibilities of key site personnel, a question-by-question review of the survey, the handling and shipping of urine specimens, paired mock exercises, editing exercises (e.g., editing the

survey instrument for proper skip-pattern usage during the interview), interviewer safety, and

a review of the concept of informed consent. Interviewers were required to complete and

demonstrate competence in basic interviewing skills and an understanding of project operating

procedures.

NIJ staff met with staff from the Ministry of Health in November 1998 to visit the facilities,

develop a data collection plan, and meet with stakeholders from the Ministries of Health and

Justice. In January 1999, shortly before data collection started, a U.S. training team was sent to

Chile to help implement the first training of the Chilean field staff. Nurses from the Ministry of

Health conducted the I–ADAM interviews.
40

I–ADAM in Eight Countries: Approaches and Challenges

The group of nurses selected for I–ADAM Chile had extensive experience with arrestees, having

been involved in an earlier study of drug use among detainees. Using nurses to conduct interviews had advantages and disadvantages. Arrestees are reluctant to trust the police and to participate in a research project that looks as if it is sponsored by the police. Using nurses clearly

shows the arrestees that the program is sponsored by the Ministry of Health and the information

will not be used against them. The Ministry of Health is seen as nonrepressive and has a positive

image as a healing organization. One belief was that if the research team did not use uniformed

nurses, few arrestees would participate and give honest responses. The disadvantage to using

nurses, especially in uniforms, is that some comparability problems will emerge with other countries. That disadvantage, however, is offset by the need to collect valid local data.

XI. Data Analytic Results

The initial I–ADAM study in Chile took place January 22–28, 1999, in three detention centers in

the capital city of Santiago: the First Police Station of Santiago (First of Santiago), the Fifth Police

Station of Conchalí, and Lo Espejo.

Uniformed nurses employed by the Ministry of Health conducted the interviews. Every eligible

male arrestee, regardless of the offense with which he was charged, was interviewed. Interview

hours were from 8 a.m. to 10 p.m. Interviews were conducted within 6 hours of the arrestees’

arrival at the detention center and lasted an average of 10 minutes. The interview process went

smoothly; the police took no action that could have influenced the number of respondents or the

quality of the data collected.

Sample Characteristics

Interviews were conducted with 134 adult males in three locations. The largest number (n = 99)

of respondents interviewed were brought to the First of Santiago detention center. When asked,

92 (68.7 percent) of 134 respondents provided urine samples. Two samples were too small to be

analyzed, however, so only 90 samples were tested. 

The age range of the study respondents was from 12 to older than 45; the average age was 29.

Comparisons of the detention centers show that 12- to 19-year-olds made up more than 23 percent of the sample in Conchalí, but 30- to 44-year-olds made up more than 71 percent of those

interviewed at Lo Espejo and about 50 percent of those interviewed at First of Santiago. As seen

in exhibit 3, most arrestees interviewed (50.8 percent) were single. Most interviewees (61.3 percent)

had a full- or part-time job. 

Only 1.5 percent of arrestees reported having no formal education; 48.1 percent had attended

high school. Although none of the respondents at either First of Santiago or Lo Espejo reported

receiving assistance from government programs, 6.3 percent of those interviewed at the Conchalí

detention center were on public assistance. Exhibit 3 shows that the largest group of respondents

were arrested for drug or alcohol offenses in Conchalí and Lo Espejo. In First of Santiago, the

largest group of respondents were arrested for illegal street vending.
41

Chile

Exhibit 3. Sociodemographic Profile of Respondents in Detention Centers

First of Santiago Conchalí Lo Espejo Total

(n = 99) (n = 21) (n = 14) (n = 134)

Age (%)

12–19 11.1 23.8 6.1 11.9

20–29 33.3 28.6 21.4 31.3

30–44 49.5 38.1 71.4 50.0

45 and older 6.1 9.5 1.1 6.7

Marital status (%)

Single 53.6 42.9 42.9 50.8

Married/living together 38.1 38.1 57.1 40.2

Separated/widowed 8.2 19.0 —* 9.1

Educational level (%)

No education 1.0 — 7.7 1.5

Primary school 42.4 28.6 30.8 39.1

High school 42.4 66.7 61.5 48.1

University 14.1 4.8 — 11.3

Source of income (%)

Government assistance — 6.3 — 0.8

Full-time employment 15.6 25.0 53.8 21.0

Part-time employment 40.0 50.0 30.8 40.3

Other 44.4 18.8 15.4 37.8

Monthly income (pesos)

Less than 100,000 23.3 18.8 42.9 25.0

100,000–149,999 33.7 18.8 14.3 29.3

150,000–199,999 23.3 43.8 7.1 24.1

200,000 and above 19.8 18.8 35.7 21.6

Offense type

Violent crime 5.1 23.8 14.3 9.0

Drug and/or alcohol offense 18.2 52.4 64.3 28.4

Property crime 7.1 — 7.1 6.0

Other offense 20.2 23.8 14.3 20.1

Street vendor 49.5 — — 36.6

Detained last year

Yes 57.1 28.6 46.2 51.5

No 42.9 71.4 53.8 48.5

*— = Not applicable.
42

I–ADAM in Eight Countries: Approaches and Challenges

Urine Test Results 

Exhibit 4 shows the test results from the urine samples taken from interviewees. Approximately

48 percent of the respondents tested positive for at least one illicit drug (excluding alcohol), and

12.2 percent tested positive for two or more illicit drugs (9 of the 11 multiple drug users tested

positive for cocaine and marijuana). The highest drug prevalence rate was for marijuana, followed

by cocaine, alcohol, benzodiazepines, and amphetamines. No prevalence was detected for the six

other drugs tested (barbiturates, propoxyphene, methaqualone, PCP, opiates, and methadone).

Respondents’ Self-Reported Drug Use

Exhibit 5 shows respondents’ self-reported drug use during the 3 months before the I–ADAM

interview. Forty-one percent reported having used an illegal drug other than alcohol; 66.4 percent

reported having consumed alcohol. Rates of use of illegal drugs ranged from 32.8 percent for

marijuana to 0.7 percent for inhalants. No interviewees reported having used amphetamines or

methamphetamines in the previous 3 months, although one interviewee tested positive for

amphetamines (see exhibit 4).

Exhibit 6 shows information gathered about arrestees who used all drugs, including coca paste,

powder cocaine, or cocaine in any other form. Information gathered includes marital status, age,

education levels, rates of treatment, and rates of multidrug use. Cocaine users also reported significant levels of use of marijuana, amphetamines, and tranquilizers. This was the case even

Exhibit 4. Urine Test Results for I–ADAM Interviewees (n = 90)

Substance found Prevalence (%)

Marijuana (n = 28) 31.1

Cocaine (n = 24) 26.7

Alcohol (n = 18) 20.0

Benzodiazepines (n = 2) 2.2

Amphetamines (n = 1) 1.1

Barbiturates 0.0

Methadone 0.0

Methaqualone 0.0

Opiates 0.0

PCP 0.0

Propoxyphene 0.0

Any of 9 drugs (excluding marijuana and alcohol) (n = 25) 27.8

Any of 9 drugs (excluding marijuana but including alcohol) (n = 39) 43.3

Any of 10 drugs (including marijuana but excluding alcohol) (n = 43) 47.8

Multiple drugs for 10 drugs (including marijuana and excluding alcohol) (n = 11) 12.2

Any of 10 drugs (including marijuana and alcohol) (n = 54) 60.0

No drugs (n = 36) 40.0
43

Chile

though no interviewees reported having used amphetamines in the previous 3 months (see

exhibit 5). Exhibit 7 shows the reported mean age of first use of certain drugs, ranging from age

15 for inhalants to age 24 for coca paste.

XII. Policy Implications and Applications of Data

The initial I–ADAM pilot data for Chile show a high level of drug and alcohol use (60 percent

of participants tested positive for drugs and/or alcohol) among arrestees in the three Santiago

sites. The data may overstate the level of drug use among all arrestees, however, given that two

of the three pilot sites (Conchalí and Lo Espejo) were chosen in part because of the high levels

of drug- related activity in those areas and that, in those two areas in particular, a majority of

those interviewed had been arrested for drug-related offenses (see exhibit 3). As the number

of interview sites increases and as the I–ADAM project moves into metropolitan areas outside

Santiago, the interview samples will become more representative of the arrestee population as

a whole, and comparisons of arrestee drug use among metropolitan areas can be made.

One unique factor of Chile’s I–ADAM program is the use of uniformed nurses from the Ministry

of Health to interview the arrestees. The rationale behind this has been to gain the confidence of

the arrestees and to encourage participation in the project. Nonetheless, urine testing of arrestees

found that, as in other countries, a higher proportion of arrestees tested positive for drugs (47.8

percent) than admitted to drug use within the previous 3 months (41.9 percent). This indicates

that some portion of arrestees will not be forthcoming about current drug use, even if there is

no incentive for them to conceal their drug use.

The involvement of the Ministry of Health in the I–ADAM program at a basic level may have

another benefit, however, in fostering closer cooperation between the Ministry of Health and

other I–ADAM stakeholders (the Carabineros, CONACE, and the Ministry of Justice) in the

Exhibit 5. Respondents’ Self-Reported Drug Use

Self-reported drug use over the previous 3 months Prevalence (%)

Any drug, excluding alcohol 41.0

Alcohol 66.4

Marijuana 32.8

Coca paste and powder cocaine 21.6

Coca paste 15.7

Powder cocaine 9.7

Stimulants 6.0

Tranquilizers 6.0

Inhalants 0.7

Amphetamines 0.0

Methamphetamines 0.0
44

I–ADAM in Eight Countries: Approaches and Challenges

Exhibit 6. Characteristics of Users of Specified Drugs

Characteristic All drugs (%) Coca paste (%) Powder cocaine (%) Any cocaine* (%)

Reporting use in past 3 months 41.0 15.7 9.7 21.6

Reporting use by site

Lo Espejo 35.7 35.7 0 35.7

First of Santiago 45.5 15.2 12.1 23.2

Conchalí 23.8 4.8 4.8 4.8

Primary age cohort of drug users

20–29 years 32.7 26.8 53.8 25.0

30–44 years 54.5 66.7 30.8 62.5

Highest educational level

Primary school 37.0 50 38.5 47.8

High school 46.3 35 30.8 39.1

University 14.8 10 30.8 13.0

Drug users married/living with someone 46.3 55 61.5 47.8

Reporting use of other drugs 

Marijuana 41.8 0 0 26.1

Powder cocaine 25.5 9.5 — —

Coca paste 10.9 — 9.5 —

Amphetamines — 9.5 53.1 0

Tranquilizers — 9.5 23.4 0

Receiving drug treatment 5.5 9.5 7.7 4.2

Arrested for street drug sales 39 42.9 38.5 29.2

Arrested for other drug/alcohol offenses 24.5 23.8 46.2 33.3

— = Not applicable.

*Coca paste and powder cocaine.

Exhibit 7. Mean Age of First Consumption of Drugs

Drug consumed Reported age

Inhalants 15

Alcohol 16

Marijuana 17

Powder cocaine 22

Coca paste 24
45

Chile

development of drug policy in general. In particular, this may lead to greater cooperation among

the stakeholders in making drug treatment and drug education programs offered by the Ministry

of Health available to arrestees and to the prison population.

Notes

1. The current Constitution of Chile was approved by a plebiscite on September 11, 1980,

and became effective March 11, 1981. The Constitution was again approved and amended

by referendum on July 30, 1989, and amended in 1993. (Constitution of the Republic of Chile,

Santiago: Government Junta, 1980, retrieved October 24, 2000, from the World Wide Web:

http://www.richmond.edu/~jpjones/confinder/Chile.htm; Central Intelligence Agency, The

World Factbook—Chile, Washington, DC: Central Intelligence Agency, 2000, retrieved August 15,

2001, from the World Wide Web: http://www.odci.gov/cia/publications/factbook/geos/ci.html;

Hudson, Rex A., Chile—A Country Study, Washington, DC: Library of Congress, Federal Research

Division, 1994, retrieved October 24, 2000, from the World Wide Web: http://lcweb2.loc.gov/

frd/cs/cltoc.html.) 

2. Hudson, Chile—A Country Study (see note 1).

3. United Nations Development Programme, Human Development Report 2001, New York,

Oxford University Press, 2001, retrieved August 30, 2001, from the World Wide Web:

http://www.undp.org/hdr2001.pdf.

4. Instituto Nacional de Estadísticas, Compendio Estadístico 2000, Santiago: Instituto Nacional de

Estadísticas, Departamento de Servicios al Usuario y Difusión, 2000, retrieved August 15, 2001,

from the World Wide Web: http://www.ine.cl/chileci/compen/compind.htm.

5. U.S. Census Bureau, Statistical Abstract of the United States 2000: The National Data Book,

Washington, DC: U.S. Department of Commerce, Economics and Statistics Administration, 

U.S. Census Bureau, 2000, retrieved August 30, 2001, from the World Wide Web:

http://www.census.gov/prod/www/statistical-abstract-us.html.

6. Hudson, Chile—A Country Study (see note 1).

7. Ibid.

8. Ibid.

9. Bureau of Democracy, Human Rights, and Labor, Human Rights Report, U.S. Department of

State—Chile Country Report on Human Rights Practices for 1997, Washington, DC: U.S. Department

of State, 1998, retrieved August 15, 2001, from the World Wide Web: http://www.state.gov/

www/global/human_rights/1997_hrp_report/chile.html.

10. Hudson, Chile—A Country Study (see note 1).

11. Ibid.
46

I–ADAM in Eight Countries: Approaches and Challenges

12. Bureau for International Narcotics and Law Enforcement Affairs, International Narcotics

Control Strategy Report, 2000—South America, Washington, DC: U.S. Department of State, 2001,

retrieved August 30, 2001, from the World Wide Web: http://www.state.gov/g/inl/rls/

nrcpt/2000/index.cfm?docid=883.

13. Ibid.

14. Bureau for International Narcotics and Law Enforcement Affairs, International Narcotics

Control Strategy Report, 1998—South America, Washington, DC: U.S. Department of State, 1999,

retrieved August 30, 2001, from the World Wide Web: http://www.state.gov/www/global/

narcotics_law/1998_narc_report/samer98_part2.html. 

15. Ibid.

16. Ibid.

17. Ibid; Hudson, Chile—A Country Study (see note 1).

18. Bureau for International Narcotics and Law Enforcement Affairs, International Narcotics

Control Strategy Report, 2000—South America (see note 12).

19. The Drug Abuse Warning Network (DAWN) is a large-scale, ongoing drug abuse data collection system sponsored by the Substance Abuse and Mental Health Services Administration of the

U.S. Department of Health and Human Services. DAWN’s major objectives are to identify substances associated with drug-related episodes and deaths reported by emergency departments

and medical examiners, monitor trends in drug use consequences, detect abuse of new drugs,

and assess health hazards associated with drug use. DAWN abstracts data from records of drugrelated visits to emergency departments of acute care hospitals in the United States and drugrelated deaths reported by 145 medical examiner jurisdictions in 43 metropolitan areas. Since

1988, DAWN emergency department data have been collected from a representative sample of

685 hospitals, including 21 oversampled metropolitan areas. DAWN medical examiner data are

not nationally representative.

20. The Drug Use Forecasting (DUF) program was the predecessor to the ADAM program.

Starting in eight U.S. cities in 1987, DUF was the first program to examine the prevalence of drug

use among arrestees using a combination of interviews and drug testing of a sample of arrestees.

For a history of DUF, see Reardon, Judy A., Drug Use Forecasting Program: Measuring Drug Use in

a Hidden Population, Washington, DC: U.S. Department of Justice, Office of Justice Programs,

National Institute of Justice, 1993, NCJ 144784. 
47

ENGLAND AND WALES

Trevor Bennett

Trevor Bennett is the director of the New England and Wales Arrestee Drug Abuse Monitoring (NEW–ADAM) Program.

He is a university lecturer at the Institute of Criminology, University of Cambridge, and a fellow of Wolfson College,

Cambridge. He has served as acting director and deputy director of the Institute of Criminology. 

I. Overview of Demographic Profile of Nation

The United Kingdom is a union of four countries: England, Wales, Scotland, and Northern

Ireland. The New England and Wales Arrestee Drug Abuse Monitoring (NEW–ADAM) Program

operates, as the name suggests, in England and Wales. Scotland is operating its own pilot program,

and Northern Ireland has not yet begun to implement a program. NEW–ADAM is a national

program that interviews arrestees and tests them for drugs. Surveys are conducted in 16 locations

in 13 of the 43 police force areas in England and Wales. Fifteen of the 16 locations are in England;

1 is in Wales. In one force area, the Metropolitan Police District in London, four sites were selected. The survey sites are evenly spread geographically and cover a range of metropolitan and

large urban areas as well as some smaller and rural districts.

The United Kingdom is a parliamentary democracy. The Parliament in London has full responsibility for England and Wales and partial responsibility for Scotland and Northern Ireland, which

are developing their own national assemblies or parliaments as part of the national devolution of

power. Local governments, which are accountable to the central government, decide how counties

and cities are administered.

England and Wales have a combined population of approximately 51 million (see exhibit 1), of

which nearly 25 million are men and slightly more than 26 million are women. About 25 percent

of the population is younger than age 20. Ninety-four percent of the population is white. The

major nonwhite ethnic groups are black (1.7 percent), Indian (1.6 percent), Pakistani and

Bangladeshi (1.2 percent), and Chinese and other (1.2 percent). 

Exhibit 2 shows crime trends over the past decade using data from the British Crime Survey (BCS),

a national household survey of self-reported crime victimization, and officially recorded crimes

submitted by the police to the Home Office. The BCS is based on a nationally representative sample
48

I–ADAM in Eight Countries: Approaches and Challenges

Exhibit 1. Demographic and Statistical Profile of England and Wales

Population size (1991) 51,100,000 

Population change (%) (1901–91) +57

Area (square miles)* 58,366

Age distribution (1991) (% < 20) / (% ≥ 20) 25.4 / 74.6

Gender distribution (1991) (% females) / (% males) 51.1 / 48.9

Ethnic distribution (% white) 94

Live birth rate (per 1,000 population) 13.7

Death rate (per 1,000 population) 11.2

Life expectancy (% of population age 85 and older) 1.6

Gross average household income (£) £19,680†

Gross domestic product (1991) £582,946m‡

Unemployment rate (1991) (% unemployed age ≥ 16) 8.4§

Urban living (% of land area designated as nonrural) 54

Poverty rate (% of households below 60% median income) 18**

Literacy rate (1996) 55

*Includes both land and water.

† Includes retired and nonretired households. Figure is for the financial year 1997–98 in the United Kingdom, including Scotland and

Northern Ireland.

‡ Gross domestic product at market prices: output approach. Covers the United Kingdom, including Scotland and Northern Ireland.

§ Males and females. Figure includes Scotland and Northern Ireland. Rates calculated as a percentage of the economically active population.

**For Great Britain, including Scotland. 

Sources: Wisniewski, D., ed., Annual Abstract of Statistics: 2000 Edition, London: Her Majesty’s Stationery Office [HMSO], 2000; Matheson, J.,

and C. Summerfield, Social Trends 30: 2000 Edition, London: HMSO, 2000; United Nations Development Programme, Human Development

Report 1996, Oxford: Oxford University Press, 1996.

Exhibit 2. Crime Trends in England and Wales

Number of crimes (in millions)

1991 1992 1993 1994 1995 1996 1997 1998* 1999

British Crime Survey

(national household survey 

of victim-reported crime)† 15.1 18.6 19.2 16.4 14.7

Police-recorded crime

(crimes officially recorded 

by the police) 5.3 5.6 5.5 5.3 5.1 5.0 4.6 4.5 4.5

*From 1998 on, totals were calculated on the fiscal year. Before 1998, calculations were based on the calendar year.

† The British Crime Survey was conducted only in odd-numbered years during the period 1991–99.

Sources: Home Office, “The 2000 British Crime Survey,” Home Office Statistical Bulletin 18/00, London: Home Office, 2000; and Home Office,

Criminal Statistics England and Wales, 1999, London: HMSO, 2000.
49

England and Wales

of the population aged 16 years and older (19,411 persons in 2000) and ascertains the number of

personal and household victimizations. Police-recorded crimes include only those offenses reported to and recorded by the police.

The two data sources show similar movements in crime rates during the past 10 years. Crime

increased during the first half of the 1990s, peaking in 1992 for police-recorded crime and 1995

for BCS-reported crime victimization, then declining. Although the BCS covers far fewer offense

types than police-recorded crimes, the number of self-reported victimizations it records far

exceeds the number of crimes recorded by the police.

The findings of the 1998 BCS on self-reported drug misuse (see exhibit 3) show that one-third

(32 percent) of the general population ages 16–59 had tried an illicit drug at some time in their

lives. About 11 percent had done so in the previous 12 months.1 The most widely used prohibited

drugs were cannabis (marijuana) and amphetamines. One-quarter (25 percent) of the general

population had used cannabis and 10 percent had used amphetamines at some time in their

lives. Use of other drugs—e.g., LSD, mushrooms, cocaine, and heroin—was much less common

in the general population. No more than 5 percent of the population reported that they had ever

used any of these drugs.

Exhibit 3. Self-Reported Drug Use Ever and in the Past 12 Months in 

England and Wales, Population Ages 16–59, 1998

Substance Ever (%) In the past 12 months (%)

Any drug 32 11

Amphetamines 10 3

Cannabis 25 9

Cocaine 3 1

Crack 1 <1

Ecstasy 4 1

Heroin 1 <1

LSD 5 1

Magic mushrooms 5 1

Methadone <1 <1

Temazepam* 3 1

Solvents 2 <1

*In the British Crime Survey 1998 report, this category includes other tranquilizers.

Source: Ramsay, M., and S. Partridge. Drug Misuse Declared in 1998: Results From the British Crime Survey, London: Home Office, 1999.
50

I–ADAM in Eight Countries: Approaches and Challenges

II. Description of Criminal Justice System,

Arrest Process, and Detention System

The criminal justice system in England and Wales comprises the police service, prison service,

probation service, judiciary, and various criminal justice agencies, including the Crown Prosecution Service and the legal profession.2 The criminal justice system costs more than £12 billion per

year to run. Nearly two-thirds of all Government expenditures for the criminal justice system is

spent on the police.

The process of arrest and detention is specified by the Police and Criminal Evidence Act of 1984

and its later additions and amendments.3 A police officer may arrest without a warrant anyone

who is guilty of an arrestable offense, who the officer has reasonable grounds to suspect is guilty

of such an offense, or who is about to commit an offense. 

Arrestees are held and processed in a section of a designated police station known as the custody

suite or custody block. The custody suite looks like a small prison. At the entrance is a custody

desk, which is often slightly elevated. This desk is staffed by two or three custody staff, usually

one or two custody sergeants and a police or civilian jailer. Computer terminals on the custody

desk are used to monitor arrestees and obtain Police National Computer (PNC) checks.

The rest of the custody block includes routine cells designated for use by males and females or

adults and juveniles and special cells designated for use when special surveillance or special conditions are required. Two or three designated interview rooms and some nondesignated interview rooms are usually available for solicitors and other outsiders to use. The block also includes

a doctor’s room, a photography and fingerprinting room, an intoximeter room, a kitchen, lavatories, offices, and storage rooms. 

All NEW–ADAM surveys are conducted in police stations that are designated to receive and

process arrestees. Their design follows Home Office guidelines, and they operate under the constraints of the Police and Criminal Evidence Act of 1984 and its Codes of Practice.4 This design

and these constraints strongly affect the research process and how interviews are conducted.

In conducting interviews and drug testing, researchers must take note of the Act’s requirements

that all persons in custody must be dealt with expeditiously and released as soon as the need for

detention ceases to apply. The key issue is whether interviewing and collecting voluntary urine

samples from arrestees delays official processing. The primary method used to avoid delaying

proceedings is to approach arrestees shortly after their arrival at the police station and before

their police interrogation begins.

A second legal problem concerns disclosure. The law relating to disclosure requires the prosecution to make available to the defense any evidence on which it intends to rely in making its case.

Information collected during the interview, the urine sample, and the urinalysis results could

conceivably be used as evidence in court. In England and Wales, the Crown Prosecution Service

has agreed not to use the materials collected as evidence. This does not, however, constrain the

defense from asking for them. 
51

England and Wales

III. Status of National Drug Policy

National drug policy in the United Kingdom, including England and Wales, is determined primarily by the U.K. Anti-Drugs Coordinator in collaboration with the Government. In April 1998,

the Government published a parliamentary paper, Tackling Drugs to Build a Better Britain, based

on a report by the U.K. Anti-Drugs Coordinator. This paper defines the Government’s strategy

on drugs for the subsequent 10 years.5 The paper reported the four main elements of the strategy:

• To help young people resist drug misuse.

• To protect communities from drug-related antisocial and criminal behavior.

• To enable people with drug problems to overcome them.

• To minimize the availability of illegal drugs on the streets.

The U.K. Anti-Drugs Coordinator’s first annual report, published in 1999,6 announced that the

Government had allocated £217 million in new money to tackle drug misuse. The report said that

a large proportion of this money would be aimed at treatment and education during the next 3

years; £6 million would be allocated to research and information gathering, some of which was

used to fund the NEW–ADAM Program.

Evidence exists that the Government has drawn heavily on research findings in devising its

antidrug strategy and will continue to do so in evaluating the strategy’s effectiveness. The Guidance

Notes that accompanied the publication of the parliamentary paper identified the research basis for

some of its initiatives.7 Evidence of the link between drugs and crime was drawn in part from the

report on the first developmental stage of the NEW–ADAM Program.8 Program results will be

used as a performance measure of at least one of the Government’s key objectives—to reduce

opiate and cocaine use among arrestees—and possibly other objectives, including the key objective to reduce the proportion of high-rate drug-misusing offenders.9

IV. Background History to I–ADAM in

England and Wales

The NEW–ADAM Program can be traced to the launch of the previous Government’s antidrug

strategy in a parliamentary paper published in 1995.10 The paper stressed the need to generate

high-quality indicators of drug misuse and develop research on the connections between drug

misuse and crime. The successor strategy, published by the Government in 1998, continued this

focus on the effective monitoring of drug misuse and the need for appropriate performance

measurements.11

In 1995, the Home Office commissioned the University of Cambridge to conduct a feasibility study

on interviewing and collecting urine specimens from arrestees. The project report reviewed the

literature on the U.S. Drug Use Forecasting (DUF) Program—the predecessor to the ADAM

Program. The review concluded that an ADAM-type program was feasible and that much could

be gained from developing such a program in England and Wales.12
52

I–ADAM in Eight Countries: Approaches and Challenges

In the same year, the Home Office received funds to commission the first stage of developmental

research. The primary goals of the research were to develop a procedure for interviewing and

testing arrestees based on the DUF Program in the United States and to generate information

about the prevalence of illegal drug use in police force areas selected as survey sites. The first

stage was conducted from January 1996 to August 1997 in five locations: Cambridge, London

(Hammersmith), Manchester (Trafford), Nottingham, and Sunderland. The research report was

published in 1998 and showed what was widely thought to be a high level of drug misuse

among current samples of arrestees.13

In 1998, the Home Office commissioned the next stage of developmental research, which was conducted from July 1998 to May 1999. The research aimed to build on the early developmental work

and move closer to a research design that might be used as the basis for a national research program. Surveys were conducted in London (South Norwood), Liverpool, and Nottingham. Because

Nottingham had been surveyed 2 years earlier, the second survey provided an opportunity to test

some of the principles involved in measuring trends in drug misuse over time.

In 1999, the Government allocated funds for monitoring drug misuse. Part of these funds was set

aside to develop a national, voluntary program of drug testing and interviewing arrestees. After

a competitive bidding process, the research program contract was awarded to the University of

Cambridge. The NEW–ADAM Program was launched on July 1, 1999.

V. Goals and Objectives of I–ADAM in England

and Wales

The goals and objectives of the NEW–ADAM Program have not yet been formally stated, but

some of the program’s broad aims can be identified based on knowledge of current and past

thinking. One aim of present and past Government antidrug strategies has been to devise a

national measure of drug misuse that can be used in conjunction with other measures of illegal

drug consumption. One formal goal of the NEW–ADAM Program will likely be to generate a

measure of drug misuse that can monitor changes in drug misuse over time and compare prevalence rates of drug misuse across locations as ADAM does in the United States. 

Another program goal is to understand more fully the connection between drug misuse and crime.

One of the main reasons for devising a measure of arrestee drug misuse is to understand patterns

of stability and change in drug misuse among actual and potential offenders. Of particular interest

is the extent to which offenders commit crimes to fund drug misuse and to which these drugmisusing offenders contribute to the total number of crimes committed.

A third goal of the NEW–ADAM Program is to help monitor the effectiveness of the Government’s

overall antidrug strategy. It is expected that one or more performance targets of the strategy will

be linked to information generated by NEW–ADAM. The Government is interested in monitoring

the extent to which its strategy reduces the prevalence of drug-misusing, high-rate offenders,

especially those who commit crimes to fund their drug use.
53

England and Wales

A fourth goal is to help monitor the effectiveness of particular initiatives within the Government’s

antidrug strategy. The BCS results can be used to monitor the spread and utility of the new Arrest

Referral Schemes and Drug Testing and Treatment Orders. The NEW–ADAM Program would

provide broad support to evaluations designed specifically to monitor these initiatives. 

VI. Getting Started

A. Obtaining Funding

The NEW–ADAM Program is funded by a central Government reserve administered by the

Home Office Research, Development, and Statistics Directorate. It is expected that funding will

be awarded in a series of 3-year research contracts. Funds are allocated on the basis of individual

contracts, so long-term funding is not guaranteed. It is hoped that the program will demonstrate

its usefulness in the first 3 years and attract Government funds in the future. 

B. Contracting for Data Collection

The Home Office contracted for data collection and the entire research program through the

research tender to the University of Cambridge. The university directly administers data collection. A team of researchers under contract travels to each survey site and establishes a base

in the area for the duration of the research. 

C. Facility Access

Access to each research site was secured through a multistage process. During the first stage, under

the first 3-year contract, the Home Office wrote letters to all police force areas in England and

Wales to determine interest in hosting the research. The responses to these letters and information

on the number of arrestees processed through the custody suites were assessed, and a sample of

forces was provisionally selected. In the second stage, the Home Office contacted the police forces

selected to arrange preliminary meetings. The meetings typically included representatives from the

Home Office, the University of Cambridge, and senior and junior police officers in the potential

host force. Following the meetings, the representatives, usually without the most senior officers,

visited each force’s custody suite to determine whether it was suitable for the research.

D. Knowing the Catchment Area

The catchment area of each NEW–ADAM survey is the arrest catchment area of the custody

suite, which is usually an entire police division. The police usually provide researchers with a

map of the area. In most cases, the catchment area has boundaries similar to those of the local

government administrative areas. This is not always so, however; in these cases, it is difficult,

but not impossible, to identify the demographic characteristics of the research area. 
54

I–ADAM in Eight Countries: Approaches and Challenges

Exhibit 4 shows the catchment areas of the first eight sites surveyed during the first year of the

NEW–ADAM Program. Most were based in city center police divisions that covered geographic

areas of about 5–10 square miles.

E. Drug Testing Issues

The Forensic Science Service (FSS) Urine Testing Unit at Chepstow conducted screening tests for

both developmental stages of the NEW–ADAM research. During the early stages of the research,

FSS provided information on the correct procedures for collecting urine specimens. The FSS’s collection equipment and recommended chain-of-custody procedures have been used throughout.

Important decisions had to be made about the method of drug testing, including whether to use

confirmatory tests in addition to screening tests, the number and nature of the package of drugs to

be tested, the type of screening test, and the cutoff levels to be used to determine a positive result.

To allow flexibility in making comparisons across areas, FSS was asked to provide the raw data

from the screening test to allow the results to be recalculated using different cutoff levels.

F. Instrument Issues

The questionnaire used in the surveys was based on the early DUF and ADAM questionnaires.

Questions were added or subtracted, and the wording of some questions was changed slightly as

appropriate. The questionnaire is in continual development, and small refinements are often made.

Such changes exact a penalty in time and effort at the analysis stage. Researchers embarking on

I–ADAM programs need to decide when to stop revising the questionnaire. The NEW–ADAM

questionnaire currently includes a main questionnaire and two followup questionnaires, each of

which is administered to alternating interviewees.

Exhibit 4. NEW–ADAM Survey Sites in the First Year of the Program,

1999–2000

City Location Catchment area

Sunderland City suburb Police division

Norwich City center Police division

Newport City center Police division

Southampton City center Police division

Wolverhampton City center Police division

Bournemouth City center Police division

London 1 Bethnal Green Police division

London 2 Hammersmith Police division
55

England and Wales

Cultural applicability 

English is the main spoken language in England and Wales. Relatively few cultural minority

groups do not speak English either as a first or second language. Hence, it was decided to use

one questionnaire designed in English. Arrestees who did not speak English were excluded from

the survey.

Standardization versus local utility 

The same questionnaire is used across all locations. It has not been found necessary to change

the questions to adjust for local cultural differences. The issue of cultural standardization is more

relevant when making comparisons across countries. Therefore, the NEW–ADAM questionnaire

includes a series of core questions that are used in the ADAM surveys in the United States.

VII. Barriers to Developing I–ADAM

The development of the NEW–ADAM Program has run fairly smoothly, but a number of potential barriers had to be tackled from the outset.

The main potential barrier to setting up an I–ADAM program was obtaining the funding and the

legitimacy to carry out the research. The program requires full Government political and administrative support and central, typically Government, funding.

Another potential barrier to developing the program in England and Wales was the legal issue

of disclosure in court of materials collected during the surveys. To avoid researchers being subpoenaed and having the research materials used as evidence (which would be impracticable on a

regular basis), it was necessary for the Crown Prosecution Service to grant the research staff

immunity from disclosure. It is hoped that this reviewable privilege will be given legal status

through an act of Parliament, such as the confidentiality regulations that have been codified in

the United States.14

Another potential barrier was the cooperation of the police. It is important that police at the most

senior level agree to host the research, that middle-ranking officers agree to the procedures proposed in their police stations, and that lower ranking police in the custody suite provide full

access to arrestees and to the confidential materials relating to them. One sensitive issue that had

to be negotiated was the need to interview arrestees shortly after their entry into the custody

suite and before their police interview. Another was the need for full access to custody records

and relevant information from the Police National Computer.
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I–ADAM in Eight Countries: Approaches and Challenges

VIII. National Stakeholders Involved in the

Development of I–ADAM

The key players in developing the NEW–ADAM Program have been the Government, the

Home Office, the police, and the University of Cambridge. The Government has provided the

central funds used to administer NEW–ADAM. Its interest is in monitoring drug misuse and

reducing the number of crimes committed by drug-misusing offenders. The Home Office’s

Research, Development, and Statistics Directorate, the Government’s criminal justice research

arm, administers the central funds set aside for monitoring drug misuse and evaluating

Government strategy. Both the Research, Development, and Statistics Directorate and the

Institute of Criminology at the University of Cambridge are interested in funding and carrying

out high-quality, policy-relevant research. The police are interested in generating policing policy and supporting police research related to tackling drug misuse, which is administered

through the central committee of the Association of Chief Police Officers (ACPO).

Other criminal justice organizations also have an interest in the results of the NEW–ADAM

Program. The Crown Prosecution Service has granted immunity from disclosure of research

materials in prosecuting arrestees taking part in the program. The Forensic Science Service provides advice and conducts all screening tests on urine specimens collected as part of the research.

The local police forces that host individual surveys and their local partners have an interest in

using published survey reports to inform local drug strategies.

IX. Research Methods

Selection of Police Forces

The NEW–ADAM surveys use two-stage sampling. Each of 16 locations will be surveyed once every

2 years. The first stage is selecting the police force areas to be included in the research. During the

first year of the program, surveys of arrestees were conducted in eight locations; during the second

year, surveys will be conducted in eight additional locations. During the third year, surveys again

will be conducted in the eight locations visited during the first year. If the fourth year is funded,

surveys will be conducted in the eight locations visited during the second year.

For several reasons, the choice of police forces to include in the survey could not be based on random sampling. Sampling sites must process a large number of arrestees, be willing to host the

research, and together make up an even geographic spread across England and Wales and across

metropolitan and other urban areas. Because the level of accuracy increases with the number of

survey respondents, single-site surveys can be conducted only in custody suites where a high

number of arrestees are processed. In England and Wales, the number of high-volume sites is

limited. The first review of police force areas identified 16 forces (15 plus the Metropolitan Police
57

England and Wales

District in London) that had custody suites with sufficient numbers of arrestees for data analysis.

Additionally, surveys can be conducted only in police force areas that agree to host the research

and are fully cooperative and committed to it. The chief constable has sole responsibility for

agreeing to provide researchers with access to the custody areas; the Home Office cannot overrule

this decision. Finally, although nearly all the eligible high-volume police force areas were selected

for the program, the final choice was made on the basis of having an even geographic spread. 

Selection of Arrestees for Surveys

The second stage of sampling—the selection of arrestees in the custody block—is based on random

or probability sampling. The research is conducted on a 24-hour, 7-day-a-week basis for approximately 30 days. During this period, all arrestees who pass through the custody suite are potentially

eligible to be selected for an interview, although certain categories of arrestees are rejected from

the outset as ineligible based on the criteria shown in exhibit 5. 

All remaining arrestees are eligible for interview and should be approached by an interviewer.

The method adopted is a 100-percent sample of eligible arrestees, or a census. In theory, all eligible arrestees have an equal probability of being approached for an interview. In practice, there

are several practical reasons why all eligible arrestees are not approached and why all arrestees

approached do not agree to be interviewed or provide a specimen. These are considered as losses

in terms of the sampling procedure and reduce the research contact rates (i.e., the approach rate,

the interview rate, and the specimen collection rate).

Exhibit 5. Criteria for Ineligibility for NEW–ADAM Survey Interviews

Fitness for interview

• Arrestees who are persistently unfit because of drug or alcohol intoxication

• Arrestees who are persistently unfit because of ill health or physical condition

Comprehension of interview and informed consent

• Arrestees with mental disorders

• Arrestees who require an interpreter

Potential danger to interviewer

• Arrestees who may be potentially violent

• Arrestees who are deemed ineligible at the discretion of the custody sergeant or jailer

Drug-testing requirements

• Arrestees who have been in custody for more than 48 hours

• Prison transfers and arrestees who are not at liberty before entering the custody suite

Other research selection criteria

• Children and juveniles

• Arrestees who are held only for breath-test or drunkenness offenses

• Arrestees who have been interviewed previously
58

I–ADAM in Eight Countries: Approaches and Challenges

X. Training Issues

The NEW–ADAM Program does not recruit new researchers for each survey (although this was

done in the first few surveys) or subcontract data collection. The program uses a trained and

dedicated team of researchers who travel to each site. Because each site is surveyed only once

every 2 years, it was not practical to set up a local team of the type used in the United States.

Because England and Wales are relatively small geographically, researchers also can travel from

one location to another relatively quickly.

Researchers are typically recent graduates, usually at a master’s or second-degree level, who

have some experience in criminology (including criminal justice) or the disciplines that make up

criminology (e.g., psychology, sociology, and other social sciences). No formal policy exists on

who can be recruited as interviewers, but the job advertisements usually state as qualifications

an educational background in a social science and research or professional experience working

with offenders or drug users. No formal policy seeks to match interviewers with arrestees in

any way. 

In practice, the team does not remain stable over time. Members of the team leave to pursue their

careers, and new team members are recruited. These new members undergo a similar initial

training before replacing outgoing members.

This method of recruiting a dedicated team of researchers has implications for training. All new

recruits are required to visit program headquarters at the University of Cambridge for an intensive

1-day training session to learn the principles of interviewing and collecting specimens from

arrestees. They are also given study materials to learn on their own.

Training continues through briefing and debriefing meetings for each survey. Briefing meetings

are typically held at each survey location the day before a new survey starts. Debriefing meetings

are typically held shortly after a survey. General issues relating to the survey site and the methods

used are evaluated. Team members regularly meet individually with the program director or

manager to discuss individual training needs and personal development.

XI. National Data Analytic Results

The results of both the first and second developmental stages of the research have been published

in Home Office reports.15 The results of the first annual NEW–ADAM report are currently being

assembled. It is hoped that this will be published in the second half of 2001. In addition to the

program reports, individual force reports are produced, but not for general distribution.

The most recent published report is the second developmental stage report, which covers four

sites surveyed in 1998–99. In total, 740 arrestees were interviewed. The proportion of males in the

samples ranged from 83 to 94 percent across the four survey locations. The percentage ages 16–20

ranged from 16 to 29 percent. The percentage of nonwhite arrestees ranged from 1 to 39 percent.

The surveys showed that 69 percent of arrestees across the four sites tested positive for one or

more drug types (excluding alcohol) and 36 percent tested positive for two or more drugs. The
59

England and Wales

most common drug identified was cannabis (49 percent tested positive), followed by opiates (29

percent), alcohol (22 percent), cocaine (20 percent), benzodiazepines (12 percent), amphetamines

(12 percent), and methadone (8 percent). Liverpool had the highest prevalence rate for positive

tests for both opiates (50 percent) and cocaine (40 percent).

About one-quarter (23 percent) of all arrestees admitted injecting at least one illegal drug at some

time in their lives. One-fifth (20 percent) reported injecting one or more drugs in the previous

12 months. One third (33 percent) said that they were currently dependent on one or more drugs.

One-fifth (20 percent) of the total sample said that they were not receiving treatment for drug

dependence but would like to receive treatment. Forty-two percent of arrestees who reported

using drugs in the previous 12 months believed that their drug use and crime were connected.

The connection cited most often was the need for money to buy drugs. 

XII. Policy Implications and Applications of Data 

Policy Implications

Evidence indicates that the published findings of the first NEW–ADAM developmental stage

report have already had an effect on Government policy. The guidance notes that accompanied

Tackling Drugs to Build a Better Britain acknowledged the first report as a source of research information.16 Evidence on the link between drugs and crime was also drawn in part from the findings

of the first developmental stage report.17 At least one of the key performance measures used to

assess the effectiveness of the Government’s drug strategy will be derived from the NEW–ADAM

Program.

There are also general policy implications from the findings. The results show that a high proportion of arrestees admits taking more than one type of drug and test positive for more than

one type of drug. A notable proportion tests positive for opiates, including heroin, and cocaine,

including crack. Almost half of drug-misusing arrestees state that their drug use and offending

are connected, and many of the measures of drug use correlate strongly with many of the measures of crime.

Data Applications

NEW–ADAM data will be used to monitor drug misuse trends among arrestees to inform

Government drug policy. The data will also be used to evaluate both the Government’s drug

strategy as a whole and individual programs.

These data have many other potential applications. The program has identified a range of problems experienced by arrestees, including health, housing, educational, and employment problems. It

may be possible to monitor these problems and perhaps take advantage of the arrestees’ contacts

with the criminal justice system to address them.
60

I–ADAM in Eight Countries: Approaches and Challenges

The data also can be applied to develop fundamental knowledge about drug misuse and crime

and how they are linked. Basic knowledge can be generated from ADAM surveys about drug

use patterns, drug epidemics, injecting behavior, health issues, ownership and use of guns,

dependency and treatment, and arrestee lifestyles. This knowledge can advance the general

understanding of drug misuse and its related problems.

The data generated by the I–ADAM partnership can be used to compare international trends in

drug misuse. The program allows for monitoring changes in drug misuse across countries and

over time. This evidence can then be used to inform national and international drug policies.

Notes

1. Ramsay, Malcolm, and Sarah Partridge, Drug Misuse Declared in 1998: Results From the British

Crime Survey, London: Home Office, 1999.

2. Home Office, Digest 4: Information on the Criminal Justice System, London: Home Office, 1999.

3. Home Office, Police and Criminal Evidence Act 1984, London: Her Majesty’s Stationery Office

[HMSO], 1986.

4. Home Office, Police and Criminal Evidence Act 1984: Codes of Practice, London: Home Office, 1995.

5. Her Majesty’s Stationery Office, Tackling Drugs to Build a Better Britain: The Government’s 10-Year

Strategy for Tackling Drug Misuse, London: HMSO, 1998 [hereinafter Tackling Drugs: The Government’s

10-Year Strategy].

6. U.K. Anti-Drugs Coordination Unit, Cabinet Office. Tackling Drugs to Build a Better Britain:

United Kingdom Anti-Drugs Coordinator’s Annual Report 1998/99. London: Central Office of

Information, 1999. Ref. J99–4196/9905/040.

7. Her Majesty’s Stationery Office, Tackling Drugs: The Government’s 10-Year Strategy for Tackling

Drug Misuse (see note 5).

8. Bennett, Trevor, Drugs and Crime: The Results of Research on Drug Testing and Interviewing

Arrestees, London: Home Office, 1998 [hereinafter Drugs and Crime: The Results of Research].

9. Her Majesty’s Stationery Office, Tackling Drugs to Build a Better Britain: United Kingdom 

Anti-Drugs Co-ordinator’s National Plan 2000/2001, London: HMSO, 2000.

10. Her Majesty’s Stationery Office, Tackling Drugs Together: A Strategy for England 1995–98,

London: HMSO, 1995.

11. Her Majesty’s Stationery Office, Tackling Drugs: The Government’s 10-Year Strategy (see note 5).

12. Bennett, Trevor, A Feasibility Study of Drug Testing of Arrestees in England and Wales, Report

to the Home Office, Cambridge: University of Cambridge, Institute of Criminology, 1995.
61

England and Wales

13. Bennett, Drugs and Crime: The Results of Research (see note 8).

14. 28 Code of Federal Regulations Part 22.

15. Bennett, Drugs and Crime: The Results of Research (see note 8); Bennett, Trevor, Drugs and

Crime: The Results of the Second Developmental Stages of the NEW–ADAM Programme, London:

Home Office, 1998.

16. Her Majesty’s Stationery Office, Tackling Drugs to Build a Better Britain: The Government’s 10-Year

Strategy for Tackling Drug Misuse, Guidance Notes, London: HMSO, 1998.

17. Bennett, Drugs and Crime: The Results of Research.
63

MALAYSIA

Visweswaran Navaratnam 

Vicknasingam Balasingam 

Hilal Hj. Othman

Visweswaran Navaratnam is a professor at the Center for Drug Research, Universiti Sains Malaysia, where

Vicknasingam Balasingam and Hilal Hj. Othman are members of the project staff.

I. Overview of Demographic Profile of Nation 

Malaysia was created in 1963 through the merger of Malaya (which became independent of

Britain on August 31, 1957), the former British Singapore (which later seceded from Malaysia in

1965), and the provinces of Sabah and Sarawak in northern Borneo. The country is divided into

two main regions 650 kilometers apart, separated by the South China Sea: Peninsular Malaysia

and East Malaysia (Sabah and Sarawak). Peninsular Malaysia borders Thailand to the north and

Singapore to the south. Sabah and Sarawak border Kalimantan (the Indonesian part of Borneo)

and Sarawak surrounds the tiny enclave of Brunei. The peninsula’s west coast borders the Andaman

Sea (Strait of Malacca). The east coast of the peninsula, Sabah, and Sarawak all adjoin the South

China Sea.

Malaysia has a land area approximately the size of New Mexico and a population of more than

23 million. Its capital, Kuala Lumpur, has a population of more than 1 million. The country’s

three largest ethnic groups are Malay, Chinese, and Indian, and the main languages spoken there

include Bahasa Malaysia (the official language), English, Chinese dialects, Tamil, and indigenous

dialects. Malaysia has 13 States and 2 Federal Territories, one of which contains the capital.

Exhibit 1 shows demographic information for Malaysia. 

Several decades of sustained economic growth and political stability have made Malaysia one of

Southeast Asia’s wealthiest countries. It ranks among the medium nations (61st) in worldwide

human development. Exhibit 2 shows economic and development information for Malaysia.

Penang, a relatively small but economically developed island State located in the Andaman Sea

off the northwestern coast of the Malay peninsula, was chosen as the site for Malaysia’s I–ADAM

pilot program. The State was chosen not only for convenience but also because it had a comparatively high rate of drug use and the crimes committed there are similar to those in Malaysia’s

larger cities.
64

I–ADAM in Eight Countries: Approaches and Challenges

As of 1998, the main drug abused in Malaysia was heroin (54.7 percent of recorded cases of drug

abuse). In Penang, 557 cases of heroin abuse were reported in the first 3 months of 2000. In 1998,

4,821 cases of substance abuse1 were reported in Penang, most of which were among 20- to 39-

year-olds.2 From January to November 1999, Penang recorded 4,959 drug users, more than any

other State.3 These high prevalence rates indicate the need for appropriate intervention strategies

to address substance abuse.

Little is known about the prevalence of alcohol abuse in Malaysia. Only recently was a law passed

against drunk driving. Enforcement agencies in Penang rarely test arrestees’ alcohol levels. ADAM

could help clarify the extent of the alcohol abuse by obtaining basic background information.

II. Description of Criminal Justice System,

Arrest Process, and Detention System 

Malaysia is a federal parliamentary democracy with three branches: executive, judicial, and legislative. The head of state, the Yang di-Pertuan Agong (paramount ruler), is a constitutional

Exhibit 1. Basic Demographic Characteristics of Malaysia

Geographic area 330,113 km2

Estimated population 23.26 million (as of November 22, 2000)

Ethnic distribution Bumiputra (Malay), 58.1%; Chinese, 24.3%; Indian, 6.9; others, 3.2%;

noncitizens, 7.5%

Religious affiliation Islam (official), Buddhism, Daoism, Hinduism, Christianity, Sikhism

Gender distribution Males, 51.2%; females, 48.8%

Age distribution 0–19 years, 43.2%; 20–39 years, 33.0%; 40–59 years, 17.7%;

60–75+ years, 6.1%

Life expectancy 70.2 years (male); 75.0 years (female); 72.2 years (average)

Population growth rate 2.3%

Birth rate 24.5 per 1,000

Total fertility rate 3.29 children per woman

Death rate 5.25 per 1,000

Literacy rate (age 15 and older) 86.4% (total); 82.0% (female); 90.7% (male) 

Languages Bahasa Malaysia (official), English, Chinese dialects (principally Cantonese 

and Mandarin), Tamil, Telagu, Malayalam, Panjabi, Thai, and indigenous 

languages

Crime rate 820 per 100,000

Drug use rate 734 per 100,000

Urbanization rate NA

Political subdivisions 13 States and 2 Federal Territories

Sources: National Census Data, Kuala Lumpur: Ministry of Homa Affairs, 2000; Central Intelligence Agency, The World Factbook: Malaysia,

Washington, DC: Central Intelligence Agency, 2000; United Nations Development Programme, Human Development Report 2000. New York:

Oxford University Press, 2000.
65

Malaysia

monarch who is elected to a 5-year term by and from among the hereditary rulers of nine

States. The Parliament (Parlimen) has two houses: the lower house, the Dewan Rakyat, to

which representatives are elected, in principle, to 5-year terms, and the upper house, the Dewan

Nagara, to which senators are appointed by the paramount ruler and the state legislatures for 3-

year terms. The leader of the party who wins a plurality of seats in the House of Representatives

becomes the prime minister and head of the Government. Judges of the Supreme Court are

appointed by the paramount ruler on the advice of the prime minister.4

In colonial times, Malaysia was confronted with the problem of opium use. The British colonial

Government introduced the Dangerous Drug Ordinance and Poisons Ordinance in 1952. Malaysia’s

current antidrug laws, especially those dealing with drug sales, are among the world’s toughest.

Anyone arrested with more than 15 grams of heroin faces a mandatory death sentence. Today,

Malaysia has five main statutes on substance abuse:

• Dangerous Drug Act, 1952.

• Poisons Act, 1952.

• Drug Dependence Act (Treatment and Rehabilitation), 1983.

• Dangerous Drug Act (Special Preventive Measures), 1985.

• Dangerous Drug Act (Forfeiture of Properties), 1988. 

Exhibit 2. Economic Information for Malaysia

Gross domestic product (GDP) US$171 billion

GDP growth rate 5.8%

GDP per capita $3,238

GDP composition by sector Industry, 46%; services, 42%; agriculture, 12%

Major export partners United States, 23%; Singapore, 16%; Japan, 11%; Hong Kong, 5%; 

Netherlands, 5%; Taiwan, 5%; Thailand, 3%

Major export commodities Electronic equipment, petroleum and liquefied natural gas, chemicals, 

wood and wood products, rubber, textiles

Labor force 9.3 million

Labor force composition by sector Manufacturing, 27%; agriculture, forestry, and fisheries, 16%; local trade 

and tourism, 17%; services, 15%; government, 10%; construction, 9%

Poverty rate 15.5%

Unemployment rate (as of June 2000) 3.3% 

Human development index (1998)* 0.771

*The human development index measures a country’s average achievement in three basic dimensions of human development: a long and

healthy life, knowledge, and a decent standard of living. The index is a composite index of three variables: life expectancy at birth; educational

attainment (adult literacy and the combined primary, secondary, and tertiary enrollment ratio); and per capita GDP (measured as purchasing

power parity in U.S. dollars). Countries are grouped into three categories: high human development (≥0.800); medium human development

(0.500–0.799); and low human development (<0.500). See United Nations Development Programme, Human Development Report 2000. New

York: Oxford University Press, 2000.

Sources: National Census Data. Kuala Lumpur: Ministry of Homa Affairs, 2000; Central Intelligence Agency, The World Factbook: Malaysia.

Washington, DC: Central Intelligence Agency, 2000; United Nations Development Programme, Human Development Report 2000. New York:

Oxford University Press, 2000
66

I–ADAM in Eight Countries: Approaches and Challenges

When someone is detained for an offense, a remand order is obtained from the court within

24 hours after the arrest to facilitate investigations. An arrestee can be detained under remand

for up to 14 days, after which formal charges must be made or the arrestee released.

Most arrestees are tested for drug use. If an arrestee tests positive for drugs, a medical officer

will determine whether the arrestee is drug dependent, usually through urine tests and physical

examinations. If an arrestee is found to be drug dependent, the National Narcotics Agency (NNA)

recommends the most appropriate treatment to the court. The two types of treatment are community supervision and institutional rehabilitation, both of which normally last for 2 years, and

both of which are discussed in more detail in Section III. First-time drug offenders and those who

are found to have strong family support are normally recommended for community supervision.

Habitual and hardcore drug users are sent for institutional rehabilitation. After 2 years of institutional rehabilitation, the drug user is placed under community supervision for another 2 years.

If the supervision rules are broken during this period, the offender can be sent to prison for not

less than 3 years.

III. Status of National Drug Policy 

In 1996, the NNA approved the new strategies of the National Drug Policy, in the following

priority order:

• Prevention.

• Enforcement.

• Treatment and rehabilitation.

• Regional and international cooperation.

Prevention, enforcement, and treatment and rehabilitation are the three main strategies;

international cooperation is sought to support these strategies. 

Prevention 

Prevention is a long-term strategy aimed at protecting individuals from drugs. Prevention

programs emphasize individual resistance to drug use and efforts to create an environment

that will protect individuals and community from drug abuse. These efforts include—

• Encouraging young people to reject the drug lifestyle.

• Changing society’s perception of and attitude toward drugs. 

• Mobilizing the community in drug abuse prevention programs.

• Providing alternatives to drugs and encouraging healthier lifestyles.

This strategy has two components: primary and general prevention. Primary prevention involves

developing an individual’s inner strengths through education in positive religious, moral, 

cultural, and social attitudes and values. Programs that have been implemented include preventive drug education in schools, teacher training, and guidance and counseling services. General
67

Malaysia

prevention involves the community in drug control and prevention. General prevention strategies have been implemented through information campaigns, publicity programs, and workplace prevention initiatives.

Enforcement 

Enforcement has three main components: interdiction, legislation, and intelligence. Interdiction

aims to reduce the supply of drugs on the market by preventing the smuggling of illicit drugs into

the country. The strategy emphasizes strengthening and intensifying enforcement measures to

curb the entry of illicit drugs by land, sea, and air. At the same time, aggressive efforts are carried out continuously to stop trafficking and sales of illicit drugs within the country. 

Legislation complements prevention efforts by imposing severe penalties that make it dangerous

to possess, supply, traffic in, or abuse drugs. As noted above, Malaysia’s drug laws are among

the world’s toughest.

Intelligence from inside and outside the country can be a major asset in combating syndicates

and individuals involved in drug smuggling. Intelligence gathering has been strengthened by

the establishment of a Special Intelligence Team in border areas with Thailand and in the States

of Sabah and Sarawak, which can carry out joint operations with the intelligence services of other

countries to curb the supply of illicit drugs at the source.

Treatment and Rehabilitation 

This strategy has two goals: eliminate drug dependency and prevent recidivism. To eliminate

drug dependency, addicts are ordered to participate in one of two treatment and rehabilitation

programs: community supervision or institutional rehabilitation. Community supervision is

rehabilitation in a community setting. Drug users under community supervision must report

weekly to the district NNA officer for urine testing and counseling. Anyone found to be using

drugs will be sent into institutional rehabilitation.

Institutional rehabilitation occurs at one of 25 residential drug rehabilitation centers. These centers treat drug addiction through a combination of “cold turkey” methods, counseling, and vocational therapy. Treatment normally lasts 2 years. 

Antirecidivism efforts focus on strengthening the attitudes and behavior of ex-addicts to prevent

relapse and to enable them to live drug-free lives. The programs implemented include supervision,

counseling, and social support programs at district-level service centers operated by the NNA.

International Cooperation 

The national drug strategy needs international support and cooperation. Its objectives are to

enhance regional and international cooperation in efforts to control and prevent drug abuse and

trafficking and to strengthen national efforts toward international drug control and prevention. 
68

I–ADAM in Eight Countries: Approaches and Challenges

IV. Background History to I–ADAM 

The relationship between alcohol and other drugs (AOD) and crime has not been studied much in

Malaysia. Although drug issues manifest themselves at every level of the criminal justice system,

from street crime to international trade in drugs, the relationship between AOD and crime is difficult to specify because most crimes result from a combination of situational, personal, cultural, and

economic factors. There are not enough data currently available to provide definitive evidence to

law enforcement authorities, service providers, and researchers of the link between drug use and

the drug trade and crime in general.

The National Institute of Justice, the research arm of the U.S. Department of Justice, invited representatives of the Center for Drug Research, Universiti Sains Malaysia, to participate in the first

International Arrestee Drug Abuse Monitoring (I–ADAM) conference in Chicago in 1999. As a

result of that meeting, Malaysia decided to implement an ADAM pilot project in Penang. The

project designers hope to show the feasibility of implementing the ADAM mechanism as an

ongoing activity in Malaysia. By measuring AOD use among arrestees, they hope to take the first

steps to reduce AOD-related crimes, which is an important component to reducing crime in Penang.

V. Goals and Objectives 

The general aims of the ADAM project are as follows:

• To assess the feasibility of implementing and sustaining an ADAM project in the State of

Penang.

• To investigate the relationship between alcohol and other drugs and crime.

• To better understand the prevalence of drug use among hidden populations (subsets of the 

general population whose membership cannot be readily distinguished or enumerated based 

on existing knowledge or sampling capabilities) and its relationship to crime.5

• To disseminate the data collected from the project to local health and law enforcement 

agencies.

• To participate in an international network of ADAM sites in order to share information and 

develop new methods of measuring arrestee drug use and of applying the information learned

to the problems of reducing drugs and crime.

The project’s specific objectives are to—

• Identify the extent of AOD use among recent arrestees in Penang.

• Identify patterns of substances abuse among arrestees in Penang.

• Investigate the extent of alcohol and substance abuse among cases referred to the hospital by 

police (e.g., automobile accidents where alcohol or drugs may have contributed).

• Assess the influence of environmental conditions on AOD use.
69

Malaysia

• Obtain a profile on arrestees (e.g., sociodemographic data, arrest history, types of offenses).

• Investigate the correlation between AOD use and crime.

• Understand arrestees’ perceptions of crime and attitudes toward law enforcement.

• Test U.S. survey instruments in local populations.

• Develop and validate reporting techniques such as self-report and biological measures 

(urine testing).

• Develop specific intervention techniques for various sectors (e.g., health, criminal justice, 

welfare, corrections).

VI. Getting Started

A. Obtaining Funding 

Funds for the pilot phase were obtained through a grant application by the NNA to the national

research program known as IRPA (Intensified Research in Priority Areas). IRPA supports research

that it believes is a national priority and has the potential to contribute to the formation of local

policies.

B. Data Collection 

NNA officers and a research officer have been appointed to collect data from participating police

stations. Police officers will notify the research team daily on how many arrests were made the

day before, and the data collectors will visit the police station daily to collect data from arrestees. 

C. Facility Access 

To ensure that the project would be implemented in accordance with ADAM procedure, the

Center for Drug Research, Universiti Sains Malaysia, collaborated with NNA and the police

in Penang. Once this collaboration was established, access to facilities was arranged by NNA

officers and the local police. 

The plan is that the police stations involved in the study will call the NNA office daily to tell

how many arrestees were brought into each station the day before. The research officer from the

Center for Drug Research will randomly pick every 10th arrestee brought in the day before to be

interviewed. The research officer will conduct the interview at the police station within 48 hours

of the arrest. A voluntary urine test will also be carried out to determine whether the interviewee

recently used drugs.
70

I–ADAM in Eight Countries: Approaches and Challenges

D. Knowing the Catchment Area 

Penang has two police divisions, the northeast and southwest divisions. The northeast division

was selected as the catchment area for this study. The division has 4 teams with a total of 12

police stations, all of which will participate in the study. Exhibit 3 lists the participating police

stations.

E. Drug Testing Issues 

Urinalysis

The validity of interviews and self-reported data can be verified by chemical drug testing of biological specimens (urine). Litmus paper is being used for the initial test on the urine sample. The

litmus paper used is in accordance with U.S. National Institute on Drug Abuse (NIDA) standards; its

detection sensitivity is 50 mg/mL or greater. Results are received in 5 minutes. If the litmus paper

shows a positive result, the urine is sent to a Government pathologist for confirmatory tests.

Because the police collect the urine specimens, arrestees may not give the specimen voluntarily,

which introduces bias into the testing. The test results of arrestees who refuse to participate in

the study are not examined and, hence, cannot be compared with the results of those who agree

to participate.

F. Instrument Issues 

Questionnaire

The ADAM questionnaire to be used in this study was translated into Bahasa Malaysia, then

translated back into English as a check on the accuracy of the translation. A pretest was carried

out among a few arrestees to determine the clarity of the translation. 

Exhibit 3. List of Police Stations Participating in Penang ADAM Project

Team A Team B Team C Team D

Palau Tikus Petani Road Air Itam Sungai Nibong

Georgetown Dato Keramat Bandar Baru Jelutong

Central Kampang Baru

Beach Street Tanjong Tokong
71

Malaysia

VII. Barriers to Developing I–ADAM 

The research team established a collaborative effort to ensure that administrative barriers do not

hamper the implementation of the project. Because this study is a pilot project, the actual barriers

can be identified only after the study is completed. Several potential problems can be noted, however, including the following:

• As noted above, the police will administer the urine testing, which may reduce participation 

by interviewees. 

• A sample of every 10th arrestee may yield too few participants to get a truly representative 

sample of arrestees (see section IX for a discussion of the potential sample size). 

• Because the arrestees will have already been in jail for a day when the researchers are notified 

of the arrest, the researchers have less opportunity to interview the arrestees before 48 hours 

have passed since the arrest. This could become more of a problem if several stations process a 

larger than usual number of arrestees at once or if not enough research officers are available to

handle all 12 stations at a given time. 

VIII. National Stakeholders Involved in the

Development of I–ADAM 

The Center for Drug Research, Universiti Sains Malaysia, is collaborating with the NNA to

implement the ADAM project in Penang. Researchers from the center and NNA officers also

have met with the police to brief them and to obtain their permission to conduct the study.

As the source of the funding for the study, IRPA is a stakeholder, as are the national and local

entities that form IRPA’s constituencies.

IX. Methodology 

Study Design 

The Penang I–ADAM project is a 1-year pilot project with a cross-sectional design to assess the

feasibility of developing an ADAM system.
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I–ADAM in Eight Countries: Approaches and Challenges

Sample Size 

As the study is still ongoing, the actual sample size is not yet known. It is hoped that approximately

150 arrestees will be interviewed and tested in the first 6 months of the study. The arrestees are

being selected randomly for interviews and testing (see section VI, D).

Men 18 years of age and older are being selected for the study. Persons younger than 18 are defined

as juveniles in Malaysia, so they come under a different jurisdiction. Because only a small fraction

of those arrested in Penang for AOD offenses are women, it would not be practical to include

women in the sample.

All arrestees in the selected police stations who have been in custody less than 48 hours and

are not considered violent or mentally ill are eligible to be recruited for the study (with their

consent). The 48-hour limit will ensure the validity of the urinalysis. Exhibit 4 lists the crimes

that are to be included in the sample.

The following arrestees will not be eligible for inclusion in the study:

• Children or juveniles.

• Persons who are mentally ill.

• Persons who are considered violent.

• Persons who have been detained longer than 48 hours.

X. Training Issues 

The research officer from the Center for Drug Research and the officers from NNA were trained

by the principal investigators on conducting interviews and the survey methodology. In addition,

police officers were briefed about the project to ensure that they understand its objectives. The

research officers from the Center for Drug Research and NNA have experience dealing with the

addict population and are familiar with the ADAM interview techniques.

Exhibit 4. List of Offenses to Be Sampled in ADAM Project

Abduction Indecent assault

Arson Intercourse with an underage girl

Assault Kidnaping

Carjacking/truck hijacking Malicious damage to property

Common burglary Motor vehicle theft

Driving under the influence of alcohol or other drugs Murder or attempted murder

Embezzlement Public violence

Fraud and misappropriation of funds Rape

Illegal possession of firearms Robbery with aggravated circumstances

Ill treatment of children
73

Malaysia

XI. National Data 

No national data are available yet.

XII. Policy Implications and Application of Data 

The I–ADAM pilot project will complement the existing Asian Multicity Epidemiology Network

and the National Drug Information System. The I–ADAM project is unique because it will provide

data on drug use among the arrestee population; the two existing programs provide data from the

addict population. The data from this study will provide an indicator to policymakers of the extent

of drug and alcohol use among those arrested for crimes. It is hoped that this study will be used

and accepted as an indicator and, in the long run, will influence existing policy regarding drugs

and crime.

Notes

1. In Malaysia, substance abuse (known as “daddah” in Bahasa Malaysia) does not refer to

alcohol abuse or dependency.

2. National Narcotics Agency, National Narcotics Report, Kuala Lumpur: Ministry of Home

Affairs, 1998.

3. National Narcotics Agency, National Drug Information System, Kuala Lumpur: Ministry of

Home Affairs, 2000.

4. Central Intelligence Agency, The World Factbook: Malaysia, Washington, DC: Central

Intelligence Agency, 2000.

5. See Weibel, W.W., “Identifying and Gaining Access to Hidden Populations,” in The Collection

and Interpretation of Data From Hidden Populations, ed. E.Y. Lambert. NIDA Research Monograph

98. DHHS Publication No. (ADM) 90–1678. Rockville, MD: U.S. Department of Health and

Human Services, National Institute on Drug Abuse, 1990.
75

THE NETHERLANDS

Peter Klerks

Janine Plaisier

Willemijn Garnier

At the time this chapter was written, Peter Klerks was a researcher for Eysink, Smeets, and Etman in The Hague, the

Netherlands. He currently works for the Dutch Police Academy. Janine Plaisier and Willemijn Garnier were

research coordinators for WODC, the research and documentation center of the Ministry of Justice, The Hague, the

Netherlands. Willemijn Garnier now works for the Ministry of Justice in The Hague.

I. Overview of Demographic Profile of Nation

The Netherlands, a small country in Western Europe bounded by Germany to the east, Belgium

to the south, and the North Sea to the west, is one of the most urbanized and densely populated

countries in the world. With an area of only 41,526 square kilometers (approximately twice the

size of New Jersey), it had a population of about 15.8 million in 1999 (7.8 million men and 8.0 million

women). There are 662,000 foreign nationals living in the country, and 17.1 percent of the Dutch

population are first- or second-generation immigrants. Basic demographic information is provided

in exhibit 1, and a more detailed demographic breakdown is given in exhibit 3.

A prosperous country, in 1999, the Netherlands had a GDP of 842 billion guilders ($365.1 billion),

an unemployment rate of 3.3 percent, a poverty rate (the percentage of families with an income

at or below the social minimum) of 10.5%, and a literacy rate—excluding functional illiterates

(people who can read but do not understand what they read)—of 87 percent.1 Basic economic

information for the Netherlands is given in exhibit 2.

The I–ADAM pilot program in the Netherlands took place in one of the country’s 25 police regions,

The Hague (Haaglanden), which is the seat of the national government and has about 450,000

inhabitants.

Crime Statistics

In 1999, there were 86,587 violent crimes in the Netherlands, a 13-percent increase from the previous year and a continuation of the upward trend since 1995, when there were 64,606 violent crimes
76

I–ADAM in Eight Countries: Approaches and Challenges

Exhibit 1. The Netherlands: Demographic Overview

Geographic area 41,526 km2

Population (1999) 15.7 million 

Ethnic distribution (1999) Dutch, 91%; Moroccans, Turks, other, 9%

Religious affiliation (1991) Roman Catholic, 34%; Protestant, 25%; Muslim, 3%; other 2%; unaffiliated, 36% 

Gender distribution Males, 49%; females, 51%

Life expectancy Males, 75.4 years; females, 81.28 years; average, 78.28 years

Population growth rate (1000) 0.6%

Birth rate 12 per 1,000 population

Total fertility rate 1.6 children per woman

Death rate 9 per 1,000 population

Literacy rate 99%

Functional literacy rate 87%

Political subdivisions 12 provinces

Sources: U.S. Census Bureau, International Database, 2000; CIA World Factbook, 2000

Exhibit 2. The Netherlands: Economic Information

Gross domestic product (GDP) (1999) $365.1 billion 

GDP growth rate (1999) 3.4% 

GDP per capita (1999) $23,100

GDP composition by sector Agriculture, 3.5%; industry, 26.8%; services, 69.7%

Major export partners (1998) EU (Germany, 27%; Belgium-Luxembourg, 13%; France, 11%;

UK, 10%; Italy 6%); Central and Eastern Europe, U.S.

Major export commodities Machinery and transport equipment, chemicals and fuels, foodstuffs, clothing

Labor force (1998) 7 million 

Labor force composition by sector (1998) Services, 73%; industry, 23%; agriculture, 4%

Poverty rate 10.5%

Unemployment rate 3.3%

Sources: U.S. Census Bureau, International Database, 2000; CIA World Factbook, 2000

(see exhibit 4).2 There were 872,362 property crimes in 1999, a 4-percent increase from the previous

year, but still below the 1995 figure of 903,871. The number of Drug Act crimes has increased from

3,473 in 1995 to 7,613 in 1999. This category reflects only violations of the Opium Act, according to

which drugs are categorized as “hard” and “soft.” Hard drugs include heroin, cocaine, and synthetic drugs such as MDMA (also known as Ecstasy or XTC); soft drugs include cannabis derivatives

such as marijuana and hashish.

Drug Use Statistics in the General Population

The first National Drug Use Survey was carried out in 1997 among 22,000 persons 12 years and

older using a computer-assisted personal interview. The design allows prevalence data to be broken
77

The Netherlands

Exhibit 3. The Netherlands—Age Distribution of Population, 1999

Age (years) Number of people

0–4 967,000

5–9 995,000

10–14 966,000

15–19 921,000

20–29 2,088,000

30–39 2,646,000

40–49 2,371,000

50–59 2,036,000

60–69 1,381,000

70+ 1,520,000

Source: U.S. Census International Database, 2000

Exhibit 4. Official Reports of Crime to the Police

1995 1996 1997 1998 1999

Violent crime 64,606 66,688 74,430 76,610 86,587

Property crimes 903,871 833,669 846,033 842,324 872,362

Malicious damage/public order crimes 152,480 170,412 179,780 178,430 188,242

Road traffic act 89,229 105,159 99,700 105,449 117,087

Drugs act 3,473 6,593 10,300 7,666 7,613

Firearms act 1,865 2,198 1,986 3,350 3,432

Other offenses 7,314 5,370 6,647 8,397 9,005

Total 1,222,838 1,190,089 1,218,876 1,222,226 1,284,328

Source: Department for Statistical Information and Policy Analysis, Registered Crime in the Netherlands, 1995–1999,

The Hague: Ministry of Justice, 2000

down into four metropolitan areas (Amsterdam, Rotterdam, Utrecht, and The Hague) and five

areas with different population densities. Data from the second survey, which was carried out in

2000, will be available by the end of 2001 (see exhibit 5).3 

It is evident from exhibit 5 that cannabis was by far the most popular illicit drug both in terms of

lifetime use and in terms of usage in the last month. Looking at lifetime prevalence rates, cocaine

was the most popular drug, followed closely by amphetamines, Ecstasy, and hallucinogens; only

0.5 percent of the respondents had reported using any “hard drug” in the month preceding the

interview. Mushrooms were used at a similarly low rate. Heroin use was so low as to be hardly

measurable, but population surveys are not suitable to quantify levels of heroin use. For all drugs,

the difference between lifetime and recent use indicates that most people who experiment with a

drug do not continue to use it. This has been expressed in a so-called continuation rate: Some 16

percent of the lifetime cannabis users continued to use it in the past month. In contrast, continuation

rates for alcohol and tobacco were 80 and 51 percent, respectively.
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I–ADAM in Eight Countries: Approaches and Challenges

If prevalence rates of last-month use are extrapolated to the general population age 12 years and

older, one may obtain a “lower bound” or minimum estimate of the number of drug users in the

country (see exhibit 6). This is a minimum estimate because some groups of drug users, such as

homeless youth, prisoners, opiate addicts, and frequent visitors of coffee shops,4 are likely to be

underrepresented in the survey. For example, cocaine is used by the large majority of opiate users,

who are generally not captured sufficiently in the sample of a population survey. The actual number

of cocaine users is probably much higher.

Political System

Since 1848, the Netherlands has been a constitutional monarchy in which the government—the

Council of Ministers under the leadership of the prime minister—is responsible for government

policy and responsible to parliament. The Queen enjoys a position of immunity.

Parliament consists of an upper house (the First Chamber), and a lower house (the Second Chamber).

The 150 members of the Second Chamber are chosen directly by the people in elections that are, in

principle, held every 4 years. The Second Chamber’s most important function is to supervise the

government’s actions. To do so, it has several powers, one of the most important of which is the right

to amend bills proposed by the cabinet. The minister responsible for a proposed bill can adopt such

an amendment, submit it to a vote in the Second Chamber, or reject it. If a parliamentary amendment

Exhibit 5. 1997 Dutch National Drug Use Survey (%)

Lifetime use Amsterdam Rotterdam The Hague Utrecht Nonurban* National average

Cannabis 36.7 18.5 20.1 27.3 10.5 15.6

Cocaine 9.5 3.4 3.4 3.6 1.0 2.1

Ecstasy 7.0 2.2 2.6 3.2 1.2 1.9

Amphetamines 6.0 2.7 2.2 2.6 1.1 1.9

Hallucinogens† 6.3 1.8 2.8 3.0 1.1 1.8

Mushrooms 6.6 2.4 2.5 n.a. 1.0 1.6

Heroin 1.8 0.4 0.5 0.3 0.3 0.3

Use in the past month

Cannabis 8.1 3.3 4.2 4.2 1.5 2.5

Cocaine 1.0 0.4 0.6 0.4 0.1 0.2

Ecstasy 1.1 0.1 0.2 0.7 0.1 0.3

Amphetamines 0.3 0.1 0.2 0.3 0.1 0.1

Hallucinogens† 0.0 0.0 0.1 0.4 0.0 0.0

Mushrooms 0.6 0.1 0.1 n.a. 0.1 0.1

Heroin 0.3 0.0 0.1 - - -

Note: Percentage of the Dutch population aged 12 years and older reporting drug use in 1997.

*Defined by Statistics Netherlands as municipalities with fewer than 500 addresses per square kilometer.

†

Including LSD, mescaline, psilocybin, 2CB, and ayahuasca and excluding mushrooms.

Source: National Drug Use Survey, CEDRO (Abraham et al., 1999)
79

The Netherlands

is rejected, the lower house may bring a motion of no confidence against the minister or the cabinet,

which, if carried, will force their resignation. The lower house also has the right of initiative (i.e.,

the right to propose bills), the right of interpellation (i.e., the right to demand clarification from

a minister), the right of inquiry, and the right to accept or reject the Government’s budget.

The 75 members of the First Chamber are elected indirectly for 4-year terms by the members of the

country’s 12 provincial councils. The First Chamber shares in the legislative function and monitors

government policy. All bills that have been passed in the Second Chamber must also be approved

by the First Chamber, but the First Chamber cannot propose or amend bills. Members of the First

Chamber have the same rights as those of the Second Chamber.

The Netherlands has 13 government ministries, each of which is headed by a minister who is

politically responsible for that ministry’s policy. Each minister is supported in this task by one

or occasionally two politically appointed state secretaries. Civil servants, who maintain an apolitical

stance and do not lose their jobs with a change in government, assist ministers and state secretaries in their work.

II. Description of Criminal Justice System,

Arrest Process, and Detention System5

The cornerstone of Dutch criminal law is Article 1 of the Criminal Code, which states that no

offense is punishable if it does not violate a previously existing statutory penal provision. Only

conduct that was punishable when the act occurred is subject to sanctions. A punishable offense

is an action that meets the statutory description of the offense, is wrongful, and is due to an

imputable fault. Crimes are divided into offenses (more serious crimes) and violations.

Criminal proceedings are held in phases, the first of which is prosecution in the first instance. This

phase commences with the police investigation, the results of which are set out in a police report

stating the nature of the offense, when it took place, and the suspect’s name.

Exhibit 6. Minimum Estimates of the Number of Drug Users in the

Netherlands, 1997

Drug Absolute number of users*

Cannabis 323,000

Cocaine 26,500

Ecstasy 40,000

Amphetamines 13,000

*Extrapolated from last-month prevalence rates to the Dutch population aged 12 years and older.
80

I–ADAM in Eight Countries: Approaches and Challenges

A suspect can be brought to the police station for interrogation, which can take place during

a maximum of 6 hours. If the investigation requires it, the suspect can be taken into custody

(only for punishable offenses for which pretrial detention is allowed) for a maximum of 3 days.6

Sometimes (e.g., in the case of minor violations), the police do not draw up an official report. If

the police do not offer a transaction (a deal under which the offender voluntarily pays a sum of

money to the Treasury to avoid further criminal prosecution and public trial), however, and decide

to press charges, the official report is passed on to the Public Prosecutions Department. Once the

criminal investigation has been closed, the Public Prosecutor may drop the case, settle it by means

of a transaction, or serve the suspect with a writ of summons if he believes sufficient evidence

exists to reach a conviction.

The trial in court concludes the first phase. In the Netherlands, there is no trial by jury; independent,

professional judges who serve for life decide both the law and the facts of the case. Lay people

are not involved in either the course of criminal proceedings or the appointment of judges. Hearings

take place in public whenever possible. In principle, juvenile court cases are heard in closed

chambers. If a punishable offense has been proved and the offender is found guilty, the judge

decides which penalty or measure should be imposed and imposes a sentence.

The second phase involves appellate proceedings in either the Court of Appeal (appeal) or the

Supreme Court (appeal in cassation). Both prosecution and defense have the right to bring a onetime appeal to a higher court. Appeals against a judgment given by a district court can be lodged

with the Court of Appeal. Taking a case (appeal in cassation) to the Supreme Court differs from

lodging an appeal because it does not result in an (entirely) new hearing of the case but serves

merely to establish whether the sentence challenged is in accordance with the law and in compliance

with the requirements.

The third and last phase involves the enforcement of a sentence. When appeals are exhausted,

the sentence becomes final and conclusive and can be enforced. The Public Prosecutions Department

is responsible for implementing the criminal sentence. It does not impose the sanctions itself, but

delegates imposition to judicial or private institutions.

The sanctions contained in the Dutch Criminal Code are classified as penalties and measures.

Penalties are retaliatory or deterrent in nature, while measures focus on protecting the interests

of society or the perpetrator. Unlike penalties, measures need not establish a direct relationship

between the gravity of the offenses committed and the severity of the legal response to it. Legal

articles set the maximum sanction the judge can impose for any given offense. The most common

sanctions for adults are as follows:

• Imprisonment, the most substantial and severe penalty in the Dutch Criminal Code, can be 

imposed only for criminal offenses. Prison sentences can be for life or of temporary duration. 

For any given offense, judges have the freedom to impose prison sentences within minimum 

and maximum limits. The maximum sentence for theft, for example, is 4 years, whereas the 

maximum sentence for murder is 20 years.

• Detention can be imposed for a minimum of 1 day and a maximum of 1 year and 4 months 

and is generally imposed for summary offenses. Detention is lighter than a prison sentence 

and, as a rule, is spent in a remand prison.
81

The Netherlands

• A community service order (taakstraf) can also be imposed on minors who have committed a 

punishable offense. The accent is on first offenders and those who have committed less serious offenses. Under a community service order, an offender can be sentenced to up to 240 

hours of community service (werkstraf), to follow a social training course (leerstraf), or a combination of the two. Both the judge and the Public Prosecutions Department can impose the 

penalty. Strictly speaking, only the community sentence imposed by a judge has the status of 

a court sanction.

• A fine can be imposed for all punishable offenses, even those for which the judge could impose

a life sentence.

In certain exceptional cases, such as if the offender is mentally ill, the judge can impose a measure

(e.g., a psychiatric hospital order or an entrustment order) instead of a penalty. 

III. Status of National Drug Policy

Health issues are of primary importance in Dutch drug policy.7 A broad approach is taken, in

which attention is given to both prevention and care (demand) and combating the sale of drugs

(supply). The demand for drugs is discouraged and the risks of drug use to individuals and their

environment are diminished by a professional care and prevention policy. The Government seeks

to prevent young people, in particular, from unthinkingly using drugs in the first place and to

make medical and social assistance available to problem drug users to alleviate their plight (harm

reduction). Harm reduction is most obvious in the criminal justice system in the imposition of

relatively low sentences for possession of small amounts of drugs, but harsh sentences for persons

involved in the drug trade. The supply of drugs is fought against by combating organized drug crime.

Dutch drug policy is also aimed at maintaining public order and reducing the nuisances caused by

drug use.

Assistance is given not only to “normal” drug users but to criminal drug users as well. The judicial authorities have followed the principle that drug addicts who commit minor crimes should

be offered the opportunity to undergo medical treatment rather than serve a custodial sentence.

This makes it easier to persuade drug addicts to participate voluntarily in special programs that

help them regulate or stop their drug use and reenter society. The aim of care services is to reach

as many addicts as possible to help them rehabilitate or limit the risks caused by their drug

habit. Social rehabilitation is an essential element.

In investigations and prosecutions, the expediency principle is applied (i.e., a public prosecutor

may decide not to prosecute if prosecution is not in the public interest). A distinction is made

between hard drugs, which pose an unacceptable hazard to health, and soft drugs, which constitute a far less serious hazard. The highest priority is given to the investigation and prosecution

of international drug trafficking; the possession of small quantities of drugs for personal use is

accorded a much lower priority. Possession of either soft or hard drugs is considered an offense.

Possession of more than 0.5 grams of hard drugs is an indictable offense. Firm action is taken in

such cases. Possession of smaller amounts of soft drugs is a summary offense and therefore has

low priority in policies on investigation and prosecution. The expediency principle is applied to
82

I–ADAM in Eight Countries: Approaches and Challenges

the sale of cannabis in coffee shops to separate the markets for hard and soft drugs and to keep

young people who experiment with cannabis away from hard drugs.

Combating drug-related crime is aimed at the fight against the trade and production of drugs,

especially hard drugs. One action recently taken was the foundation of the Synthetic Drugs

Unit, which is specifically aimed at the fight against the production of, and trade in, Ecstasy,

amphetamines, and other synthetic drugs.

Research on drug use is of great importance in the Netherlands. More and more information is

being gathered because of the accessibility of drug treatment services and better data registration

systems. First of all, research is done to obtain information about trends in drug use, drug users,

and the supply of drugs and related dangers. Studies are regularly conducted on drug use

in general and among students in particular (all forms of research are applied: field research,

investigative research, evaluation research and policy-oriented research). In the past few years,

multidisciplinary research has been conducted into the use, effects, and risks of Ecstasy and

other synthetic drugs on the basis of, for example, data obtained from tablet tests at rave clubs.

Much information is available because of field research.8 Less information is available, however,

on persons who use more than one kind of drug (including alcohol) and the relationship of such

use to criminal behavior. One way to obtain more information about this could be through the I–ADAM

project. The following sections describe the pilot program conducted in the Netherlands in 1999.

IV. Background History of I–ADAM in the

Netherlands

In 1998, WODC, the Research and Documentation Center of the Dutch Ministry of Justice, was

contacted by the U.S. National Institute of Justice (NIJ) about the ADAM project. NIJ wanted to

expand ADAM internationally (in a project called International ADAM, or I–ADAM) and asked

whether WODC would be interested.

A senior advisor of the Dutch Ministry of Justice and a police commissioner of the Hague police

were invited to attend the first I–ADAM conference in Miami in April 1998. On returning to The

Hague, they decided to join forces and managed both to secure both the funds to finance a feasibility

study (from WODC) and to persuade the Hague regional police force to serve as a testing ground

for an ADAM experiment. WODC could then start a feasibility study and a pilot.

V. Goals and Objectives of I–ADAM in the

Netherlands

As previously stated, the Netherlands has a well-established tradition of research on drug consumption patterns. The initiators of the new I–ADAM pilot program would have to prove that it

could bring new insights to the field. Starting carefully, they decided that a feasibility study would
83

The Netherlands

first have to show that the major stakeholders were prepared to allow a “live” experiment involving

arrestees. The burgomaster of The Hague, who is the head of the regional police force; senior

decisionmakers from the Public Prosecutions Department and the Ministry of Justice; the chief

commissioner of the police; health care officials; and the Bar Association (orde van advocaten)

were all consulted. With the exception of the Bar Association, they reacted positively to the idea.

The Bar Association demanded a very strict privacy regime under which each arrestee would

have to confirm his willingness to participate in the program by signing an informed consent form.

Another objective of the feasibility study was to ascertain what kind of information the stakeholders

desired and expected to learn from the I–ADAM study. It turned out that most respondents thought

that the innovative approach could give new insight into the drug consumption patterns of people

who normally remain outside the established drug research studies, either because they do not feel

they have a drug problem or because they have become so marginalized that even field workers

cannot reach them anymore. The prospect of discovering a connection between specific forms of

criminal behavior and drug consumption habits also stimulated enthusiasm, as did the possibility

that new trends could be identified at an early stage and that of making international comparisons

through the I–ADAM research network. The realistic and most frequently expressed opinion,

however, was that the experiment was aimed primarily at determining—

• Whether such a method could be carried out with success.

• Whether I–ADAM in the Netherlands would produce policy-relevant information.

• Which barriers would be encountered and how could they be overcome.

The actual results of the interviews and urine tests would be less important than the process

evaluation of the experiment itself and the experiences of the interviewers involved. The experiment would have to produce insight on how I–ADAM could best be implemented on a large scale

in this and other facilities throughout the country.

The feasibility study (and a mini-pilot that tested 11 arrestees) took place in December 1998. The

pilot experiment was scheduled to start in the spring of 1999, but after the Bar Association objected,

it was necessary to review certain procedural arrangements to comply with its demands. In the

end, all the Bar Association’s objections were satisfied and the experiment was allowed to proceed

under strict guarantees of anonymity and voluntary participation. Preparations were completed

in the summer, and on August 16, 1999, the first arrestees were interviewed.

The intention was for the pilot study to obtain 250 completed interviews in an estimated 6 weeks

of interviewing. After a full month of interviewing, however, fewer than 100 interviews had been

completed, mainly because there was limited time during the day when arrestees could be interviewed (only during the morning, after showering). The supervisory commission therefore decided

to stop after the 125th interview. On September 27, after 125 interviews were held, the gathering

of data was terminated, and evaluation and data analysis began.
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I–ADAM in Eight Countries: Approaches and Challenges

VI. Getting Started

A. Obtaining Funding

Funding for the I–ADAM pilot came from the research budget of WODC, the Dutch Ministry of

Justice’s in-house research department. WODC’s research in the broad field of criminal justice is

carried out in part by its own researchers and in part by contracted researchers from universities

and research companies. WODC’s director decided to fund the pilot because the objectives of a

Dutch I–ADAM project fit into WODC’s research program and the project could produce interesting results for Dutch policymakers on drug-related subjects. 

B. Contracting for Data Collection

The work for the feasibility study and mini-pilot to establish whether the I–ADAM concept would

be acceptable to stakeholders in the Netherlands was granted to Eysink, Smeets, and Etman (ES&E),

an independent research and consultancy firm specializing in crime prevention and security matters

that has an extensive track record researching difficult and inaccessible groups.

C. Facility Access

Since the Hague regional police force had been involved in the project from the beginning, gaining

access to the cell block facilities posed no problem at all. The chief of the cell block staff was

cooperative and interested in the experiment, as were most of his staff. In the interest of the

arrestees’ privacy and the professional detachment required of the research staff, the initially

very informal atmosphere had to be restrained by a set of guidelines involving strict instructions

not to discuss anything related to the interview subjects. Since the normal daily routine in the

cellblock is based on an efficient and optimal use of personnel and requires a tight schedule,

however, it was not always easy to get access to the arrestees themselves.

D. Knowing the Catchment Area

Arrestees were brought in from the entire region covered by The Hague regional police force. Since

not all the arrestees in the region participated in the I–ADAM pilot program, the results cannot be

compared with the general population of arrestees in this area. The following statistics give some

general indications of the area’s total arrestee population. In 1998, 14,605 persons, 15 percent of

whom were female, were arrested for one or more offenses. Approximately 60 percent of arrestees

in The Hague were of Dutch nationality, whereas 10 percent were from Suriname, 4 percent were

Turkish, 4 percent were from the Netherlands Antilles, and 7 percent were Moroccan. The mean

age was 33 years. The main offenses were theft and burglary without violence (53 percent), traffic

offenses (38 percent), criminal damage (32 percent), and violent crime (27 percent).9 In 1998, 1,007

hard-drug addicts (7 percent of all arrestees) were arrested for one or more offenses, accounting

for 15 percent of all known offenses, mostly theft and burglary without violence.
85

The Netherlands

E. Drug Testing Issues

Drug testing was performed by one of Holland’s leading laboratories in this field, the Delta

Laboratory of the Psychiatric Hospital in Poortugaal, near Rotterdam. The methods and standards

applied in this project are equivalent to those of the U.S. ADAM program. Processing of the urine

samples was done at the laboratory, usually within 3 days after the samples were obtained.

F. Instrument Issues

The standard U.S. ADAM interview list was translated into Dutch and adapted to match Dutch

circumstances, (e.g., changes were made to the survey for the categories of housing, education, cultural background, and the like). Some questions were dropped at the request of the Bar Association, which believed that these questions would be too intrusive or that they could interfere with the

judicial process. Among the questions dropped were those on how illegal income was obtained,

the purchase of drugs shortly before arrest, and the time of arrest. Some new questions were

added, such as reason for arrest, place and town district of residence, mode of use of drugs (e.g.,

injection or inhalation), use of medicines (some prescription drugs can cause false positives in

testing), and more categories of nationality. Finally, the Dutch questionnaire was translated back

into English and French. Interviews usually went smoothly, although for users of multiple drugs,

the repetitive questions could become somewhat tedious. 

Cultural applicability

With the adaptations mentioned above, the questionnaire proved to be quite user-friendly. Some

interviews were held in other languages (English and French). Some respondents were not native

speakers of any of these languages, and some of these were also illiterate; in these cases, explaining the questions and obtaining the right answers sometimes proved difficult.

Standardization versus local utility

Most of the material obtained in the pilot test can be compared with that collected in other countries,

especially the United States. This applies to both the urinalysis and the encoded answers. Since

the questionnaire used in the Dutch I–ADAM was adapted to fit standard categories used in other

addiction programs and studies, local utility should be guaranteed as well.

In interpreting the comparative results, however, differences in legal and socioenvironmental

conditions should be considered. Prison conditions, for example, may differ from country to

country. Police stations in the Netherlands are spacious, clean, and relatively comfortable. Arrestees

there may be less willing to cooperate in a research project than arrestees in countries such as the

United States, where circumstances in police cells are less pleasant. Another difference among countries is whether the use of soft drugs is forbidden. In countries such as the Netherlands, Belgium

(since 2001), and Switzerland, where the use of cannabis is not seen as a crime anymore, people

obviously will be more willing to tell researchers that they have used cannabis. In countries such

as the United States or Malaysia, where the use of soft drugs is seen as a crime, people are more

reluctant to admit drug use, even in an anonymous research setting.
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I–ADAM in Eight Countries: Approaches and Challenges

VII. Barriers to Developing I–ADAM

The Bar Association’s objections resulted in an arrangement under which every candidate had to

grant written permission to be interviewed. This introduced a formal element in the introduction

procedure involving a routine (i.e., the signing of an informed consent form) that many people in

police custody presumably have negative associations with. Several people could not read or write

any of the four languages used. The need to hand out and collect informed consent forms added

yet more work to the time-consuming and sometimes irritating formalities that were part of the

I–ADAM procedure. The researchers believe that the obligation to obtain written consent from

the arrestees resulted in a lower response rate. An additional problem is that, whereas normally,

after the interviewing period, the research organization would not have any data that could ever

be traced to individual persons, there is now a collection of 125 signed statements on which

arrestees have quite often put their full name in legible writing. Under the agreement reached

with the Bar Association, these statements have to be kept for a certain period of time in case any

of the arrestees were to claim that he or she had been forced into participating in the project.

Other barriers were more technical in nature. Interviewers were not able to interview many potential

candidates because they had been removed from the premises to be presented to the investigating

magistrate very early in the morning after having been brought to the central holding facility at

police headquarters late the previous night. In such cases, they remained out of reach for the

interviewers, who could not visit them earlier in the day at a district police station or during the

night, when the holding facility functions with only a limited number of guards. To cover all the

potential candidates, researchers would have to interview at all of the more than 20 police stations

in the region and at all hours at the central facility. This would pose substantial financial problems

for both the research project and the police force, which would have to bring in additional guards

if it were to grant interviewers access to the cells.

Another issue that emerged was the language barrier: Some of those approached for an interview spoke only Turkish, Moroccan (Berber), or an African or Eurasian language not spoken

by the researchers. It would seem infeasible and impractical to prepare for interviewing in all 

possible languages.

VIII. National Stakeholders Involved in the

Development of I–ADAM

As was mentioned before, all stakeholders whose approval was required for the pilot to be carried

out were interviewed, and their permission was obtained in the fall of 1998. These stakeholders

included the Ministry of Justice, WODC, the Public Prosecutions Department, the chief commissioner of the police force, the local police where the pilot tests took place, the Bar Association,

and the Burgomaster of The Hague. Simultaneously, the relevant senior officials at the Ministry

of Justice and the Procurator General responsible for narcotics issues on a national level in the

Public Prosecutions Department were informed as well.
87

The Netherlands

IX. Research Methods

To establish which subgroups would have to be represented in a selected arrestee sample, the

characteristics of the overall population of arrestees in the Hague region had to be understood.

Because such information is not available from police figures, there was no reason to draw up

criteria for a weighted sample of candidates. Since the overall number of arrestees in any one

Dutch police region is lower than that in typical U.S. ADAM sites, it was considered best simply

to approach every arrestee who met the established criteria until the agreed number of interviews

was obtained. Because this was a pilot project, as many persons as possible had to be tested in a

relatively short time, so the easiest (rather than the most representative) sampling scheme was

selected. Subjects in the pilot project had to meet the following criteria:

• No persons under the age of 16.

• No persons who had been arrested more than 48 hours before.

• Only persons arrested on suspicion of a crime.

• Only persons who understood and spoke Dutch, English, German, or French.

• No persons who were mentally unstable, incoherent, or extremely aggressive.

• No persons arrested for traffic violations.

X. Training Issues

The interviewers were junior researchers and students working for ES&E who received instructions

on how to do the interview from senior ES&E researchers with extensive interviewing experience.

No other persons (including law enforcement officers or court personnel) were allowed to participate

in the interviews with the arrestees. In preparing for the instruction sessions, the I–ADAM training

material was put to good use, but no extensive training exercise sessions were held to establish

whether interviews observed by multiple interviewers would produce similar reports. During the

interviews, interviewers were asked to keep a logbook to record every remarkable or unusual

experience they encountered or observation they made. These were analyzed, but no substantial

problems influencing the integrity or professionalism of the research work were recorded.

XI. Analysis of Interview Data

Although obtaining and analyzing the interview data was, in fact, of secondary importance in the

initial pilot study, some results were worth mentioning. Readers have to keep in mind, however,

that at this early stage, the small sample size (only 125 interviews) and the relatively low response

rate can result only in indicative data that should be interpreted with the greatest caution. Any

comparisons with I–ADAM data from other countries should perhaps be restricted to hypothesisforming impressions and should not be used to form conclusions about the drug situation in the

Netherlands. In this brief report, only a limited part of the results is presented.
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I–ADAM in Eight Countries: Approaches and Challenges

A. Response Rate

Thirty-eight percent of the total number of arrestees fell outside the agreed category of arrested

suspects taken into legal custody (such as suspects arrested and then released) (see exhibit 7). Of

those that would qualify on this condition, another 20 percent could not be interviewed because

they did not meet other criteria (such as age or length of time after arrest). Of those who met all

the criteria, 23 percent were missed because they were either in transport or in interrogation and

therefore could not be interviewed. Finally, 49 percent of those who met the criteria and were

approached refused to cooperate.

Those who refused to cooperate gave the following reasons: An estimated 70 percent said that

they saw no benefits in cooperation; about 20 percent objected to giving permission in writing

(a condition required by the Bar Association); and about 10 percent were approached by a

guard in a way that did not motivate them to cooperate. Of the 125 respondents (51 percent of

those approached), 80 (64 percent) provided urine samples for analysis, 43 refused to give a

sample, and 2 were incapable of urinating. A total of 111 men and 14 women were interviewed.

The age breakdown of program participants is shown in exhibit 8.

Exhibit 7. Arrestees Participating in Dutch I–ADAM Pilot Program

Arrestees at the police station during the pilot 651

Not taken into legal custody: 248

Did not meet criteria (e.g., age) 82

Could not be interviewed (e.g., transport) 75

Total of available arrestees who met criteria 246 (38% of total population)

Willing to participate in interview 125 (51% of approached arrestees)

Gave urine samples 80 (64% of persons interviewed)

Were unwilling to give urine samples 43 (34% of persons interviewed)

Were unable to give urine samples 2 (2% of persons interviewed)

Exhibit 8. Age of Dutch I–ADAM Pilot Program Participants

Age (years) Percent

16–20 24.8

21–30 40.8

31–40 25.6

41–50 7.2

51–65 1.6

Total 100.0

N = 125
89

The Netherlands

B. Offenses

The grounds for arrest (category of primary offense) are presented in exhibit 9.

C. Reported Drug Use

None of those who declared themselves addicted reported currently being in any drug rehabilitation

program, although many stated that they would like to participate in such a program. Respondents

were asked if they had ever used drugs, and if they used drugs during the past 12 months and or

during the past 3 days. The results are shown in exhibit 10.

Approximately 45 percent of the arrestees reported using alcohol in the 3 days before the interview, and 34 percent said that they used cannabis during that time. Percentages for other drugs

are lower—approximately 13 percent for cocaine and opiates.

Exhibit 9. Offenses for Which I–ADAM Pilot Program Participants Were Arrested

Offense Percent

Sexual offenses 1.6

Violent offenses (including murder and attempted murder) 32.0

Property crimes 46.4

Opium law 9.6

Other 8.0

Unknown 2.4

Exhibit 10. Self-Reported Drug Use of I–ADAM Program Participants

Drug Ever used (%) Used in the past 12 months (%) Used in the past 3 days (%)

Alcohol 92.8 83.2 45.6

Cannabis 74.4 56.8 34.3

Crack 17.6 12.8 9.6

Cocaine 48.0 27.2 12.8

Opiates (mostly heroin) 24.8 19.2 13.6

Methadone 21.6 14.4 8.0

Amphetamines 16.8 4.0 0.8

Benzodiazepines 14.4 10.4 7.2

Other drugs 24.8 12.8 2.4
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I–ADAM in Eight Countries: Approaches and Challenges

In total, 48 of the 125 respondents (38 percent) reported some form of addiction, and 26.4 percent

have been treated for some kind of addiction at some time in the past. There are many “poly-users,”

mostly combinations of heroin and cocaine or crack, but also quite a few persons addicted to

only one narcotic. Apart from the 48 self-declared addicts, about 10 people have a daily and often

substantial drug intake but do not consider themselves addicted.

When the results of the urine tests are compared with self-reported use, a big difference can be

seen in the results for alcohol. Although approximately 45 percent of the arrestees told researchers

that they had used alcohol in the past 3 days, only 4 percent tested positive for alcohol in urine tests.

This clearly shows that urinalysis is not an effective way to test for alcohol. For cannabis, cocaine,

and opiates, however, urinalysis results showed a higher rate of use than did self-reports from

arrestees. For cannabis, the difference is relatively small (34 percent of arrestees said that they

used it, but 41 percent tested positive in the urinalysis). As expected, differences for cocaine and

heroin were much larger. Approximately 13 percent of the arrestees said that they had used

cocaine in the past 3 days, but urine tests showed 32 percent testing positive; 13 percent of the

arrestees reported using heroin, whereas urine tests showed 17 percent testing positive.

Apparently, arrestees are more honest about their use of cannabis. This is not a surprise, since

the use of cannabis is not considered to be an offense.

When compared with the lifetime use of drugs in the country (exhibit 5), one can see that arrestees

use drugs more frequently than the general population. Many of the arrestees in the sample were

arrested for theft and violent offenses, and the relatively high rate of cocaine use may be related

to this. Research shows that cannabis use in the Netherlands is not higher, and may even be lower,

than in other countries, such as the United States. It will be interesting to compare the results for

arrestees in these two countries.

D. Tested Drug Use

The results of the urine tests of the 80 persons who gave a urine sample are given in exhibit 11.

Because many more respondents (28 percent) reported drinking alcohol shortly before being

arrested than is reflected in the urine test, this test cannot be considered very useful. In view of

the importance of the relationship between alcohol and crime, the administrators of the program

will have to determine how to deal with this problem and whether alcohol can be measured in

some other way.

Of the 80 arrestees willing to give a urine sample, 61 percent tested positive for some drug. Given

the limited quantitative basis of 125 interviews, however, and the relatively low response rate on

the urine sample, these data should be interpreted with the greatest caution.

E. Drug Use Before Committing the Offense

Respondents were asked whether they had used alcohol or drugs shortly before committing the

offense. The results are shown in exhibit 12.

Those who reported that they used drugs shortly before committing the offense (44 percent)

were asked which drugs they used. The results are shown in exhibit 13.
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The Netherlands

F. Offenses and Drug Use

The relationship between offenses and drugs found in the urine samples was examined. The results

are shown in exhibit 14, an overview of the primary offenses (of which 46 percent were theft, 27

percent violent offenses, 2 percent sexual offenses, 13 percent opium, and 1 percent other offenses)

of the 80 arrestees who were willing to give urine samples. From this overview, one can see that 19

of the 37 persons arrested for theft (51 percent) tested positive for cocaine. Persons arrested for

theft and violent offenses test positive for a relatively large number of drugs. Persons arrested for

Exhibit 11. Urine Test Results

Positive urine sample

Drug Number Percent

Alcohol 3 3.8

Cannabis 33 41

Cocaine 26 32

Ecstasy 1 1

Opiates 14 17

Methadone 7 8

Benzodiazepines 13 16

Any drug 49 61

Exhibit 12. Alcohol and Drug Use Before Committing Offense

Less than Less than

Drug 6 hours before offense (%) 12 hours before (%) 24 hours before (%)

Alcohol 28.0 5.6 2.4

Other drugs 36.8 5.6 1.6

N = 125

Exhibit 13. Type of Drug Used Before Committing Offense

Drug Percent 

Cannabis 43.6

Cocaine 25.5

Heroin 25.5

Crack 9.1

Ecstasy 3.6

Amphetamines 1.8

Methadone 1.8

Note: Some I–ADAM program participants reported use of more than one drug.
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I–ADAM in Eight Countries: Approaches and Challenges

Exhibit 14. Offenses and Drug Use

No drugs

Offense Total Alcohol Cannabis Cocaine Ecstasy Opiates Methadone Amphetamines Benzo found

Theft 37 3 19 19 1 9 6 1 9 7

Violent offenses 22 0 10 4 0 2 1 0 3 8

Sexual offenses 2 0 1 0 0 0 0 1 1 1

Drug offenses 11 0 1 2 0 1 0 0 0 9

Other offenses 8 0 2 1 0 2 0 0 0 5

Total 80 3 33 26 1 14 7 2 13 30 

Note: Drug use determined using urine test.

other offenses test positive for relatively fewer drugs. Again, these data should be interpreted with

the greatest caution, since the number of urine samples and the response rate were relatively low.

G. Previous Arrests

Of those interviewed, 41.6 percent reported having been arrested at least once in the past year;

55.8 percent of these had been arrested once before, the others more frequently. Going back even

farther, 59.2 percent of all respondents reported having been arrested before the past year and

52.7 percent of all respondents reported having been detained in prison.

H. Cultural Origin and Nationality

More than three-quarters of all respondents (77.2 percent) claimed Dutch citizenship, although 57.7

percent were of a non-Dutch ethnic background (i.e., their parents were, or had originally been,

citizens of other countries). Most of these were Moroccan, Surinamese, or Turkish.

XII. Policy Implications and Applications of Data

This I–ADAM pilot project has shown that research on arrestees may produce valuable information

that could be useful for the further development of Dutch drug policy, both from the standpoint

of maintaining public order and in terms of the treatment of drug addiction. The low response rate

(51 percent), however, gives reason for concern. The experience of running the pilot project has

given researchers some ideas on how to improve the response rate, but additional testing would be

required to prove that a higher response will be possible. The relatively costly and time-consuming

procedure is another cause for concern. 

After the pilot program concluded, it was up to the Ministry of Justice to decide whether I–ADAM

would be continued on a broader scale in the Netherlands. The report of the pilot program were

presented to the persons involved from the Ministry of Justice and the Ministry of Health, Welfare,

and Sports, and the results were discussed within the two ministries and with Dutch health care
93

The Netherlands

officials. If these persons are interested, the results will be brought to the attention of other interested

parties (such as policy and care organizations) in other police regions in the Netherlands. A possible

next step could then be to test I–ADAM in three other police regions to find out whether the response

rate would be higher and whether more data would be received. After that, the Ministry of Justice

could decide whether to expand the program further.

The results of the pilot study were made available at the end of 1999 and were discussed with

policymakers at the Ministries of Justice and Health, Welfare, and Sport in 2000. The study report

held that if the pilot program were to be continued, the response rate would have to be higher and

arrestees would have to be tested for alcohol as well. If so, the project could provide interesting data.

Policymakers in these ministries, however, decided not to continue the project. One reason for this

may be that much is already known about Dutch drug users. The main reason for not continuing

the project was that policymakers did not see that response rates could be improved enough to

generalize results to the whole population of arrestees. Much is already known about drug users

in the Netherlands. Policymakers thus chose to give priority (and allocate funding) to other

research, including research on a new system of compulsory treatment for the most persistent

drug-related offenders (the “SOV” project), in which offenders who have committed numerous

offenses are now forced to join a 2-year program, in which they spend the first 6 months in jail

and then go to other surroundings, where they are helped to stop using drugs (or at least to use

them in a more controlled way), and to find work and housing. This project will be evaluated

extensively and will provide information about the group of arrestees.

Although SOV will give information about arrestees, the authors regret that I–ADAM will not be

continued, especially because I–ADAM could have produced important international comparative

data. The only chance for the ADAM project to be resumed in the Netherlands is if those running

the program can work out a reliable way to test arrestees for alcohol, or, if it turns out that

I–ADAM can generate information needed by parliament, it is possible that the project may be

continued after all.

If it were expanded to more regions on a regular basis, the Dutch I–ADAM program promises to

become an important information resource that would—

• Produce better and more policy-relevant information on drug use (quantities and sorts of 

narcotics, monitoring specific user groups and risk groups) and on the relationship between 

drug use (including alcohol) and specific forms of crime.

• Help to discover and confirm new drug use trends.

• Provide more and better information on local trends and relationships between drug use and 

crimes and eventually lead to the development of user/perpetrator profiles.

• Improve understanding of user groups that have so far escaped the focus of addiction and 

drug treatment programs, with the possibility of improving the range and effectiveness of 

narcotics care for criminal users.

• Supply the material needed for international comparative studies within the broader 

I–ADAM framework.
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I–ADAM in Eight Countries: Approaches and Challenges

Additionally, if the questionnaire currently used can be expanded with some of the questions that

had to be removed earlier at the request of the Bar Association, operationally relevant information

on local drug markets and channels and ways of distribution would become available.

In summary, the results of the I–ADAM pilot in the Netherlands suggest that the program would

improve understanding of drug use among people committing crimes and help shape future

drug policy. The relatively low response rate and the difficulties in measuring alcohol in urine samples, however, are reasons for concern that cannot be easily overcome. In countries where

response rates were higher, however, I–ADAM has the potential to provide new information

about the relationship between drug use and crime. The authors believe that international data collection and comparison should be encouraged.

Notes

1. U.S. Census Bureau, International Database, 2000.

2. Department for Statistical Information and Policy Analysis, Registered Crime in the Netherlands,

1995–1999, The Hague: Ministry of Justice, 2000.

3. National Drug Monitor: 2000 Annual Report, Utrecht: Trimbos Institute, 2001: 24–25.

4. Coffee shops can best be described as cafés (which are not allowed to sell alcohol) in which

soft drugs may be sold under the following conditions:

• No more than 5 grams per person may be sold in any one transaction.

• No hard drugs may be sold.

• Drugs may not be advertised.

• No selling to minors may take place.

• No more than 500 grams may be kept in stock.

• Coffee shops must not create a nuisance.

5. Information in this paragraph is based on Tak, P.J.P., The Dutch Criminal Justice System: Organization

and Operation, The Hague: Ministry of Justice, Research and Documentation Center (WODC), 1999.

6. Arrestees participating in the I–ADAM pilot were all taken into custody.

7. Information in this paragraph is based on the following Dutch Government publications:

Drugs Policy in the Netherlands: Documentation 1, The Hague, Ministry of Health, Welfare and

Sport, 1997; Drugs Policy in the Netherlands, Continuity and Change, The Hague, Ministry of

Foreign Affairs, Ministry Health, Welfare and Sport, Ministry of Justice, Ministry of the Interior,

1995; Nederlandse bijdrage inzake de implementatie van het Gemeenschappelijk Optreden Drugs, rapportage

1999; Drugbeleid, voortgangsrapportage September 1997–September 1999, The Hague: Ministry of

Health, Welfare, and Sport, 1999.
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The Netherlands

8. For example: Korf, D.J., Dutch Treat: Formal Control and Illicit Drug Use in the Netherlands,

Amsterdam: Thesis Publishers, 1995; and Grapendaal, M., E. Leuw, and H. Nelen, A World of

Opportunities: Life-Style and Economic Behavior of Heroin Addicts in Amsterdam, Albany: State

University of New York Press, 1995. Much information on drugs research can be found 

at the Netherlands Institute of Mental Health and Addiction (Trimbos-Institute) in Utrecht

(http://www.trimbos.nl).

9. These numbers add up to more than 100 percent because they include offenders who

committed one or more of the listed offenses.
97

SCOTLAND

Neil McKeganey 

Clare Connelly

John Norrie

Janusz Knepil

Neil McKeganey is the director of the Centre for Drug Misuse Research at the University of Glasgow. Clare Connelly is

a lecturer at the School of Law, University of Glasgow. John Norrie is the assistant director of the Robertson Centre for

Biostatistics, University of Glasgow. Janusz Knepil is an honorary lecturer in the Department of Pathological Biochemistry

at the University of Glasgow and a member of the Department of Biochemistry at Gartnavel General Hospital, Glasgow.

Introduction 

This chapter describes research piloting the Arrestee Drug Abuse Monitoring (ADAM)

Program in Scotland and covers the following background: 

• Negotiation of access to Scottish police stations.

• Development of the research instrument.

• Drug testing procedures used in the pilot.

• Extent of drug abuse identified among arrestees.

• Practical difficulties of undertaking the pilot.

• Policy implications arising from the pilot and the next stage of ADAM research in Scotland. 

I. Overview of Demographic Profile of Nation 

Scotland is a devolved part of the United Kingdom. Although it shares some powers of government with the Parliament in London, Scotland has its own Parliament and distinctive legal system. Exhibits 1 and 2 present some basic demographic and economic information about Scotland.

Police in Scotland recorded 432,000 crimes in 1998, up from 421,000 in 1997. In 1999, 118 murders

and 712 attempted murders were committed in Scotland; 6,323 serious assaults and 5,075 incidents of robbery and assault were reported to police. 
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I–ADAM in Eight Countries: Approaches and Challenges

Exhibit 1. General Demographic Information for Scotland

Geographic area 31,510 mi2 (78,789 km2)

Estimated population 5.1 million

Gender distribution 50.8% female, 49.2% male (U.K.)

Age distribution 0–15 years, 19.9%;

16–64 years, 64.7%;

≥65 years, 15.4% 

Life expectancy (1998) Scotland, 72.1 years (male), 78.1 years (female);

United Kingdom, 74.9 years (male), 79.8 years (female)

Population growth rate –0.09%

Birth rate 10.56 per 1,000

Death rate 11.67 per 1,000

Languages English, Scottish Gaelic (approx. 60,000 speakers)

Literacy rate <99% (1978 est.)

Political subdivisions 9 regions (Borders, Central, Dumfries and Galloway, Fife, Grampian,

Highland, Lothian, Strathclyde, and Tayside); 3 island areas (Orkney,

Shetland, and Western Isles)

Sources: Registrar General for Scotland, Annual Report of the Registrar General for Scotland, 1999. Edinburgh, General Register Office for

Scotland, 2000; Central Intelligence Agency, The World Factbook: United Kingdom, Washington, DC: Central Intelligence Agency, 2000.

Exhibit 2. Economic Information for Scotland

Gross domestic product (GDP) (1997) £56.2 billion

Average weekly earnings Scotland, £394.6 (males), £276.7 (females); 

United Kingdom, £425.6 (males), £308.7 (females)

Unemployment rate 7.1%

Source: Scottish Executive

Although little information exists on the size of the problematic drug-misusing population within

Scotland, it is clear that the country has a substantial and growing drug problem. A comparison

of the results of national household surveys conducted in 1993 and 19961 shows that self- reported

lifetime drug use increased for all drugs and use in the previous 12 months increased for all

drugs except LSD (see exhibit 3). In 1996, 22.5 percent of the Scottish population had ever used

illegal drugs, compared to 9 percent in the previous year. Cannabis was by far the most widely

used illegal drug, followed by amphetamines and LSD. The drugs with the largest proportionate

increases in use were temazepam (benzodiazepene) and Ecstasy (MDMA); lifetime use rates for

both doubled from 1993 to 1996 (see exhibit 3). On the basis of the 1996 Scottish Crime Survey,

approximately 679,000 people within Scotland have tried at least one illegal drug, 560,000 have

used cannabis, and 41,000 have used opiates.2

Research has identified high levels of drug misuse among young people in Scotland. By age 15,

40 to 50 percent of young people have started to experiment with illegal drugs.3 Recent research

has also shown that young people in Scotland are starting to use illegal drugs at an increasingly

young age; McKeganey and Norrie have reported that 10 percent of 11- to 12-year-olds in Scotland

have already begun to use illegal drugs.4
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Scotland

Exhibit 3. Prevalence of Self-Reported Drug Use in Scotland, 1993 and 1996,

Ages 16–59

1996 1993

Lifetime Use in past Lifetime Use in past

use (%) 12 months (%) use (%) 12 months (%)

Any drug 22.5 9.0 18.3 6.8

Cannabis (marijuana) 19.0 8.2 14.5 6.1

Amphetamines 7.3 3.1 5.2 2.2

LSD 5.5 1.3 4.0 1.6

Psilocybin (mushrooms) 5.1 1.3 3.7 1.0

Ecstasy (MDMA) 4.0 2.1 2.0 1.1

Temazepam (benzodiazepine) 3.7 1.1 1.7 0.9

Valium 4.2 0.9 2.7 0.3

Solvents 2.1 0.2 1.6 0.1

Powder cocaine 2.6 1.0 1.5 0.4

Crack cocaine 0.7 0.2 0.4 —

Heroin 0.8 0.1 0.4 —

Methadone 0.9 0.3 0.2 0.1

Source: Anderson, S., and M. Frischer, “Drug Misuse in Scotland: Findings From the 1993 and 1996 Scottish Crime Surveys,” Crime and Criminal

Justice Research Findings, No. 17, Edinburgh: The Scottish Office, Central Research Unit, 1997.

The rates of injection drug use, drug-related mortality, and hepatitis C and HIV infection among

injection drug users (IDU) are sources of concern in Scotland. Glasgow, Scotland’s largest city, has

an estimated 9,500 injecting drug users (IDU).5 Dundee, Scotland’s third-largest city, has an estimated 3,500 opiate and benzodiazepine misusers.6 Drug-related mortality has been increasing in

Scotland over the past several years.7 An estimated 60 percent of IDUs in Scotland may be hepatitis C positive.8 Approximately 20 percent of IDUs in Edinburgh (Scotland’s capital and secondlargest city) and 26.8 percent of IDUs in Dundee are thought to be HIV positive.9 In Glasgow,

however, only 1 to 2 percent of IDUs are thought to be HIV positive.10

Relatively little research has been undertaken to quantify drug-related crime within Scotland.

Recent research has estimated that IDUs in Glasgow spend approximately £94 million each year

on drugs. To support that level of drug purchasing, an estimated £129 to £258 million worth of

goods is being stolen each year.11

II. Description of Criminal Justice System, Arrest

Process, and Detention System 

Police in Scotland can make arrests when they witness, or are called to the scene of, a crime and

the accused is present. In these circumstances, the suspect is often immediately charged with an

offense and either detained in custody in the police station, to appear in court the next morning,

or set free on an undertaking to appear in court at a future date. If a warrant is issued for an
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I–ADAM in Eight Countries: Approaches and Challenges

accused’s arrest, the accused is detained in the police station and appears in court the next day. If

an offense is committed over the weekend, the accused is held in custody until Monday morning,

when the first court sits. Courts in Scotland do not sit on Saturday or Sunday.

Following an arrest or a charge, a report is sent to the procurator fiscal, who decides whether a

prosecution should take place and, if so, what the charges should be. Procurator fiscals are civil

servants who prosecute crimes in the lower courts in Scotland and draw up charges for the higher

courts, where a case is prosecuted by an advocate depute. The case is prosecuted if the procurator

fiscal decides that sufficient evidence exists and that prosecution is in the public interest. The

procurator fiscal decides whether or not there should be a jury trial; an accused has no right to

demand a jury. In cases of rape and murder, however, trial must be by jury.

An arrestee held in police custody is given a statement of the charges on which he or she is to be

prosecuted in the court appearance the next day. At this hearing the arrestee is either remanded

to custody (prison) to await trial or set free, pending trial. If the arrestee is remanded to custody,

the trial must start within 110 days; if the arrestee is set free, the trial must start within 1 year of

the date of appearance. If the prosecutor fails to bring the case to trial in a timely fashion, the

accused is set free, and no future trial on the same charges can occur. If not detained in police

custody, an arrestee is set free on an undertaking to attend a specified court at a specified time. 

Scottish criminal law is mainly a body of common law; hence, limited criminal statutes and no

criminal code exist. For all common law crimes except murder, sentence following conviction

is at the judge’s discretion. Murder carries a mandatory life sentence, with release being on life

license. For statutory offenses (e.g., all drug offenses within the Misuse of Drugs Act, 1971),

judges’ sentencing powers are detailed in the legislation.

III. Status of National Drug Policy 

The primary U.K. legislation relating to drug abuse is the Misuse of Drugs Act, 1971. Section 1

of the Act authorizes the creation of the Advisory Council on the Misuse of Drugs, a group of

Government officials and external experts who advise the Government on the changing nature

of the drug problem in the United Kingdom. Section 2 of the Act identifies the range of drugs

falling within the terms of the Act and places these in one of three classes. Exhibit 4 sets forth the

drugs in each class and the penalties for possession for personal use and possession with intent

to supply. 

Government anti-drug-abuse policy is set forth in the documents, Tackling Drugs to Build a Better

Britain12 and Tackling Drugs in Scotland: Action in Partnership.13 Both documents present Government goals under four key headings: young people, treatment, communities, and availability

(see “Objectives of Scottish Drug Misuse Strategy”).

IV. History of I–ADAM in Scotland

The idea of conducting an ADAM study within Scotland came from John Hamilton, Chief

Constable of Fife Constabulary. Chief Hamilton had attended the first annual I–ADAM meeting
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in Miami in April 1998 and saw the value of applying the ADAM methodology in Scotland.

Following discussions with government officials, funding was provided for a pilot of the ADAM

approach in two police jurisdictions in Scotland. 

Shortly after the first annual I–ADAM meeting, National Institute of Justice (NIJ) staff from the

U.S. Department of Justice visited Scotland in June 1998 to provide government officials with

details of ADAM operations in the United States and gain a better understanding of how ADAM

would operate in Scotland. In August 1998, Scottish officials conducted a press briefing with the

Fife police force regarding their work in developing an I–ADAM site in Fife and the process for

selecting a research team. In October 1998, the Scottish Office conducted a second press briefing

to announce the inclusion of the Strathclyde Police Force in the I–ADAM project. 

The pilot was carried out over 6 months from June to November 1999.14 Both police forces were

actively involved at all stages of the research and both sent representatives, along with the research

team, to the 1999 and 2000 I–ADAM annual meetings. 

V. Goals and Objectives of I–ADAM in Scotland 

The Scottish ADAM pilot aimed to—

• Test the feasibility of using the ADAM methodology within the Scottish context. 

• Consider the requirements of ADAM data collection sites and their application in Scotland.

• Consider the value of using the ADAM methodology to monitor and assess changes in 

drug use over time.

• Gather information about the type and extent of drug use among recent arrestees in the 

selected areas.

• Compare self-reported drug use with the results of urine testing.

Exhibit 4. Classes and Penalties of Drugs in the United Kingdom

Maximum penalties*

Class of Possession for Possession with 

drugs Types of drugs personal use intent to supply

A Cocaine including crack, opiates (heroin,

morphine, opium), LSD, methadone, Ecstasy 

(MDMA), injectable amphetamines, PCP, magic 

mushrooms, cannabinol and derivatives 7 years’ imprisonment life imprisonment 

B Cannabis (marijuana, herbal and resin),

barbiturates, noninjectable amphetamines,

codeine, dihydrocodeine, methylamphetamines 5 years’ imprisonment 14 years’ imprisonment 

C Benzodiazepines (temazepam, Valium), anabolic steroids 2 years’ imprisonment 5 years’ imprisonment 

*All penalties are in addition to or in place of an unlimited fine.

Source: Independent Inquiry Into the Misuse of Drugs Act, 1971. Drugs and the law: Report of the Independent Inquiry Into the Misuse of Drugs

Act, 1971, London: Police Foundation 1999. [cited herein as Runciman Report 1999].
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I–ADAM in Eight Countries: Approaches and Challenges

• Consider the ways in which arrestees describe and justify their behavior.

• Assess the utility of additional questionnaires for identifying and exploring issues potentially 

related to drug use.

VI. Getting Started 

Although there was considerable support for an ADAM pilot at the planning stage, all key stakeholders involved in the research (police, officials from the Crown Office, and senior civil servants

from the Health and Criminal Justice Departments) were acutely aware of the problems and

sensitivities that the study was likely to involve. Never before in Scotland had an independent

Strategic Aim 1: Young people—to help

young people resist drug misuse in order

to achieve their full potential in society.

Key Objective: Reduce the proportion of young

people under age 25 reporting use of illegal

drugs in the past month and the previous year.

• Establish a consistent and coordinated

evidence-based approach to drug education, prevention, and harm reduction

that takes account of individual and

community needs.

• Implement education strategies and initiatives and provide public education that

increases knowledge and awareness of

drug misuse and promotes the avoidance

of drug misuse.

• Reduce the acceptability and incidence

of drug misuse among children and

young people.

• Ensure that every school pupil in Scotland

has effective drug education, including

accurate and up-to-date information on

the consequences of drug misuse.

• Reduce the harm from drug misuse by

encouraging positive alternative lifestyles.

• Increase access to services for vulnerable

young people, including school excludees,

truants, looked-after children, young

offenders, young homeless, very young

children at risk of drug misuse, and the

children of drug-using parents. 

Strategic Aim 2: Communities—to protect

our communities from antisocial and criminal behavior.

Key Objective: Reduce levels of repeat offending among drug-misusing offenders.

• Strengthen and protect communities

from drug-related crime and the fear of

drug-related crime.

• Reduce the level of drug misuse in 

prisons.

• Develop constructive alternatives to

prosecution and imprisonment for drugrelated offenses.

• Support partnerships among professionals, local people, and businesses in

developing local initiatives for tackling

drug misuse.

• Promote drug awareness and the development of drug policies and health promotion in the workplace.

• Ensure that drug misuse is addressed

within the wider context of area regeneration and social inclusion. 

Objectives of Scottish Drug Misuse Strategy
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agency undertaken research interviewing individuals within hours of their arrest. The concerns

voiced were of several kinds, including—

• Human rights concerns:

— How to ensure that arrestees provide free and full informed consent to take part in the study.

— How to ensure that no one participating in the study would be held in custody for longer 

than would otherwise occur. 

• Practical concerns:

— Whether to interview arrestees in the cells or in an adjacent area. 

— How to ensure that no other arrestees could overhear answers to specific questions. 

Strategic Aim 3: Treatment—to enable

people with drug problems to overcome

them and live healthy and crime-free lives.

Key Objective: Increase participation of problem drug misusers, including prisoners, in

drug treatment programs that have a positive

impact on health and crime.

• Reduce the health risks to individuals

and communities from drug misuse, and

reduce related infectious diseases.

• Increase the number of drug misusers

becoming and remaining drug free, and

promote their inclusion in society.

• Reduce the incidence of injecting, sharing, and polydrug misuse among drug

misusers.

• Reduce the number of drug-related

deaths.

• Increase the proportion of drug misusers

in contact with services, including those

in prison, through the development of

good, accessible, responsive, and effective services.

• Reduce the number of drug misusers

who have no quick access to appropriate

treatment. 

Strategic Aim 4: Availability—to stifle the

availability of illegal drugs on our streets.

Key Objective: Reduce access to drugs among

5- to 16-year-olds.

• Reduce access to drugs among all age

groups. 

• Enforcement agencies to continue to

identify, investigate, and obtain evidence

for the prosecution of persons engaged

in drug trafficking and supply.

• Reduce the amount of drugs entering

Scotland by targeting distribution 

networks and dismantling organized

trafficking.

• Support local constructive community

efforts at reducing the local availability 

of drugs.

• Reduce the availability of drugs in 

prisons. 

Source: Scottish Office, Tackling Drugs in Scotland:

Action in Partnership, Edinburgh: The Scottish Office,

1999.

Objectives of Scottish Drug Misuse Strategy (continued)
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I–ADAM in Eight Countries: Approaches and Challenges

• Interviewer safety concerns:

— What kind of arrangements would be needed to reduce the possibility of interviewers being

assaulted during face-to-face interviews with arrestees. 

• Concerns with obtaining and analyzing urine samples:

— What kind of collection devices to use to obtain urine samples.

— How to avoid possible risks of injury from sharp edges on collection devices, and how to

keep collection materials from being bent or manipulated to create a sharp edge for use as a

possible weapon.

• Confidentiality issues:

— What level of confidentiality to afford the interviewee who admits to a serious crime.

A number of key stakeholder agencies, including the police, were concerned as to how an ADAM

interviewer should respond if an arrestee admitted to having recently carried out a serious offense

(e.g, murder) of which the police were unaware. Police and government officials believed that

such information should be passed on to the police, but such a stipulation was problematic from

a research standpoint because it would provide arrestees with only limited confidentiality when

taking part in the interviews. 

In the light of these and similar issues, a set of protocols was prepared that specified the procedures to be followed at each stage of the research. Topics covered by the protocols included the

following:

• Selecting arrestees for interviews.

• Developing sample inclusion criteria.

• Scheduling interviews in the police stations.

• Recruiting arrestees into the pilot.

• Obtaining informed consent.

• Collecting and analyzing urine samples.

• Responding to inappropriate arrestee behavior during interviews.

• Recording information on all arrestees with participating custody areas over the period

of the ADAM pilot. 

Once the protocols had been agreed to by the commissioning group (which contained representatives of the Crown Office, senior civil servants from the Health and Criminal Justice Departments,

and representatives of both police forces), the research was authorized to proceed and the research

instrument was designed. After the team of interviewers for the research had been recruited and

trained, letters were sent to all defense solicitors operating in the pilot areas informing them

about the nature of the research that would soon be under way. Only two responses were

received to the letters sent out from the research team: one congratulated the team on the valuable research they were doing, and the other requested a copy of the questionnaire and stated
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that the firm would be advising its clients to refuse to collaborate with the research. As it turned

out, no clients of this particular law firm were knowingly involved in the pilot. 

Facility Access 

The ADAM pilot was carried out in Strathclyde and Fife. Strathclyde represents the largest area

within Western Scotland and contains Glasgow, Scotland’s largest city and home to some threequarters of a million people. Fife, by contrast, is a predominantly rural area with small towns in

eastern Scotland. Both Strathclyde Police and Fife Constabulary were actively involved at all

stages of the research, including identifying the police stations where the ADAM program would

be undertaken. At the outset, these were identified on the basis of the number of arrestees received.

Two out of 115 police stations were identified in Strathclyde. All three of Fife’s police stations

were identified, but, in practice, the pilot was confined to the two main stations. The small number of arrestees processed in the third station would have required the fieldwork to be extended

over a very considerable time period in order to recruit arrestees in sufficient numbers.

Both police forces requested an indemnity against possible legal action in the event of an interviewer being attacked by an arrestee in the course of this pilot. The University of Glasgow granted

this indemnity on the condition that, when interviews were taking place, a police officer or force

support officer would be positioned to see what was happening at all times and able to speedily

intervene if an arrestee behaved aggressively toward an interviewer.

Once the participating police stations were identified, it was necessary to meet with the station

commanders and their senior management staff to outline the nature of the proposed research.

Each shift commander was briefed on the research procedures. In addition, police liaison officers

associated with this research prepared a set of written protocols for custody officers to follow. 

It would be difficult to overestimate the importance of this phase of the research. Clearly, the

pilot could not have been conducted without the support of senior officers in both areas. Even

with such support, however, this study also required the active support of all custody area staff

who would be working directly with the interviewing team. Securing the involvement of this

staff was not a once-and-for-all process. The ADAM pilot involved a continuous balancing

between the needs of the research and the day-to-day demands of the police officers involved

in the pilot. The following field note illustrates how the normal work of the custody area could

affect the ADAM fieldwork:

When Inspector Adams and I were going through the Arrestee Monitoring Forms (which

provide details on all individuals arrested during each shift), we noticed that a substantial

number of individuals had been arrested but had apparently not been considered for interview. When Inspector Adams spoke to the shift concerned, it was explained that an operation was under way within the station to target shoplifters and that, although a large number

of shoplifters had been arrested, they had been processed very quickly and then released,

leaving no time for them to be approached about a possible interview. Clearly, from a

research point of view, it was disappointing to see so many arrestees being lost to interview,

but to have held onto the individuals for the purposes of the research would have been

unethical. Within such circumstances, there was nothing that could be done. 
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Drug Testing Issues 

The key drug testing issue faced in the Scottish ADAM pilot was whether to rely on generic testing procedures or to undertake further confirmatory analyses of positive urine samples. It was

decided to combine generic and confirmatory testing in the Scottish pilot for two reasons. First,

because the study was a pilot, it was important to identify whether the confirmatory analysis

would be necessary in any wider extension of the ADAM program in Scotland. Second, a variety

of medicines containing low levels of opiates can be legally bought within Scotland; ingestion of

these medicines can produce a positive result under generic urinalysis. Only by undertaking further confirmatory work could possible innocent opiate use be differentiated from more problematic forms of opiate misuse. 

Clearly, one cannot, in this short report, discuss at length the results of generic and confirmatory

drug testing analyses. Of the 87 urine samples that tested positive for opiates on the basis of the

generic screening, four were reclassified as negative on the basis of the confirmatory analysis. Of

the 21 urine samples that tested positive for amphetamines, no samples were reclassified on the

basis of the confirmatory analysis. Two samples, however, that had been categorized as opiate

positive but amphetamine negative were found, on further testing, to be amphetamine positive.

One sample that had been classified as opiate negative but amphetamine positive was found to

be opiate positive. These results are interesting but not conclusive, and they may indicate that

combined generic and confirmatory analyses of urine samples are necessary. 

Instrument Issues 

The questionnaire used in this pilot was similar to that used in the first U.K. pilot (the New

England and Wales Arrestee Drug Abuse Monitoring [NEW–ADAM] pilot). A copy of that questionnaire had been made available to the Scottish research team. In particular, the questionnaire

covered the following areas:

• Demographic characteristics—age, education, employment.

• Legal and illegal drug use over the previous 12 months, 30 days, and 3 days.

• Drug buying activities.

• Arrestee’s views of a possible link between his or her drug use and offending behavior.

• Extent of drug use and needle and syringe sharing.

• Personal expenditure on drugs.

• Sources and amounts of legal and illegal income.

• Past offending behavior.

• Use of drug treatment facilities and self-perceived need for help.

• Access to and carrying of weapons.

• Involvement in and experiences of domestic violence.

In addition to the standardized survey instrument, an arrestee monitoring form was designed and

used for this pilot. This form, completed by the custody staff, recorded details on all individuals
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arrested during the pilot period. Through this means, the sample of arrestees who were interviewed could be compared with the broader population of arrestees in each custody area. 

VII. Barriers to Developing I–ADAM in Scotland 

There were no barriers as such to conducting the ADAM pilot in Scotland; however, the research

raised many problems and difficulties that needed to be resolved in the execution of the pilot. At

one level the ADAM methodology is very simple; indeed, what could be simpler than interviewing and drug testing members of a captive population? In fact, the research involves a complex

array of problems, many of which could not be anticipated. Examples of issues that surfaced in

the course of the pilot follow.

Security Cover

As stated earlier, the University of Glasgow granted an indemnity to police forces on the basis

that, at all times when an interview was taking place, a police officer or force support officer

would be in the vicinity of the interview, able to see what was happening but not able to overhear what was being said. An unanticipated consequence of this arrangement was that, during

periods when the police stations were busy processing large numbers of arrestees, it was often

impossible to release an officer to provide the necessary security cover. Conversely, when the

custody areas were not particularly busy, it was easy to identify an officer who could provide

security cover, but few arrestees were available for interview. The field note below illustrates

this problem:

On my usual trip to the station this afternoon, I spoke to one of the interviewers, who was

sitting rather glumly in the room that had been allocated to us for the interviews. He said

that there was a football match on in the area, that there had been considerable crowd trouble, and whilst a number of arrests had been made, the officer in charge of the shift had said

that his staff were simply too busy to spare somebody to provide security cover to enable

any interviewing to take place. When I then spoke to the officer in charge, he said that whilst

he was sympathetic to the needs of the study, there was simply nothing he could do because

all of his staff were fully committed to policing the football match. I then spoke to the interviewer and said that, although it looked unlikely that any interviewing would take place

on his shift, he would still have to remain in the custody area in case the situation changed.

When I asked if he wanted me to pick up a newspaper for him, the enthusiasm with which

he greeted that suggestion spoke volumes about the prospect of another 4 hours sitting on

his own in this tiny office. 

The research often involved a complex negotiation with custody staff as to what was possible.

Sometimes potential blockages in the interviewing could be resolved by reference to higher

authority (a more senior officer); at other times, the interviewer simply had to recognize that

other events occurring within the custody area were going to take precedence over the research.

At such times, it was necessary to take a step back and wait for a more opportune moment when

the interviewing could resume. 
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Confidentiality 

At an early stage in this fieldwork, both police forces expressed the concern that, if an arrestee

disclosed to the interviewer that he or she had committed a serious crime—for example, a murder or a kidnaping, this information would have to be passed on to the police as soon as possible

at the conclusion of the interview. In effect, then, arrestees could be provided with only limited

confidentiality. Clearly, it was essential that this limited confidentiality be explained to all arrestees.

The research team agreed to provide arrestees with both written and verbal statements of the

limited basis on which confidentiality could be granted to them in connection with their involvement in the ADAM pilot. This meant that arrestees’ answers to questions covered on the research

instrument could be considered confidential; however, any additional information volunteered by

arrestees was not covered by the confidentiality clause. It was further explained to the arrestees

that unsolicited disclosures would be regarded as inappropriate behavior and would result in the

termination of the interview. In the planning stage of this research, this arrangement was considered to be a way of ensuring that the research team would not find themselves in the position of

passing information to the police that had arisen in the course of an interview thought to be confidential by arrestees. As the following field note illustrates, however, even this arrangement was

less than wholly adequate: 

At around 6 a.m., I received a telephone call from one of the interviewers who was clearly in

an agitated state over an interview she had just completed. I said I would drive down to the

custody area immediately, and, when I met her, she explained that midway through an interview, the arrestee had stated that his stepfather had abused him over many years. This was

not an area covered by the questionnaire; the interviewer asked the arrestee to confine himself only to the questions that would be put to him and repeated that any additional information could not be regarded as confidential. The arrestee said that he understood this and

wanted to continue with the interview and would stick only to answering the questions that

were put to him. However, when the interviewer came to the section of the questionnaire

that asks about the arrestee’s access to guns, he indicated that he did indeed have access to

a gun and that it was his intention, on being released from the police station, to kill his stepfather. The interviewer had then become very concerned about this disclosure. Unsure of

whether she should have alerted the police to this threat, she had telephoned me. I was also

unsure of how to respond to this occurrence. Since murder had not taken place the incident,

as such, was not of the same kind as had been anticipated in the planning stage for the pilot.

However, a threat to murder someone made within the context of a police station by an

arrestee who has admitted access to a gun hardly seemed the kind of thing that one could

simply ignore. Following a more general discussion with our police liaison officer and discussions with a colleague within the University, I made the decision that we had to alert

the police to the nature of the threat that had been made. Since only one arrestee had been

interviewed on that shift, it was not difficult to indicate to the relevant police officer which

arrestee had made the threat. 

It is important to recognize that, in responding to this incident, no clear guidelines existed as

to how to proceed. As a result, the interviewer and her supervisor had to determine a response

largely on the basis of what seemed right at the time. At the simplest level, it would have been

intolerable to have been warned about a murder in advance of its occurrence and done nothing
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to prevent it. Since the likelihood that the individual would act in accordance with this threat

could not be assessed, the only sensible option was to pass the information on to the police

authorities.

VIII. National Stakeholders Involved in the

Development of I–ADAM 

Numerous parties have been involved in the development of I–ADAM in Scotland. These include

the Scottish Executive, which funded this pilot program through a grant; the Fife Constabulary

and the Strathclyde Police, which were the local police forces who cooperated in the program;

the University of Glasgow, which sponsored the study and provided the interview team; and the

Scottish Advisory Committee on Drug Misuse, which is the group responsible for setting and

reviewing Scottish drug policy. 

IX. Research Methods 

The ADAM pilot in Scotland entailed a combination of research methods. First, custody staff were

asked to complete an Arrestee Monitoring Form on all arrestees passing through each of the custody areas participating in this research. The form recorded key information to allow comparison

of the arrestees who were interviewed and had their urine tested against the broader arrestee

population within the study areas. Second, a sample of arrestees was interviewed about their

drug use, using a standardized instrument (questionnaire). Third, the interviewees’ self-reports

of their drug use were confirmed by a laboratory examination of urine samples provided by

those interviewed who consented to a urine test.

Sampling 

The original plan was to have an interviewer available in each of the custody areas over the full

24 hours of each day of data collection. As a result of staffing difficulties, it was necessary to revise

the interview schedules so as to make interviewers available 18 hours a day, 7 days a week. For

each day of data collection, interviewer shift times were constructed so as to minimize the loss

of any arrestees from this study as a result of the reduced coverage. The shift times used in this

research were from 11 a.m. to 8 p.m. and from 9 p.m. to 6 a.m. in Strathclyde, and from 7 a.m.

to 4 p.m. and from 6 p.m. to 3 a.m. in Fife. It became evident that most arrestees were in the custody area for longer than 2 to 3 hours, which meant that even if someone had been arrested in

the period when no interviewer was present, the interviewer could usually request an interview

when he or she came on shift.
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I–ADAM in Eight Countries: Approaches and Challenges

Eligibility Criteria 

The Scottish ADAM pilot included adult arrestees (age 16 and older) who could provide informed

consent to participate in the research. The following arrestees were excluded from the pilot:

• Arrestees younger than 16.

• Arrestees who could not provide fully informed consent to participate in the research. These

included arrestees who were impaired by alcohol or drug use, and individuals arrested on suspicion of murder. These last were excluded on the advice of the Crown Office because they are

routinely assessed by a psychiatrist and, therefore, could not be assumed to be of sufficiently

sound mind to provide fully informed consent to the research.

• Arrestees who the custody officer determined posed a threat of violence to the interviewer or

whose interview might interfere with an ongoing police investigation.

• Arrestees in connection with drunk driving charges. Drunk drivers tend to be processed very

quickly through police stations, and their recent alcohol use might impair their ability to provide informed consent to participate in the research.

Over the period of data collection in the Scottish ADAM pilot, 581 individuals were deemed

ineligible for inclusion within the pilot. Exhibit 5 shows the reasons for the exclusion. 

X. Training 

A team of eight interviewers was recruited for this pilot, all of whom were either current or

recently graduated students at the University of Glasgow. It was felt that using young people

in this capacity would help in building up a rapport with arrestees and would counter any suggestion that the interviewers were undercover police officers. All interviewers were trained to

use the research instrument and underwent rigorous security checks by the two police forces

Exhibit 5. Reasons for Ineligibility for I–ADAM Pilot Interviews

Reasons for ineligibility Percent ineligible*

Impairment due to alcohol intoxication 26

Detained rather than formally arrested 23

Risk of potential violence by the arrestee 17

Arrestee younger than age 16 12

In custody too short a time 12

Drunk driving charge 8

Discretion of the custody staff 8

Impairment due to mental disorder 6

Impairment due to recent drug use 4

*Percentages add up to more than 100 because some arrestees were ineligible for more than one reason.
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involved in this pilot. The police requested the security checks, given that the interviewers would

be spending a considerable amount of time within secure areas of the police stations chosen as

pilot sites. 

The interviewing team comprised four men and four women. At the time the interviewers were

selected, there was no way of knowing how well they would relate to arrestees or how close or

distant they would be from the social background of arrestees. As it turned out, the vast majority

of arrestees were from the poorer classes, while the interviewers generally had more middle-class

backgrounds. More important than class, however, was the interviewers’ ability to adopt a nonthreatening stance toward arrestees and to reassure them that they were not undercover police

officers. All interviewers wore visible identity cards noting their employment at the University

of Glasgow.

XI. National Data Analytic Results 

For this pilot program, 427 arrestees were interviewed, 220 in Strathclyde and 207 in Fife. In

addition, urine samples were successfully collected from 67 percent (280) of interviewed

arrestees. See exhibit 6 for demographic information on arrestees. 

Exhibit 7 shows the results of urine testing in the Scottish ADAM pilot. Overall, 71 percent of

urine samples were found to be positive for any drugs (excluding alcohol and volatile substances),

as compared with 61 percent in the NEW-ADAM pilot.15 Of the 280 arrestees who provided

usable urine samples, 52 percent tested positive for cannabis. Cannabis use for male arrestees

was 54 percent, compared to 42 percent for female arrestees. More than 50 percent of male

arrestees tested positive for cannabis in only 1 of 35 U.S. ADAM sites (53.1 percent in Oklahoma);

and more than 30 percent of female arrestees tested positive for cannabis in only two U.S. ADAM

sites (31.9 percent in St Louis and 31.2 percent in Indianapolis).16 These results indicate that

cannabis use appears to be more prevalent among male and female arrestees in Scotland than

among their counterparts in the United States. 

Exhibit 6. Demographic Information About Scottish I–ADAM Arrestees (n = 427)

Pilot location arrested Strathclyde, 220; Fife, 207

Sex Male, 351; female, 75

Race White, 100%

Marital status Men, 67% single; women, 67% single

Employment status Employed, 28%; unemployed/sick or disability benefit, 68%

Homeless status 16% within the past year

Education 38% ended at or before age 15
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Thirty-one percent of urine samples in the Scottish ADAM pilot tested positive for opiates

(29 percent in Fife and 33 percent in Strathclyde). Opiate misuse was more common among

female arrestees (51 percent) than male arrestees (26 percent) (p = 0.0009). Methadone use rates

were also twice as high among female as male arrestees in Scotland (see exhibit 7). More than

10 percent of adult male arrestees tested positive for opiates in only 8 of the 35 U.S. ADAM sites;

none of the U.S. sites identified levels of opiate misuse greater than 20 percent among adult

males. Twenty percent or more of female arrestees tested positive for opiates in only four U.S.

ADAM sites (the highest figure was in Chicago, where 27 percent of female arrestees tested

positive).

Exhibit 8 shows the results of the ADAM pilot interviews. In interviews, 89 percent of arrestees in

the Scottish ADAM pilot reported having used an illegal drug at some time, 80 percent within the

last 12 months. The self-reports confirmed the data from urine testing that cannabis was by far

the most widely used illegal drug among arrestees; 71 percent reported having used cannabis

within the past 12 months. Arrestee self-reports also confirmed the high prevalence of injection

drug use in Scotland and of needle sharing among injection drug users. Twenty-six percent of

arrestees reported that they had injected drugs; 22 percent had done so within the past 12 months.

Of those who had injected drugs (110), 20 percent had used another individual’s injecting equipment within the past 12 months, and 33 percent had passed on their own injecting equipment for

another’s use.

Exhibit 9 reports arrestees’ self-reports of their own drug dependence, their perceptions of the

links between drug use and crime and drug use and violence, and their access to weapons. These

reports confirm the high rates of drug misuse among offenders in Scotland: 52 percent of arrestees

stated that they felt they had been dependent on a drug other than alcohol at some point in the

past, and 40 percent said that they had recently been drug dependent. IDUs were more than

twice as likely as other arrestees to perceive a connection between their drug use and their

offending behavior (84 percent for IDUs compared with 32 percent for all arrestees) and to own

or have access to a gun (56 percent compared with 25 percent for all arrestees). Arrestees also

strongly perceived links between drugs, especially alcohol, and violence (see exhibit 9). A significant minority of arrestees (20 percent) had carried a knife when committing a crime.

Exhibit 7. Results of Urine Testing (n = 280)

Percent testing positive

Drugs All Male Female

All drugs 71 — —

Cannabis (marijuana) 52 54 42

Benzodiazepines 33 — —

Opiates (p = 0.0009) 31 26 51

Methadone (p = 0.096) 12 10 19

Amphetamines 8 — —

Cocaine 3 — —

— = Not available.
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Exhibit 8. Self-Reports of Drug Use by Scottish ADAM Interviewees

Lifetime use Use in past 12

Self-reports (%) months (%)

Any illegal drug use 89 80

Dependence on illegal drugs (excluding alcohol) 52 40

Cannabis (marijuana) — 71

Amphetamines — 43

Heroin — 31

Injection drug use 26 22

Use of others’ injecting equipment — 20*

Passing along injecting equipment to others — 33*

*Percentage of those who reported injecting drugs within the previous 12 months.

— = Not available.

Exhibit 9. Self-Reports of Connections Between Drugs and Crime

Exhibit 10. Self-Reports of Drug and Alcohol Treatment Among Arrestees

Self-reports Percentage reporting

Lifetime drug dependence 52

Recent drug dependence 40

Perceived connection between drug abuse and offending behavior 32

Perceived connection between drug abuse and offending behavior (current IDUs)* 84

Perceived connection between alcohol and violence (all arrestees) 93

Perceived connection between illegal drugs and violence (all arrestees) 65

Own or have access to gun (all arrestees) 25

Own or have access to gun (current IDUs) 56

Have carried knife when committing offense (all arrestees) 20

*IDU=Injecting drug users.

Exhibit 10 shows arrestees’ self-reports of receiving treatment for drugs and alcohol misuse. The

percentage of arrestees who stated that they would like to receive treatment for an alcohol or drug

problem was considerably higher than the percentage of those who were receiving treatment

currently or had received treatment in the past (see exhibit 10). This indicates a significant unmet

Percentage of arrestees reporting

Self-reports Drug misuse Alcohol misuse

Received treatment in past for drug or alcohol misuse 23 11

Currently receiving treatment for drug or alcohol misuse 13 4

Would like to receive treatment for drug or alcohol misuse 30 15
114

I–ADAM in Eight Countries: Approaches and Challenges

need for drug and alcohol treatment among arrestees, which is of concern given the high proportion of arrestees, especially IDUs, who saw a link between their drug use and their offending.

XII. Policy Implications and Applications of Data 

A number of policy implications flow from this pilot. First, the pilot has shown that the ADAM

methodology can be applied in Scotland. It also has shown that a very high proportion (71 percent) of arrestees in at least certain parts of Scotland have used illegal drugs and that nearly onethird (31 percent) may have used opiates. It is not now known whether the close link between

drug misuse and crime identified in the two areas of the pilot would be replicated elsewhere in

Scotland. The second key policy implication of this research is to underline the importance of

extending the ADAM work to other areas within Scotland.

The third key policy implication arising from this limited pilot concerns what one might do to

reduce the link between drugs and crime in Scotland. The Scottish Drug Enforcement Agency

has recently been created, modeled along similar lines to the U.S. Drug Enforcement Administration. The Scottish Drug Enforcement Agency arose out of a growing recognition of the need to

coordinate drug enforcement initiatives at a national level rather than at the level of individual

police forces in Scotland (Scotland does not have a national police force, as such, but a collection

of regional police forces of which Strathclyde is by far the largest).

The ADAM pilot, however, also has implications in terms of drug misuse treatment and prevention. The results of the pilot illustrate the need to integrate treatment and prevention initiatives

better into the criminal justice arena. The ADAM pilot has shown that a high percentage of

arrestees perceive a link between their drug misuse and their offending behavior, but few arrestees

received help for a drug and/or alcohol problem while in custody. There may be merit in ensuring

that drug counselors can access arrestees during their confinement and can provide the necessary

support to try to reduce the cycle of offending that so many of the arrestees appear to be locked

into as a result of their dependence. Very little is known about the likely success of such an initiative; however, the close link between drug misuse and offending that this pilot has identified in

two areas in Scotland underlines the importance of strengthening enforcement, treatment, and

prevention initiatives with regard to drug-related offending.

The Future 

Following publication of the results of the ADAM pilot, the deputy minister for justice in Scotland

announced that there will be a national rollout of the ADAM program in Scotland. Before this

takes place, however, the authors are carrying out a scoping study to assess the logistics of initiating a national program involving the interviewing and drug testing of arrestees. This study is

investigating sampling methods and what can be done to ensure that a representative sample of

arrestees is interviewed, the cost of a nationwide ADAM program, the likely value of combining

generic and confirmatory testing of urine samples, and the possible impact on future ADAM work

in Scotland of recent legislative changes, including the European Convention on Human Rights. 
115

Scotland

Acknowledgments 

The research described in this chapter was funded by a grant from the Scottish Executive; the

views expressed in the chapter are those of the authors and should not be ascribed to the funding

body. The interviewers on this study deserve special thanks for the energy and commitment they

brought to the project; they were: David Boyd, Anne Broderick, Emily Duizend, Peggy Dwyer,

Pablo Jelic, Daniel Martin, Daniel Sumpton, and Shanti Williamson. Dr. Trevor Bennett of the

University of Cambridge provided advice to the research team, for which we were very grateful.

In undertaking the pilot we owe a debt to Superintendent John McNab (Fife Constabulary) and

Inspectors Jo McGallagly and Brian Dunn (Strathclyde Police). The research would not have

been possible without the active support of police officers in each of the custody areas or of the

arrestees who agreed to be interviewed and to provide urine samples. We are grateful to all of

the arrestees who agreed to be interviewed in this research.

Notes

1. Anderson, S., and M. Frischer, “Drug Misuse in Scotland: Findings from the 1993 and 1996

Scottish Crime Surveys,” Crime and Criminal Justice Research Findings, No. 17, Edinburgh: The

Scottish Office, Central Research Unit, 1997.

2. Advisory Council on the Misuse of Drugs, Tackling Drugs to Build a Better Britain: The

Government’s Ten-Year Strategy for Tackling Drugs Misuse, London: Her Majesty’s Stationery

Office, 1998. 

3. Miller, P., and M. Plant, “Drinking, Smoking and Illicit Drug Use among 15 and 16-year-olds in

the United Kingdom,” British Medical Journal 313 (1996): 394–397.

4. McKeganey, N., and J. Norrie, “Pre-Teen Drug Users in Scotland,” Addiction Research 7 (1999):

493–507.

5. Frischer, M., A. Leyland, R. Cormack, D.J. Goldberg, M. Bloor, S.T. Green, A. Taylor, R. Covell,

N. McKeganey, and S. Platt, “Estimating the Population Prevalence of Injection Drug Use and

Infection with Human Immunodeficiency Virus Among Injection Drug Users in Glasgow,

Scotland,” American Journal of Epidemiology 138 (3) (1993): 170–181.

6. Hay, G., and N. McKeganey, “Estimating the Prevalence of Drug Misuse in Dundee, Scotland:

An Application of Capture-Recapture Methods.” Journal of Epidemiology and Community Health

50 (4) (1996): 469–472.

7. Frischer, M., D. Goldberg, M. Rahman, and L. Berney, “Mortality and Survival Among a

Cohort of Drug Injectors in Glasgow, 1982–1994,” Addiction 92 (4) (1997): 419–427; Hammersley,

R., M.T. Cassidy, and J. Oliver, “Drugs Associated With Drug-Related Deaths in Edinburgh and

Glasgow, November 1990 to October 1992,” Addiction 90 (1995): 959–965; Neale, J., “Experiences

of Illicit Drug Overdose: An Ethnographic Study of Emergency Room Attendances,”

Contemporary Drug Problems (Fall 1999): 505–530.
116

I–ADAM in Eight Countries: Approaches and Challenges

8. Goldberg, D., S. Cameron, and J. McMenamin, “Hepatitis C Virus Antibody Prevalence Among

Injecting Drug Users in Glasgow Has Fallen but Remains High,” Communicable Disease and Public

Health 1 (2) (1998): 95–97.

9. Davies, AG., N.J. Dominy, A. Peters, G.E. Bath, S.M. Burns, and A.M. Richardson, “HIV in

Injecting Drug Users in Edinburgh—Prevalence and Correlates,” Journal Of Acquired Immune

Deficiency Syndromes and Human Retrovirology 8 (1995): 399–405.

10. Taylor, A., M. Frischer, S. Green, D. Goldberg, N. McKeganey, and L. Gruer, “Low and Stable

Prevalence of HIV Among Drug Injectors in Glasgow,” International Journal of STD and AIDS 5

(1994): 105–107.

11. Hutchinson, S., S.M. Gore, A. Taylor, D.J. Goldberg, and M. Frischer, “Extent and Contributing

Factors of Drug Expenditure by Injectors in Glasgow: A Multi-Site Citywide Cross-Sectional

Study,” British Journal of Psychiatry 176 (2000): 166–172.

12. Advisory Council on the Misuse of Drugs, Tackling Drugs to Build a Better Britain: The

Government’s Ten-Year Strategy for Tackling Drugs Misuse (see note 2).

13. Scottish Office, Tackling Drugs in Scotland: Action in Partnership, Edinburgh: The Scottish

Office, 1999.

14. McKeganey, N., C. Connelly J. Knepil, J. Norrie, and L. Reid, Interviewing and Drug Testing

of Arrestees in Scotland: A Pilot of the Arrestee Drug Abuse Monitoring Methodology, Edinburgh:

Scottish Executive, Central Research Unit, 2000.

15. Bennett, Trevor, Drugs and Crime: The Results of Research on Drug Testing and Interviewing

Arrestees, London: Home Office, 1998.

16. National Institute of Justice, Arrestee Drug Abuse Monitoring (ADAM) Program: 1997 Annual

Report on Drug Use Among Adult and Juvenile Arrestees, Research Report. Washington, DC:

U.S. Department of Justice, National Institute of Justice, 1998, NCJ 171672.
117

SOUTH AFRICA

Elna van Niekerk

Charles Parry

Andreas Plüddemann

Antoinette Louw

Gina Weir-Smith

D. Locke

Elna van Niekerk is project manager at the Division of Roads and Transport Technology of the Council for Scientific and

Industrial Research in Pretoria, South Africa. Charles Parry is director of the Medical Research Council in Cape Town,

South Africa. Andreas Plüddemann is a scientist at the Medical Research Council in Cape Town, South Africa.

Antoinette Louw is head of the Crime and Justice Programme at the Institute for Security Studies in Pretoria, South Africa.

Gina Weir-Smith works at the Human Sciences Research Council, Pretoria, South Africa. D. Locke is with the South

African Police Service’s Crime Information Analysis Centre in Pretoria, South Africa.

I. Overview of Demographic Profile of Nation

The Republic of South Africa occupies the southernmost part of the African continent. The geographic size of South Africa is 1,219,090 square kilometers (757,543 square miles). It has common

boundaries with the republics of Namibia, Botswana, and Zimbabwe; the Republic of Mozambique

and the Kingdom of Swaziland lie to the northeast. Completely enclosed by South African territory

in the southeast is the Kingdom of Lesotho. To the west, south, and east, South Africa borders on

the Atlantic and southern Indian Oceans, which gives South Africa a lengthy coastline that

is swept by two major ocean currents: the Mozambique Agulhas and the Benguela systems.

Isolated, 1,920 kilometers southeast of Cape Town in the Atlantic, lie Prince Edward and Marion

Islands, which were annexed by South Africa in 1947. 

Exhibit 1 shows general demographic information for South Africa; the country has an estimated

population of 43 million people,1 54 percent2 of whom live in urban areas. South Africa’s nine

provinces have varying degrees of urbanization, from 11 percent in the Northern Province to

97 percent in Gauteng. Economic information is provided in exhibit 2.
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I–ADAM in Eight Countries: Approaches and Challenges

Exhibit 1. General Demographic Information for South Africa

Geographic area 1,219,090 km2

Estimated population*,† 43 million

Racial distribution African, 77%; white, 11%; colored,‡ 9%; Indian, 3%

Religious affiliation Christian, 68%; Muslim, 2%; Hindu, 1.5%; indigenous beliefs and animist, 28.5% 

Gender distribution 52% female, 48% male

Age distribution ≤19 years, 47%; 20–39 years, 35%; 40–69 years, 16%; ≥70 years, 2%

Life expectancy (at birth) 57–64 years

Population growth rate 2.1%§

Birth rate (2000 est.)** 24.56 per 1,000

Total fertility rate (2000 est.) 2.47 children per woman

Death rate 11.89 per 1,000

Literacy rate†† 81%

Principal languages IsiZulu, 22.4%; IsiXhosa, 17.5%; Afrikaans, 15.1%; Sepedi, 9.8%; English, 9.1%‡‡

Urbanization rate 54%

Political subdivisions 9 provinces: Eastern Cape, Free State, Gauteng, KwaZulu-Natal, Mpumalanga, 

Northwest, Northern Cape, Northern Province, Western Cape

*Updated current population statistics are from Census 1996 in Brief, Pretoria: Statistics South Africa, 1998.

†

Where not otherwise stated, information is from Census 1996 in Brief, Pretoria: Statistics South Africa, 1998.

‡

“Colored” now refers to a person of mixed white and African or Malay descent. Historically this group originated in unions between white men

and slave women or slave men and Khoikoi or Bushman women. Slaves were from Madagascar, Malaysia, Sri Lanka, and India.

§

Source: United Nations, Department of International Economic and Social Affairs, World Population Prospects, 1994.

**The 2000 estimates for the birth rate and the total fertility rate are taken from Central Intelligence Agency, The World Factbook 2000: South

Africa, Washington, DC: Central Intelligence Agency, 2000, retrieved August 20, 2001, from the World Wide Web at www.odci.gov/cia/

publications/factbook/geos/sf.html.

††The literacy rate is the percentage of the population aged 15 or older who can read or write. Literacy rates for men and women are roughly equal.

‡‡South Africa has 11 official languages. Other principal languages with fewer speakers include Setswana, Sesotho, Xitsonga, siSwazi,

isiNdebele, and Tshivenda.

Crime Rates 

A current moratorium on the publication of police statistics prevents analysis of crime statistics

for 2000. Some statistics are available for previous years, however. Exhibit 3 presents crime statistics for 1999. Crime levels are measured as a ratio per population and, in the case of car theft and

hijacking, the number of licensed vehicles.3 Between 1998 and 1999, the number of reported 

violent crimes increased by 9.3 percent. Between 1994 and 1999, this figure increased by 21.6 

percent.4

Prevalence of Drug Use 

Various studies by the Human Sciences Research Council (HSRC) document drug use and its

socioeconomic correlates. Findings are based on different household surveys of self-reported use.
119

South Africa

Exhibit 2. Economic Information for South Africa

Gross domestic product (GDP) (1999 est.) $135 billion

GDP growth rate (1999) 1.2%

GDP per capita (1999 est.) $3,215

GDP composition by sector (1999 est.) Services, 60%; industry, 35%, agriculture, 5%

Major export partners (1997) United Kingdom, Italy, Japan, United States, Germany 

Major export commodities gold, diamonds, other metals and minerals, machinery and equipment

Labor force (1999 est.) 15 million economically active

Labor force composition by sector (1997 est.) Services, 45%; agriculture, 30%; industry, 25% 

Poverty rate* NA

Unemployment rate (1996 est.)† 34%

Human development index (1999)‡ 0.702

*As of 1993, the percentage of income and consumption among the lowest 10% of the population in socioeconomic status was 1.4%, and the

percentage of income consumption among the highest 10% was 47.3% (Central Intelligence Agency, The World Factbook 2000: South Africa,

Washington, DC: Central Intelligence Agency, 2000, retrieved August 20, 2001, from the World Wide Web at www.odci.gov/cia/publications/

factbook/geos/sf.html).

†

The unemployment rate is given as a percentage of the economically active population. In addition, another 26 percent of income earners earn

less than R500 (approximately US$73.53 at the 1998 exchange rate) per month.

‡

The human development index measures a country’s average achievement in three basic dimensions of human development: a long and healthy

life, knowledge, and a decent standard of living. The index is a composite index of three variables: life expectancy at birth, educational attainment

(adult literacy and the combined primary, secondary, and tertiary enrollment ratio), and per capita GDP (measured as purchasing power parity in U.S.

dollars). Countries are grouped into three categories: high human development (≥0.800 on a scale of 0–1.000), medium human development

(0.500–0.799), and low human development (<0.500) (United Nations Development Programme, Human Development Report 2001, New York:

Oxford University Press, 2001, retrieved August 20, 2001, from the World Wide Web at www.undp.org/hdr2001).

Exhibit 3. Urbanization and Incidence of Selected Crimes in South Africa in 1999

Gauteng Western Northern Northern National 

Province Cape Province Cape Province Province average

Percentage of population in urban areas 97 NA NA 11 54

Highest and lowest incidence of 

selected crimes per 100,000 population*

Murder 81 17 55

Robbery w/aggravated circumstances 595 46 226 

Residential burglary 1,149 253 603

Car theft 2,081 331 1,541

Car and truck hijacking 507 10 312

*For individual provinces, statistics are given only for the province with the highest and lowest rate for each crime. Crime levels for crimes

against persons and residences are measured as a ratio per 100,000 population. For car theft and hijacking, crime levels are measured as a ratio

per 100,000 licensed vehicles.

NA = Not available.

Source: ISS, Comparing Crime in the Provinces, Nedbank ISS Crime Index, vol. 4, (2000).
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I–ADAM in Eight Countries: Approaches and Challenges

Illicit drug5 use generally manifests as a male phenomenon, but women are overrepresented as

users of prescription drugs, such as tranquilizers, amphetamines, and sedatives. Illicit drug use

tends to concentrate in urban areas. The ratio of past-year alcohol use to cannabis use seems to be

about 10:2. An increase in drug use may have emerged among adults in both the lowest and highest socioeconomic categories. On average, 30.9 percent of African male drinkers and 16.4 percent

of African female drinkers may be involved in risky drinking. Cannabis is the most popular illicit

drug, especially among offenders and among males in low socioeconomic urban sectors. The use

of cocaine, mandrax (or mixtures of mandrax and cannabis), LSD, and heroin also occurs, but to

a lesser extent, and it is seemingly more prevalent among subsectors such as offenders.

II. Description of the Criminal Justice System Arrest

Process and Detention System 

The Criminal Justice System 

The criminal justice system, based on Roman Dutch Law and common law, is administered

nationally. The Constitution of the Republic of South Africa6 (Act 108 of 1996) is the supreme law

of the country and binds all legislative, executive, and judicial organs of state at all levels of government. The judicial authority of the Republic of South Africa is vested in the courts, which are

independent, impartial, and subject only to the Constitution and the law. The administration of

justice is a function of the national Government. Fundamental rights (in terms of chapter 2 of the

Constitution) bind all legislative and executive bodies of state at all levels of government; they

apply to all laws, administrative decisions taken, and acts performed during the period in which

the Constitution is in force.

Court structures

The Constitutional Court is the highest court in cases regarding the interpretation, protection,

and enforcement of the Constitution. The Supreme Court of Appeal is the highest court in cases

dealing with final appeals on all other matters. High courts are divided into 13 divisions. A provincial or local division has jurisdiction in its own area over all persons residing or present in that

area, in all causes of action arising and all offenses triable within that area, and over all other matters

of which it may take cognizance according to law. These divisions hear matters that are usually of

such a serious nature that the magistrate’s or regional courts would not be competent to make an

appropriate judgment or impose an appropriate penalty. Other courts include special superior courts,

regional courts, and magistrate’s courts. In terms of statutory law, jurisdiction may be conferred

upon a chief (or headman) or his deputy to try and punish an African person who has committed

an offense under common law or indigenous law and custom, with the exception of certain serious

offenses specified in relevant legislation.
121

South Africa

The Attorney-General

The authority to institute and conduct a prosecution in the case of an offense that falls within

the jurisdiction of a lower court or the high court is vested in the state. The function of deciding

whether or not a prosecution should be instituted is, by law, vested in the attorney-general and

the public prosecutors under his or her control. The attorney-general exercises his or her function

independently and is accountable only to Parliament. The authority of the attorney-general is

delegated to public prosecutors in order to conduct prosecutions in the lower courts.

Juveniles

A child is a person under the age of 18 years. Every child who is in detention shall, in addition to

other rights, have the right to be detained and treated in a manner that takes account of his or her

age. The South African Law Commission is currently attending to policy and legislation for a new

juvenile justice system, under which juveniles can be diverted from the formal court system.

The Arrest Process 

The arrest process is based on rules laid down by the Constitution, the Criminal Procedure Act

(Act 51 of 1977), other legislation, and a police standing order. As a general rule, the object of an

arrest is to secure the attendance of such person at his or her trial. There are, however, exceptions

to this rule: arrest for the purpose of further investigation, arrest to verify a name and/or address,

arrest to prevent the commission of an offense, arrest to protect a suspect, and arrest to end an

offense. The requirements of a lawful arrest are that—

• The arrest must have been properly authorized.

• The individual who effected the arrest must exercise physical control over the person who

has been arrested.

• The person who has been arrested must be informed of the reason for the arrest and of the

rights that he or she has as an arrested person in terms of the Constitution.

• The person who has been arrested must be brought to the appropriate place as soon as 

possible.

The information to be furnished to the arrested person is printed in the 11 official languages in

the formal police pocket book. 

The Detention System 

On arrival at the police station, the arrested person must be handed over to the community service center commander or the member in charge of the detention facilities, and the arresting officer

should provide information regarding the arrest and complete the Arrest Statement. The fact

that the person has been arrested and has arrived at the police station must be recorded in the

Occurrence Book. This entry contains the name of the individual who arrested the person; the

name of the arrested person; the reason for arrest and, if possible, the case number; and whether
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I–ADAM in Eight Countries: Approaches and Challenges

the arrested person has any visible injuries, is sick, or is under the influence of intoxicating liquor

or any other substance with narcotic effect (in the opinion of the community service center commander). The same information is also entered into the Custody Register.

The community service center commander issues a Notice of Constitutional Rights to every person

who is admitted into a police cell. The reference number of the notice, together with other information, is recorded in the Custody Register. A person in custody has the right to choose and consult

with a legal practitioner or to have a legal practitioner assigned to him by the state and at state

expense. A juvenile (a person below the age of 18) may be detained only as a last resort and should

be detained separately from adults.

The arrested person must be brought before a lower court as soon as reasonably possible, but not

later than 48 hours after the arrest or, if the 48-hour period expires outside ordinary court hours,

the end of the first court day after the expiration of 48 hours.

III. Status of National Drug Policy

In the past, efforts to address substance abuse in South Africa focused largely on control measures

that fell under the jurisdiction of the law enforcement and justice sectors. In addition, through

welfare agencies such as the South African National Council on Alcoholism and Drug Dependence

(SANCA), the state provided resources for the treatment of persons with substance abuse problems. The health and education sectors were minimally involved and scant resources were spent

on prevention. Although a number of national plans or strategies to address substance abuse

were formulated during the 1980s and early 1990s, the government failed to implement such

plans. This resulted in fragmentation of effort and a failure to secure sufficient resources to combat substance abuse. 

Under the previous government, South Africa became a signatory to the 1961 U.N. Single

Convention on Narcotic Drugs, the 1972 Protocol (which amended the Single Convention), and

the 1971 Convention on Psychotropic Substances.7 In 1992, the South African Drugs and Drug

Trafficking Act came into being, making it an offense to supply certain substances to any person

knowing or suspecting that the substances will be used for the manufacture of illegal drugs, prohibiting any person from converting property that is known or suspected to be gained from the

proceeds of drug trafficking, and making dealing in dangerous and undesirable drugs an offense

punishable by up to 25 years’ imprisonment. The maximum sentence for possession of drugs is

15 years. There are no prescribed minimum sentences.8

Since 1994, Parliament has signed into law several pieces of legislation that have strengthened

the legislative basis that would allow the country to sign the 1988 U.N. Convention Against Illicit

Traffic in Narcotic Drugs and Psychotropic Substances (1988 U.N. Convention). Two of the most

important of these laws are the International Co-operation in Criminal Matters Act of 1996 and

the Proceeds of Crime Act of 1996. The former provides formal procedures to be used in obtaining and providing information during a criminal investigation that spans international borders,

as well as procedures for the repatriation of criminal proceeds. The latter criminalizes money
123

South Africa

laundering in general and provides procedures for the restraint and confiscation of criminal proceeds. The Extradition Amendment Act of 1996 further defines extraditable offenses and provides

for the designation of states to which extradition may be effected in the absence of formal agreements. The Money Laundering Control Bill of 1997 makes certain bodies and institutions “accountable institutions.” Bodies and institutions that receive money on behalf of clients in the normal

course of business are required to identify their clients and keep proper records of business transactions with them. Certain transactions that have the potential of being used for money laundering

purposes will have to be reported to a central authority9; this bill has yet to be passed by Parliament.

In 1995, the National Crime Prevention Strategy (NCPS) was approved by Cabinet. This strategy

draws together a range of government departments to develop a holistic approach to fighting

crime. Organized crime was listed as one of seven priority areas. The NCPS has been criticized,

however, for not adequately confronting the issue of illegal substance abuse and its links to

crime. In 1997, the Minister of Safety and Security announced that the Government would introduce strict measures to tighten South Africa’s ports of entry in a bid to stem the influx of drugs

and arms. He stated that bulk commercial traffic would be cleared through only 19 of the 52

existing border posts and that cargo would be cleared at only 8 of the 36 ports of entry.10 The

Department of Justice has indicated its aim of increasing the number of offenders referred to and

entering treatment by way of arrest referral schemes; the court process and post-sentencing provisions and various initiatives are under way to move this initiative forward.

In December 1998, South Africa signed the 1988 U.N. Convention in New York. It was hoped

that the Money Laundering Control Bill would be enacted before signing the Convention, but

legal opinion was that the legislative basis was sufficient to go ahead without that step having

been accomplished. The Prevention of Organised Crime Act of 1998 provides for drastic new

powers for police and prosecutors including the forfeiture of criminals’ assets on the grounds of

“a balance of probabilities” rather than “beyond a reasonable doubt.” The focus here is on civil

rather than criminal prosecution. The legislation allows the state to confiscate assets gained

through illegal means regardless of whether the suspects are convicted. February 2000 saw the

first deposit of monies confiscated from alleged drug dealers into the Criminal Assets Recovery

Fund. The money is to be used to support law enforcement initiatives. The legislation initially

ran into difficulty in the courts, which overturned several forfeitures of property belonging to alleged

drug lords by the Scorpions’ Asset Forfeiture Unit, resulting in amendments to the legislation.

In terms of regional cooperation, South Africa also signaled the Protocol on Combating Illicit

Drug Trafficking in the Southern African Development Community (SADC) Region,11 which was

ratified by Parliament in July 1998. The Protocol provides a policy framework that allows the SADC

region to cooperate to ensure that it does not become a producer, consumer, exporter, and distributor of illicit drugs or a conduit for illicit drugs destined for international markets.12 Although the

SADC Regional Drug Control Programme13 focuses mainly on drug supply reduction, Article 7

of the SADC Protocol gives special attention to demand reduction by requiring member states to

“develop, implement and evaluate policies and strategies aimed at establishing a comprehensive

and integrated demand reduction programme” that will include the development of community

prevention, public and school education, and research activities to address the underlying causes

of drug abuse.14
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I–ADAM in Eight Countries: Approaches and Challenges

Although an accurate determination of the amount of government spending on supply and

demand reduction activities is not possible, one can be almost certain that a drop in spending on

demand reduction activities relative to supply reduction has occurred during the past few years.

Treatment centers have been closed and the plan to handle more substance abuse cases through

the primary health care system has not been implemented. Without an increase in the budget

for prevention activities, the national and provincial departments of welfare have generally had

to reduce their support to nongovernmental agencies (NGOs) involved in prevention activities

while initiating few prevention activities themselves. One exception to this outcome is the national “I’m addicted to life” campaign, which was launched in 1995 and is aimed at youths between

ages 11 and 20. The campaign uses television, radio, information leaflets, and posters and has

been expanded to include video and a teachers’ manual.

A major reason for the failure to redirect resources to drug demand reduction activities has been

the delay in formulating and implementing a national drug master plan. A committee was established toward the end of 1996 by the national Drug Advisory Board to formulate such a plan;

after a lengthy period of consultation and drafting, the National Drug Master Plan (1999–2004)

was approved by Cabinet in 1999.15 Implementation began in 2000 following the appointment of

members of the Central Drug Authority. 

The vision of the plan is to “build a drug free society together and to make a contribution to

[addressing] the global problem of substance abuse”; it focuses on crime, youth, community

health and welfare, research and information dissemination, international involvement, and

communication. The plan recommends the establishment of—

• A national central drug authority to oversee and monitor its implementation.

• A secretariat to oversee its administration. 

• Action committees in 382 magisterial districts to ensure its implementation and the uniform

spread of information and policies in every part of the country. 

• Provincial substance abuse forums to strengthen member organizations in carrying out their

existing functions and to keep substance abuse high on the public and political agenda. 

Among the key activities to be implemented within the first year are establishing a secretariat,

developing a database of research and a national clearinghouse, developing and implementing a

mass media campaign aimed at youths, developing recommendations regarding alcohol advertising,

formulating model drug policies for schools, and initiating a radio program aimed at educating

the public. 

The plan focuses on demand reduction but recognizes the importance of harm reduction without

setting out detailed harm reduction approaches. Further research is recommended before reaching

any policy decision on the issue of decriminalization of cannabis. With regard to the relationship

between drugs and crime, the plan recognizes that drug issues manifest themselves at every level

of the criminal justice system but that the precise relationship between drugs and crime is hard

to determine. Recognition is given to the fact that there are three main ways in which the two are

linked: crimes committed due to the psychopharmacological effects of drugs ingested by perpetrators,

crimes committed to feed a drug habit, and crimes committed as a byproduct of involvement in

drugs and/or drug trafficking.16
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South Africa

IV. Background History to SA–ADAM 

In 1996, the Human Sciences Research Council (HSRC), together with the Crime Information

Analysis Centre (CIAC) of the South African Police Services, conducted a pilot study in the

Hillbrow police station (in Johannesburg), based on the Drug Use Forecasting (DUF) program

principles. (DUF was superseded by the ADAM program in 1997.) In 1998, a researcher of the

Medical Research Council (MRC) and the Institute for Security Studies (ISS) attended the first

annual I–ADAM conference in Miami.

During 1998, the Department of Arts, Culture, Science and Technology extended an invitation to

consortiums of research partners to submit substantial proposals for innovative research in various categories, one of which was crime prevention. HSRC joined with CSIR to form a consortium

and ISS joined with MRC. A strategic decision was taken to form a consortium of all four organizations—HSRC, CSIR, MRC, and ISS—and to partner with CIAC to develop an integrated proposal

based on the ADAM model. This proposal was successful and the project was awarded in

December 1998.

The South African ADAM program is based on four waves of data collection: three phases of

data collection in three sites, done approximately 6 months apart, and one national data collection phase. The three ADAM sites are: 

• Three police stations in the province of Gauteng, within or in close proximity to Johannesburg.

• Four police stations in Cape Town (in the Western Cape Province).

• Two police stations in Durban (KwaZulu-Natal Province).

Cape Town, Durban, and Johannesburg are among South Africa’s largest cities. Both Cape Town

and Durban are port cities, and Johannesburg, with South Africa’s largest airport, is also a common

port of entry for drugs. In addition, drug problems are known to be most prevalent in these three

cities, and they are already part of an ongoing drug abuse surveillance system, the South African

Community Epidemiology Network on Drug Use (SACENDU). The ADAM survey, therefore,

would feed into this system. The national survey was conducted in 150 police stations countrywide and based on a stratified random sample.

V. Goals and Objectives 

The goals and objectives of the South African ADAM program should be understood within the

context of the broad funding principles of the Department of Arts, Culture, Science and Technology.

The current undertaking is a 30-month project. The main goal is to establish a South African

ADAM program but with some objectives not necessarily directly related to the U.S. ADAM

model. The principal aims of this study are listed below:

• Establish a monitoring system based on the U.S. ADAM model to monitor trends in drug use

and crime and the crime/drugs nexus.

—Establish a database to provide tactical and strategic information to combat crime, support

intervention strategies, and support policy.
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I–ADAM in Eight Countries: Approaches and Challenges

—Identify correlates of substance abuse with other factors (firearms, HIV/AIDS infection).

—Compare different methodologies (national/sentinel, urinanalysis with extrapolation, rural

surveillance, alternative drug screening).

• Communicate data to practitioners in an innovative way.

• Explore the relationship between serious drug traffic crimes and other criminal activities.

• Explore how different law enforcement agencies, supported by information from this program,

could work cooperatively on drug-related issues. 

• Establish a framework of reference and interpretation of arrestee data within the context of

other databases. 

• Develop a training course for arresting officers regarding arrestees under the influence of

drugs.

The study timed data collection as follows:

• The first phase of data collection (sentinel sites or Three Metro Study) took place during

August and September 1999, and some results are available.

• The second phase of data collection for the Three Metro Study was scheduled for February and

March 2000.

• The third phase of data collection for the Three Metro Study was scheduled for August and

September 2000.

• Data collection for the national study was scheduled for February and March 2000. 

VI. Getting Started 

A. Obtaining Funding 

As stated earlier, funding for this project was obtained through the South African Department of

Arts, Culture, Science and Technology. Because the project’s funding did not come from the most

important stakeholders in this project, the challenge of funding a sustained effort remains.

B. Contracting for Data Collection 

A request for bids to perform data collection was put out to research/fieldwork/market research

companies. Data collection for the national survey was done by a different company than the one

that collected data for the Three Metro Study, but the latter was somewhat involved in the areas

of training and quality control. 

DRA Development was chosen to do the Metro study and A.C. Nielsen to do the national study.

The fieldwork companies were selected on the basis of pricing, experience in the field of social

research, and capacity.
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South Africa

C. Facility Access 

Access to police stations was negotiated through CIAC. Police stations were informed of the survey

and instructed to cooperate with field workers. CIAC representatives visited most of the police

stations, and the project leaders of the ISS/MRC made personal followup visits. For the most part,

the problems experienced dealt with communications (e.g., the duty roster or procedures on arrival

at the police station). Results of the August-September survey were shared with the police at the

site level to sustain support for future data collection phases.

Access to police stations for the national data collection phase was more complicated from a

logistical point of view because high-level personal visits were not always possible. Supervisors

of each fieldwork team telephoned the police station and visited at least 1 day before the fieldwork was due to start. CIAC developed protocols to be followed by fieldwork teams in order to

ensure security for themselves, members of the police, and people in custody.

D. Knowing the Catchment Area 

Brief description of the three sites for the Three Metro Study 

Cape Town is a port city on the southwestern coast of South Africa with a population of about

2.7 million. It is the legislative capital of the country and the capital city of the Western Cape

Province, which has the second highest per capita income, the highest rate of students passing

the national high school matriculation examination, and an unemployment rate of approximately

17 percent. Cape Town has the second busiest harbor in the country and the number of international

flights handled by its airport has dramatically increased during the past few years. Approximately

51 percent of the population of Cape Town is colored,17 with the remainder being African (26 percent), white (22 percent), and Asian (1 percent).18

Durban, located on the east coast in the province of KwaZulu-Natal, is a port city with a population of more than 1.8 million persons, of whom 55 percent are African, 24 percent are Asian,

17 percent are white, and 4 percent are colored.19 Durban hosts the busiest harbor in South Africa

and also has an increasingly busy international airport. Unemployment rates are roughly twice

those of Cape Town, and rates of poverty are much higher. 

Gauteng Province comprises 7.3 million persons; 97 percent live in urban areas. The majority of

the residents of Gauteng are Africans (70 percent), followed by whites (23 percent), coloreds

(4 percent), and Asians (2 percent). Gauteng is the most economically developed of South

Africa’s nine provinces; its two main cities are Pretoria (the administrative capital of South

Africa) and Johannesburg, a cosmopolitan city that is close to Soweto (a large so-called township). Eight percent of the population of Gauteng Province aged 20 years or older have higher

than a grade 12 education. Just over 25 percent of the population is classified as being unemployed, substantially more than in Cape Town. Of employed persons, 16 percent earn less than

R500 per month ($73.53).20
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I–ADAM in Eight Countries: Approaches and Challenges

Police stations were chosen on the basis of their arrest flow (i.e., only stations with larger numbers of arrestees processed weekly were chosen to facilitate the progress of interviewing) and

their geographic area (i.e., an attempt was made to cover all population groups by including

police stations in various residential areas). Four police stations were chosen in Cape Town, three

in Johannesburg, and two in Durban.

National survey 

The sampling of police stations was based on the latest available census data. Socioeconomic categories were identified for use in the analysis of arrestee data. The results are representative of the

entire nation, including rural areas. Arrest flow data for 1 year have been collected and analyzed.

E. Drug Testing Issues 

Panel of drugs tested 

The panel of drugs tested included dagga (cannabis), mandrax (methaqualone), cocaine, amphetamines, benzodiazepines, opiates, and LSD. South African drug usage differs from other countries

with respect to the high use of mandrax (usually together with cannabis).

The fact that no LSD was found in the sample of 878 arrestees in the Three Metro Study led to

discussion about excluding LSD in the national sample. The test for LSD costs double that of the

tests for other drugs. A decision was made, however, to include LSD in the national study because

the market for LSD may have shifted from urban to rural areas and a national study of this size

and budget will possibly never be conducted again and should be as inclusive as possible, within

budget constraints.

Laboratory responsible for testing of urine samples 

Choice of laboratory in the Three Metro Study was based on the lowest bid (University of Cape

Town). The bid for the national survey was awarded to a private laboratory with a national network

and infrastructure. Both laboratories used the same drug testing methodologies and cutoff points.

F. Instrument Issues 

The survey used two slightly different questionnaires, which have been calibrated to enable comparison.

Cultural applicability

In the Three Metro Study, providing multicultural interview teams solved the problem of cultural

diversity. The national study was translated into three languages other than English. The focus

was on languages not close to the languages normally spoken, and that may not be as well

known to field workers. 
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South Africa

Differences between U.S. and South African surveys 

The survey used in the Three Metro Study was based largely on items included in the adult ADAM

interview, but the South African instrument differs from the U.S. instrument in the following ways:

• Response categories for several items differ to account for different terminology use (e.g., on

the item of race).

• Additional items were included in the South African questionnaire to address issues that were

felt to be not adequately covered in the ADAM questionnaire (e.g., regarding binge drinking,

the type or style of dwelling structure, and knowledge of HIV/AIDS and sexual practices).

• Some items were excluded from the South African instrument, either to allow space for including other items felt to be of greater relevance or because they were thought to be irrelevant in

the South African context.

• Some items from the U.S. instrument were included but set out differently in the South African

instrument (e.g., on the issues of legal and illegal income and sources of drugs).

• Many items from the U.S. instrument were included but placed in a different position on the

South African instrument.

• The South African instrument also included some items from the U.S. Addenda on the main

questionnaire (e.g., those relating to firearm use).

VII. Barriers to Developing ADAM 

Other than operational restrictions, few obstacles existed to developing the South African ADAM.

Because this project ended in March 2001, however, the long-term implementation of the project is

the real issue at stake. The main barriers are expected to be:

• Future funding. SA–ADAM was conducted with funds from the Department of Arts, Culture,

Science, and Technology, which allocates funds to research and other organizations to stimulate

new research ideas that may have national value. The Department has formal ownership of the

projects it funds only until the funding period of such projects expire.

• Strategic ownership. The results from this project can provide useful information to many

relevant departments (Safety and Security, Justice, Welfare, and Correctional Services). One of

these departments or the Central Drug Authority would have to take ownership of the program

to ensure future data collection and analysis.

VIII. National Stakeholders Involved in the

Development of I–ADAM 

The two main national stakeholders in the development of this project are the Department of Arts,

Culture, Science and Technology, which provided the funds for development; and the Department

of Safety and Security, which provided the infrastructure of its Crime Information Analysis Centre

to ensure access to police stations. Other departments, such as the Departments of Health and

Welfare, are also seen as stakeholders to be approached once the results of the project’s first phase

are known.
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I–ADAM in Eight Countries: Approaches and Challenges

IX. Research Methods (Sampling) 

Sampling Within Police Stations 

The sampling frame included all persons arrested during the time period for which fieldwork

was planned (e.g., 1 week). The practical methodology was based on suggestions of the U.S.

National Institute of Justice (NIJ): Choose from a calculated proportion of the arrestees already

within the holding cells at the start of the shift (using systematic sampling) and supplement this

group with arrestees as they are brought in. This was not practical in all cases because the arrest

flows were often very low, and interviewers had to take whoever was in the cells and corresponded

to the selection criteria of age and time lapsed since arrest.

Sampling of Police Stations 

For the national survey, which had to be representative of the country, Statomet (a statistical

analysis group affiliated with the University of Pretoria) was requested by the HSRC to design

and draw a scientific sample of the catchment area population of police stations. All police areas

were classified into 20 homogeneous groups by the HSRC Geographic Information System (GIS)

center. A sample of 150 police stations was drawn and a total of 2,000 arrestees interviewed at

these stations.

Sample Design 

The population consisted of 1,089 points (police stations). The 1998 data of the South African

Police Services (SAPS) were used to decide on the number of arrestees to be interviewed at each

police station. Police stations were arranged so that, when drawn, a systematic sample would be

representative of province, police areas, and the 20 homogeneous groups of police stations.

To make the sample cost effective, a minimum of five arrestees per station were interviewed. 

For the urine sample, every third police station was selected. A total of 717 urine samples were

taken (budget constraints did not allow 100-percent testing of urine samples).

X. Training Issues 

Three Metro Study 

All field workers were trained during a 2-day training period in Cape Town. NIJ supported the

training by sending experienced personnel to assist. Training covered a study overview, questionnaire guidelines, models for setting up at police stations, urine handling protocols, and shipment

of urine samples.
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South Africa

National Survey

Training began on January 24, 2000. Although a different fieldwork company has been contracted for the national study, the company involved in the Three Metro Study was contracted to play

a mentoring role in the training process. This decision was made to ensure that the national

study would benefit from the learning gathered in the first round of data collection. Both studies

produced a training manual.

XI. Data Analysis Results for the Three Metro Study 

Demographics 

Interviews were done at three sites, which included nine police stations. A total of 970 arrestees

were interviewed; of these, 878 (90.5 percent) consented to urine tests (see exhibits 4 and 5 for the

number and percentage of arrestees tested at each site). Eighty-three percent of arrestees were

male. Most (64 percent) were African, 20 percent were colored, 3 percent were white, and 12

percent were Asian/Indian. More than 70 percent of arrestees were 30 years old or younger (see

exhibit 6 for general demographic information about arrestees and exhibits 7 and 8 for information

about arrestees by gender and age). 

Offense Categories 

Violent offenses include murder and attempted murder, assault, weapons, rape (including

attempted rape), robbery/theft, and other violent offenses. The category of robbery/theft posed

a problem because, although theft is a nonviolent offense, the investigating officer often must

decide under which offense to seek prosecution.

Property offenses include shoplifting, theft of motor vehicle, theft from motor vehicle,

housebreaking, and other property offenses.

Drug/alcohol-related offenses include drug dealing/possession and alcohol offenses

(including driving under the influence of alcohol).

Miscellaneous offenses include illegal immigrant/deportation, fraud, false ID, and others

(e.g., obstruction of police, prostitution, gambling, reckless driving).

Prevalence of the main offense categories per site is shown in exhibit 9. For all three metropolitan

areas, violent crimes were the most prevalent.

Use of Drugs 

Overall, 48.6 percent of arrestees tested positive for any drug. Site-specific figures were 34.8 percent for Gauteng, 52.2 percent for Durban, and 60.1 percent for Cape Town.
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I–ADAM in Eight Countries: Approaches and Challenges

0

50

100

150

200

250

300

350

Cape Town Durban Gauteng

Exhibit 4. Number of Arrestees Tested for Drugs at Each Site

0

20

40

60

80

100

Cape Town Durban Gauteng

Exhibit 5. Percentage of Arrestees Consenting to Urine Sample
133

South Africa

100

80

60

40

20

0

Cape Town Durban Gauteng

Male Female

Percent

Exhibit 7. Demographics of Arrestees by Gender

Exhibit 6. Demographics of Arrestees

Cape Town Durban Gauteng Total sample

Gender # % # % # % # %

Male 291 85.8 206 77.4 306 83.8 803 82.8

Female 48 14.2 60 22.6 59 16.2 167 17.2

Total 339 100.0 266 100.0 365 100.0 970 100.0

Race

Black 148 45.1 158 59.8 285 84.8 591 63.7

Colored 173 52.7 4 1.5 12 3.6 189 20.4

White 5 1.5 7 2.7 15 4.5 27 2.9

Asian/Indian 1 0.3 95 36.0 11 3.3 107 11.5

Other 1 0.3 0 0.0 13 3.9 14 1.5

Total 328 100.0 264 100.0 336 100.0 928 100.0

Age (years)

≤20 65 19.3 85 32.0 71 19.5 221 22.9

21–25 99 29.5 66 24.8 106 29.0 271 28.0

26–30 66 19.6 40 15.0 111 30.4 217 22.4

31–35 29 8.6 27 10.2 33 9.0 89 9.2

36–40 40 11.9 18 6.8 19 5.2 77 8.0

>40 37 11.0 29 10.9 24 6.6 90 9.3

Total 336 100.0 266 100.0 365 100.0 967 100.0
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I–ADAM in Eight Countries: Approaches and Challenges

0

20

40

60

80

100

120

≤20 21–25 26–30 31–35 36–40 >40

Cape Town

Durban

Gauteng

Number of arrestees

Exhibit 8. Demographics of Arrestees by Age

In Gauteng, especially, a substantial number of arrests were made for immigration offenses

(i.e., a person was arrested only for being an illegal immigrant). Because this group of offenders

showed relatively low drug use, figures were also calculated with the exclusion of immigration

offenses, as follows: 53.7 percent overall, 41.9 percent in Gauteng, 55.5 percent in Durban, and

60.9 percent in Cape Town.

Exhibit 10 shows the prevalence of use of different drugs by offenders, and exhibit 11 shows a

breakdown of offenses by drug use and crime type. Seventy-seven percent of housebreaking

offenders tested positive for at least one drug, with a high prevalence for dagga (marijuana) of

70.8 percent and for mandrax (methaqualone) of 56.3 percent. Although results were positive for

cocaine in 3.7 percent of the tested sample, 12.5 percent of those arrested for housebreaking tested positive for cocaine. Among those arrested for drug/alcohol offenses, 70.9 percent tested positive for at least one drug. Seven percent of those arrested for murder or attempted murder tested

positive for cocaine.

Combination Drug Use 

In Cape Town, 53.5 percent of the sample tested positive for both dagga and mandrax, followed

by 35.9 percent in Durban and 15.3 percent in Gauteng. Drugs that were found in combination

were (in numbers rather than percentages) dagga, mandrax, and benzodiazepines (11) and

dagga, mandrax, and cocaine (12). Smaller numbers were found for dagga, mandrax, and opiates;
135

South Africa

mandrax and cocaine; dagga and cocaine; mandrax and benzodiazepines; and a few other combinations. Sixty-three percent of arrestees in Cape Town, 49 percent of arrestees in Durban, and

31 percent of arrestees in Gauteng tested positive for more than one drug.

Comparison Between Phase 1 and Phase 2 Results 

The proportion of arrestees testing positive for any drug was fairly consistent over the two study

phases. Overall, the proportion of arrestees testing positive for dagga (marijuana) or mandrax

(methaqualone) was slightly lower in phase 2 results from 44 percent in phase 1 to 36 percent

in phase 2 for dagga, and from 25 percent in phase 1 to 19 percent in phase 2 for mandrax.

However, a slightly higher proportion of arrestees (2 percent) tested positive for amphetamines

in phase 2, compared with none during phase 1. 

Although overall prevalence of arrestees testing positive for any drug and for the various drugs

separately was lower in phase 2, some offense categories in phase 2 data showed a higher prevalence of drug-positive arrestees than in phase 1 data. Most notably, the proportion of persons

arrested for the motor vehicle theft testing positive for dagga, mandrax, or any drug was considerably higher in phase 2 (74 percent versus 35 percent in phase 1). The proportion of persons

arrested for shoplifting testing positive for any drug and for dagga were also higher in phase 2

(37 percent) than in phase 1 (27 percent). The proportion of those arrested for housebreaking

testing drug positive remained high (70 percent) in phase 2, although not as high as in phase 1

(74 percent). 

0

10

20

30

40

50

Violent Property Drug/alcohol Other

Cape Town

Durban

Gauteng

Percentage

Exhibit 9. Percentage of Arrestees in Offense Categories by Metropolitan Area
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I–ADAM in Eight Countries: Approaches and Challenges

0

10

20

30

40

50

60

Benzodia- Opiates Any drug

zepines

Dagga Mandrax Cocaine

Exhibit 10. Percentage of Arrestees Testing Positive for Drugs (Excluding

Arrestees for Immigration Offenses)

0 10 20 30 40 50 60 70 80

Murder

Assault

Robbery

Weapons

Rape

Shoplifting

Theft of motor vehicle

Housebreaking

Alcohol/drug offense

Immigration documents

Other

Overall

Dagga

Cocaine

Mandrax

Any drug

Exhibit 11. Percentage of Arrestees Testing Positive for Selected 

Drugs by Crime Type
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South Africa

XII. Policy Implications and Applications of Data 

Although the data have not been analyzed yet, some thought about their application and policy

implications seems appropriate. Specifically, consideration should be given to the following: 

• Strategies to reduce drug use and drug-related crime must be area specific.

• Combination drug use seems to be normal for arrestees, especially in Cape Town.

• Crack/cocaine is highly addictive and socially damaging; users should possibly be targeted at

police stations.

• Police officers should be sensitive to the fact that the person arrested (especially for housebreaking) is possibly under the influence of dagga and/or mandrax. Police training should

include how to recognize the presence of drugs in a suspect and how to handle such a person.

• The crime patterns found are a reflection of police activity. 

• The focus on immigration offenses should be reconsidered. 

• This project would benefit greatly from the computerization of police arrest data.

• Although alcohol’s role in criminal behavior has been better researched and understood than

that of drugs, the possibility of alcohol use (alone and in combination with other drugs) should

be kept in mind, especially in rural areas, where alcohol is perceived to figure in high violent

crime rates.

Notes

1. Updated current population figures by Statistics South Africa, Census 1996 in Brief, Pretoria:

Statistics South Africa, 1998.

2. Where not otherwise stated, the information is from the 1996 census. Statistics South Africa,

Census 1996 in Brief (see note 1).

3. Institute for Security Studies, “Comparing Crime in the Provinces: Trends Since 1994,” Nedbank

ISS Crime Index 4 (2000): 7–14.

4. Institute for Security Studies, “A Battle Lost? Violent Crime Trends in 1999,” Nedcor ISS Crime

Index 4 (2000): 1–5.

5. Lee da Rocha-Silva, “The Nature and Extent of Drug Use and Related Problems in South

Africa: SARPA National Surveillance Project,” Annual Report, South African Researcher

Practitioner Association (SARPA), December 1997, available online at http://www.hsrc.ac.za/

sarpa/smain.htm.

6. In 1961, when South Africa became a republic, the constitution adopted in 1910 remained in

place. In 1983, white voters approved a new constitution that created separate chambers in the

legislature for Asians and coloreds. In 1993, a year before the first universal voting in South

Africa, a majority rule interim constitution was approved. The current constitution, approved in

1996, was written through a process of consultation and guarantees a broad range of political,

social, and economic rights for all the peoples of South Africa. 
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I–ADAM in Eight Countries: Approaches and Challenges

7. Drug Advisory Board, National Drug Master Plan. Pretoria: Department of Welfare, 1999.

8. Omar, D., “The Drug Trade in Southern Africa.” Paper presented at a workshop organized by

the South African Institute of International Affairs on “The Illegal Drug Trade in Southern

Africa,” Johannesburg, June 5–6, 1997. 

9. Ibid.

10. Kibble, S., Drugs and Development in South Africa: How Europe Could Help. London: Catholic

Institute for International Relations, 1998.

11. Southern African Development Community, Protocol on Combating Illicit Drug Trafficking in

the Southern African Development Community (SADC) Region, Gaborone: SADC, 1996.

12. Omar, D., “The Drug Trade in Southern Africa” (see note 8).

13. Southern African Development Community. SADC Regional Drug Control Programme

1998–2002, Gaborone: SADC, 1998.

14. Southern African Development Community, Protocol on Combating Illicit Drug Trafficking in the

Southern African Development Community (SADC) Region (see note 11), 7.

15. Drug Advisory Board, National Drug Master Plan (see note 7).

16. Ibid.

17. “Colored” now refers to a person of mixed white and African or Malay descent. Historically,

this group originated in unions between white men and slave women or slave men and Khoikoi

or Bushman women. Slaves were from Madagascar, Malaysia, Sri Lanka, and India.

18. Statistics South Africa, Census 1996 in Brief (see note 1).

19. Ibid.

20. Ibid.
139

UNITED STATES

OF AMERICA

Bruce Taylor

Bruce Taylor is the deputy director of the Arrestee Drug Abuse Monitoring (ADAM) Program in the Office and Research

and Evaluation at the National Institute of Justice (NIJ).

I. Overview of Demographic Profile of Nation

The United States of America is a federal republic on the continent of North America. It has an

area of 9,629,047 square kilometers (3,717,796 square miles) and is the fourth largest country in

the world after Russia, Canada, and China. The United States consists of 48 contiguous States,

the noncontiguous States of Alaska and Hawaii, and the District of Columbia. Dependent areas

and territories include the Commonwealth of Puerto Rico and the U.S. Virgin Islands in the

Caribbean Sea, and the islands of American Samoa and Guam and the Commonwealth of the

Northern Mariana Islands in the Pacific Ocean. Political power in the United States is divided

between a central governing authority and individual State governments. The Federal Government consists of three branches: executive, legislative, and judicial. Executive power is vested

in the President, who conducts the Nation’s administrative business with the aid of a Cabinet

consisting mainly of the secretaries of the executive departments. The Congress of the United

States, the legislative branch, is bicameral, consisting of a Senate and a House of Representatives.

The judicial branch comprises the Federal courts. The highest court in the land is the nine-member

Supreme Court, which also functions as the court of last resort for the 50 State judiciary systems.

The U.S. population is approximately 281 million, which makes the United States the third most

populous country in the world, after China and India (see exhibit 1 for demographic information).

Its economy is by far the world’s largest, and it ranks sixth in the world in terms of human

development (see exhibit 2 for economic information).

Two main sources track victimization and crime in the United States: official police records and

research victimization surveys completed by a sample of households. The Federal Bureau of

Investigation’s (FBI’s) Uniform Crime Reports (UCR) program collects information from local

law enforcement agencies about crimes reported to police. The UCR crime index includes seven

offenses: homicide, forcible rape, robbery, aggravated assault, burglary, larceny/theft, and motor
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I–ADAM in Eight Countries: Approaches and Challenges

vehicle theft. According to the UCR, the crime index rate fell for the seventh straight year in

1998 and is down almost 14 percent from 1994’s rate. Murder was the least frequent violent victimization—there were about 6 murder victims per 100,000 persons in 1998, a rate not seen since

the late 1960s.1

The National Crime Victimization Survey (NCVS) interviews a nationally representative sample

of approximately 49,000 households (about 100,000 persons). In this survey, members of these

households who are at least 12 years old are interviewed. The NCVS collects information on crimes

suffered by the individuals within those households, whether or not those crimes were reported

to law enforcement. Survey data tell how many rapes, assaults, sexual assaults, robberies, thefts,

household burglaries, and motor vehicle thefts U.S. residents age 12 or older experience each year.

According to the NCVS, U.S. residents age 12 or older experienced approximately 31.3 million

crimes in 1998: 73 percent were property crimes, 26 percent were crimes of violence, and 1 percent

were personal thefts. Serious violent crime levels decreased from a high of 4.2 million violent

victimizations in 1993 to 2.8 million violent victimizations in 1998. Property crime rates also fell,

from 552 property victimizations per 1,000 households in 1974 to 217 per 1,000 in 1998.2

Self-reported national data on the prevalence of drug use are collected from two main sources:

the National Household Survey on Drug Abuse (NHSDA) and the Monitoring the Future (MTF)

study. The NHSDA is an annual survey of a nationally representative sample of the civilian,

noninstitutionalized population of the United States age 12 and older; 25,500 persons were interviewed in 1998. This survey has been the primary source for estimates of the prevalence and incidence of illicit drug, alcohol, and tobacco use in the United States since the early 1970s. According

to the NHSDA, the fraction of today’s U.S. population using illicit drugs is well below the peak

of the early 1980s. Initiation into the use of illicit drugs rose through the late 1970s and into the

early 1980s, then began a sharp decline around 1983. First-time drug use started to rise again in

1992, but in 1997, it was still well below the peak of the early 1980s. Although the number of

people who continued using drugs may have risen steadily into the mid-1980s, it almost certainly

decreased after 1987. Since 1990, the percentage of the population using drugs has remained

essentially the same.3

According to the NHSDA, the number of current illicit drug users did not change significantly

from 1996 to 1997. In 1997, 6.4 percent (13.9 million persons) of the population age 12 and older

reported using an illicit drug during the previous month, down from 14.1 percent (25.4 million

persons) in 1979. In 1997, an estimated 0.7 percent (1.5 million persons) of this population group

reported using cocaine at least once in the previous month. Overall, the reported use of cocaine,

including crack, has not increased significantly since 1991. In 1997, the percentage of Americans

age 12 and older reporting the use of marijuana at least once in the previous month was 5.1 percent (11.1 million persons), which was statistically unchanged from 1996.4

The other main source of nationally representative drug use data is the MTF study, an ongoing

study of the behaviors, attitudes, and values of American secondary school students, college students, and young adults. Each year, approximately 50,000 8th-, 10th-, and 12th-grade students

are surveyed (12th graders have been surveyed since 1975, 8th and 10th graders since 1991). In

addition, annual followup questionnaires are mailed to a sample of each graduating class for a
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United States of America

number of years after their initial participation. At each grade level, the students surveyed are

chosen to represent all public and private secondary school students nationwide. Nearly 50,000

students in 422 public and private secondary schools were surveyed in 1998. When this survey

began in 1975, 30.7 percent of high school seniors surveyed reported that they had used some

type of illicit drug in the previous month. This figure declined gradually to 14.4 percent in 1992

but increased to 25.6 percent in 1998. Previous-month drug use increased from 5.7 percent in

1991 to 12.1 percent in 1998 for 8th graders and from 11.6 percent in 1991 to 21.5 percent in 1998

for 10th graders.5

Exhibit 1. General Demographic Information for United States

Geographic area 9,629,047 km2 (3,717,796 mi2)

Estimated population (April 1, 2000) 281,421,906

Population by racial group 75.1% white, 12.3% black, 3.6% Asian, 0.9% American Indian and

Alaska Native, 0.1% Pacific Islander, 5.5% other, 2.4% multiracial*

Religious affiliation 55% Protestant, 28% Roman Catholic, 2% Jewish, 6% other, 8% none

Gender distribution 50.9% female, 49.1% male

Age distribution 0–14 years, 21.4%; 15–64 years, 66.1%; ≥65 years, 12.4% 

Life expectancy (at birth for 2000 cohort) 77.1 years, average; 74.2 years, male; 79.9 years, female

Population growth rate 0.91%

Birth rate 14.2 per 1,000

Total fertility rate 2.075 children per woman

Death rate 8.8 per 1,000

Literacy rate (age 15 and older) Level 1, 21–23%; level 2, 25–28%; level 3, 31–34%; levels 4 and

5. 18–21%†

Language English

Urbanization rate 89%

Political subdivisions 50 States and the District of Columbia

*As of April, 2000, 12.5% of the U.S. population was of Hispanic origin. The U.S. Census Bureau defines Hispanic as an ethnic, not a racial classification. Persons of Hispanic origin may be of any race (U.S. Census Bureau, Table DP–1, Profile of Demographic Characteristics for the United

States: 2000, retrieved August 22, 2001, from the World Wide Web: http://www.census.gov/Press_Release/www/2001/tables/dp_us_2000.pdf).

†

Kirsch, Irwin S., Ann Jungeblut, Lynn Jenkins, and Andrew Kolstad, Executive Summary of Adult Literacy in America: A First Look at the Results

of the National Literacy Survey, Washington, DC: U.S. Department of Education, National Center for Education Statistics, 1993. Generally, levels 1

and 2 represent very poor and poor literacy; level 3 represents the minimum level for functioning in an advanced society (high school graduate or

college-entry level); and levels 4 and 5 represent command of higher order information processing skills. For a more detailed discussion of the

five levels of literacy, see Organisation for Economic Cooperation and Development and Statistics Canada, Literacy in the Information Age: Final

Report of the International Adult Literacy Survey, Paris: Organisation for Economic Cooperation and Development, and Ottawa: Minister of

Industry, Canada, 2000. 

Sources: U.S. Census Bureau, Table DP–1, Profile of Demographic Characteristics for the United States: 2000, retrieved August 22, 2001, from

the World Wide Web: http://www.census.gov/Press_Release/www/2001/tables/dp_us_2000.pdf; U.S. Census Bureau, Statistical Abstract of the

United States 2000: The National Data Book, Washington, DC: U.S. Department of Commerce, Economics and Statistics Administration, U.S.

Census Bureau, 2001; Kirsch, Irwin S., Ann Jungeblut, Lynn Jenkins, and Andrew Kolstad, Executive Summary of Adult Literacy in America:

A First Look at the Results of the National Literacy Survey, Washington, DC: U.S. Department of Education, National Center for Education

Statistics, 1993.
II. Description of Criminal Justice System, 

Arrest Process, and Detention System

Origin of the U.S. Criminal Justice System

The U.S. criminal justice system is founded on the principles of English common law and is

based on a complex series of laws, procedures, and decisionmaking processes. The system stems

from the premise that crimes against individuals are crimes against the state as well and are

therefore punishable through state prosecution. The United States does not have a single criminal justice system; systems vary from State to State, county to county, and city to city. All these

systems are governed by the broad principles of due process as defined by the U.S. Constitution

and as interpreted by U.S. Supreme Court rulings, but legislation and judicial interpretation can

vary from State to State.

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Exhibit 2. Economic Information for the United States

Gross domestic product (GDP) (1999 est.) $9.256 trillion

GDP growth rate (1999 est.) 4.1%

GDP per capita (1999 est.) $33,833

Median household Income (1999 est.) $40,816

GDP composition by sector (1999 est.) Services, 80%; industry, 18%; agriculture 2%

Major export partners (1998) Canada, 23%; Mexico, 12%; Japan, 8%; United Kingdom, 6%; 

Germany, 4%; France, 3%; Netherlands, 3%

Major export commodities Capital goods, automobiles, industrial supplies and raw materials,

consumer goods, agricultural products

Labor force (1999 est.) 139.4 million

Labor force composition by sector (1999) Managerial and professional, 30.3%; technical, sales, and administrative

support, 29.2%; services, 13.4%; manufacturing, mining, transportation,

and crafts, 24.5%; farming, forestry, and fishing, 2.6%

Poverty rate (1999 est.) 11.8%

Unemployment rate (July 2001 est.) 4.5%

Human development index (1999)* 0.934

*The human development index measures a country’s average achievement in three basic dimensions of human development: a long and

healthy life, knowledge, and a decent standard of living. The index is a composite index of three variables: life expectancy at birth; educational

attainment (adult literacy and the combined primary, secondary, and tertiary enrollment ratio); and per capita GDP (measured as purchasing

power parity in U.S. dollars). Countries are grouped into three categories: high human development (≥0.800 on a scale of 0–1.000); medium

human development (0.500–0.799); and low human development (<0.500) (United Nations Development Programme, Human Development

Report 2001, New York: Oxford University Press, 2001, retrieved August 22, 2001, from the World Wide Web at www.undp.org/hdr2001.

Sources: U.S. Census Bureau, Statistical Abstract of the United States 2000: The National Data Book, Washington, DC: U.S. Department of

Commerce, Economics and Statistics Administration, U.S. Census Bureau, 2001; Dalaker, Joseph, and Bernadette D. Proctor, Poverty in the

United States 1999, Washington, DC: U.S. Department of Commerce, Economics and Statistics Administration, U.S. Census Bureau, September

2000, Publication P60–210; Central Intelligence Agency, The World Factbook 2000—United States, Washington, DC: Central Intelligence Agency,

retrieved from the World Wide Web August 22, 2000 at http://www.odci.gov/cia/publications/factbook/geos/us.html.
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Types of Offenses

Most offenses committed in the United States are under the jurisdiction of State and local criminal

justice systems. Laws are most commonly enforced by cities, counties, and other local jurisdictions;

the court systems are most commonly directed by State governments with regional or county

jurisdictions; and corrections is primarily the responsibility of county and State governments.

Additionally, all but the smallest cities engage in some type of corrections enterprise.6

Federal crimes (e.g., kidnaping or transportation of stolen goods across State lines) account for

only a small proportion of crimes in the United States. For the most part, State and local authorities

investigate and respond to crimes. Of 1,901,773 justice system employees, 8.5 percent (161,058)

are Federal and 91.5 percent (1,740,715) are State and local.7

Offenses against the state are categorized according to seriousness. The distinction between a

felony and a misdemeanor is one of the oldest in the criminal law. In general, a felony is distinguished from a misdemeanor by the punishment that may be exacted for the crime. Conviction

on a felony charge usually means that a prison sentence of more than 1 year is authorized.

Punishments for felonies range from 1 year in prison to, in some States, a sentence of death.

Misdemeanors are usually dealt with more leniently and in many cases do not carry a prison sentence. In general, the maximum prison sentence for a misdemeanor is 1 year in prison plus a fine.

Arrest Through Supervision

An offender’s participation in the criminal justice system most often begins when a victim or

witness reports a crime to the police. Crimes are also discovered by police officers in the field,

through the use of informants, and from investigations and intelligence.

Once it is determined that a crime has been committed, law enforcement personnel will try to

identify and apprehend the suspect. In cases in which a suspect is identified, apprehended, and

charged with a crime, the police will work in conjunction with the prosecutor (representing the

government) to determine whether formal charges will be filed. When charges are not filed, the

accused is released.

If formal charges are filed, the suspect must be taken to court, where a judge or magistrate will

determine whether the police and the prosecutor have obtained enough information or have

“probable cause” to detain the suspect. If there is insufficient information, then the charges will

be dropped. If the charges hold, the suspect will obtain or will be assigned counsel to represent

him or her throughout the remainder of the process. (A defendant in a criminal case has the right

to represent himself or herself, but in the majority of such cases, an attorney will be assigned by

the court to help the defendant prepare his or her defense.) The suspect can be released at this

point to await his or her next court appearance. Commonly, suspects are released on their own

recognizance, to the custody of a third party, or under conditions imposed by the court.

A preliminary hearing may follow the initial court appearance, depending on the jurisdiction.

This hearing is held to discover if there is probable cause to believe that the accused committed
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the known crime. If the judge does not determine probable cause, the case is dismissed. If there

is a finding of probable cause, the case will likely go to trial.

The first segment of the adjudication process is the arraignment. The accused is formally charged

with a specific criminal violation, advised of his or her rights as a criminal defendant, and asked

to enter a plea to the charges against him or her. The defendant can plead guilty, not guilty, or

nolo contendere (accepting the penalty without admitting guilt). The judge can either accept or

reject the plea. A judge may choose to reject a guilty plea if he or she believes the defendant was

coerced or did not understand the consequences of the plea bargain.

If the accused pleads not guilty, the case proceeds to trial. At trial, the prosecution and the

defense present their evidence to the judge or a jury of the defendant’s peers. Defendants accused

of serious crimes have a right to a trial by jury (as do all criminal defendants in Federal court),

but even in these cases, the defendant can waive that right in favor of having the judge determine the outcome. The trial will result in a finding that the defendant is guilty or not guilty. If

the defendant is found not guilty, he or she is acquitted of all charges and released immediately.

If convicted, the defendant is sentenced. Once convicted, a defendant has the right to appeal the

conviction. Appeals, however, are often rejected if there is insufficient evidence to show that the

offender did not receive a fair trial. In certain cases, such as those in which the death penalty is

imposed, the right to appeal is automatic.

The judge most often determines the sentence, but in many States a jury may hand down the sentence at a separate hearing. Sometimes the same jury is used, and in some cases a new panel is

convened for sentencing purposes.

Common sentences include fines, restitution, probation, and incarceration. Alternatives to traditional sentencing are often less restrictive than incarceration but are designed to provide more

supervision, and are more punitive, than regular probation. In some jurisdictions, the law mandates specific sanctions for certain types of offenses. For example, many States have imposed

mandatory sentences for drug offenders.

III. Status of National Drug Policy

The Federal Government plays a significant role in developing drug control policy. On behalf of

the President, the Office of National Drug Control Policy (ONDCP) and disseminates broad

national policies and strategies designed to affect drug use on a national scale. Additionally, the

Federal Government is actively involved in enforcing Federal drug laws through several of its

Federal law enforcement agencies, principally the Drug Enforcement Administration, the Federal

Bureau of Investigation, and the U.S. Customs Service. The Department of Transportation,

through the U.S. Coast Guard, and, to a lesser extent, the Department of Defense are also actively

involved in the Nation’s counter-drug efforts. Offenders who violate Federal laws are prosecuted

in the Federal court system.

In addition to Federal criminal and regulatory law concerning the transportation, sale, possession, and use of drugs, each of the 50 States has enacted its own criminal laws on this subject.
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United States of America

State law enforcement agencies enforce these laws under the direction of the Governor, often

through a State attorney general. In many cases, Federal and State law enforcement agencies

work together to combine investigative and enforcement resources. In some areas of the country,

these joint efforts have been systematized into formalized agreements. Offenders who violate

State laws are prosecuted by the respective State court system.

In some instances, both Federal and State drug laws apply to individual violations. In such cases,

Federal and State prosecutorial authorities often coordinate with each other as to which level of

government will initiate the prosecution of the offender. The caseload of the State and Federal

courts and the likely punishment are often determining factors as to who will take the lead.

Federal Responsibilities for Drug Control Policy

The central coordinating agency for U.S. national drug policy is the ONDCP. The Director of

ONDCP is a presidential appointee who is confirmed by the U.S. Senate and serves on the

President’s Drug Policy Council and National Security Council for drug-related issues. Since the

late 1980s, ONDCP has been mandated to coordinate Federal efforts to reduce the use of illegal

drugs in the United States. The Anti-Drug Abuse Act of 1988, which established ONDCP,

requires the Office to develop an annual strategy for reducing illegal drug use and to incorporate

goals and measurable objectives for monitoring its progress. In early 1992, underage alcohol use

was included among the drugs to be addressed by ONDCP. The Act mandates ONDCP to develop an annual National Drug Control Strategy; a consolidated National Drug Control Budget; and

guidelines for cooperation among Federal, State, and local drug control entities. The Act further

requires the Director of ONDCP to evaluate, coordinate, and oversee the international and

domestic antidrug efforts of executive branch agencies and to ensure that those efforts sustain

and complement State and local antidrug activities. The ONDCP Director advises the President

regarding changes in the organization, management, budgeting, and personnel of Federal agencies that could affect the Nation’s antidrug efforts.9

The Violent Crime Control and Law Enforcement Act of 1994 and the Reauthorization Act of

1998 extended ONDCP’s mission to include budget and resource powers related to formulating and implementing the President’s National Drug Control Strategy, and established new

reporting requirements for ONDCP. This new authority gives ONDCP influence over agency

budgets to ensure they carry out the priorities, goals, and objectives of the Strategy. ONDCP’s

reporting requirements under the Crime Control Act include assessing the following areas:

prevalence of drug use, reduction in drug availability, and reduced consequences of illicit drug

use and availability.10

The National Drug Control Strategy is designed to reduce illicit drug use and its consequences,

building on five goals first proposed as part of the 1996 National Drug Control Strategy:11

• Goal 1: Educate and enable America’s youth to reject illegal drugs, alcohol, and tobacco.

• Goal 2: Increase the safety of America’s citizens by substantially reducing drug-related 

crime and violence.

• Goal 3: Reduce the health and social costs to the public of illegal drug use.
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• Goal 4: Shield America’s air, land, and sea frontiers from the drug threat.

• Goal 5: Break foreign and domestic drug sources of supply.

The Strategy is intended to prevent and deter first-time use among children and youth, prevent

casual users from becoming addicts, remove violent criminals from the streets, dismantle drug

networks in the United States and abroad, provide treatment to drug abusers, and reduce the

supply of illicit drugs entering the United States. To assess the effectiveness of this strategy,

ONDCP has instituted a National Performance Measures of Effectiveness system. This system

provides feedback for refining antidrug strategy and allocating resources to antidrug efforts.

IV. Background History of the ADAM Program

The history of the Arrested Drug Abuse Monitoring (ADAM) program can be traced back to the

1980s. In 1984, the National Institute of Justice (NIJ) funded arrested pilot studies in Washington,

D.C., and Manhattan to assess the utility of pretrial drug testing and the feasibility and effectiveness of assessing pretrial risk. Together, these two projects involved data collection on 14,000

arrestees.12 In both studies, urinalysis revealed that more than half of those tested were positive

for drugs.13 This level was far higher than other estimates in 1984 suggested.14 The results of this

pilot work also challenged the validity of self-reported information on drug use and confirmed

the usefulness of drug testing for arrestees. More than half of those who tested positive for illicit

drug use by urinalysis failed to admit using drugs during a face-to-face research interview.15 NIJ

funded a followup study in Manhattan in 1986 that revealed that cocaine use was rising rapidly;

double the percentage of people who tested positive for cocaine in 1984 (42 percent) tested positive in 1986 (83 percent).16 Had self-reports been relied on exclusively, this increase might never

have been detected; the proportion who admitted to ever having used cocaine was about the

same for both years.17

The high levels of cocaine use detected in these two pilot cities and the steep increase in use over

a short period of time (1984–86) raised the question of whether the trend might be an anomaly of

these two large East Coast cities. To gauge drug use among arrestees in other urban areas, NIJ,

with co-funding from the Bureau of Justice Assistance (BJA), created the Drug Use Forecasting

(DUF) program in 1987.

DUF initially collected data in only eight large cities. Adult male arrestees were interviewed in

all eight locations and adult female arrestees were interviewed in five locations. In 1988, DUF

expanded to include juvenile arrestees in five DUF sites, and a separate interview instrument for

juveniles was created. In 1989, the DUF program established 14 new adult male interview sites

for a total of 22 sites. The following year (1990), the program expanded to include 21 female sites

and 11 juvenile sites. Also in 1990, a special addendum designed to track the spread of “Ice”

(methamphetamines) from Hawaii was fielded in the DUF sites. During 1992 and 1993, DUF

operations and funding were consolidated within NIJ, and in 1994, DUF moved into NIJ’s Office

of Research and Evaluation (ORE).
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In spring 1995, NIJ proposed the development of the ADAM program. The ADAM program

preserves many of DUF’s features but includes a call to do the following:

• Expand operations to 75 sites.

• Redesign the data collection and sampling methodology to provide policymakers and practitioners with a rigorous basis from which to assess local arrested drug use and crime patterns.

• Establish an outreach program through which ADAM will monitor the leading and trailing

edges of drug problems in targeted populations, such as suburban, rural, or Indian Nation

populations.

• Develop local coordinating councils that will generate research addenda, guide the selection

of outreach sites, and disseminate each site’s findings.

At its core, however, ADAM preserves DUF’s simple concept: interviewing and drug-testing

arrestees. Between 1995 and 1997, the DUF program carried out a number of projects, including

the following:

• Revising the main interview instrument.

• Developing a Spanish version of the interview instrument.

• Piloting TELEDUF (an automated version of the DUF instrument).

• Developing and fielding the Gun Addendum.

• Conducting a special study (in collaboration with ONDCP) on cocaine/crack and heroin drug

markets and drug procurement patterns in six DUF sites.

• Studying methamphetamine markets in five western DUF sites.

In 1997, the President included ADAM in the Administration’s 1998 budget request to Congress

and the formal transformation of DUF into ADAM began. In that year, ADAM began to develop

a sampling protocol, review interview instruments, and develop a process for selecting new

ADAM sites.

In 1998, 12 new sites were added to the ADAM program for a total of 35 sites (see exhibit 3).

During 1998 and 1999, the new ADAM instrument was developed and tested from several perspectives: cognitive testing, experiments on diagnostic validity, and field tests of the interview

package.

Other ADAM projects completed during 1998 and 1999 include—

• An analysis of the impact of specimen handling and storage procedures on test results.

• An assessment of opiate testing that confirmed its ability to differentiate heroin use from the

use of medications containing opiate compounds.

• Tests for metabolites and markers that indicate crack as well as general cocaine use.

Also during this period, ADAM hosted a series of meetings on publication and communication

approaches with local, regional, and national representatives. Finally, this period marked the

release of four drug-specific reports that moved away from the community level to assess regional, subgroup, and other issues evident in the trend data.
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In 2000, NIJ began to incorporate two new elements that significantly strengthen the value of the

data collected. First, ADAM introduced a new sampling strategy that provides representative

samples at the county level for each site. Second, the new ADAM instrument was implemented.

Pending congressional approval, ADAM is expected to begin enrolling 15 new sites in fiscal year

(FY) 2002 and 25 new sites in FY 2003 for a total of 75 sites. When fully funded at 75 sites, ADAM

will include the largest U.S. cities with populations of 200,000 or more and the largest city in each

State where no city has a population greater than 200,000. By collecting drug use data in these

sites nationwide, the program will cover more than 40 States, represent more than 20 percent of

the U.S. population, and encompass an offender base that is responsible for more than 45 percent

of the UCR Part 1 crimes. At full projected size, interviews will be administered to more than

75,000 adult males, 30,000 adult females, and 45,000 juveniles.

V. Goals and Objectives of ADAM

Although the goals of the ADAM program are not formally stated, some of its broad aims can be

identified. The ADAM program is an information system on drugs, crime, and related social/public

health issues that can be used to meet the following five goals:

1. Provide insights into the link between drugs and crime. By sampling arrestees, the ADAM

program can assess the extent to which those involved in criminal activity consume illicit drugs.

ADAM data can help enhance understanding of the drug use patterns of actual or potential

offenders, the extent to which offenders commit crime to fund drug misuse, and the extent to

which these drug-misusing offenders inflate the total number of crimes committed.

2. Monitor the prevalence of hardcore drug use. Research addressing the prevalence of drug use

typically does not include those in jail or prison and, therefore, may underestimate levels of drug

use in the United States. ADAM is one of several drug indication systems that operate in the U.S.

(e.g., National Household Survey on Drug Abuse, Monitoring the Future, Drug Abuse Warning

Network). Monitoring drug use among criminal suspects is important not only because of the

links between drug use and crime but also because arrestees are likelier than household members

and schoolchildren to be heavily drug involved. ADAM contributes to research on the prevalence

Exhibit 3. ADAM Sites, 2000

Albany, NY Des Moines, IA Miami, FL Sacramento, CA

Albuquerque, NM Detroit, MI Minneapolis, MN Salt Lake City, UT

Anchorage, AK Fort Lauderdale, FL New Orleans, LA San Antonio, TX

Atlanta, GA Honolulu, HI New York, NY San Diego, CA

Birmingham, AL Houston, TX Oklahoma City, OK San Jose, CA

Chicago, IL Indianapolis, IN Omaha, NE Seattle, WA

Cleveland, OH Laredo, TX Philadelphia, PA Spokane, WA

Dallas, TX Las Vegas, NV Phoenix, AZ Tucson, AZ

Denver, CO Los Angeles, CA Portland, OR Washington, DC
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of drug use by sampling persons who are not sampled by other drug surveys. By focusing on a

hardcore population such as arrestees, NIJ can provide estimates of low-base-rate drugs, such as

heroin, that are not typically used in the general population. As an ongoing surveillance system,

ADAM can monitor changes in drug use over time and compare rates of use across U.S. sites

and regions.

3. Assess the dimensions of particular local substance abuse problems at the county level.

ADAM is one of the few ongoing drug surveillance systems that provides local estimates of drug

use. The vast majority of the crimes committed in the United States fall under the jurisdiction of

county or city governments. National, and even regional, drug surveillance statistics tend not to

be useful for local policymakers. ADAM responds to the needs of local law enforcement, judicial,

and government entities by providing data that is representative of their local areas. The ADAM

program has been useful in illustrating local variations in drug use (e.g., methamphetamine use

is much more prevalent in many of the western ADAM sites than in East Coast sites).

4. Evaluate, in a low-cost manner, programs and interventions that serve or target criminally

active populations. The ADAM program offers a rare opportunity to collect primary data without absorbing the basic operational costs already funded by ADAM. The ADAM data can be

used as a source of preintervention data for a before-and-after design. For example, Birmingham,

Alabama’s Breaking the Cycle (BTC) program is being evaluated through a quasi-experimental

design in which the control group is made up of ADAM arrestees selected before the implementation of BTC. Other programs can be evaluated with the ADAM platform. For example, ADAM

could be useful for evaluating jail-based programs designed for arrestees, pretrial diversion

programs, communitywide initiatives, public awareness campaigns for drugs, and specialized

criminal courts. Rigorous experimental evaluations can be integrated into the basic ADAM platform. At the Sacramento, California, ADAM site, an experimental evaluation is being conducted

on a treatment program for detained domestic violence arrestees.

5. Provide the necessary data for policy responses appropriate for the arrested population. The

ADAM program provides useful drug epidemiological data for many components of Federal,

State and local governments that are tackling the problem of drug abuse. Law enforcement, treatment providers, prevention specialists, and other service providers can use ADAM data to assess

the impact of their interventions. For example, the congressionally created Methamphetamine

Interagency Task Force, co-chaired by the Attorney General and the ONDCP Director, collected

information on and proposed strategies to address the growing methamphetamine problem in

the United States. ADAM data have been used to support the work of this task force and provide

data for the Attorney General to launch a variety of initiatives.

VI. Getting Started

A. Obtaining Funding

The ADAM program is based in the NIJ’s Office of Research and Evaluation (ORE). NIJ is based

within the U.S. Department of Justice’s Office of Justice Programs (OJP). The original funding for

the former DUF program was supported by base funds from NIJ’s general research budget. In
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1998, NIJ received a congressional appropriation to increase ADAM from 23 to 35 sites. Along

with a base budget of $2.3 million, ADAM received $4.4 million for a total FY 1998 budget of

$6.7 million. This $6.7 million budget remained basically the same in FYs 1999, 2000, and 2001.

ADAM has been designated for expansion to 50 sites in FY 2002 and 75 sites in FY 2003. To obtain

the funds needed for expansion, NIJ has assembled a budget proposal that must be approved

by officials within OJP, the U.S. Department of Justice, the Office of Management and Budget

(OMB), the President, the Senate, and the House of Representatives. Each of these “budget hurdles” requires the careful documentation of past accomplishments and future potential of the

ADAM program.

Additional funding for new ADAM sites could come from other Federal sources. In the past, the

Centers for Substance Abuse Treatment (CSAT) has funded a number of State data collection

programs similar to ADAM. Also, the ADAM program has recently started an ADAM affiliate

program. ADAM-affiliated sites operate like other ADAM sites, using all NIJ/ADAM protocols,

instruments, and training materials; receiving technical assistance from NIJ/ADAM staff as well

as contractor staff; and accessing data from the other ADAM sites. Most of the funding for the

ADAM-affiliated sites will not come from NIJ. Funding for these sites may come from State or

other Federal sources (e.g., the Federal Byrne grant program). The first ADAM-affiliated site was

Albany, New York. Other sites have opened in Charlotte, North Carolina; Kansas City, Missouri;

and Tulsa, Oklahoma.

B. Contracting for Data Collection

The ADAM program has four main administrative components: NIJ’s internal ADAM program

staff (including the ADAM Director), a national data collection contractor (currently Abt Associates

Inc.), a laboratory contractor for urinalysis testing (currently PharmChem), and 35 local data collection teams.

NIJ’s internal staff

NIJ’s internal staff manage the ADAM program, oversee the work of contractors, conduct intramural research, work on ADAM developmental projects (e.g., new survey instruments and using

ADAM as an evaluation platform), establish and maintain partnerships with other governmental

agencies, and promote the use of ADAM data to a variety of constituencies.

National data collection contractor

The contractor was selected through a competitive solicitation process and is responsible for data

collection, consistency, integrity, and management. The contractor collaborates with NIJ on the
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design and management of ADAM data collection and processing. The current data collection

contract is for 4 years and covers responsibilities in the following task areas:

1. Managing all 35 ADAM sites. 

• Identify potential sites.

• Assess readiness to collect data.

• Staff all sites through subcontracts with local data collectors (e.g., university data 

collection teams).

• Train all site personnel.

• Monitor sites for adherence to specified procedures, collection deadlines, data 

integrity, expenditures, and staff performance.

2. Specific data collection procedures.

• Subcontract with local data collectors to carry out data collection

• Ensure that local data collectors properly identify potential research participants, secure 

participants’ informed consent, conduct interviews with appropriate surveys, and collect 

urine specimens according to specified procedures.

3. Maintaining and organizing data.

• Edit and enter data into database.

• Process the ADAM urine specimen data.

• Maintain ADAM data files.

4. Analyzing data.

• Prepare the ADAM data findings for semiannual/annual reports, special topic monographs, 

and proposed specialized research studies/analyses.

• Conduct NIJ-approved studies.

Drug testing laboratory contract

This contract provides for urinalysis testing for all 35 sites, a flexible drug testing program that

responds to changing substance abuse trends, and a U.S. Department of Health and Human

Services (HHS)-certified laboratory partner that has been tasked with keeping NIJ apprised of

changing drug technologies and their relevance to ADAM’s policy-related research. The current

laboratory contract is for 4 years and covers the following task areas:

• Supply sites with necessary materials (cups, bar coded labels, protective gloves, shipping 

cartons and materials, mailing labels, etc.).

• Develop and update a specimen handling procedures manual and training plan.

• Analyze urine specimens according to flexible 10-drug panels.
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• Maintain routine communications with the data collection contractor and NIJ on data 

reporting discrepancies.

• Report the results of the drug tests to the data collection contractor and all 35 sites.

• Assist NIJ with special requests to support special research projects (including providing 

the expertise of a Ph.D. chemist who writes brief technical papers that explain or analyze 

drug testing).

• Ensure proper quality-control systems to provide valid and reliable urinalysis testing.

Local data collection teams

Each of the 35 ADAM sites have local teams of interviewers and managers that have been hired

through subcontracts with the national data collection contractor. Many of these data collection

teams come from local universities and research firms. The key personnel that make up the local

data collection teams include a site director, a site coordinator, interviewers, and security officers.

Their roles are outlined in the ADAM training manual and are briefly reviewed below.

The site director has direct responsibility for all site work, and negotiates and executes the subcontract with the national data collection contractor, establishes and maintains contact with the

booking (jail) facilities, hires and maintains adequate staff for project performance, oversees data

collection and monitors site adherence to national data collection standards, coordinates and

communicates with the national data collection contractor and NIJ on implementing changes to

ADAM protocols, oversees proper invoicing and fiscal monitoring of the site budget, and works

with the local coordinating council.

The site coordinator has day-to-day operating responsibility for collecting data. This includes

scheduling data collection, obtaining supplies, preparing questionnaire materials, training and

supervising interviewers, editing data, coordinating the activities of the security officer, packaging

and shipping questionnaires and specimens, and filling out all of the necessary log and transmittal

sheets on completion of data collection. Although some of these tasks may be delegated to others

(e.g., interviewers may help prepare questionnaire materials), the coordinator has operational

responsibility for and firsthand knowledge of the data collection process. Some sites require

more than one site coordinator.

Interviewers conduct the interviews in a manner that is consistent with the procedures and

maintain scientific standards of accuracy and objectivity. Security officers move the arrestees to

and from the interviewing area while not discussing the nature and scope of the study. In some

sites, a detention facility guard, reserve deputy sheriff, or private security officer is used.

C. Facility Access

Without facility access, there would be no ADAM program. Each U.S. ADAM site voluntarily

joined the program through competitive solicitation to NIJ. NIJ funds all elements of data collection, including the cost of officers who provide security for the interviewers. Typically, NIJ, contractor, and local data collection staff have worked together to get the necessary approvals from

local government officials for access to specific local facilities. Although the Federal Government
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does not have the right to mandate participation, NIJ can set the rules for participation in the

ADAM program.

To be an ADAM site, each participating jurisdiction and system of facilities needs to be able to—

• Ensure that interviewers have access to all of the facilities necessary to obtain a sample of

arrestees from the total arrested population that corresponds with the population of interest

to the ADAM program.

• Ensure that site staff have access to information at the time of each interview period that

describes the total arrested population so that appropriate arrestees can be selected for 

interviewing and appropriate statistical adjustments, such as sample weighting, can be 

accomplished.

• Ensure that the interview staff have access to interview rooms where they can conduct confidential and anonymous interviews and to toilets for collecting urine specimens.

• Make booking data available to ADAM site staff so that an informational cover sheet can be

completed prior to the interview.

• Provide arrestees for interviewing within 48 hours of arrest.

The participating facilities are told that they will need to provide this level of access four times

per year for approximately 2-week intervals for data collection.

D. Knowing the Catchment Area

To interpret ADAM data, analysts need to understand the population from which the ADAM

sample has been drawn. One criticism of DUF was the lack of standardization across the sites

and the lack of a consistent catchment area unit. Some sites used city borders and others used

county borders to define their samples. The larger county area often drew more nonurban

arrestees than if the catchment area had been the city. Without this common unit, comparisons

across sites may be difficult or, in some cases, impossible. Another problem with some of the

earlier DUF sites was a lack of understanding of the catchment area parameters. In designing

the new ADAM sampling scheme, it became apparent that jails that were believed to have

arrestees from only one county drew from surrounding counties as well. In these cases, DUF

produced city- or county-level estimates that were partially confounded by cases from

nonparticipating jurisdictions.

To address this issue, the ADAM program intensively examined the flow of arrestees from

the participating counties to ensure that a representative sample of the designated county was

drawn. For ADAM to succeed, evaluators need to understand how and when arrestees arrive at

the jails and how these factors affect or limit the ability to conduct interviews. Are arrestees held

in precinct houses or other facilities prior to booking? When do arrestees make their first court

appearance or make bond? The answers to these questions can affect the timing or location of

the interview.

A key element of ADAM is that it standardizes data collection at the county level.18 Therefore,

although most ADAM sites are referred to by the name of the largest city in the area, the catchment area of most sites is substantially larger than the named city. Using the county as the
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ADAM catchment area offers a number of advantages. First, in many counties, the largest city

operates its own jail, and the county sheriff operates a jail for the smaller cities and towns in the

county. Often, then, it is relatively simple to expand data collection to the county level. Second,

county populations often differ from city populations along such demographic lines as employment, socioeconomic status, and ethnicity. Therefore, county-level data can produce a more mixed

population than city-level data can. Finally, counties are easier geopolitical boundaries to track,

particularly with respect to the processing of arrestees. The population in city jails tends to change

not only because of annexations and population growth but also because cities may start and

stop jailing service contracts with smaller surrounding municipalities depending on jail capacity

and other factors. County boundaries tend to be more fixed, with little movement of arrestees

across county borders. Thus, counties are an easier unit of analysis to monitor over time.

The change from DUF to ADAM has occurred incrementally at many sites. Catchment areas

were gradually expanded to the county level during 1998. Therefore, for sites that were not previously operating at the county level, the catchment area may have changed during the 1998

data collection year. In certain complicated sites with multiple jails, sites gradually increased the

number of facilities where they collected data as they added interview staff and gained access

to additional jails.

E. Drug Testing Issues

As discussed in the Research Methods section of this chapter, drug testing is a key element of the

ADAM program because it reveals with a high degree of certainty whether a person has used

drugs within 48 hours of testing. During the course of operating the ADAM program, it has

been periodically necessary to change laboratory firms that test the urine specimens because

Government regulations require rebidding contracts. As a result, the program has had four

drug-testing laboratories in the past decade. The most recent change occurred in 1998 when the

laboratory services contract was again rebid. In addition, program data collection procedures

have changed substantially over time. Through mid-1998, specimens were not shipped for analysis until the end of the 2-week data collection period. There was substantial concern that this delay

in shipping could lead to the degradation and decay of urine specimens, resulting in skewed test

results. Beginning with the laboratory services contract awarded in 1998, data collection staff

were required to send specimens to the laboratory daily or every other day.

NIJ staff undertook a research exercise during the most recent change in laboratory service

providers.19 The goal of the project was to determine the consistency of the urinalysis results

when the same urine specimens were analyzed by two independent laboratories (the new and

the old laboratory). A total of 931 specimens were collected from four locations and four demographic groups (adult males, adult females, juvenile males, and juvenile females). The samples

were analyzed first by the incumbent laboratory and then by a new laboratory using the EMITTM

(enzyme multiplied immunoassay testing) screening assay to test for the presence of the 10 common drugs with the same cutoff levels. The experimental results revealed that the concordance

rate was approximately 97.4 percent. The highest concordance rates (100 percent) occurred for

methadone, methaqualone, and phencyclidine (PCP).
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F. Instrument Issues

The original DUF survey included only basic demographic and drug use questions, because the

main focus of DUF was on the urinalysis results. As discussed in the Research Methods section

of this chapter, the new ADAM survey includes a wider array of questions than the old DUF survey. There are still a number of inherent limitations in the ADAM data collection environment.

First, many things that we would like to know about the arrested population cannot be addressed

in this survey. Interview time is limited and certain types of questions cannot be asked in a setting

in which extensive development of rapport is not possible. A long and unmanageable survey

with many threatening questions will not work in this environment. The process of selecting a

limited number of topical areas for the survey included consultation with a variety of policymakers and drug policy researchers. The ultimate product includes a variety of questions that

are important to meet the monitoring needs of policymakers and assist researchers in modeling

the dynamics of drug use.

Cultural applicability

The United States is often referred to as the “great melting pot” of different ethnic groups. This

mixture of ethnic groups can present a serious challenge to researchers interested in collecting

standardized data across 35 different cities. There are often fairly substantial cultural differences

among the types of participants that can be found in these 35 sites. A substantial proportion of

ADAM participants in the Hawaii site is of Pacific Island descent, and in Los Angeles the largest

group of male arrestees is Hispanic. The Pacific Islanders have a very different culture from the

Hispanic arrestees.

A variety of assumptions are often embedded within surveys. These assumptions can be based

on a set of unfamiliar norms that members of minority groups may not understand. To the extent

that members do not understand the ADAM survey, the problem of measurement error is introduced. Therefore, when designing the ADAM survey, careful attention was paid to making sure

that it applied to the widest group possible. In some cases, non-English versions of the ADAM

survey were developed (currently a Spanish-language version of the ADAM survey is in place).

In other cases, extensive pretest consultation was undertaken with members of these minority

groups to make sure that the nuances of the ADAM survey would be understood. ADAM staff

will continue to monitor and assess the issue of cultural applicability. In some cases, these issues

can be addressed through training and related protocols; in other cases, specialized studies will

need to be conducted to accurately measure the drug use of these other groups.

Standardization versus local utility

Related to the issue of cultural applicability is maintaining ADAM as a useful local research platform. To the extent that ADAM cannot accurately measure the drug use of local ethnic groups,

its local utility is diminished. To allow for cross-site comparisons, ADAM has instituted training

procedures and related protocols to ensure that each site collects and measures the same data.

The core ADAM survey ensures that sites can be compared across a number of key variables.

Through the ADAM addendum program, however, each site is given the opportunity to collect

supplementary data outside the core areas. For more than a decade, a number of sites have been
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collecting data on gun use. Other topical areas for addenda that sites have used include gangs,

domestic violence, human immunodeficiency virus (HIV), drug markets, specific drugs, and

gambling. As a participant in the International Arrestee Drug Abuse Monitoring (I–ADAM)

program, the U.S. ADAM program has agreed to collect a smaller subset of core questions to

allow for international comparisons.

VII. Barriers to Developing ADAM

One key issue that NIJ has had to contend with in running its drug monitoring program is

revising the former DUF program into ADAM. Building on an established program like DUF

has many advantages over creating an entirely new program. Many policymakers and other

stakeholders were already familiar with the concept of monitoring the drug use patterns of

arrestees. The ADAM program did not need to “sell” people on the importance of the arrested

population as an interesting hardcore population worthy of monitoring; DUF had already done

that. A number of practices and conventions, however, that had developed over the years with

the former DUF program needed to be reformed.

In 1993, the General Accounting Office (GAO) reviewed the major national drug data collection

programs (including the former DUF program).20 GAO’s report heavily criticized the sampling

methodology of the former DUF program. The problems detailed in the report were major barriers that NIJ had to address. As a response to this report, NIJ reengineered DUF into ADAM.

Although heavily criticized by researchers, the non-probability-based sampling scheme of the

DUF program was accepted by many stakeholders at the site level. The rationale for changing to

a more representative sampling scheme did not always translate well. The new sampling method

sometimes required access to additional jail sites, additional floors or locations within the existing jails, or additional time shifts. These new access issues could be difficult to accommodate at

jails where the primary concern was detaining persons suspected of committing crimes. The

ADAM program staff and site staff have had to work to convince all of the involved parties of

the necessity of the new scheme and why it is worth the extra trouble.

VIII.National Stakeholders Involved in the

Development of ADAM

The U.S. ADAM program is based within NIJ, which is the research arm for the U.S. Department of

Justice. Within DOJ, NIJ is part of the Office of Justice Programs, which is headed by an Assistant

Attorney General.21 A number of DOJ components are key users of ADAM data, including the

Attorney General, the Drug Enforcement Administration, and the Federal Bureau of Investigation. These Justice components have used ADAM data to help allocate resources to drug

enforcement and identify drug hot spots.
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The ADAM program has developed partnerships with other Federal agencies. NIJ has been

working with CSAT to estimate the need for treatment among the arrested population. NIJ has

partnered with the Centers for Disease Control and Prevention (CDC) to develop an HIV addendum instrument for use with ADAM arrestees. The addendum focuses on risk behaviors for HIV,

sexually transmitted diseases (STDs), hepatitis, and tuberculosis. It includes items measuring

unprotected sex and needle sharing, history of HIV testing, and exposure to HIV prevention messages. The HIV addendum was piloted in Miami in December 1999 and three other ADAM sites

were designated as data collection sites in 2000. Finally, ADAM works closely with ONDCP on

coordinating the interests of NIJ with those of other Federal agencies involved in drug control

policy. In 1997, ONDCP helped provide bridge funding for ADAM’s expansion from 23 to 35

sites. ONDCP has sponsored a number of joint ADAM-related projects with NIJ, including a

study of drug markets22 and the price elasticity of demand and supply for illicit drugs (grant

99–IJ–CX–K004).

These organizations and others have been important in the development of the ADAM program.

In particular, these groups supported budget authority and congressional approval for the

expansion of the ADAM sites to 35. Support from the highest levels of these groups and from the

Office of Management and Budget (OMB) will continue to be important for the ADAM program

as it plans to expand to 75 sites.

IX. Research Methods

The ADAM program has two fundamental components. The first is a questionnaire administered

by a trained interviewer to an arrested in a booking facility within 48 hours of arrest. The second

is a urine specimen collected from the respondent that is used to corroborate claims about recent

drug use. Together, these two techniques provide a powerful research platform.

The Survey

Trained interviewers administer the ADAM questionnaire to arrestees in booking facilities within

48 hours of arrest. Interviews with arrestees are conducted in the jails of 35 participating counties.

Information is obtained from respondents with the assurance that it will be kept confidential and

will not be used to influence the outcome of their arrest. An informed consent statement is read

to all the participants requesting their voluntary participation in an interview and informing

them that a urine specimen will be taken. The interviews are conducted by trained personnel

over the course of approximately 14 consecutive days.

In 1999, the program began redesigning and testing a new ADAM survey that would focus more

specifically on issues of interest to policymakers and practitioners. In FY 2000, the new instrument

will allow researchers to estimate the proportion and number of arrestees who use a variety of

illegal drugs, estimate the need for treatment and dependence on substances in the arrested population, describe drug markets in an area over time, and establish links to other datasets (such as

the National Household Survey on Drug Abuse and the Treatment Episode Data Set) to facilitate

development of more comprehensive and integrated national estimates of drug use. Another
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innovative element of the new ADAM instrument is its use of a “calendar” or “life events” method

of collecting data. The calendar method is designed to collect data using a visual cue (a calendar)

to better characterize complex behaviors or events and to increase the accuracy of recall. With the

new instrument, each face-to-face interview will last approximately 25 minutes (twice as long as

the former DUF instrument). A more detailed discussion of the ADAM instrument can be found

in the 1998 Annual Report on Drug Use Among Adult and Juvenile Arrestees.

23

The Drug Test

Drug testing is an important component of the ADAM program because it reveals, with a high

degree of certainty, whether a person has used drugs recently. ADAM is the only national drug

research program in the United States that utilizes drug testing. The ADAM program uses the

EMIT system to screen for the presence of drugs in urine. The EMIT system provides an inexpensive, yet reliable, drug testing method for screening for a wide variety of drugs. EMIT is highly

accurate, with low false-positive rates.24 Moreover, EMIT has been extensively studied so that

cross-reactivity (the sensitivity of the test to drugs that are not actually being tested for) is well

documented. The ADAM program uses confirmation testing methods only where the EMIT

screening method cannot sufficiently differentiate among drugs that are of interest for policy

purposes. For example, policymakers as well as researchers and practitioners have an interest in

distinguishing between methamphetamine and amphetamine use. EMIT is specific only to

amphetamines as a class of drugs. To determine whether methamphetamine was used, the

ADAM program conducts confirmatory testing on specimens that screen positive for amphetamines.

Sampling

Data are collected from male and female arrestees in 35 jurisdictions in the United States. Respondents represent offenders arrested from all crime categories, including property crimes,

drug crimes, and violent crimes. The ADAM program introduced a new sampling strategy in

2000 that provides representative samples at the county level and greater ability to make site-tosite comparisons. The DUF program collected data using nonprobability sampling.25 ADAM’s

redesigned sampling methodology allows policymakers and planners to generalize ADAM data

to all arrest and booking activity that occurs in the catchment area. Use of probability samples

provides policymakers with more accurate ADAM estimates and allows them to quantify the

uncertainty associated with those estimates. In addition, local policymakers will be able not only

to report the proportion of arrestees testing positive for illegal drugs in their counties, but to

estimate the number of arrestees who would test positive, which is a powerful tool for resource

allocation and planning.

The goal set in establishing sample sizes across sites was to provide an adequate number of cases

to each site so that all sites would have a similar level of precision in estimating the proportion

of arrestees who test positive for a drug. Cases are sampled with known probability of selection

within each 24-hour period (to capture types of cases over the entire day) and on each day of the

week (to capture variation in types of cases over different days). Simple sites with a single facility

in the catchment area can thus collect a random sample of arrestees, determine the proportion
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with the characteristic of interest (e.g., dependency for drugs), and, using data on the total number of arrests in the target area for the data collection period, estimate the number of arrestees

with that characteristic. The sampling problem is little more complicated in sites with just a few

jails. Site staff would sample arrestees from every jail, developing proportionately more cases in

large jails than in small jails. In the case of a few jails, the standard error associated with a given

sample size would be about the same as in places with a single jail. Sites with many booking

facilities, however, have a more complex problem. To capture variation in arrestees across facilities requires that all sites be represented and adequate numbers of cases (representing times and

days as discussed earlier) be collected. For sites with many facilities, this requires clustering or

grouping them in some logical fashion. This clustering of facilities reduces the precision of the

estimates and necessitates collecting a larger sample. In both the simple and complex sites, the

overall number of cases is determined in part by the volume of arrest activity. Sites with fewer

annual arrests but numerous facilities may collect a larger proportion of their total flow than

large, high-volume sites.

The Data Collection Process

Sites collect data on specific populations (adult males, adult females, juveniles) for 2 weeks, four

times a year. Data collection is done quarterly for several reasons. First, quarterly data collection

helps the program maintain access to jail facilities. Quarterly collection is frequent enough that

jail facility staff become familiar with program operations but not so frequent that data collection

becomes intrusive. Because continuous data collection is not practical due to the interference it

would generate, quarterly data collection ensures that interviewers get frequent opportunities

to hone their skills in a live interview environment. Quarterly collection also helps account for

potential seasonal variations in arrest and crime patterns that occur in some sites. One byproduct

of quarterly data collection is that it generates new information more frequently than many

other national data collection programs. Quarterly collection allows policymakers and analysts

to view trends as they develop, potentially permitting earlier intervention against problems that

may occur.

During data collection periods, a random selection of arrestees is approached and asked to participate in the study. Prospective respondents are read an informed consent statement that notes

that no identifying information will be requested and that a urine specimen will be requested at

the end of the interview. Bar code strips are placed on both the interview form and the urine

specimen bottle to ensure that the interview form is matched to the correct specimen. In some

cases where the facility staff permit it, a small incentive, such as a candy bar, is given to respondents who complete the interview. In most sites, more than 80 percent of the individuals approached agree to the interview and, of those, more than 80 percent agree to give the urine specimen. The decision not to collect identifying information is an essential component to achieving

such high response rates. With the knowledge that the interview is anonymous and confidential,

respondents feel more confident in giving honest answers about sensitive topics.

In addition, the ADAM program ensures that interviewers have no potential conflicts of interests

with the respondents. Police officers, whether off duty or on, court workers, and pretrial services

staff are not allowed to be ADAM interviewers. Their job-related duties may present potential
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conflicts of interest with information that may be disclosed during the interview process. Equally

important, respondents may be less likely to want to talk to interviewers they see working around

the jail in other capacities or who they encounter during pretrial release interviews.

At the conclusion of the interview and the collection of the urine specimen, site staff may ask

additional questions of the respondent. It is important that the ADAM interview process be

completed prior to asking supplemental questions so that all ADAM arrestees are exposed to the

same stimulus and interviewed under the same circumstances. These supplemental questions,

called addenda, are usually oriented around a specific topic that policymakers want to address.

Examples of addenda administered in the past include: patterns of acquiring and attitudes about

firearms;26 patterns of acquiring and using crack, powder cocaine, and heroin;27 and patterns of

acquiring and using methamphetamines.28

X. Training Issues

Training is an important component of the ADAM program. The goal of ADAM training is to

convey the practices and procedures required to conduct scientific research surveys to a team of

interviewers. Each ADAM site receives training using a standard curriculum and manual that

addresses basic and advanced interview skills and site operational procedures. The ADAM training covers the issue of maintaining interviewer safety. Interviewer safety is a team effort between

the holding facility personnel and ADAM data collection staff. A key step in the interview process

is securing the arrestee’s informed consent to participate in the study. The training staff review

the concept of informed consent. Each interviewer must understand the principle of informed

consent and should be prepared to secure informed consent from the arrestees. Interviewers are

required to complete and demonstrate competence in basic interviewing skills and an understanding of project operating procedures. Their continued competence is monitored through

quarterly evaluations and site error rates.

ADAM training is conducted by the ADAM national contractor, who works with the local site

directors and interviewers to provide one core training per year per site and enhancement training as needed. NIJ oversees the national contractor and sets priorities for the training program.

XI. National Data Analytic Results

For more than a decade, the DUF/ADAM program has published an annual report of the basic

drug use prevalence findings (based on urinalysis results) for each of its sites. These reports have

shown that the majority of detained arrestees test positive for recent drug use within 48 hours

of their arrest. Interestingly, while drug use in the general U.S. population declined dramatically

in the mid- to late 1980s, drug use rates seemed to rise among criminal offenders, including

arrestees. In Washington, D.C., the first DUF site, the percentage of arrestees testing positive for

any drug (mostly cocaine) rose from 55 percent in 1984 to nearly 75 percent in 1989. Throughout

the 1990s, however, the rates of detected cocaine use among arrestees stabilized. By 1997, the
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rates of arrestees who tested positive for any drug were below their highest levels, although the

rate of cocaine use remained high.

Aside from playing a key role in tracking hardcore drug use (such as cocaine, heroin, and, more

recently, methamphetamine), the ADAM program has provided strong evidence that drug use is

subject to powerful cohort effects. For example, cocaine use has declined for the most recent birth

cohort of arrestees (born in the 1970s and sometimes referred to as “the blunts generation”) but

has remained at high levels for older cohorts (born in the 1950s and 1960s). ADAM’s trend data

show that cocaine-using offenders are getting older. The percentage of 18- to 20-year-old arrestees

who tested positive for cocaine in Los Angeles, for example, dropped from 47 percent in 1988 to

24 percent by 1996. There has not, however, been a corresponding decrease in cocaine use by

older cohorts (age 30 and over). More recently, ADAM data have helped point out the emerging

marijuana epidemic among younger arrestees since the mid-1990s.29 ADAM data have been very

useful for getting drug policymakers to acknowledge this “aging in” and “aging out” process.

The ADAM program has also demonstrated regional variations in the drug problem in the United

States. For example, methamphetamine use continues to be seen primarily in Western U.S. cities.

In 1998, the methamphetamine urinalysis positive rate in San Diego was more than 30 percent, in

Sacramento about 25 percent, in San Jose about 20 percent, in Portland about 20 percent, and in

Los Angeles about 10 percent. There is hardly any methamphetamine use among the East Coast

ADAM sites, but cocaine is a major problem in these sites. In 1998, the cocaine urinalysis positive

rate was more than 50 percent in New York, Atlanta, Philadelphia, and Fort Lauderdale. When

the media began suggesting that methamphetamine use would be the drug epidemic of the 1990s,

ADAM studies demonstrated no material increase.

The ADAM program has been useful in identifying the prevalence of drug use within a hardcore population of youths. Thirteen ADAM sites also collect data from juveniles (Birmingham,

Cleveland, Denver, Indianapolis, Los Angeles, Phoenix, Portland, St. Louis, San Antonio, San

Diego, San Jose, Tucson, and Washington, D.C.). Over the years, DUF and ADAM have found

that the ADAM sample of youths are generally more likely to use “harder” drugs (e.g., cocaine)

than those found in high school samples from the Monitoring the Future study.

The ADAM program has helped many communities understand the dynamics of their local drug

and crime problem. For example, an analysis of opiate use among arrestees in New York City

focused renewed attention on some of the unique elements of New York’s heroin problem. In

Los Angeles, specialized ADAM studies have provided a better understanding of the correlations

between HIV and STDs and drug use among arrestees. ADAM data were also used to distinguish

the differences in use patterns and purchasing practices among crack, powder cocaine, and heroin

in Chicago; Manhattan; Portland, Oregon; San Antonio; San Diego; and Washington, D.C. Finally,

ADAM data are a key component of the local evaluations of the OJP-funded Breaking the Cycle

programs (in Birmingham, Alabama; Jacksonville, Florida; and Tacoma, Washington).
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XII. Policy Implications and Applications of Data

As a policy tool, ADAM has been used to assist a variety of practitioner groups. ADAM can help

law enforcement better understand changes in local drug markets and how to police these markets. ADAM can be used to help treatment providers plan for the number of requests they may

receive for treatment services. The ADAM program has tried to respond to the needs of policymakers by ensuring the information provided is current (ADAM provides more than one data

collection point per year), timely (ADAM quarterly reports are delivered to the sites within

30 days after the ADAM Data Center receives all of the necessary site data), and accessible

(easy-to-read reports).

ADAM data are invaluable to local, State, and national drug policymakers, courts, law enforcement agencies, treatment providers, and prevention specialists as they seek the most effective

and most efficient ways to control illicit drug use and to provide necessary substance abuse treatment. Data collected at ADAM sites inform the decisions of practitioners and policymakers and

are used by the Nation’s top criminal justice, drug control, and substance abuse researchers as

they uncover links between drug abuse, crime, and a variety of other contemporary social issues.

States and localities use ADAM data to better understand the impacts of drug use in individual

communities. ADAM data have proved so useful to states and localities that California, Maryland,

Missouri, and New York have used other funding sources to expand or replicate the ADAM

program. This localized understanding increases the effectiveness of the planning and resource

allocation processes. States often use ADAM data in their applications for Federal treatment

block and formula grants.

National policymakers use ADAM data to assess larger trends and changes in drug use, drug

trafficking, criminal activity, and treatment needs. Many agencies have incorporated ADAM

data into their strategic planning processes. ONDCP uses ADAM data to monitor the problem of

hardcore drug use and ADAM results are central to its Performance Measurement System. CSAT

has used ADAM data in its block grant allocation process and is considering funding programs

that correspond to the ADAM protocols to assess local treatment needs. DEA has used ADAM

data to guide its efforts in allocating agents to drug hotspots. ADAM data have been linked to

the DEA STRIDE (System To Retrieve Information from Drug Evidence) data set to demonstrate

that higher illicit drug prices reduce demand for illicit drugs among arrestees. ADAM data are a

routine component in the National Institute of Drug Abuse’s Community Epidemiology Work

Group’s assessment of drugs and drug abuse in America’s communities. Other Federal users of

ADAM data include the Senate Judiciary Committee, the Congressional Budget Office, the

National Institutes of Health, the National Drug Intelligence Center, the Bureau of Alcohol,

Tobacco and Firearms, and the CDC.

ADAM data are used in a variety of different capacities in a variety of different settings. Between

1995 and 1999, more than 100 articles, projects, and presentations using ADAM data were reported

to NIJ. This count does not include the multitude of studies, projects, and reports that cite data

from ADAM’s annual report or the citations of ADAM data in support of local, State, or Federal

program or policy initiatives. The following list illustrates some of the ways ADAM data have

affected policymaking, program implementation, resource allocation, and the overall understanding of drugs and crime:
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• In Louisiana, State legislation on pretrial drug testing programs was passed in part due to the

findings of the ADAM program.

• In Oklahoma City, Oklahoma, the County Community Sentencing Commission used ADAM

data to determine the extent of drug use among arrestees before implementing a $4.7 million

strategy to take over probation from the State.

• In Indianapolis, Indiana, a special committee convened by the mayor’s office that included law

enforcement, court officials, and service providers used ADAM data in developing a plan to

address prostitution and drug and crime issues.

• In Omaha, Nebraska, the Nebraska Crime Commission and the U.S. Attorney, in response to

legislation, commissioned a special research project to assess the growing methamphetamine

problem. The findings of this project are being used by the Nebraska State Wide Substance

Abuse Treatment Task Force to assess the need for treatment and by other organizations and

agencies as they plan responses to drug use issues.

• San Diego, California, continues to use ADAM data to provide direction for its methamphetamine task force.

• In Philadelphia, Pennsylvania, ADAM data guide the deployment of city police officers.

• ADAM data play a key role in direction taken by the Methamphetamine Interagency Task

Force, chaired by the Attorney General and the Director of ONDCP.

• ADAM data have been used to determine the effects of policing strategies in reducing drug

use and associated criminal activity. In New York City, data were used to assess the effects of

“quality of life” enforcement by the New York Police Department.

• CSAT’s Substance Abuse Need for Treatment Among Arrestees (SANTA) project used

ADAM as its core protocol in early efforts to develop statewide needs assessments.

• Cleveland, Ohio, uses ADAM data in specialized treatment programs for prostitutes.

• Cook County (Chicago), Illinois, and Orleans Parish (New Orleans), Louisiana, use ADAM

data in their arrested and pretrial drug testing programs.

Notes

1. Federal Bureau of Investigation, Crime in the United States 1998: Uniform Crime Reports,

Washington, DC: U.S. Department of Justice, Federal Bureau of Investigation, 1999.

2. Rennison, C.M., Criminal Victimization 1998: Changes 1997–98 With Trends 1993–98,

Washington, DC: U.S. Department of Justice, Office of Justice Programs, Bureau of Justice

Statistics, 1999, NCJ 176353.

3. Substance Abuse and Mental Health Services Administration, Summary of Findings From the

1998 National Household Survey on Drug Abuse, Washington, DC: U.S. Department of Health and

Human Services, Substance Abuse and Mental Health Services Administration, Office of Applied

Studies, 1999.

4. Ibid.
164

I–ADAM in Eight Countries: Approaches and Challenges

5. Johnston, L.D., P.M. O’Malley, and J.G. Bachman, Monitoring the Future: National Survey Results

on Drug Use, 1975–1999. Volume I: Secondary School Students, Bethesda, MD: U.S. Department of

Health and Human Services, National Institutes of Health, National Institute on Drug Abuse,

2000, NIH publication 00–4802.

6. Clear, T.R., and G.F. Cole, American Corrections, 5th ed., Belmont, CA: Wadsworth Publishing

Company, 2000.

7. Maguire, K., and A.L. Pastore, eds., Sourcebook of Criminal Justice Statistics, 1998, Washington,

DC: U.S. Department of Justice, Office of Justice Programs, Bureau of Justice Statistics, 1999,

NCJ 176356.

8. In fiscal year 1999, only 33 percent of the Federal drug budget was allocated to prevention and

treatment; 67 percent was allocated to supply-side programs. Office of National Drug Control

Policy, 1999 National Drug Control Strategy Budget Summary, Washington, DC: Executive Office

of the President, Office of National Drug Control Policy, 1999.

9. Office of National Drug Control Policy, 1999 National Drug Control Strategy, Washington, DC:

Executive Office of the President, Office of National Drug Control Policy, 1999.

10. Ibid.

11. Ibid.

12. Wish, E.D., Drug Use Forecasting: New York 1984 to 1986, Research in Action, Washington, DC:

U.S. Department of Justice, Office of Justice Programs, National Institute of Justice, NCJ 107272.

13. Toborg, M.A., and M.P. Kirby, Drug Use and Pretrial Crime in the District of Columbia, Research

in Brief, Washington, DC: U.S. Department of Justice, Office of Justice Programs, National

Institute of Justice, 1984, NCJ 94073; Wish, Drug Use Forecasting (see note 12).

14. Reardon, J.A., The Drug Use Forecasting Program: Measuring Drug Use in a “Hidden” Population,

Research Report, Washington, DC: U.S. Department of Justice, Office of Justice Programs,

National Institute of Justice, 1993, NCJ 144784.

15. Carver, J., Drugs and Crime: Controlling Use and Reducing Risk Through Testing, Research in

Action, Washington, DC: U.S. Department of Justice, Office of Justice Programs, National

Institute of Justice, 1986, NCJ 102668.

16. Wish, Drug Use Forecasting (see note 12).

17. Ibid.

18. Some States, such as Alaska, do not have counties or comparable units of government. In

those States, the catchment area is defined by the city or municipal boundaries. The New York

City site includes all five boroughs of the city, which are five separate counties.

19. Riley, K.J., N.T. Lu, and B.G. Taylor, “Drug Screening: A Comparison of Urinalysis Results

From Two Independent Laboratories,” Journal of Drug Issues 30 (1) (2000): 171–186.
165

United States of America

20. U.S. General Accounting Office, Drug Use Measurement: Strengths, Limitations, and

Recommendations for Improvement, Washington, DC: U.S. General Accounting Office, 1993, 

GAO report PEMD–93–18.

21. The National Institute of Justice funds most basic and evaluative research through extramural grants and broad investigator-initiated solicitations or directed solicitations related to such

Crime Act initiatives as community policing, violence against women, boot camps/prisons, or

drug courts. NIJ also funds intramural research by NIJ staff researchers. NIJ was created by the

Omnibus Crime Control and Safe Streets Act of 1968 and was founded in 1968 within the Law

Enforcement Administration Agency.

22. Riley, K.J., Crack, Powder Cocaine, and Heroin: Drug Purchases and Use Patterns in Six U.S. Cities,

Research Report, Washington, DC: U.S. Department of Justice, Office of Justice Programs, National

Institute of Justice, and Executive Office of the President, Office of National Drug Control Policy,

1997, NCJ 167265.

23. Arrestee Drug Abuse Monitoring Program, 1998 Annual Report on Drug Use Among Adult and

Juvenile Arrestees, Research Report, Washington, DC: U.S. Department of Justice, Office of Justice

Programs, National Institute of Justice, 1999, NCJ 175656.

24. Frederick, D.L., J. Green, and M.W. Fowler, “Comparison of Six Cannabinoid Metabolite

Assays,” Journal of Analytical Toxicology 9 (3) (1985): 116–120; Jones, D.W., D. Adams, P.A. Martel,

and R.J. Rousseau, “Drug Population in One Thousand Geographically Distributed Urine

Specimens,” Journal of Analytical Toxicology 9 (3) (1985): 125–130; Willson, N.J., M.J. Kogan, D.J.

Pierson, and E. Newman, “Confirmation of EMIT Cannabinoid Assay Results by Bonded Phase

Adsorption With Thin Layer Chromatography,” Journal of Clinical Toxicology 20 (5) (1983):

465–473; Verebey, K., S.J. Mule, J. Alrazi, and J. Lehr, “One Hundred EMIT Positive Cannabinoid

Urine Samples Confirmed by BPA/TLC, RIA, and GC/MS,” Journal of Analytical Toxicology 10 (2)

(1986): 79–80; Weaver, M.L., B.K. Gan, E. Allen, L.D. Baugh, F.Y. Liao, R.H. Liu, J.G. Langner,

A.S. Walia, and L.F. Cook, “Correlations on Radioimmunoassay, Fluorescence Polarization

Immunoassay, and Enzyme Immunoassay of Cannabis Metabolites with Gas Chromatography/

Mass Spectrometry Analysis of 11-Nor-Delta-9-Tetrahydrocannabinol-9-Carboxylic Acid in

Urine Specimens,” Forensic Science International 49 (1) (1991): 43–56; Dextraze, P., W.C. Griffiths,

P. Camara, L. Audette, and M. Rosner, “Comparison of Fluorescence Polarization Immunoassay,

Enzyme Immunoassay, and Thin-Layer Chromatography for Urine Cannabinoid Screening.

Effects of Analyte Adsorption and Vigorous Mixing of Specimen on Detectability,” Annals of

Clinical Laboratory Science 19 (2) (1989): 133–138; Fenton, J., M. Schaffer, N.W. Chen, and E.W.

Bermes, Jr., “A Comparison of Enzyme Immunoassay and Gas Chromatography/Mass

Spectrometry in Forensic Toxicology,” Journal of Forensic Science 25 (2) (1980): 314–319.

25. Evidence suggests that DUF program interviewee samples were fairly representative of their

populations. A 1993 study that investigated the sampling method used by the DUF program concluded that “the current DUF procedures appear to select a sample of interviewees that is highly

representative of the arrestees who are detained in the particular booking centers where the DUF

program operates” (Chaiken, J.M., and M.R. Chaiken, “Understanding the Drug Use Forecasting

(DUF) Sample of Adult Arrestees,” unpublished report prepared for the U.S. Department of

Justice, National Institute of Justice, Washington, DC, 1993, p. 45). The authors of the study note,
166

I–ADAM in Eight Countries: Approaches and Challenges

however, that the samples are not wholly representative of all UCR arrestees because the DUF

selection procedures rule out minor offenses.

26. Decker, S.H., S. Pennell, and A. Caldwell, Illegal Firearms: Access and Use by Arrestees,

Washington, DC: U.S. Department of Justice, Office of Justice Programs, National Institute of

Justice, 1997, NCJ 163496.

27. Riley, Crack, Powder Cocaine, and Heroin (see note 22).

28. Pennell, S., J. Ellett, C. Rienick, and J. Grimes, Meth Matters: Report on Methamphetamine Users

in Five Western Cities, Research Report, Washington, DC: U.S. Department of Justice, Office of

Justice Programs, National Institute of Justice, 1999, NCJ 176331.

29. Golub, A., and B. Johnson, “The Marijuana Upsurge,” unpublished final report submitted

to the U.S. Department of Justice, Office of Justice Programs, National Institute of Justice,

Washington, DC, 2000.
167

CONCLUDING THOUGHTS

Henry H. Brownstein

Henry H. Brownstein is the director of the Drugs and Crime Research Division of the National Institute of Justice.

On a political level, the problem of drug using and trafficking is an international problem. In

terms of social welfare and public health and safety, the problems associated with drug using and

trafficking are local problems. That apparent paradox is precisely what makes the International

Arrestee Drug Abuse Monitoring (I–ADAM) program so interesting and valuable. In participating

nations, I–ADAM provides data about local problems with drugs and crime and offers an international context through which to understand and explain those local problems as they relate to

the global drug problem.

For 3 days in September 2000, representatives of 11 different countries from 6 different continents

met in Washington, D.C., at an I–ADAM conference sponsored by the National Institute of Justice

of the U.S. Department of Justice. Present were researchers and policymakers actively working on

ADAM-type programs in their own nations and researchers and policymakers from nations that

were considering the development and implementation of such a program.

For 3 days, those present at the third annual I–ADAM meeting in Washington talked about the

status of the project in their own countries, data availability and the potential for sharing data,

the data collection instrument and how it could be improved, the different laboratory methods for

drug testing, and the future of the I–ADAM program. In turn, participants spoke about what they

were learning about drug use among arrestees in their own countries. To the extent possible, findings from data analysis in each country were presented and shared. What was remarkable was

how similar and yet how different were the problems and concerns in different nations.

Sharing Information

The different drug problems of different nations were plainly delimited in presentations at the

I–ADAM meeting in September 2000. Everyone at the meeting agreed that data from an ADAMtype program provides useful information that can inform local policy and practice. It also became

clear, however, that given different systems of criminal justice in different nations, each nation

faces its own limitations and difficulties in establishing and operating an ADAM-type program.
168

I–ADAM in Eight Countries: Approaches and Challenges

Representatives from nations with existing ADAM-like programs and those from nations considering or planning such programs indicated similar levels and types of interest in the program.

Vicknasingam Balasingam in Malaysia, where the program is “in its infancy,” noted that his minister of justice and the local police chief supported a program that would substantiate claims that

crimes are committed by drug addicts and provide information to local health and enforcement

agencies. In Taiwan, where the program is still in the planning stage, Shu-Yu Lyu reported that it

has support from the Ministry of Justice, the National Police Administration, the Department of

Health, and the Ministry of Foreign Affairs. Daleen Lock reported that the South Africa ADAM

(SA–ADAM) program, which was piloted in 1996, has been found useful by the police for narrowing the focus of their efforts to deal with the problems of drugs and crime.

According to the I–ADAM presentations, of all illicit substances used by people in all nations

of the world, marijuana in one form or another is the drug that is most commonly used by

arrestees throughout the world. For example, Toni Makkai reported that, in Australia’s Drug

Use Monitoring in Australia (DUMA) sites, from 50 to 66 percent of all arrestees tested positive

for cannabis, 40 percent tested positive for opiates in Sydney sites, and 20 percent tested positive

for opiates in East Perth and Southport. Luis Caris reported that in Chile, alcohol was the primary

drug used by arrestees, but of all illicit drugs, marijuana was used most often (by 30 percent of

arrestees).

Although some drug problems are commonly shared by many nations, others are peculiar to

particular countries. Trevor Bennett reported that in England, across the sites in the NEW–ADAM

program (New England and Wales ADAM), from 14 to 50 percent of arrestees tested positive

for opiates. In South Africa, Andreas Plüddemann reported that, similar to other nations, from

36 to 44 percent of arrestees tested positive for cannabis. However, from 19 percent to 25 percent of arrestees in South Africa tested positive for mandrax, a blend of methaqualone and

antihistamine that is rarely, if ever, found being used by arrestees in other nations. Neil

McKeganey reported that, in Scotland, drug injection is a particularly serious problem. Apinum

Aramrattana reported that the main problem in Thailand is opiates.

In addition to the similarities and differences in findings, those present also reported differences and similarities in terms of the methodologies nations use and the problems they have in

implementing I–ADAM. For example, in all countries people commit crimes and are arrested

and booked without regard to the time, yet in most countries, including the United States, it is

not possible to conduct interviews 24 hours every day. In England, interviews are collected for

24 hours, but it is not unknown for a respondent to doze off during an interview (this may be

due to the high proportion who test positive for opiates). Gina Weir-Smith reported that

SA–ADAM researchers in South Africa have been combining databases using artificial intelligence to try to develop strategies for extrapolation of findings to the whole nation. Natalie Lu

of the U.S. ADAM program reported on the results of an experiment that showed that different

laboratory tests used by different nations for testing urine for drugs produce similar results.

Writing chapters for this compendium offered researchers working on ADAM-like programs

around the world an opportunity to focus on their own programs in the context of their national

system of criminal justice. Consequently, many of the same researchers who spoke at the I–ADAM
169

Concluding Thoughts

conference were able, for this compendium, to provide greater detail and more insight into the

operation and output of their ADAM effort. The result is that a number of patterns or themes

about both drug problems and the study of drug problems in different nations can begin to

be seen.

Each chapter in this compendium outlines the character and principles of the criminal justice

system in that nation, the processes and problems of establishing an ADAM-like program, and to

the extent they are available, findings and policy implications of the effort to date. For example,

in Australia there is no central facility for detainees in Sydney, one laboratory is used to conduct

EMITTM (enzyme multiplied immunoassay testing) testing of urine samples, and arrestees who

test positive for substance use most commonly test positive for cannabis and opiates. In Chile,

where nurses from the Ministry of Health conduct the interviews, arrestees most often test

positive for alcohol, marijuana, and coca paste (more often than they do for powder cocaine).

In England and Wales, tests are most often positive for cannabis, alcohol, opiates, and, to a lesser

extent, cocaine, and about 23 percent of arrestees admit to having ever injected at least one substance. Malaysia has yet to implement its planned ADAM program, but it will do so in a nation

with laws that are particularly tough with regard to drug dealers. In the Netherlands, where

drug policy is focused on health issues, arrestees most often have been found to be using

cannabis or cocaine at the time of their arrest. In Scotland, where the local police have been

actively involved in the program from the beginning, opiates seem to be a problem. In South

Africa, where the criminal justice system is administered nationally, the problem drugs among

arrestees appear to be marijuana and mandrax. In the United States, where ADAM programs are

operating in numerous sites around the country, marijuana appears to be used by large proportions of arrestees in most all sites and there appears to be regional variation in the use of other

drugs.

Generally, the chapters in this compendium show that researchers in those nations where

I–ADAM programs have been implemented or planned typically have found high levels of

interest in the program among policymakers and practitioners in the areas of criminal justice

and public health. At the same time, most are experiencing problems identifying and securing

adequate funding to support an ongoing program. All must deal with collecting data in an

environment that is inherently hectic, and all must be able to work with local law enforcement

and correctional officials to ensure that the local ADAM program operates in a way that benefits

the community without disrupting the ongoing operation of the local jail. Finally, all must be

able to produce findings that can be translated into conclusions that are interesting and valuable

to the local community. 

Moving Forward

I–ADAM is a network of researchers from various nations working together to address problems

in each of their countries that are unique in some ways yet common in others. The drug problem

is global, yet the problems associated with drugs in individual nations are distinctive to the political, social, and cultural life of that nation. Through statistical modeling, I–ADAM can produce
170

I–ADAM in Eight Countries: Approaches and Challenges

some interesting comparisons about drug use among arrestees in different countries. I–ADAM

allows researchers to inform policymakers and practitioners in their own countries about the

problems of drugs and, in turn, to be informed by an international community of researchers

who are committed to addressing those same problems in their own countries.

On the last day of the 2000 I–ADAM meeting in Washington, D.C., everyone at the table came to

recognize the same potential for the program. The focus of the meeting turned to finding ways

that the researchers involved in these efforts could begin to communicate with each other more

routinely and more broadly. The result was the formation of a number of what might be called

“international cybercommittees.” Those present all agreed at some level to participate through

the Internet as a member of such a committee in one or more areas. On an organizational level,

one group would consider strategic planning and coordination, a second methods and technical

support, and a third publications and dissemination. A mission was identified for each group.

It was decided that the mission of the strategic planning and coordination group was to ensure

the future development and policy relevance of the work of I–ADAM, and the connectedness

of the mutual efforts to national goals. To these ends, in the months following the meeting, several researchers from a variety of involved nations began to consider common themes for cooperative study (e.g., violence and drugs) and different ways to communicate. These themes and

plans will be integrated into the planning for the next I–ADAM meeting.

The methods and technology group established a multifaceted mission that included helping

I–ADAM participating nations and others planning to participate through advice, research

design support, encouragement, facilitation of implementation, promotion of common methods,

and mutual planning. In effect, there were two ideas. One was to find within the context of each

national I–ADAM effort something that several, if not all, nations could do in the same way

that would allow an international comparison. For example, following the meeting, one member

of the group proposed expanding the current core instrument so comparisons could be done.

The second idea was to ensure that participating nations share what they have learned with

other nations planning to start an I–ADAM program. This is being done through meetings and

through e-mail communications.

Perhaps the most work is being accomplished in the area of publication and dissemination. The

mission of the publications and dissemination group at the meeting was defined in terms of

planning, encouragement, and promotion of information from I–ADAM that addresses the

problems of drugs and crime. This compendium is certainly an important step in disseminating

the information that is being learned from I–ADAM. There are others as well. A number of

I–ADAM researchers have published reports and articles from findings in their own countries that

are shared with researchers in other nations. In addition, since the meeting in Washington, a number of researchers have been regularly communicating by e-mail to plan joint publications. Trevor

Bennett and Bruce Taylor have been working together to prepare a multiyear publication plan.
171

Concluding Thoughts

In reality, it is not easy for people from different countries with obligations in their own nations

to not only communicate but also plan and cooperate to do things beyond the scope of their

normal responsibilities. In that sense, the progress of I–ADAM planning may be moving more

slowly than one would like. But in that same sense, it is remarkable that anything is getting done.

The fact that plans and publications exist is a tribute to the commitment of the people who are

involved in I–ADAM. Ultimately, I–ADAM is a fragile multinational network of people who

share a common interest in the problem and problems of drugs and are trying to work together

to do something about it.
APPENDIX A

MODEL I–ADAM 

SURVEY INSTRUMENT
175

[sponsoring agency]

ADULT I–ADAM INTERVIEW

English Language Version

DRAFT

NOTICE: Information contained on this form that would permit identification of any individual or

establishment has been collected with a guarantee that it will be held in strict confidence, will be used

only for purposes stated for this study, and will not be disclosed or released to others without the

consent of the individual or the establishment in accordance with [cite relevant legislation]

Collection of information is estimated to average 15 minutes per interview. Send comments 

regarding this estimate or any other aspect of this collection of information, including suggestions 

to [cite relevant contact]

INTERVIEW DATE 

___ ___/___ ___/___ ___

month / date / year 

SITE ID #

___ ___ ___

ANONYMOUS STUDY ID#

[PLACE BARCODE STICKER HERE]

INFORMATION FROM RECORDS

(COMPLETE BEFORE APPROACHING ARRESTEE)

Year of Birth: ____ ____

Sex: 1 - Male 2 - Female

Ethnicity Information: [use locally appropriate categories]

1 - 2 - 3 - 4 -

5 - 6 - Other: Specify _______________________________

Precinct/location of arrest: _________________

Location of arrest postal code: ___ ___ ___ ___ ___

If not postal, specify nearest intersection to arrestee’s residence: ______________________________ and ______________________________________________

Arrestee’s residence postal code: ___ ___ ___ ___ ___

If not postal, specify nearest intersection to arrestee’s residence: ______________________________ and ______________________________________________

Was the person charged with a warrant only? 0 - NO 1 - YES

Was the person charged with a probation/parole/release on own recognizance violation? 0 - NO 1 - YES

Booking Facility code: 1 2 3 4 5 6 7 8 9 0

Charge Code

(WRITE IN CHARGE, WITH NO ABBREVIATIONS) (from list below) Penal Law Code Misd Felony Status

Most serious charge: _________________________________________ ______________ _____________ M F S

Second most serious charge: ___________________________________ ______________ _____________ M F S

Third most serious charge: ____________________________________ ______________ _____________ M F S

VIOLENT OFFENSES

1.01 Assault

1.02 Blackmail/Extortion/Threat

1.03 Kidnapping

1.04 Manslaughter by negligence

1.05 Murder/Homicide (Non-negligent

Manslaughter)

1.06 Robbery

1.07 Sexual Assault/Rape by force

1.08 Weapons

1.09 Domestic Violence

1.10 Child Abuse

1.11 Spouse/Partner Abuse

1.12 Child Neglect

1.13 Violation of Protection Order
176

DRUG/ALCOHOL RELATED OFFENSES

2.01 Driving While Intoxicated/

Driving Under the Influence

2.02 Drug Possession

2.03 Drug Sale

2.04 Liquor violation

2.05 Possession of alcohol

2.06 Under the influence of a Controlled

Substance

PROPERTY OFFENSES

3.01 Arson

3.02 Bribery

3.03 Burglary

3.04 Burglary Tools

3.05 Damage/Destroy Property

3.06 Forgery

3.07 Fraud

3.08 Larceny/Theft

3.09 Stolen Property

3.10 Stolen Vehicle

3.11 Trespassing

MISCELLANEOUS OFFENSES

5.01 Commercial Sex/Prostitution

5.02 Embezzlement

5.03 Fare Beating

5.04 Flight/Escape/Bench Warrant

5.05 Gambling

5.06 Obscenity (e.g., indecent exposure)

5.07 Obstructing Police/Resisting Arrest

5.08 Other (specify above)

5.09 Public Peace/Disturbance/Mischief/

Reckless Endangerment

5.10 Pickpocket/Jostling

5.11 Other Sex Offenses

5.12 Unspecified Probation/Parole/ROR

Violation

NOTE: INTERVIEWER INSTRUCTIONS ARE IN CAPITAL LETTERS. READ ANSWER CHOICES TO THE RESPONDENT ONLY WHEN

INSTRUCTED TO DO SO. EVERYTHING ELSE IN LOWER CASE OR INITIAL CAPS MUST BE READ TO RESPONDENT. USE PEN, NOT

PENCIL TO COMPLETE INTERVIEW. 

Interviewer’s Initials: ___ ___ INTERVIEW START TIME __ __ : __ __ [ ] AM [ ] PM

READ AS WRITTEN: This interview is part of a [x-agency] funded study.

Your participation is voluntary. The information you provide is confidential

and anonymous and it will not help or hurt your case. At the end of the

interview I will ask you to provide a urine sample. Can we begin the

interview now?

(CIRCLE ONE)

1 Agreed to interview

2 Declined

3 Not available (ill, asleep, taken to court)

4 Other reason not interviewed (Specify) _______________________________

THE INTERVIEW SHOULD ONLY BE CONDUCTED IN THE

LANGUAGE USED ON THE FORM. CIRCLE THE CORRECT

NUMBER AT THE RIGHT:

(CIRCLE ONE)

1 Interview conducted in the language on this form

2. No form in appropriate language (specify language needed)

_________________

3 No interviewer available to conduct the interview in the appropriate language

4 Other (specify)

1. What day and what time were you arrested? ___ ___ / ___ ___ __ __ : __ __ AM PM

DAY MONTH 

CALCULATE # OF HOURS. IF MORE THAN 48 HOURS AGO, TERMINATE INTERVIEW

___ ___ HOURS AGO

2. What is the highest grade in school you have completed? ___ ___ 

EXAMPLES: NEVER ATTENDED SCHOOL =00; 9TH GRADE=09;

H.S./SECONDARY GRAD =12; 1 YEAR COLLEGE=13;

3. Did you graduate from secondary school/high school or get a 

certificate equal to secondary school?

(CIRCLE ONE)

0 NO

1 YES, SECONDARY SCHOOL (SKIP TO Q5)

2 YES, RECEIVED A CERTIFICATE (SKIP TO Q5)

4. Are you currently in secondary school/high school, college or some

other training or education program?

(CIRCLE ONE)

0 NO

1 YES

5. What is your current marital status? (READ ALL CATEGORIES, CIRCLE ONE)

1 Single, and have never been married

2 Married

3 Separated or divorced

4 Widowed
177

6. In the last 30 days, where did you live most of the time? (READ ALL CATEGORIES, CIRCLE ONE)

1 In your own house or apartment

2 In someone else’s house or apartment 

3 In a shelter or emergency housing (SKIP TO Q9)

4 In jail or prison? (SKIP TO Q9)

5 In a halfway house or honors facility? (SKIP TO Q9)

6 In a drug or alcohol treatment program? (SKIP TO Q9)

7 On the street or no fixed address? (SKIP TO Q9)

7. Do you live in subsidized housing? That is, where you or your

family qualifies for reduced housing payments or financial 

assistance based on your income?

(CIRCLE ONE)

0 NO

1 YES

9 DON’T KNOW

9. How many children have you [given birth to/fathered]? _____ NUMBER OF BIOLOGICAL CHILDREN

11. How much money did you get from your family or friends in the

past 30 days?

(Total in local currency units) _______________

8. In the last 30 days, how many people have lived in your household

on a regular basis, including yourself? (1= SELF, IF GREATER

THAN 1 ASK 8A)

A. IF ARRESTEE SAYS MORE THAN ONE, ASK—

How are they related to you?

TOTAL NUMBER OF PEOPLE IN HOUSEHOLD

INCLUDING THE RESPONDENT: ___ ___

_____ 1 MOTHER/STEPMOTHER

_____ 2 FATHER/STEPFATHER

_____ 3 SPOUSE

_____ 4 BOY/GIRLFRIEND

_____ 5 BIOLOGICAL CHILDREN

_____ 6 ADOPTED OR STEPCHILDREN

_____ 7 OTHER RELATIVES

_____ 8 CHILDREN OF BOYFRIEND/GIRLFRIEND

_____ 9 FRIENDS/ROOMMATES/OTHER UNRELATED

(CIRCLE ALL THAT ARE MENTIONED AND GIVE THE NUMBER OF EACH)

10. We are interested in knowing the kinds of things you did to get 

money in the last 30 days. 

ASK FOR EACH INCOME TYPE, A - D

Did you receive money from (INCOME SOURCE) in the last 

30 days?

CIRCLE YES OR NO FOR EACH TYPE

A. IF ANY CATEGORY IS ANSWERED YES—

How much did you earn from all legal sources during the past 

30 days [Include the value of government payments plus the net 

value of any job earnings.]

NO YES

A. Welfare or other regular government payment? 0 1

B. Working full time the whole month? 0 1

C. Working part time or doing odd-jobs? 0 1

D. Other means? (SPECIFY) 0 1

________________________ 

(Total in local currency units) _______________

12. We’re also interested in knowing the kinds of illegal things

you did to get money in the last 30 days. 

ASK FOR EACH INCOME TYPE, A - D

Did you earn money from (INCOME SOURCE) in the past 30 days? 

CIRCLE THE CODE FOR YES OR NO FOR EACH TYPE

A. IF ANY CATEGORY IS ANSWERED YES—

How much were your earnings or profits from all illegal sources

during the past 30 days?

(Use local terms as appropriate) NO YES

A. Prostitution or hustling? 0 1

B. Dealing, growing or manufacturing drugs? 0 1

C. Doing other illegal things such as stealing,

selling stolen property or running scams? 0 1

D. Other means? 0 1

Specify ________________________ 

(Total in local currency units) _______________
178

13. DRUG GRID

(CIRCLE "0" FOR NO AND "1" FOR YES) 

AGE_________ 

(CALCULATE FROM Y.O.B. AND 

VERIFY WITH ARRESTEE)

AlcoholTobacco MarijuanaCrackPowder CocaineHeroin, Black Tar, Dilaudid, Morphine (opiates)PCP/Angel DustAmphetamines/SpeedDowners/BarbituratesQuaaludes/LudesMethdoneCrystal Meth.Valium or other TranquilizersLSD/AcidInhalents

11. Have you ever tried any of the following 

drugs? (READ ALL DRUGS) 0 1 0 1 0 1 0 1 0 1 0 1 0 1 0 1 0 1 0 1 0 1 0 1 0 1 0 1 0 1

PROCEED DOWN THE COLUMN FOR 

EACH DRUG THE ARRESTEE EVER 

TRIED

12. When you first tried (NAME DRUG) 

how old were you?

13. Have you used (NAME DRUG) during 

the last 12 months? 0 1 0 1 0 1 0 1 0 1 0 1 0 1 0 1 0 1 0 1 0 1 0 1 0 1 0 1 0 1

IF NO, SKIP TO QUESTION 18 

(SKIP MAY DIFFER FOR EACH DRUG)

14. In the past 3 days did you use (NAME 

DRUG)? 0 1 0 1 0 1 0 1 0 1 0 1 0 1 0 1 0 1 0 1 0 1 0 1 0 1 0 1 0 1

15. How many days did you use (NAME 

DRUG) in the past 30 days?

16. During the past 12 months, have you 

consciously tried to cut down or quit using 

(NAME DRUG) on your own? 0 1 0 1 0 1 0 1 0 1 0 1 0 1 0 1 0 1 0 1 0 1 0 1 0 1 0 1 0 1

A. If yes, were you successful? 0 1 0 1 0 1 0 1 0 1 0 1 0 1 0 1 0 1 0 1 0 1 0 1 0 1 0 1 0 1

17. Have you felt that you needed or were 

dependent on (NAME DRUG) in the past 

12 months? 0 1 0 1 0 1 0 1 0 1 0 1 0 1 0 1 0 1 0 1 0 1 0 1 0 1 0 1 0 1

18. Are you now receiving treatment or detox 

for (NAME DRUG)? 0 1 0 1 0 1 0 1 0 1 0 1 0 1 0 1 0 1 0 1 0 1 0 1 0 1 0 1 0 1

19. Have you received treatment or detox for 

(NAME DRUG) in the past? 0 1 0 1 0 1 0 1 0 1 0 1 0 1 0 1 0 1 0 1 0 1 0 1 0 1 0 1 0 1

20. Do you feel you could use treatment for 

(NAME DRUG)? 0 1 0 1 0 1 0 1 0 1 0 1 0 1 0 1 0 1 0 1 0 1 0 1 0 1 0 1 0 1

14. Are there any other drugs that you have used illegally in the past 

30 days?

(CIRCLE ONE)

0 NO

1 YES (Specify) ________________________________________

15. Now I am going to ask about your experience with drug and alcohol treatment.

A. Have you ever participated in a

[TREATMENT TYPE] program?

(Use locally appropriate treatment

types)

(IF YES)

B. How many times

have you entered a

[TYPE] program?

C. Are you currently in [TYPE]?

(IF NO) What year were you most

recently in [TYPE]?

D. What type of substance abuse (including alcohol) [are/were] you mainly being

treated for [the most recent time you were

in treatment]?

TYPE A. EVER

NO YES YES YEAR

B. # OF TIMES C. CURRENTLY/YR D. TYPE OF SUBSTANCE

Detox

Residential

Outpatient

Methadone Maint.

Self Help (AA, CA)

Spiritual or Religious
179

16. Had you been drinking alcohol when you got involved in the 

activities for which you were just arrested?

(CIRCLE ONE)

0 NO

1 YES

19. Have you ever made money or obtained drugs by selling illegal

drugs or being involved in the manufacture or transportation 

of drugs?

(CIRCLE ONE)

0 NO

1 YES

17. Had you recently used any illegal drugs when you got involved in

the activities for which you were just arrested? 

A. What drug(s) had you used?

CIRCLE ONE)

0 NO (SKIP TO Q. 18)

1 YES

(CIRCLE ALL THAT APPLY)

1. Marijuana

2. Cocaine/Crack/Cocaine paste

3. Heroin/opiates

4. Amphetamines

5. Other (Specify) _______________________

18. Had you been looking for, or trying to buy or sell, any illegal 

drugs when you got involved in the activities for which you were 

just arrested?

A. What drug(s) had you used?

20. During the past 12 months, have you been arrested and booked 

for breaking a law, whether or not you were guilty?

(CIRCLE ONE)

0 NO (SKIP TO Q. 23)

1 YES

21. How many times have you been arrested in the past 12 months? ___ ___ NUMBER OF ARRESTS

22. What were the arrest charges?

CIRCLE ONE)

0 NO (SKIP TO Q. 19)

1 YES

(CIRCLE ALL THAT APPLY)

1. Marijuana

2. Cocaine/Crack/Cocaine paste

3. Heroin/opiates

4. Amphetamines

5. Other (Specify) _______________________

The next several questions are about previous arrests, not including the arrest for which you are here now.

23. In the past 12 months, have you served time in jail or prison on 

a sentence?

INTERVIEW COMPLETION TIME ___ ___: ___ ___ [ ] AM [ ] PM 

Now I need for you to take this specimen container to [DESIGNATED AREA] and provide a urine specimen. 

SPECIMEN (AFTER ANY ADDITIONAL QUESTIONS/ADDENDA) WAS: 

0 Refused/did not try 1 Provided 2 Tried/could not produce specimen

(CIRCLE ONE)

0 NO

1 YES

24. How would you describe your racial or ethnic background? 

Please answer “yes” or “no” to each of the following . You can

answer “yes” to more than one . Do you consider yourself to be?

(Use racial/ethnic groupings appropriate to local situation)

1. 2. 

3. 4.

5. 6.

7. 8.
APPENDIX B

DEMOGRAPHIC,

ECONOMIC, AND

DRUG INFORMATION

BY COUNTRY
182

I–ADAM in Eight Countries: Approaches and Challenges

Exhibit B–1. General Demographic Information for I–ADAM Countries

Australia Chile England and Wales Malaysia

Geographic area 7,692,030 km2 756,950 km2 145,915 km2 330,113 km2

(3,076,812 mi2) (302,780 mi2) (58,366 mi2) (132,045 mi2)

Political subdivisions 6 States and 13 regions (Regions England: 39 counties, 13 States and 

2 Territories I–XII and Santiago 7 metropolitan counties; 2 Federal Territories 

Municipal Region) Wales: 8 counties

Estimated population 19.1 million 15,153,797 51.1 million 23.3 million

Population by racial or 92% white, 5.9% 95% white/white- 94.0% white, 2.9% 58.1% Malay, 24.3% 

ethnic origin Asian, 2.1% aboriginal/ Amerindian, South Asian, 1.8% black, Chinese, 6.9% Indian, 

indigenous (24% born 3% Amerindian, 0.7% East Asian, 3.2% other, 7.5% 

outside Australia) 2% other 06% other noncitizens

Religious affiliation 50.4% Protestant, 89% Roman Catholic, 48% Protestant, Islam (official religion), 

26% Roman Catholic, 11% Protestant, 15% Roman Catholic, Buddhism, Daoism, 

1% non-Christian, <1% Jewish 1.7 % Muslim, 0.7% Hindu, Hinduism, Christianity, 

12.6% unaffiliated 0.5% Sikh, 35% unaffiliated and Sikhism

(U.K.)

Gender distribution 50.2% female, 50.5% female, 51.1% female, 51.2% female,

49.8% male 49.5% male 48.9% male 48.8% male

Age distribution (years) 0–14, 20.6%; 0–14, 28%; 0–15, 20.3%; 0–19, 43.2%;

15–64, 15–64, 65%; 16–64, male/ 20–39, 33.0%;

67.1%; ≥65, ≥65, 7% 16–59, female, 40–59, 17.7%;

12.3% 61.5%; ≥65 male/ ≥60, 6.1%

≥60 years, 18.1%

Life expectancy (years) 78.6, average; 75.74, average; 72.2, average;

75.2, male; 72.43, male; 70.2, male;

81.9, female 79.22, female 75.0, female

Population 1.1% 1.2% 0.3% 2.3%

growth rate (U.K.)

Birth rate 13.08 per 1,000 17.19 per 1,000 13.7 per 1,000 24.5 per 1,000

Total fertility rate 1.8 children 2.2 children 1.7 children 3.3 children

(per woman)

Death rate 5.9 per 1,000 5.5 per 1,000 11.2 per 1,000 5.3 per 1,000

Literacy rate (age 15 >99% 95.2% total, 95.4% male, >99% 86.4% total, 90.7% male,

and older) (1999) 95.0% female 82.0% female

Languages English Spanish English, Welsh (26% of Bahasa Malaysia

of population of Wales) English, Chinese dialects

(principally Cantonese and

Mandarin), Tamil, Telagu,

Malayalam, Panjabi, Thai,

and indigenous languages

Urbanization rate 86% 85.4% 89% (U.K.) 57%

Human development 0.936 (world rank: 2) 0.825 (world rank: 39) 0.923 (world rank: 14)* 0.774 (world rank: 8)

index (1999)

*The human development index given for England and Wales and for Scotland is for the United Kingdom as a whole.
183

Appendix B: Demographic, Economic, and Drug Information by Country

The Netherlands Scotland South Africa United States

Geographic area 41,526 km2 78,789 km2 1,219,000 km2 9,629,047 km2

(16,610 mi2) (31,510 mi2) (487,636 mi2) (3,717,796 mi2)

Political subdivisions 12 provinces 9 regions and 9 provinces 50 States and District 

3 islands areas of Columbia 

Estimated population 15.7 million 5.1 million 43.1 million 281.4 million

Population by racial or 91% Dutch, 98.7% white, 77% African, 11% white, 75.1% white, 12.3% black 

ethnic origin 9% Moroccan Turks, 0.7% South Asian, 9% colored (mixed white 3.6% Asian, 0.9% American

other 3% East Asian, and African or Malay), Indian and Alaska Native 

0.1% black, 0.2% other 3% Indian 0.1% Pacific Islander,

5.5% other, 2.4% multiracial

(12% Hispanic—may be 

categorized as any race)

Religious affiliation 34% Roman Catholic, 48% Protestant, 15% 68% Christian, 28.5% 55% Protestant, 28% 

25% Protestant, Roman Catholic, 1.7 % indigenous beliefs and Roman Catholic, 2% 

3% Muslim, 36% Muslim, 0.7% Hindu, animist, 2% Muslim Jewish, 6% other,

unaffiliated 0.5% Sikh, 35% 1.5% Hindu 8% unaffiliated

unaffiliated (U.K.)

Gender distribution 51% female, 50.8% female, 49.5% 52% female, 50.9% female,

49% male male (U.K.) 48% male 49.1% male

Age distribution (years) 0–14, 18%; 0–15, 19.9%; 0–19, 47%; 0–14, 21.4%;

15–64, 68%; 15–64, 64.7%; 20–39, 35%; 15–64, 66.1%;

≥65, 14% ≥65, 15.4% 40–69, 16%; ≥65, 12.4%

≥70, 2%

Life expectancy (years) 78.28, average; 75.1, average; 57–64, average 77.1, average;

75.4, male; 72.1, male; 74.2, male;

81.28, female 78.1, female 79.9, female

Population growth rate 0.690% –0.1% (Scotland) 2.1% 0.990%

Birth rate 12.1 per 1,000 10.6 per 1,000 24.6 per 1,000 14.2 per 1,000

Total fertility rate 1.6 children 1.5 children 2.5 children 2.1 children

(per woman)

Death rate 8.72 per 1,000 11.67 per 1,000 11.89 per 1,000 8.8 per 1,000

Literacy rate (age 15 99% >99% 81% >99%

and older) (1999)

Languages Dutch English, Scottish Gaelic IsiZulu, 24%; IsiXhosa, 17.5%; English

(60,000 speakers) Afrikaans, 15.1%;

Sepedi, 9.8%; English, 9.1%;

Setswana; Sesotho; Xitsonga; 

siSwazi; IsiNdebele; Tshivenda

Urbanization rate 89% 89% (U.K.) 54% 89%

Human development 0.931 (world rank: 8) 0.923 (world rank: 14)* 0.702 (world rank: 94) 0.936 (world rank: 6)

index (1999)

*The human development index given for England and Wales and for Scotland is for the United Kingdom as a whole.

Exhibit B–1. General Demographic Information for I–ADAM Countries (continued)
184

I–ADAM in Eight Countries: Approaches and Challenges

Australia Chile England and Wales* Malaysia

Gross domestic $416.2 billion $185.1 billion $1.29 trillion $171 billion

product (GDP) (annual)

GDP growth rate 1.6% –1% 1.9% 5.8%

GDP per capita $22,200 $12,400 $21,800 $3,238

GDP composition Services, 71%; Services, 61%; Services, 73%; Industry, 46%;

by sector industry, 26%; industry, 33%; industry, 25.3%; services, 42%;

agriculture, 3% agriculture, 6% agriculture, 1.7% agriculture, 12%

Major export Japan, 20%; European Union, 27%; European Union, 58% United States, 23%;

partners European Union, 14%; United States, 16%; (Germany, 12%; Singapore, 16%;

Association of Southeast Japan, 14%; Brazil, 6%; France, 10%; Japan, 11%;

Asian Nations (ASEAN), 11%; Argentina, 5% Netherlands, 8%); Hong Kong, 5%;

United States, 10% United States, 13% Netherlands, 5%;

Taiwan, 5%;

Thailand, 3%

Major export Coal, gold, meat, wool, Copper, fish, Manufactured goods, Electronic equipment, 

commodities alumina, iron ore, wheat, fruits, paper, fuels, chemicals, food, petroleum and

machinery, and transport pulp, and beverages, and liquefied natural gas, 

equipment chemicals tobacco chemicals, wood and wood

products, rubber, textiles

Labor force 8.9 million 5.8 million 29.2 million 9.3 million

Labor force Services, 73%; Services, 59%; Services, 69%; Manufacturing, 27%; 

composition by industry, 22%; industry, 27%; manufacturing agriculture, forestry, and

sector agriculture, 5% agriculture, 14% and construction, 18% fisheries, 16%;

local trade and tourism, 

17%; services, 15%;

government, 10%;

construction, 9%

Poverty rate 13.0% 22% 18% 15.5%

Unemployment rate 6.8% 9% 8.4% 3.3%

*Figures provided for England and Wales and for Scotland relate to the United Kingdom as a whole.

Exhibit B–2. General Economic Information for I–ADAM Countries
185

Appendix B: Demographic, Economic, and Drug Information by Country

The Netherlands Scotland South Africa United States

Gross domestic $365.1 billion $1.29 trillion $135 billion $9.256 trillion

product (GDP) (annual)

GDP growth rate 3.4% 1.9% 1.2% 4.1%

GDP per capita $23,100 $21,800 $3,215 $33,833

GDP composition Services, 69.7%; Services, 73%; Services, 60%; Industry, 80%;

by sector industry, 26.8%; industry, 25.3%; industry, 35%; services,18%;

agriculture, 3.5% agriculture, 1.7% agriculture, 5% agriculture, 2%

Major export Germany, 27%; European Union, 58%; United Kingdom, Canada, 23%;

partners Belgium-Luxembourg, 13%; Germany, 12%; Italy, Japan, Mexico, 12%;

France, 11%; France, 10%; United States, Japan, 8%;

United Kingdom, 10%; Netherlands, 8%; Germany United Kingdom, 6%;

Italy, 6%; Central and United States, 13% Germany, 4%;

Eastern Europe; France, 3%;

United States Netherlands, 3%

Major export Machinery and transport Manufactured goods, Gold, diamonds, other Capital goods, automobiles,

commodities equipment, chemicals and fuels, chemicals, metals and minerals, industrial supplies and raw

fuels, foodstuffs, clothing food, beverages, and machinery and materials, consumer goods,

tobacco equipment agricultural products

Labor force 7 million 29.2 million 15 million 139.4 million

Labor force Services, 73%; Services, 68.9%; Services, 45%; Managerial/professional, 

composition by industry, 23%; manufacturing and agriculture, 30%; 30.3%; technical, sales, and 

sector agriculture, 4% construction, 17.5%; industry, 25% administrative support, 29.2;

government, 11.3%; services, 15%; 

energy, 1.2%; government, 10%;

agriculture, 1.1% services 13.4%;

manufacturing, mining,

transportation, and 

crafts 24.5% 

Poverty rate 10.5% 18% 28.5% (based on 11.8%

imputed expenditures

per household < R800 per

month)

Unemployment rate 3.3% 8.4% 34% 4.5%

*Figures provided for England and Wales and for Scotland relate to the United Kingdom as a whole.

Exhibit B–2. General Economic Information for I–ADAM Countries (continued)
186

I–ADAM in Eight Countries: Approaches and Challenges

Australia Chile England and Wales The Netherlands Scotland United States

Lifetime Past Lifetime Past Lifetime Past Lifetime Past Lifetime Past Lifetime Past 

use 12-month use 12-month use 12-month use 12-month use 12-month use 12-month 

use use use use use use 

Any drugs 48 24 

(male) (male)

41 19 

(female) (female) 17.45 5.31 32 11 — — 22.5 9.0 39.7 11.9

Cannabis

(marijuana) 39 18 16.77 4.73 25 9 15.6 4.5 19.0 8.2 39.7 11.9

Amphetamines 9 4 10 3 1.9 0.3 7.3 3.1 7.2 1.0

Powder cocaine 4 1 4.02 1.32 3 1 2.1 0.6 2.6 1.0 11.5 1.7

Crack cocaine — — 2.27 0.81 1 <1 — — 0.7 0.2 2.7 0.5

LSD 10 3 — — 5 1 1.8 0.3 5.5 1.3 8.7 1.4

Other 

hallucinogens 10 3 — — 5 1 1.6 0.6 5.1 1.3 11.3 1.4

Ecstasy (MDMA) 5 2 — — 4 1 1.9 0.7 4.0 2.1 4.3 0.5

Barbiturates 2 — 12.52 6.89 3 1 19.6 8.2 3.7 1.1 9.8 1.6

Heroin 2 1 1 <1 0.3 0.1 0.8 0.1 1.4 0.2

Methadone — — — — <1 <1 — — 0.9 0.3 — —

Solvents/

inhalants — — — — 2 <1 0.5 0.1 2.1 0.2 7.8 1.1

Other — — — — — — 7.3 2.6 4.2 0.9 11.6 3.1

Notes: Figures for Malaysia are not available. For information on drug use in South Africa, see “The Nature and Extent of Drug Use and Related Problems in South Africa:

SARPA National Surveillance Project,” available online at http://www.nrf.ac.za/netpro/docs/lee_sarpa_project_1997.doc.

— = Not available.

Exhibit B–3. Prevalence (Percentage) of Drug Use in the General Adult Population in

I–ADAM Countries
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