The Relationship Between Drug Use, Drug-related Arrests, and Chronic Pain Among Adults on Probation

• 18% of probationers reported suffering from chronic pain.
• Probationers who reported chronic pain were more likely to use opiates.
• Probationers who reported chronic pain were more likely to use other illicit drugs.
• Mental health conditions were more common among probationers with chronic pain.

The intersection between chronic health conditions, drug use, and treatment seeking behavior among adults in the criminal justice system has been largely understudied. This study examined whether chronic pain was associated with opiate use, other illicit drug use, and drug-related arrests in a sample of substance-using probationers. We expected that probationers with chronic pain-related diagnoses would report more opiate use and drug-related arrests. This study used baseline data from 250 adults on probation in Baltimore, Maryland and Dallas, Texas who were participating in a larger clinical trial. Eighteen percent of probationers in this sample reported suffering from chronic pain. In bivariate analyses, probationers with chronic pain reported more drug-related arrests (t = − 1.81; p < 0.05) than those without chronic pain. Multivariate analyses support the hypothesis that probationers who reported chronic pain were marginally more likely to use opiates (OR = 2.37; 95% CI .89–1.05) and non-opiate illicit drugs (OR = 3.11; 95% CI 1.03–9.39) compared to offenders without chronic pain. In summary, these findings suggest that adults under probation supervision who suffer from chronic pain may be involved in criminal activity (specifically, drug-related criminal activity) in an effort to self-medicate their physical health condition(s). Screening probationers for chronic pain in the probation setting and referring these adults to pain management treatment may be an important step in advancing public safety.