2021 Adult Arrestee Drug Use in the San Diego Region

Criminal Justice Research & Clearinghouse  /  Substance Abuse Monitoring  /  2021 Adult Arrestee Drug Use in the San Diego Region

Highlights

Drug use is at a 22-year high for males, but at the second lowest for females.

In 2021, 83% of adult males tested positive for at least one illicit substance, a new 22-year high. However, 60% of adult females tested positive, the lowest rate since 2008, most likely reflecting who was booked into jail during the pandemic.

Almost two in every three adult males booked into jail tested positive for meth in 2021.

Despite regional efforts to combat methamphetamine (meth) use, it was the second most common drug in adults with justice contact, with 58% of males and 44% of females testing positive in 2021.

Despite legalization, arrestees continue to obtain marijuana illegally.

While recreational dispensaries (72%) were the most common place arrestees obtained marijuana in 2021, almost two-thirds (62%) reported still obtaining marijuana illegally on the street.

Opioid overdose remains a concern for this population.

Almost one in five (19%) of adult arrestees reported having an overdose, with an average of about three in their lifetime. Of those administered naloxone, the majority said they had received it more than once, with the most common provider being Fire/Emergency Medical Services (EMS).

Mental health and drug use is a complex issue for this population.

Just over two in five (41%) of the adults interviewed said they had been diagnosed with a mental health issue, 22% had attempted suicide, and of those who had been hospitalized, the average number of times hospitalized was four. Around one in four (24%) said that a drug had led to a psychotic episode, just under half (45%) had been admitted to a mental health facility under the influence of a drug, and 56% said they began using illegal drugs as a substitute for medication they had previously been prescribed for Attention-Deficit Disorder/Attention-Deficit Hyperactivity Disorder (ADD/ADHD)

Background

This CJ Bulletin, 2021 Adult Arrestee Drug Use in the San Diego Region, is one in a series highlighting findings from data collected as part of the San Diego County Substance Abuse Monitoring (SAM) program.
Since 2004, when federal funding for the Arrestee Drug Abuse Monitoring (ADAM) program was suspended, San Diego has been the only site to continue this project uninterrupted. With funding from the SANDAG Criminal Justice Clearinghouse, these data have been reported on an annual basis, providing useful information to policy makers, law enforcement, and prevention and treatment professionals regarding drug use trends and involvement in other risky or illegal behavior over time. In 2021, this data collection effort was generously supported by the San Diego-Imperial High Intensity Drug Trafficking Area (HIDTA); Health and Human Services Agency, Behavioral Health Services; the District Attorney’s Office; and the Public Safety Group. Their support, as well as the cooperation of the San Diego County Sheriff’s Department, is gratefully acknowledged.
As part of this project, arrestees are approached (using a random sampling method) within 48 hours of their booking into jail. If the arrestee is available and willing to participate in a confidential interview, she/he/they is/are asked a series of questions related to her/his/their drug use history and to provide a urine sample for drug testing. In 2021, 227 male arrestees were interviewed at the Central Jail and 80 female arrestees at Las Colinas. Of these 307 arrestees, 305 (99%) completed the interview and provided a valid urine sample for analysis. At the end of the interview, 7% responded affirmatively when asked in a new question added in 2021 if they remembered doing this interview before.

How has testing positive for any drug changed over time for male and female arrestees?

In 2021, 83% of male arrestees and 60% of female arrestees tested positive for an illicit drug, which includes marijuana,[1] meth, cocaine, opiates, and PCP. The 2021 male positive test rate of 83% represented a new 22-year high, continuing an increasing trend since 2018. The 2021 female positive test rate of 60% was the lowest since 2008 (when it was 58%). These trends most likely reflect at least in part changes seen in who was booked during the COVID-19 pandemic (i.e., modified booking criteria and differences in the type of charges males and females are typically booked for).
Note: Males (n=225-761) Females (n=80-345). Prior to 2013 and since 2015, percent positive was based on marijuana, meth, cocaine, opiates, and PCP. In 2013 and 2014, the PCP test was replaced with a test for alcohol.

How many arrestees are polydrug[2] users?

Males (42%) were significantly more likely to test positive for multiple drugs in 2021, as compared to females (25%). Of those testing positive for multiple drugs, 83% tested positive for two, 16% for three, and 2% for four drugs. Of those who tested positive for multiple substances, 92% were positive for meth, 92% marijuana, 18% opiates, 13% cocaine/crack, and 3% PCP.
Note: Males (n=225-761) Females (n=80-345).

How does testing positive vary by the arrestee’s highest booking charge?

As the following graph shows, regardless of crime type, over two-thirds of arrestees tested positive for a drug in 2021 and over one in four tested positive for multiple drugs. While any differences were not significant and due to chance, it is interesting to see that those booked for a drug offense as their most serious charge were least likely to be positive for any or multiple drugs, as compared to those booked for other reasons.
Note: Violent (n=147) Property (n=70) Drug (n=39) Other (n=49).

How have positive test rates by drug type changed over time?

The percent of male arrestees testing positive for marijuana increased to 60% in 2021, from 51% in 2020, representing a new 22-year high. As in previous years, females continued to test positive at a lower rate than males (significantly lower in 2021), even though the percent testing positive for marijuana also increased from the previous year (to 35%). While there was no significant change in the percent testing positive for marijuana by age, there was by race/ethnicity, with 77% of Black individuals testing positive, as compared to 53% of Hispanic individuals and 44% of White individuals.
Notes: Males (n=225-761) Females (n=80-345).
For meth, the percent of males that tested positive increased to 58% in 2021, a new 22-year high. In comparison, the female rate of 44% was the second consecutive decrease and represented the lowest positive test rate since 2011. Recent meth use also varied significantly by an arrestee’s age. Specifically, older arrestees (59% of those 40 and older and 56% of those between 25 and 39) were more likely to test positive for meth than those under the age of 25 (36%). Meth use did not vary significantly by an individual’s race/ethnicity.
Notes: Males (n=225-761) Females (n=80-345).
The percent of arrestees testing positive for cocaine in 2021 decreased slightly for males (from 8% to 7%) but increased slightly for females (2% to 3%). There were no significant differences in recent cocaine use by an individual’s age or ethnicity/race.
Notes: Males (n=225-761) Females (n=80-345).
For opiates [3] the percent of males that tested positive decreased to 7% in 2021 (from 11% in 2020), but increased for females (to 9%, from 6% in 2020). There was no significant difference in the percent testing positive for opiates by age or ethnicity/race in 2021.
Notes: Males (n=225-761) Females (n=80-345).

How does history of drug use vary by drug type?

Marijuana was the drug most commonly tried by arrestees (89%) and also was tried at the earliest age (15.1) – about five years earlier than any other drug. Those who used it in the past 30 days used it an average of 18.0 days. Males were significantly more likely than females to report using marijuana in the past 12 months (78% versus 65%) and to have tried it for the first time at an earlier age (14.5 versus 16.9).
Meth was tried by almost two-thirds (63%) of arrestees, and it also was reported by the highest percent (81%) as having been used in the last year. Meth users reported using it an average of 18.1 days out of the past 30, more often than any other drug. Males were significantly more likely than females to report having tried meth (67% versus 51%).
Cocaine was tried by around three in five (61%) arrestees and at the youngest average age (19.9), following marijuana. Only around one in four (27%) reported using it in the past year and the average use in the past month was 4.0 days. Males were significantly more likely than females to report having tried cocaine (65% versus 50%).
Heroin was tried by 31% of arrestees, almost half (46%) of whom had used it in the past year. Heroin was used an average of 12.4 days in the past 30 of those who had used it.
Crack was tried by 27% of arrestees and was least likely to be used in the last year (25%). Those who used it in the past month did so about every one in three days, on average (9.5). Females were significantly more likely to report using crack in the past 12 months (47%), as compared to males (20%) and to have used it a greater number of days, on average, in the past 30 days (18.3 versus 4.4)
In addition to these five drugs, almost three in every five (58%) arrestees reported having tried at least one of nine other illicit substances, including hallucinogens (34%), ecstasy (32%), LSD (29%), spice (20%), PCP (18%), inhalants (17%), GHB (13%), ketamine (11%), and kratom (7%). When those who had used an illegal substance were asked if they had used it in the past 30 days, GHB users were most likely to respond affirmatively (26%), followed by inhalants (22%) and ecstasy (14%) users.
Note: Past 30 Days (n=20-102) Ever (n=299-302). Cases with missing information not included.
Due to the increased attention to combatting synthetic drug use in San Diego County, questions were added to the instrument to better understand why individuals use spice. Interestingly, males were significantly more likely than females to report having tried spice (26% versus 3%). In addition, 75% of those who used spice said they use it as an alternative to marijuana and 42% said they use it to avoid a positive drug test.

How do drug market dynamics vary for each drug type, according to arrestees?

Over the years, a number of standard questions have been asked of arrestees regarding drugs they may have obtained, including what they traded to get them (cash and/or non-cash means), how easy they were to obtain, and if they got them in the same area in which they lived.
As shown below:
  • Marijuana was most likely to be reported as “very easy” to obtain (72%) among the five drugs in 2021. Meth followed with 62% reporting it was “very easy” to obtain.
  • Over two-thirds of arrestees were able to obtain their drug of choice in the MSA[4] in which they lived. The range was 69% of those obtaining marijuana to 78% of those obtaining crack.
  • Regardless of the drug, arrestees reported obtaining the substance using cash as well as non-cash means. Crack and heroin were the substances obtained more frequently with non-cash means as compared to cash
Arrestees were asked about buying drugs on the regular internet or dark web and if they had used electronic currency (e.g., bitcoin, PayPal, Venmo, or Zelle). Overall, only 5% reported purchasing drugs on the regular internet and 2% on the dark web. Nine percent reported they had used electronic currency to buy drugs.
In addition, more detailed questions have been added over the years regarding marijuana, including how individuals obtain the drug.
  • Around two-thirds (68%) of arrestees reported they obtained marijuana in more than one way in 2021, with 32% saying they had just one preferred way. Of those who said they just obtained it only one way, the most common was illegally on the street (42%), followed by a recreational dispensary (32%), medical dispensary (18%), and delivery from a dispensary (8%).
  • As shown, the two most common ways to obtain marijuana over the past 12 months (regardless of how many methods were used) were at a recreational dispensary (72%) and on the street (62%). When asked their preferred method, 36% said a recreational dispensary, followed by 28% saying on the street.
Note: Obtained at all past 12 months (n=195) Preferred method past 12 months (n=179).

What do we know about prescription drug abuse by the arrestee population?

In 2021, 52% of arrestees reported they had abused prescription drugs, with the most commonly abused including tranquilizers (i.e., benzodiazepines), codeine, Percocet, fentanyl, and OxyContin. [5]
Note: Cases with missing information not included.
When those who had abused a prescription drug were asked if they had abused it in the past 30 days, the top five drugs currently being abused included fentanyl (61%), barbiturates (33%), Dilaudid (13%), OxyContin (11%), and tranquilizers (10%).
Additional analyses revealed that White arrestees were significantly more likely to report abusing prescription drugs (63%), as compared to arrestees of other ethnic groups (47% Black and 46% Hispanic). An arrestee’s age also was a significant predictor, with younger ones more likely to abuse prescription drugs (48% of those under 25 and 58% 25 to 39), as compared to older arrestees (42%). Additionally, arrestees who abused prescription drugs were significantly more likely to test positive for marijuana (61% versus 44%) and meth (71% versus 36%).
When asked how difficult it was to obtain prescription drugs illegally, just over half said it was “very easy” or “easy”.

What do we know about tobacco use and vaping?

Given the growth in e-cigarettes and vaping over the past several years, a series of questions were asked addressing arrestees’ history of vaping, the types of products vaped, and the frequency of use of vaping products.
  • Overall, 66% of adult arrestees reported currently using tobacco products. Males were significantly more likely to report using tobacco (71%), as compared to females (52%). There was also a significant difference by race/ethnicity with Black individuals most likely to report using tobacco (77%), followed by White individuals (69%) and those who were Hispanic (57%). There was no difference by age.
  • Sixty-three percent (63%) reported they had vaped. There was no significant difference by gender or race/ethnicity, but there was by age, with 73% of those under the age of 25 having vaped, as compared to 69% of those between 25 and 39, and 47% of those 40 years of age and older.
  • Individuals who reported using tobacco products were significantly more likely to report vaping (77%), as compared to those who don’t use tobacco products (35%).
  • Sixty percent (60%) of arrestees who had vaped said they had done so in the last 30 days and of those who had vaped in the past month, the average number of days vaped was 15.6 (range 1 to 30).
  • When asked what they had vaped, the most common answer was flavored nicotine (84%), followed by THC/marijuana (62%), and non-flavored nicotine (35%).

Homelessness

  • About two thirds (65%) of those interviewed reported being homeless and 27% described themselves as being homeless in the past 30 days. Males were significantly more likely to report ever being homeless (70%) and to be recently homeless (33%), as compared to females (49% and 8%).
  • The majority (78%) said they had first become homeless in San Diego County, as opposed to somewhere else.
  • As shown, the most common reasons these individuals gave for becoming homeless were money issues, followed by loss of job, and loss of family.
Note: Percentages based on multiple response.
Overall, 28% of arrestees reported they had been arrested for driving under the influence. Sixty-three percent (63%) reported they had been arrested just once for driving under the influence, 27% twice, and 10% three or more times. When asked what they had consumed when they drove under the influence most recently, 71% said alcohol, 11% drugs, and 18% both alcohol and drugs. When the individuals who had used drugs were asked and answered which type of drug, 57% said meth, 48% marijuana, 5% powder cocaine, and 15% some other type of drug (e.g., prescription).
In terms of how self-reported alcohol and drug use is potentially related to risky behavior, as shown, arrestees were more likely to report that drug use preceded each of the four outcomes (health problems, DUI, riding with someone under the influence, and participating in sexual acts), as compared to alcohol
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Endnotes
  1. The drug test panel continues to include marijuana even though California voters approved Proposition 64 on November 8, 2016. Marijuana will continue to be tested while it remains illegal federally and because changes in use pre- and post-legalization among this population is expected to continue to be an issue of interest.
  2. Polydrug use refers to the use of two or more psychoactive drugs in combination to achieve a particular effect.
  3. It should be noted that a positive opiate drug test could indicate use of opiates other than heroin, including morphine, hydrocodone, hydromorphone, and codeine.
  4. Major Statistical Area (MSA) refers to different areas of San Diego County, including Central, North City, South, East Suburban, East, North County East, and North County West
  5. It should be noted that in 2020 the interview instrument was updated to ask individuals if they had used the prescription drug with a prescription, without a prescription, or both. The drugs most often used both ways (legally and illegally) included codeine (4%), Vicodin (4%), Demerol (3%), OxyContin (3%), and tramadol (3%).