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What Does Self-identified Drug of Choice Tell Us About Individuals Under Community Corrections Supervision?

Clark, Brendan C. PhD; Perkins, Adam MA; McCullumsmith, Cheryl B. MD, PhD; Islam, Aminul M. MD, MSc, DrPH; Sung, Janelle DO; Cropsey, Karen L. PsyD

Journal of Addiction Medicine: March 2012 - Volume 6 - Issue 1 - p 57–67
doi: 10.1097/ADM.0b013e318233d603
Original Research

Objectives: The term “drug of choice” (DOC) refers to substance abusers' preferred drug and this information often adds to the clinical picture of the patient because substance users often meet diagnostic criteria for dependence on multiple drugs. Characteristics such as age, race, marital status, and psychiatric illnesses have been shown to differentiate among individuals with different DOC preferences. However, no studies have examined DOC in the context of criminal behavior and other drug dependencies.

Methods: The participants (N = 15,475) of a community corrections program, Treatment Alternatives for Safer Communities (TASC), were classified by DOC for the 4 main drugs of abuse (alcohol, marijuana, cocaine, and opioids) and each drug class was compared with the other 3 DOC using binary logistic regression.

Results: Alcohol as DOC was associated with being older, white, male, having private health insurance, being medicated for a mental health disorder, and having a criminal history of person offenses. Cocaine as DOC was associated with being older, black, female, attempting suicide, having less than a high school education, living in a shelter or with relatives, being unemployed, being uninsured, being physically and sexually abused, and committing property and court offenses but not person or substance offenses. Marijuana as DOC was associated with being younger, black, male, never being married, and committing substance but not property or court offenses. Opioids as DOC were associated with being white, female, being married, higher education, being unemployed, and being medicated for a mental health disorder.

Conclusions: Overall, there were substantial differences between the 4 DOC groups, and the results are commensurate with expectations based on the abuse and dependency literature.

From the University of Alabama at Birmingham, Birmingham, AL.

Send correspondence and reprint requests to Brendan C. Clark, PhD, University of Alabama at Birmingham, Department of Psychiatry & Behavioral Neurobiology, 401 Beacon Parkway West, Birmingham, AL 35209. E-mail:

Received April 19, 2011

Accepted August 21, 2011

© 2012 American Society of Addiction Medicine