Michael Curtis
All Authors:M. Curtis1,2, B. Quinn2, J. Stone3, L. Maher2,4, P. A. Agius2,5,6, M. Stoové2,6,7, B. Ward8, R. Jenkinson2,6,9, M. Hickman3, P. Higgs2, P. Dietze1,2,6. 1National Drug Research Institute, Curtin University, Australia; 2Disease Elimination, Burnet Institute, Australia; 3Bristol Medical School, University of Bristol, United Kingdom; 4Kirby Institute, University of New South Wales, Australia; 5Faculty of Health, Deakin University, Australia; 6School of Public Health and Preventive Medicine, Monash University, Australia; 7School of Psychology and Public Health, La Trobe University, Australia; 8School of Rural Health, Monash University, Australia; 9Australian Institute of Family Studies, Australia
Background:
Imprisonment is associated with numerous and often enduring adverse outcomes. Methamphetamine is the most commonly used illicit drug among people entering Australian prisons. However, the incidence and factors contributing to imprisonment of Australians who use methamphetamine are poorly understood. In a prospective study of people who use methamphetamine, we determined incidence of, and explored factors associated with, self-reported imprisonment.
Methods:
Data (2017–2023) were from VMAX, an ongoing cohort study of people who smoked methamphetamine at least monthly at study enrollment in Victoria, Australia. Crude imprisonment rates were calculated; associations between imprisonment, demographics, and lagged (one interview) homelessness, substance use, and service use characteristics were estimated using multiple-event discrete-time survival analysis.
Results:
Among 539 participants (interviews: 2207, median=4, range=1–8), 114 (21%) reported a total of 164 imprisonments (range=0–4) during 1955 person-years (PY) of observation, a crude imprisonment rate of 84 (95% confidence interval [95%CI]: 72-98) per 1000 PY. Being Aboriginal or Torres Strait Islander (Adjusted Hazard Ratio [AHR]: 1.69, 95% Confidence Interval [95%CI]: 1.05–2.70), weekly or more frequent methamphetamine use (AHR: 1.60, 95%CI: 1.12–2.29), and a previous history of adult imprisonment (AHR: 3.92, 95%CI: 2.66–5.78) were associated with an increased hazard of subsequent imprisonment. Older age at baseline (AHR: 0.94, 95%CI: 0.92–0.97), female or ‘other’ gender (versus male; AHR: 0.58, 95%CI: 0.37–0.89) and employment (AHR: 0.54, 95%CI: 0.33–0.88) were associated with a reduced hazard of subsequent imprisonment. Homelessness and recent injecting drug use were not associated with imprisonment.
Conclusion:
In a cohort of people who use methamphetamine in Victoria, Australia, we observed an imprisonment rate 40-fold greater than the general Australian population. The use of non-custodial responses to drug-related offences, and initiatives which improve employment outcomes, or reduce frequency of methamphetamine use, could reduce imprisonment among people using methamphetamine.