The number of individuals passing through the criminal justice system with substance misuse problems is increasing, and doctors should be aware of current drug trends in their area.

In the United States, there is a well-established program of research drug-testing urine samples of people arrested by the police—known as the Arrestee Drug Abuse Monitoring Program (ADAM), which recently replaced the Drug Use Forecasting Program, which was originally established in 1988. Data from urinalyses performed in 2000 show that 64% or more of adult male arrestees had recently used at least one of the following drugs: cocaine, marijuana, opiates, methamphetamine or phencyclidine (1). Marijuana was the drug most commonly used, followed by cocaine.

The New English and Welsh Arrestee Drug Abuse Monitoring (NEW-ADAM) program is a national research study of interviews and voluntary urine tests designed to establish the prevalence of drug use among arrestees. Summary results of the first two years of the NEW-ADAM program (2) show that 69% of urine samples from arrestees tested positive for one or more illegal drugs and 36% tested positive for two or more substances. In particular, 38% of arrestees tested positive for opiates and/or cocaine.

2. General Principles (3)

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