Lawmakers’ attention deficit on crime

A recently published study in the New England Journal of Medicine supports the growing trend in America to think differently about the problem of crime. While the research targets a very specific group of individuals, it provides yet one more indication that the current culture of mass incarceration may be wrong-headed.

Paul Lichtenstein, a researcher at Stockholm’s Karolinska Institute, observes that about 5 percent of children in the U. S. and other Western nations have attention deficit hyperactivity disorder (ADHD), which is known to cause impulse behavior control and problems with attention span.

Lichtenstein’s team writes: “It is well known that individuals with ADHD have much higher rates of criminality and drug abuse than people without ADHD, but the effect of treatment on this is not well known.”

The Stockholm study used 16,000 men and 10,000 women in Sweden aged 15 and older who had been diagnosed with ADHD. Their criminal records were tracked for four years for the purpose of determining whether study subjects were taking ADHD medication consistently when their crimes were committed. As a control, each test subject was compared against 10 similar individual without ADHD.

Researchers concluded that 37 percent of men with ADHD were convicted of at least one crime during the study period, compared with just 9 percent of men without the disorder. For women the rates were 15 percent with ADHD and 2 percent without it.

When subjects used ADHD drugs consistently, their likelihood of committing crimes dropped by 32 percent in men and 41 percent in women.

According to Lichtenstein, consistent treatment with ADHD medications reduced the likelihood of all types of crime.

Studies like this are especially important for us in the U.S. because of our vast correctional population. With over 2.1 million people incarcerated in jails and prisons, we have developed a costly and ultimately unsustainable addition to incarceration. Therefore, it is incumbent upon us to analyze the current path and devise effective alternatives. Preventing crime in the first place seems the most obvious place to start.

Why do studies like Lichtenstein’s matter? A 2009 study by the National Bureau of Economic Research published in the Journal of Correctional Medicine observes that 25 percent of U.S. inmates have been diagnosed with ADHD.

The NBER sought an explanation for a decline in violent crimes that began in the 1990s. They theorized a relationship between the increase in prescribing newer-generation antidepressants for depression (such as bupropion) and also in the prescribing of stimulants for ADHD. The researchers compared the rates of prescriptions for these psychiatric medications to rates of violent crimes in the United States from 1997-2004. They observed that as prescriptions went up, violent crimes came down.

The NBER researchers state: “Our evidence suggests that, in particular, sales of new-generation antidepressants and stimulants used to treat ADHD are negatively associated with rates of violent crime. To put this in perspective, doubling the prescription rate [of antidepressants] would reduce violent crimes by 6 percent, or by 27 crimes per 100,000, at the average rate of 446.5 crimes per 100,000 population. A similar calculation with stimulants would decrease crimes by a range of 30-38 crimes per 100,000. While doubling the prescription rates seems like a large change, it has been estimated that 28 percent of the U.S. adult population in any year has a diagnosable mental or addictive disorder, yet only 8 percent seeks treatment.”

Here again, we see the inexorable comingling of social problems. On the one hand we have a medical infrastructure that has failed to adequately address the mental health crisis in America, while at the same time we remain surprised when crime spikes. Even so, our lawmakers are loathe to connect the dots. If we are to address crime effectively, we will have to concomitantly address mental health and criminality. One goads the other. It’s time we own that fact.