To our knowledge, this is the largest national epidemiological study examining the associations between criminal victimization, substance use and psychiatric disorders and antisocial behavior among residents in the United States. The prevalence of past-year criminal victimization in the U.S. population was 4.1%, which is higher than the NCVS estimates but somewhat lower than those from the ICARIS – 2. Demographically, findings indicated that the prevalence of criminal victimization was higher among persons reporting lower levels of income, who were separated or divorced, and residing in urban areas. However, we found no significant relationship between victimization and education, which is correlated with income. This may reflect that income itself is a stronger factor in its association with heightened exposure to risk of experiencing a criminal victimization rather than education per se. Further, among those engaging in various forms of antisocial behavior, there was a uniform pattern of increased odds of experiencing a criminal victimization. Thus, the present study provides solid evidence of the heightened level of risk experienced by different forms of antisocial behavior. The hypothesis that alcohol, marijuana, cocaine, stimulants, opioids, and heroin abuse/dependence would significantly increase the likelihood of experiencing a criminal victimization even while controlling for aforementioned mental health and psychiatric diagnoses and demographic variables was partially supported. Marijuana, stimulants and heroin use disorders, although elevated, were not significantly associated with criminal victimization. The strongest effects were found for adults with cocaine use disorder who were nearly four times more likely to be victimized than persons without such disorders, whereas respondents with opioid disorders had approximately doubled risk for victimization compared to non-dependent respondents.
That drugs of abuse may increase victimization is consistent with theories and findings from genetics, developmental psychology and criminology that describe generalized disinhibitory neuroregulatory processes (e.g., diminished self-control) that increase risk exposure to violence (27
). Research suggests that the links between substance abuse and victimization are somewhat bidirectional in that drug use predicts later victimization and early victimization is associated with later illicit substance use (30
). In addition, drug transactions often involve situations and persons that may pose environmental risks for victimization. These explanations are consistent with the psychopharmacologic and systemic components of Goldstein’s tripartite framework (31
). Another mechanism placing persons at increased risk for victimization is derived from behavior genetics. Consistent behavior genetic research has implicated MAOA in decreased regulation in prefrontal functioning among males (32
). Recent research, for example, has suggested that males with low activity MAOA alleles were associated with gang membership but also weapon use while in a gang (33
). Thus, genetic liability is one mechanism by which individuals are at increased risk for placing themselves in victimization situations. In addition, drug transactions often involve situations and persons that may pose environmental risks for victimization. Another set of factors to consider is that crime and victimization tends to co-occur, at least in most industrialized countries, in areas that experience relatively high levels of concentrated disadvantage (e.g., poverty, racial segregation, high unemployment). Unraveling the conjunction of individual liability and structural factors will require a more “syndemic” approach that is beyond the scope of the present investigation. Given the complexity of the substance abuse and criminal victimization relationship, future research might beneficially employ an explicit syndemic biosocial framework in facilitating systematic study of the various components of this relationship.
As with other studies, current study findings require interpretation within the context of several limitations. One limitation is the data are cross-sectional. As such, the findings cannot clarify the causal relations between experiencing a criminal victimization and identified correlates. However, findings do suggest that criminal victimization and substance abuse are intertwined. The prognostic relationship between victimization and substance use disorders and psychiatric disorders will require longitudinal study designs beginning earlier in the life course. Although the NESARC is a nationally representative sample, it is uncertain how the association between victimization and substance use disorders and psychiatric comorbidity would be similar or different if enriched correctional or clinical samples were employed. An additional important limitation is that the data on victimization was assessed by a single item and thus did not include important contextual, situational, and precipitating information which is important to understanding the nature of victimization episodes. Future studies on victimization and substance use disorders would benefit from including these natural history features in such assessments. Despite these limitations, findings from this study provide new epidemiologic insights from which additional hypotheses can be derived. As victimization costs are extensive, in-depth analyses in large representative data sets becomes a valuable source for guiding prevention and policy efforts.