Program Background
In January 2000, Honolulu became the 37th metropolitan site in the US to join the National Institute of Justice’s Arrestee Drug Abuse Monitoring (ADAM) Program. The core objectives of the ADAM Program are to provide an objective means for documenting local trends in drug use and as a means of examining the relationship between drugs and crime. ADAM also allows for assessing the need for mental health and substance abuse treatment needs among arrestees. ADAM data collection consists conducting interviews on drug use and obtaining urine specimens from arrestees booked by the Honolulu Police Department during the previous 48-hours. In each quarter of data collection, between 150 and 200 interviews and specimens are collected.
ADAM Program Data
Since January 2000, the Honolulu ADAM site has conducted interviews with more than 1,400 arrestees. The data show that Honolulu had a consistently high prevalence of drug use (over 60 percent) among the arrested population since the program started. In fact, Honolulu had the highest proportion of male arrestees testing positive for methamphetamine use among all 37 ADAM sites.[2] The prevalence of methamphetamine use has remained higher than 33 percent of all male arrestees since data collection began. The results for the most recent round of data collection in March 2002 show that as many as 48 percent of male arrestees tested positive for methamphetamine (see Figure 1 below).
Comparisons to National ADAM data
Compared to the 37 ADAM sites across the nation, Honolulu ranks highest in prevalence of methamphetamine use. Figure 2 shows the relative ranking among ADAM sites for the first three quarters of 2001. For cocaine, marijuana, and heroin, Honolulu ranked relatively low compared to other ADAM sites. The gap between Honolulu (at 38.1 percent) and the second ranked city, San Jose, for methamphetamine use was the largest for any of the drug categories. By comparison, 27.7 percent of San Jose’s arrestees tested positive for methamphetamine.
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Figure 2: Relative site rankings for males testing positive for each drug among 31 ADAM sites reporting between Q1, 2001 through Q3, 2001
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Any Drug |
Cocaine |
Marijuana |
Heroin |
Meth |
PCP |
Multiple Drug |
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Highest Ranking City |
New York City
(77.5%) |
New York City
(46.3%) |
Omaha, Nebraska
(58.0%) |
New York City
(17.7%) |
Honolulu,
Hawai’i
(38.1%) |
Cleveland, Ohio
(9.1%) |
Albuquerque, New Mexico
(27.8%) |
|
Honolulu Ranking (%) |
25
(58.8%) |
30
(11.2%) |
33
(29.8%) |
27
(3.3%) |
1
(38.1%) |
20 (tied)
(0.0% |
16
(21.5%) |
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Mean
Median |
63.4%
62.6% |
26.8%
30.4% |
41.6%
41.6% |
6.9%
5.4 |
10.0%
3.5% |
1.5%
1.0% |
20.9%
21.5% |
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|
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In terms of self-reported “heavy use” of any drug, Honolulu also ranked highest among all ADAM sites. Heavy use is defined as 13 or more days of self-reported consumption of a drug in a 30-day period in the year before the interview.[3] Nearly three quarters (74.6 percent) of arrestees inter-viewed in 2001, reported heavy use. By comparison, the median self-reported heavy use for all ADAM sites was 40.6 percent.
Other cross-site comparisons during the Q1, 2001 – Q3, 2001 period also show that Honolulu ranked poor or worst on several indicators.
· 48.9 percent were at risk of drug dependence (Honolulu rank = 3rd highest);
· 42.1 percent were at risk of alcohol dependence (Honolulu rank = 2nd highest
· 24.8 percent lacked stable housing in past 30 days (Honolulu rank = 2nd highest);
· 49.6 percent are unemployed (Honolulu rank = 4th highest);
· 48.5 percent had health insurance in past year (Honolulu rank = lowest);
· 12.4 percent received drug treatment in past year (Honolulu rank = 8th highest);
Discussion of survey results
The Honolulu ADAM survey results shown above underscore the increasingly epidemic nature of methamphetamine use in Honolulu. Findings from the 1998 Statewide Survey of Substance Abuse conducted by the Department of Health, Alcohol and Drug Abuse Division showed prevalence of methamphetamine use among Hawai’i’s general population as being higher than the national average. The ADAM data show that much of the methamphetamine use is concentrated among the arrested population. However, the data also show that Honolulu’s arrested population is substantially different to mainland arrestees. A greater proportion of Honolulu’s arrestees lack stable housing, employment, mental health treatment, and treatment for substance dependence.
Program Methodology
Honolulu joined the national ADAM Program at the same time that NIJ introduced a new interview instrument. The ADAM survey consists of two major parts, the questionnaire and a confirmatory urine toxicology screen. Both the interview and urine specimen are both completely voluntary and confidential.
The questionnaire consists of several sections covering extent of drug and alcohol use, demographics, substance treatment and mental health treatment history, experience in the criminal justice system, and an evaluation of substance abuse or dependency. A “market and use” section of the questionnaire explores arrestees’ most recent drug transactions, including price and amount obtained. A 12-month calendar is used to obtain details on recent drug use, mental health and substance use treatment, and arrest history. Self-reported drug use is verified by comparing the questionnaire to the urine screen results.
The survey methodology is uniform among all ADAM sites so that the data are comparable across locations. At the same time the new instrument was introduced, NIJ also introduced systematic sampling of arrestees so ADAM sites can estimate more accurately the proportion of arrestees who test positive for drug use. By selecting appropriate proportions of arrestees from those held, interview results can be generalized to represent all male arrestees booked during the data collection period. The ADAM Program also interviews a small number (approximately 30) of female arrestees each quarter. The results for women could not be weighted due to the small sample size.
The National Institute of Justice has allowed sites to include addenda to the core ADAM questionnaire. Such addenda are site-funded and allow sites to focus on issues of local concern. Examples of these addenda have included questions on HIV and safe-sex awareness, firearms, and gambling.
The data discussed above are generalizable to all arrestees in Honolulu county during the survey period. The data do not represent statewide trends in arrestee substance use. It has been suggested during criminal justice forums that other counties in the State of Hawai’i seek “affiliate” site status from the NIJ. ADAM affiliates are sites that follow the same ADAM data collection protocol, but are funded through sources other than the NIJ.
Footnotes
[1] Data shown are for the first three calendar quarters of 2001. Data from the fourth quarter, 2001 are forthcoming
[2] Although there are 37 ADAM sites nationwide, not all sites were able to report data for Q1, 2001 – Q3, 2001.
[3] Definition used in the National Household Survey on Drug Abuse (NHSDA).