A life course perspective of drug use offers an organizing framework for:

• classifying distinctive patterns of drug use over the life course,

• identifying critical events, factors, and system interactions responsible for continuity or change in drug use patterns over the life course, and

• analytically ordering the immense variety of events that occur during the life course.

A Life Course Perspective

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1. Over the 10 years following first use of heroin, cocaine, and meth:a. Long periods of heavy use (7-18 days of use per month) persist.b. Users are more exposed to the criminal justice system than to

treatment (1.4 years of incarceration vs. 5 months of treatment).c. Time from first use to first treatment is 7 years for heroin, 8 years for

meth, and 10 years for cocaine.d. Heroin and meth users who start using before age 15 are less likely to

stop using over time.e. Periods of no use are aided by treatment and self-help participation for

cocaine and meth users.f. Timing of first drug treatment (early, late, or not at all) appears to

impact use patterns over time.

2. Over the 5 years following drug treatment:

a. Even among persistent criminals, decreases in drug use and incarceration, and increases in employment occurs.

b. HIV risk behaviors don’t always decrease.

Some Lessons from Applying a Life Course Perspectiveto Drug Use

www.caldar.org Findings may not apply to non-treatment seeking populations.

• Changes in use happen at different stages of the life course for different people.

• Interventions are needed to delay, and prevent, first use of drugs.

• Treatment can be a life changing event.

• Treatment must be prompt, tailored, and ongoing.

• Treatment impacts non-drug using behaviors and it can benefit serious offenders.

• Strategies are needed to engage the treatment naïve but CJ experienced.

• Treatment may not be necessary for everyone but it must be available to all.

Some Implications for Practice & Policy

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