(Accepted for publication by Substance Abuse Treatment, Prevention, and Policy Journal)

Summary: Conducted in 2023, this study explores drug use patterns among first-time arrestees in 25 county jails across the United States, emphasizing the urgent need to address drug-related health crises within carceral settings.

Research Methodology: This study utilized a naturalistic research design to collect de-identified urine drug screens (UDS), jail characteristics, and arrestee demographic variables from 25 jails across the United States in 2023.

Key Findings:

• Drug Use: Out of one third of all arrestees tested for drugs, 74.8% tested positive for at least one drug, with cannabis (69.0%) and stimulants (54.8%) being the most frequently detected substances. Opioids (29.6%) and sedatives (12.4%) were also present. Many arrestees exhibited poly-drug use, particularly combinations of cannabis, stimulants, and opioids.

• Demographic Patterns: Males and females showed similar overall positivity rates, but females were less likely to test positive for stimulants and opioids, while more likely to test positive for sedatives. White arrestees had higher rates of opioid and stimulant use, and Black arrestees had higher rates of cannabis use.

• Age-Related Trends: Younger arrestees (ages 20-39) were more likely to test positive for cannabis, while older adults exhibited higher rates of sedative use.

Conclusion: This investigation underscores the critical role jails can play in addressing drug use within their communities. This study calls for policy changes to ensure confidentiality of health data by promoting safer disclosures of drug use among individuals in custody.