This book is about crime and drugs. It also is about sex, with special emphasis on sexually offensive behavior.
However, this book does not suggest that crime simply leads to drug misuse, wich in turn leads to crimes. The
chapters will show that alcohol and drug misuse can be more intimately related to some types of crimes even
when we are not considering those crimes properly associated with drug sale or possession with intention to sell.
Furthermore, considering a same type of crime, such as rape, different patterns of alcohol / drug abuse can be
observed in different types of perpetrators in accordance with the choice of victims.
The co-occurrence of criminal behaviors and substance misuse has frequently affected the public perceptions of
the influence of alcohol and drug usage on criminal demeanours. In fact, substance abuse can perform different
roles in diverse types of crimes. The idea that violent crimes, such as rapes, homicides and robberies are more
commonly committed by delinquent drug users cannot be generalized for all of these crimes; however, some
violent crimes are more frequently associated with drug abuse than others. This finding should help to improve
the development of more specific and individualized correctional treatments. However, multiple other variables
interact and cumulate to lower the violence threshold and must also be considered during all evaluations. For
example, drug-dependent people who are known to commit crimes tend to be clustered in areas that are socioeconomically
deprived, in the same way as people known to commit crimes without drug usage. Thus, the
connection between drugs and crime is far too complicated to be summarized as a straightforward relationship.
Anyway, it would be impossible to describe all types of crimes and their connections with substance abuse here.
Thus, we provide ten manuscripts that describe different aspects of the relationship between drugs and crimes,
always focusing on Brazilian reality.
Brazil is the largest and the most populous country in Latin America and the fifth largest in the world in both
area and population. It covers over 3.3 million square miles (8.5 million square kilometers) and spans some
2,700 miles from north to south and roughly the same distance from east to west. Thus, an enormous and rich
cultural diversity is observed in different points of this country. However, some ‘common denominators’ can be
noted here. We lived in a phallocentric society, where virility is sometimes viewed as synonymous with power.
Men are characterized by strength, virility, activity, potential for violence, and the legitimate use of force. Thus,
machismo stresses diametrically opposed male / female roles. Male must be tough, aggressive, and worldly, and
destined to rule family, community and nation. Some of these ‘internalized concepts’ can influence criminal
demeanors and even the psychosocial management for inmates.
The chapters are organized by a number of phenomena that are known (or supposed) to link drugs and crime. In
three out of ten chapters, we emphasized the study on sexual offenders because this is one of the main research
lines of the editor. I have also pointed out that the assessment and the management of these types of offenders in
Brazil is in its first infancy still and many controversies about an adequate medical treatment for paraphilic
sexual offenders have risen. Sometimes, different members of our society reveal intense prejudice and
misunderstandings with respect to the medical treatment for sexual offenders in general.
It is opportune to report that Brazilian Sexual Crime Law has changed since August 2009 and established an
increase in the penalties, especially for those offenders that perpetrate any sexual acts against children. I believe
that many policy actions against sexual crimes have been motivated primarily by the need for policy makers and
policy making to be seen to be doing something that looks to the public, particularly the media, to be likely to
work. Often, policy simply panders to cruel and naïve opinions on sexual crimes, which sells newspapers and
satisfies society’s most punitive urges, at least in public. The application of punishment under the guise of
deterrence, despite its ineffectiveness, has been preferred to a more adequate management for some types of
these offenders. It is our contention that a partnership between specialized mental health professionals, lawyers
and policy makers is urgent with respect to this subject in Brazil and other countries.
In chapter 1, we report that the relationship between drug consumption and criminal activities is recognized as a
serious social problem around the world. In fact, drugs may cause crime directly (by desinhibition; cognitive
impairment); drugs and crime may be linked through a shared third factor (personality; social disadvantage);
crime may lead to drug usage; or the relationship may be absolutely spurious. In many different countries, the
penal system does not punish the individuals who at the moment of the crime do not have the capacity to
understand the unlawfulness of their acts or to behave in accordance with this understanding. However,
voluntary or culpable drunkenness does not exclude imputability which should only occur in cases that
drunkenness results from accidents or force majeure. Therefore, an adequate knowledge of the laws is essential
to psychiatrists involved with clinical and forensic evaluations who should provide the juridical authority with
conclusive and good prognostic elements for consideration of penal liability. Besides, the recognizing of the
different criminological aspects associated with the genesis of crime is an essential subject in the clinical and
In chapter 2, we present data on the realities of alcohol, tobacco and illicit drug consumption in Brazil. In fact,
epidemiologic studies on drug use may improve our understanding about patterns of usage, changes in these
patterns, the impact of hazardous use, abuse and dependence as well as special issues associated with the use of
these substances, such as risk consumption and violent behavior.
In chapter 3, we analyse the role of alcohol and drug consumption among adult sexual offenders. In fact,
according to different published researches, substance misuse can be an important factor that sets apart rapists
from children molesters. The severity of alcohol misuse seems to be higher among children molesters; on the
other hand, sexual offenders against adults seem to have more serious problems with drug usage. This difference
must deserve more adequate attention by health and law professionals, aiming at delineating effective proposals
of management for this complex population.
In chapter 4, we talk about the juvenile sexual offenders, in terms of alcohol and drug abuse and dimensional
personality traces. Although this population is also tremendously heterogeneous, some psychosocial and
criminological aspects can be used to distinguish some groups of adolescent sexual aggressors. Also, there seems
to be some different personality characteristics between the juvenile sexual offenders who acknowledge and
those that deny the crime, in terms of adherence to our treatment programme.
In chapter 5, we discuss a medical condition that has been extremely stigmatized, known as Pedophilia. The
socially sensitive nature of this disorder and the stigma associated with it has harmed the active involvement of
mental health professionals in its treatment. Pedophilia is a serious disorder and, sometimes, other psychiatric
problems may co-occur, such as alcoholism, personality disorders and mood disorders. Unfortunately, many
different law and health professionals have questioned whether Pedophilia is a disease or simply a criminal
activity. Rarely has a medical condition been so stigmatized as Pedophilia. The socially sensitive nature of this
disorder as well as the stigma associated with it has harmed the active involvement of mental health
professionals in its treatment. In this chapter, we compare pedophilic with nonpedophilic children molesters in
terms of alcohol and drug misuse, victims involved, impulsiveness and other aspects and we report some
problems related to the adequate medical and psychological treatment in our country.
In chapter 6, we point out that, among women condemned to prison for violent crimes (Homicide and Robbery),
a longer criminal career is verified in those that initiated the street drug consumption more precociously. We
have verified that the majority of robberies committed by women are economically driven. Furthermore, the vast
majority of these women who are financially motivated have revealed that the money would support their drug
usage. Also, the women with early-onset drug usage have most likely resided in areas with high concentration of
poverty and frequently have family histories of psychiatric problems. In truth, for many women, the own
victimization is associated with the involvement in delinquent or criminal demeanors. Although female inmates
consist of a highly heterogeneous population, some common crime-related factors have been seen among many
of them, such as pressure to commit a crime, lack of social opportunities and necessity of retaliation against an
In chapter 7, we studied alcohol and drug problems among male prostitutes. Male sex work is not a unitary
phenomenon but, rather, a multifaceted one. Despite this, we have classified these sex workers into two different
groups: those with and those without gender identity disorders. Actually, the motivations, rationales, and life
patterns of our respondents vary to such an extent that we could divide them into more than these two categories.
However, our sample size has not permitted this yet. Some preliminary differences between both groups that
have been found may help us develop more effective proposals of management for this population.
In chapter 8, we reviewed some studies on different psychiatric and criminological aspects of filicides and
parricides. Brazilian research on family crimes is very scarce, although several cases of filicides and parricides
have been reported by the communication means. The role of alcohol and drug use in filicides and parricides is
also unclear, but it is analysed in this chapter.
In chapter 9, we present possible relationships between AIDS and sexual crimes. Certainly, sexual acts without
consent increase the risk of HIV infection. In the same way, alcohol and drug misuse before or during sexual act
increases the risk of unprotected sex, multiple partners, oral and vaginal non-protected sex and not allowed sex
practice. Unfortunately, statistics are not yet available on the rates of HIV transmission during rape and other
sexual offences, in part because the prevalence of HIV among sexual offenders is unknown. Also, AIDS can be a
consequence of diverse behaviors associated with drug misuse and can also be a “side effect” of forced behaviors
inside prisons. Although this theme has been seriously neglected by criminological research, we have pointed out
it as an important aspect to be considered during forensic and clinic evaluations.
In chapter 10, we comment on the treatment for addicts with justice problems. Unfortunately, medical and
psychological treatments inside prisons have not been carried out in our country adequately. However, proposals
of management for inmates with drug problems should be developed and installed as a way to prevent criminal
recidivism. Anyway, the current correctional practice must decidedly be evidence-based and public resources
should be provided to treat offenders and not only to arrest them. The assessment of criminogenic needs is
essential for the provision of appropriate case-based correctional intervention. Although poverty, social
victimization and lack of job opportunities or skills are associated with crimes in general, frequently are not treatable medical and psychological factors. With respect to these relevant social needs, intensive efforts of the
governments will be necessary as soon as possible.
This book was written to address the following issues:
Are violent crimes related to alcohol and drug consumption ?
Have pedophilic children molesters demonstrated higher alcohol or drug problems than nonpedophilic children molesters ?
How are researches on crime-related factors being carried out in Brazil ?
Despite the high prevalence of alcohol and drug misuse in Brazil, have inmates received adequate medical and psychological treatment for this serious problem?
There are multiple criminological factors associated with the perpetration of violent crimes. Has this been considered in political, medical and psychological contexts ?
It is our position that legal, medical and political sciences need to reach a consensus on what to do with offenders in general and particularly sexual offenders. Thus, an adequate, just and viable management could be effectively carried out in our country.
Danilo Antonio Baltieri
Department of Psychiatry of ABC Medical School
Avenida, Lauro Gomes 2000
Vila Sacadura Cabral