Elsevier

Addictive Behaviors

Volume 28, Issue 9, December 2003, Pages 1533-1554
Addictive Behaviors

Drugs of abuse and the elicitation of human aggressive behavior

https://doi.org/10.1016/j.addbeh.2003.08.033Get rights and content

Abstract

The drug–violence relationship exists for several reasons, some direct (drugs pharmacologically inducing violence) and some indirect (violence occurring in order to attain drugs). Moreover, the nature of that relationship is often complex, with intoxication, neurotoxic, and withdrawal effects often being confused and/or confounded. This paper reviews the existing literature regarding the extent to which various drugs of abuse may be directly associated with heightened interpersonal violence. Alcohol is clearly the drug with the most evidence to support a direct intoxication–violence relationship. The literatures concerning benzodiazepines, opiates, psychostimulants, and phencyclidine (PCP) are idiosyncratic but suggest that personality factors may be as (or more) important than pharmacological ones. Cannabis reduces likelihood of violence during intoxication, but mounting evidence associates withdrawal with aggressivity. The literature on the relationship between steroids and aggression is largely confounded, and between 3,4-methylenedioxymethamphetamine (MDMA) and aggression insufficient to draw any reasonable conclusions. Conclusions and policy implications are briefly discussed.

Section snippets

Alcohol

Conventional wisdom tells us that individuals who are under the influence of alcohol will act aggressively. This is a situation in which conventional wisdom is likely correct—crime studies consistently implicate alcohol intoxication as one of the most significant factors in violent behavior. In large-scale review of 26 studies, involving 11 countries, it was determined that 62% of offenders convicted of a violent crime had been consuming alcohol shortly before committing the crime in question

Benzodiazepines

There is considerable confusion among both the general population and some clinicians regarding the extent to which benzodiazepines lead to violence. While this relationship does appear to consistently exist in animals, it is probably better explained by dose and individual difference factors than a pervasive pharmacological effect when it is manifested in humans.

There have been numerous case reports linking benzodiazepines with increased anger and aggression since their introduction in the

Cannabis

While cannabis has historically been excoriated for being a social “menace” and for inducing homicidal rages (Julien, 1992), more contemporary research indicates cannabis-intoxicated individuals are in fact less likely to act aggressively. However, a developing literature demonstrates an authentic cannabis withdrawal syndrome, one symptom of which may be increased likelihood of interpersonal aggression.

The debate regarding the ills of cannabis dates back decades and rages on today. While most

Phencyclidine (PCP)

Like the aforementioned psychostimulants, the “reputation” of PCP and the empirical evidence to support that reputation are considerably discrepant. While PCP may indeed lead to violent behavior in some individuals, the effect appears inconsistent and may be explained by factors other than direct pharmacological action.

Although mass media representations would suggest that PCP is the drug most likely to produce a violent “rage,” the literature is at best inconsistent Fauman & Fauman, 1979,

3,4-Methylenedioxymethamphetamine (MDMA; “ecstasy”)

A relatively recent arrival to the recreational drug scene, MDMA, and its association with aggression has nonetheless been the focus of studies in both animals and humans. The extant animal studies have tended to demonstrate that MDMA administration leads to a pattern of “anxiogenic-like” behavior (Maldonado & Navarro, 2001), characterized by a marked decrease of aggression (threat and attack) as well as decreased social investigation, body care, and digging behaviors. One study, comparing MDMA

Anabolic–androgenic steroids

Although not typically considered drugs of abuse, anabolic–androgenic steroids appear relevant to the topic at hand because (a) they are often used for nonmedicinal (i.e., recreational) purposes, and (b) numerous retrospective reports propose a link between violence and the use of these drugs Choi et al., 1990, Pope & Katz, 1994, Yates et al., 1992. The retrospective nature of the data is problematic, as is the fact that the typical user is a young male athlete, a very specific population, and

Conclusions

Is there a relationship between drugs and aggression? Clearly, the answer is a resounding yes. However, just as clearly, the nature of the relationship is interactional and multifactorial and moreover different for different classes of drug. Moreover, some drugs, at different doses, have paradoxical effects. While there are drugs that undeniably lead to heightened aggression (alcohol), there are others whose reputation for eliciting violence seems unwarranted (PCP). The one thing that can be

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