The antisocial opiate addict

Opiate addicts have frequently been characterized as having antisocial personality disorder, but rates of this diagnosis using specified diagnostic criteria have not been determined. In this paper, rates of antisocial personality disorder derived from two different diagnostic systems are reported on a sample of treated opiate addicts. Two mutually exclusive types of antisocial addicts are identified: (a) primary antisocial addicts, comprising 27.2% of the sample and consisting of those with a history of antisocial activities that are independent of the need to obtain drugs, and (b) secondary antisocial addicts, comprising 27.7% of the sample, whose antisocial behavior was found to be directly related to drug use. Both types of antisocial addicts were distinguished from those without this disorder by having a history of heavier drug use and greater evidence of criminal activity. However, the primary antisocial addicts were distinguished from both secondary antisocial addicts and non-antisocial addicts by having greater evidence of childhood disruptions and more severe psychopathology, with high rates of depression, borderline personality, and alcoholism.