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Azac 037
Azac 037
https://doi.org/10.1093/bjc/azac037
Article
Since the 1990s, Sweden has witnessed a steady increase in the control measures focused on drug
offences. These changes are results of political dynamics once pushed by centre-right parties but thereaf-
ter embraced by Social Democrats in government. The article examines the structure of police controls
of drug offences and the extent to which these controls have focused on different sociodemographic
groups during the period 1995–2015. The study shows that this intensified control of minor drug crimes
has resulted in successively larger proportions of youths from deprived areas being forced to provide
samples of body fluids. The criminalization of drug use constitutes an example of the significance of
crime policy for both crime levels and the composition of the offender population.
KEY WORDS: crime trends, policing, discrimination, register data, inequality, Sweden
INTRODUCTION
Over recent years, several countries and states in the United States have moved towards a decrim-
inalization of drug use. Sweden has not followed this trend, however, and the country’s strict
drug policy, with the goal of a drug free society, remains in place. Further, Sweden has witnessed
a steady increase in the control measures focused on drug offences. Important factors behind
this trend have been the criminalization of personal drug use in 1988, and the police being given
the power to take compulsory urine and blood samples from persons suspected of using drugs.
These changes are also reflected in Swedish crime statistics. While general offending has fol-
lowed the international trend of declining crime levels since the early 1990s, the so-called crime
drop (Tonry 2014), registered drug offences, and minor offences in particular, have instead
increased dramatically (Figure 1). This trend is thus primarily not an effect of a substantial rise
in the number of people using drugs, but rather of legislative changes and intensified efforts to
detect and prosecute these offences (Brottsförebyggande rådet [Brå] 2016; Tham 2021).
© The Author(s) 2022. Published by Oxford University Press on behalf of the Centre for Crime and Justice Studies (ISTD).
This is an Open Access article distributed under the terms of the Creative Commons Attribution License
(https://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and
reproduction in any medium, provided the original work is properly cited.
1214 • The British Journal of Criminology, 2022, Vol. 62, No. 5
Usually, drug offences are not brought to the attention of the police via crime reporting, but
rather through police-initiated encounters based on suspicion. Suspicion formation, which is
particularly important in the case of minor drug offences, is linked to both police working meth-
ods and perceptions, and also to appearance, behaviour, time and place, which are all factors
that can lead to an initial suspicion. At the same time, suspicion formation based on these fac-
tors may also include elements of negative stereotyping and bias (see e.g. Quinton et al. 2000;
Schclarek Mulinari 2020).
The aim of this study is to examine the structure of police controls of drug offences in the
form personal use and analyse the extent to which these control activities have focused on dif-
ferent sociodemographic groups during the period 1993–2015. Our data comprise information
from various population registers on individuals, their childhood conditions and criminal con-
victions, and information from the Swedish National Board of Forensic Medicine (RMV) on
the individuals subject by the police to compulsory urine/blood tests as a result of suspected
drug use, and also the results of these tests. The data sources have a longitudinal structure that
allows us to follow the same individuals over time.
Specifically, we will study (1) to what extent different social groups have been required to
take urine or blood tests; (2) whether these tests have been positive or negative, i.e. whether
they have confirmed or disproved the police’s suspicion of drug use; and (3) whether the risk of
being forced to take such tests when one is innocent of drug use is affected by sociodemographic
conditions or other offending activity. We will also identify possible changes in different groups’
exposure to compulsory police drug testing over this period of enforcement expansion (1993–
2015). We focus on the presence of differences among individuals of majority and non-majority
background and among individuals who have grown up with low-income parents and who live
in the most socially disadvantaged areas of Sweden’s cities. We have restricted our analysis to
those aged 15–20. We know from previous research that the hit rate for police testing is very
high among older individuals, who are often known drug abusers, but comparatively low among
youths (Brå 2016), which makes youths the more relevant group to study given our interest in
sociodemographic variance in the focus of police controls.
There is an extensive literature on police bias focused primarily on poor, young, black males
(see e.g. Miller 2010; Legewie 2016; Ba et al. 2021). Although the central tendency in this
SOCIODEMOGRAPHIC DIFFERENCES IN POLICE DRUG TESTING • 1215
research is a finding of a clear police bias in suspicion formation, which results in individuals
from specific social or population groups running a higher risk of being stopped by the police,
Fagan et al. (2016a: 628) have argued that several empirical challenges remain in relation to the
detection of such bias. Among other things, there is often a lack of relevant control groups and
benchmarks to assess proportionality. Legewie (2016) also emphasizes that we, despite all the
research on disproportionality in stop and search, still know very little about whether and how
it has changed over time.
Studying differences among people suspected of drug offences in the form of personal use
goal of Swedish drug policy. This goal was then used to push the new Social Democratic govern-
ments in the 1980s in a more punitive direction (Tham 2021). In 1985 prison sentences for the
possession of small quantities of drugs for personal consumption were introduced and later also
drug use itself was criminalized (1988). However, the centre-right parties were not satisfied and
following a campaign promising more law and order, they won the election in 1991 (Estrada
2004). After only two years in office (1993), this new government initiated and implemented
a law that gave the police the authority to take compulsory urine/blood tests from individuals
suspected of drug use. This legislative change is of central importance to our study since the
In an American study, Legewie (2016) was able to show that discriminatory outcomes vary
over time. Events in the wider community, such as police officers being shot, have a marked
effect on the intensity of police activities focused on blacks. Legewie argues that to the extent
that such incidents occur with some regularity, and in the absence of strategies aimed at reduc-
ing discriminatory police practices (such as educational efforts, broadened recruitment etc;
see Ba et al. 2021), this may be assumed to result in an increase in discrimination over time.
Legewie concludes that the research literature is lacking in analyses of possible changes over
time in police suspicion formation, and in the focus of policing activities on different social
We may thus assume that there are different processes in play that might be expected to result
in both increases and decreases in the level of between-group differences in exposure to police
controls.
Fig. 2 Potential for bias in connection with different areas of police practice linked to the policing of
minor drug offences. Bold text indicates the data to which the study has access
SOCIODEMOGRAPHIC DIFFERENCES IN POLICE DRUG TESTING • 1219
high degree of accuracy. At the same time, as a result of the extensive level of control, a certain
number of innocent individuals will nonetheless be subjected to interventions, such as arrests
for compulsory testing due to suspected drug offences. Less highly controlled groups of young
people living in other types of neighbourhood will instead go free.
Studies from England and Scotland have emphasized the significance of drug offences
for the extent of stop and search activities (Lennon and Murray 2018). Despite the major
infringement of personal integrity involved in being compelled to provide a urine/blood
sample (in most cases on suspicion of cannabis use), little research has been conducted on
Dependent variables
We study both prevalence and incidence of compulsory drug testing. Negative tests describes the
number of tests that fail to establish drug use. Hit rate describes the number of positive tests
per test conducted. In an initial, descriptive analysis, we present the distribution of these meas-
ures across different sociodemographic groups. The risk for a negative test is then used as the
dependent variable in a multivariate analysis, since this outcome is a function of both the testing
and hit rates and thus captures the possible bias in both these elements. We also view being
subjected to a negative test as constituting a greater infringement of the individual’s personal
integrity than being tested when one has actually used drugs. We consistently focus on the out-
come for individuals over the entire six-year period when they were aged 15–20. Since the first
year for which data are available is 1993, the first year for which we are able to create indicators
for accumulated risk for 15–20-year olds is 1998.
1 Since the data contain sensitive personal information, the project has been reviewed by Swedish Ethical Review Authority.
All data to which the study has access are anonymized.
SOCIODEMOGRAPHIC DIFFERENCES IN POLICE DRUG TESTING • 1221
three groups: (1) Natives, individuals born in Sweden to at least one Swedish-born parent; (2)
Western background, individuals born in Sweden to foreign-born parents from West or Central
Europe, United States, Canada, Australia or New Zealand, or themselves born in one of these
countries; and (3) Non-Western background, individuals born in Sweden to foreign-born par-
ents from other countries, or themselves born in other countries.
As an indicator of socioeconomic circumstances, we use the family’s equivalized disposable
income when the study subject was aged 15. The income variable is divided into three catego-
ries: High income includes those households in the top 20 per cent of the income distribution,
Covariates
We are also able to control for two additional factors. Firstly, we control for which of the three
metropolitan areas of Sweden (Stockholm, Gothenburg or Malmö) the individuals live in.
Secondly, we control for levels of criminal activity, since this places individuals at risk of being
subject to controls in other criminal contexts, or of already being known to the police. In the
absence of self-report data, we employ criminal convictions data, excluding convictions for
minor drug offences. For all individuals in the study population, we have micro-data from the
Swedish convictions register. We have used these to create a variable that differentiates between
individuals with no convictions at age 15–20, those with one conviction and those with two or
more convictions. In previous studies, our use of this very rough categorization of registered
offending has shown itself to differentiate individuals with different offending histories and also
different life chances (Bäckman et al. 2014). In addition to this, all models include controls for
age and sex.
Methodological considerations
In the multivariate analyses below, we are interested in how the effects of risk factors change
over time. For this reason, we separate the observation period into two categories: one with a
relatively high hit rate and low test rate (1998–2006) and one with a relatively low hit rate and
2 As with household income, this indicator is also highly correlated with other indicators of deprivation at the neighbour-
hood level, such as the proportion with criminal convictions, the proportion with a low level of education and the proportion of
non-western immigrants (not shown).
1222 • The British Journal of Criminology, 2022, Vol. 62, No. 5
high test rate (2007–15; see Figure 3). It can be shown that comparing estimates from logis-
tic regressions across samples may result in false conclusions about changing effects (see e.g.
Mood 2010). This would suggest that linear probability models (LPMs) may constitute a better
choice, since the estimates from such models can be compared, while they avoid the potential
flaws of logistic regression.
One drawback of LPM is that the models may predict probabilities of less than zero and
greater than unity. As will become clear below, in our analyses, where the outcome is very
rare, the risk for negative predictions is clear. For this reason, the estimates reported should be
RESULTS
Figure 3 presents the total number of tests accumulated at age 15–20, plotted in the year in
which the individuals in the study population were aged 20, and the proportion of these tests
that produced a positive result. As can be seen from the figure, there is a substantial increase
in the number of tests conducted throughout most of the period examined. As the police have
subjected suspected drug users to more tests, the accuracy of the suspect identification process
has declined.
The trends shown in Figure 3 can be roughly divided into two periods, which will be used as a
basis for comparisons in the multivariate analyses. The first period (see Table 1) covers the years
1998–2006, when the number of tests was lower and the hit rate higher. During the second
period, 2007–15, the number of tests is higher but the hit rate lower.
Table 1 presents comparisons for our four outcomes. To begin with, it is clear that there are
substantial differences in the prevalence of drug testing between different sociodemographic
groups. The proportion of young males subjected to tests is almost five times that of young
females (5 per cent as compared to 1 per cent), which is in line with previous studies (see above).
Looking to differences in the number of tests, the predominance of young males increases even
further.
Fig. 3 Number of police tests for drug use in the study population as a whole (at age 15–20, among
those resident in Stockholm, Gothenburg and Malmö), and the proportion of positive tests,
1998–2015
SOCIODEMOGRAPHIC DIFFERENCES IN POLICE DRUG TESTING • 1223
Looking to the three factors that are of central interest to this study, background, income
and the socioeconomic status of the residential neighbourhood, we find marked differences
for each of these variables. Among those born in Sweden to Swedish-born parents (‘natives’),
half as many have been tested per 1,000 of population compared to those with a non-native
background. Similarly, substantial differences can be seen between individuals who grew up in
households in the lowest- and highest-income categories, respectively (43.2 compared to 21.8
per 1,000 of population) and between those living in the poorest neighbourhoods and those
living in other neighbourhoods. Furthermore, these differences become even more marked
Table 1 Accumulated number of positive tests (hit rate), number of tests, tested and negatively tested
per 1,000 of population, during age 15–20. Residents of Stockholm, Gothenburg and Malmö at age
20.a N = 665,326
Tested Tests per % Positive Negatively N
per 1,000 1,000 tests tested per 1,000
Native 27.70 49.32 70.62 14.49 531,293
background
Western 48.55 93.62 74.93 23.47 32,129
background
Non-Western 51.27 106.18 71.91 29.82 101,904
background
High incomeb 21.83 36.11 69.95 10.85 180,655
Middle income 33.91 63.36 71.75 17.90 363,603
Low income 43.20 86.51 71.12 24.99 121,068
Not poor 29.39 53.01 70.50 15.64 580,357
neighbourhood
Poor 52.36 109.10 73.94 28.43 84,969
neighbourhood
1998–2006 20.21 32.77 74.92 8.22 294,553
2007–15 41.94 81.94 70.14 24.47 370,773
Male 53.28 103.45 72.01 28.95 327,079
Female 10.80 15.73 66.44 5.28 328,247
Stockholm 35.17 64.46 70.57 18.97 373,765
Gothenburg 24.75 46.10 75.56 11.27 168,015
Malmö 33.98 66.33 69.40 20.30 123,546
0 convictionsc 14.69 19.19 62.70 7.16 588,346
1 conviction 80.64 122.32 66.14 41.42 54,734
2+ convictions 379.75 991.19 77.26 225.39 22,246
a
Swedish residents at age 15.
b
Household disposable income at age 15.
c
All criminal convictions besides minor narcotics offences.
1224 • The British Journal of Criminology, 2022, Vol. 62, No. 5
greater than the number tested who have two or more convictions for other types of crime.
This means that for a large proportion of the youths who test positive, a conviction for minor
drug offences is the only conviction they are registered for during their youth. Further, the pro-
portion of those with a positive test comprised of youth who have no other convictions has
increased over time (from 31 per cent 1998–2006 to 44 per cent 2007–15, not shown), which
means that drug offences have become increasingly important as a determinant of which indi-
viduals are registered for crime.
One result that was perhaps not as expected is that differences in the proportion of positive
Table 2 Estimates from linear probability regressions on the accumulated risk (× 1,000) for having a
negative drug test at age 15–20 in Sweden 1998–2015. All models include controls for period, sex and
metropolitan area. Non-significant (p ≤ 0.05) estimates in parentheses. N = 665,326
1a 2 3 4 5 6 Risk-level at ref.b
Native background 0 0 0 0 0 14.49
Western background 9.71 8.35 8.01 6.94 (0.89)
Non-Western background 13.79 10.90 10.08 7.86 2.01
High incomec 0 0 0 0 0 10.85
Middle income 6.99 5.82 6.13 5.45 2.61
Low income 13.85 9.02 10.81 7.94 3.74
Not poor neighbourhood 0 0 0 0 0 15.64
Poor neighbourhood 15.08 10.77 12.63 9.95 3.24
0 convictionsd 0 7.16
1 conviction 32.43
2+ convictions 213.19
a
Factors entered separately with control for period, sex and metropolitan area.
b
Average unadjusted risk × 1,000 at reference category (see Table 1).
c
Equivalized disposable household income at age 15.
d
Accumulated over ages 15–20. Minor narcotics convictions excluded.
SOCIODEMOGRAPHIC DIFFERENCES IN POLICE DRUG TESTING • 1225
risk-units (expressed in terms of the risk per 1,000 of population) higher than the risk for the
native-background group. These results confirm the bivariate patterns presented in Table 1. The
single greatest excess risk for being subjected to a drug test that produces a negative result is
found for those individuals who live in poorly resourced neighbourhoods. In order to examine
how these different factors interact, Models 2–4 study outcomes following pairwise controls.
Model 2, for example, shows the results for non-native background following control for paren-
tal income, and vice versa, but without controlling for the neighbourhood in which individuals
live. As expected, since individuals of non-native background more often live in low-income
background, and during Period 2, we see that the risk is higher for these groups than for youth
of native background.
A similar pattern can be seen in Figure 4b, which shows the interaction effect between period
and household income at age 15. During the first period, the risk for a negative test is lower for
the low-income group than for those who had grown up in a high-income household, given con-
trols for the other variables in the model. During Period 2, the risk for a negative test increases
Fig. 4 ( a–c) Risk (× 1,000) differences for a negative drug test. Interaction effects between period
and three factors
SOCIODEMOGRAPHIC DIFFERENCES IN POLICE DRUG TESTING • 1227
in all income groups, but the increase is greater for those from low- and middle-income house-
holds than for those from high-income households, which has resulted in the risk for both the
low- and middle-income groups exceeding the risk for youths from high-income households.
In Figure 4c, the same pattern is repeated once again, with a negative correlation between
living in a poor neighbourhood and the risk for testing negative during the first period shifting
to a positive correlation during Period 2.
Thus, we see a clear pattern whereby a negative correlation between risk exposure, in
terms of non-native background, growing up in a low-income household or living in a
DISCUSSION
The aim of this study has been to examine the structure of police controls of drug offending
and more specifically to analyse the extent to which these control activities have focused
on different sociodemographic groups during the period 1993–2015. Since our data have a
longitudinal structure, we have been able to study experiences of having been forced to take
a compulsory urine/blood test during youth as a result of a suspicion of drug use. We have
noted that there is an extensive literature on policing bias focused primarily on poor, young,
males from minority backgrounds. We have contributed to this literature by means of an
analysis in which we are able to account for various relevant background factors, such as
offending activity, but also by addressing the knowledge gap concerning whether and how
disproportionalities in policing bias have changed as (drug) enforcement has expanded.
Furthermore, to the extent that there are differences between sociodemographic groups
in the rate at which the risk of being subjected to controls for drug use changes over time,
our results are also of significance for how we should interpret increasing or decreasing
differences in registered crime between different groups. Our results can be summarized in
the following four points:
Firstly, there are significant differences between social groups with regard to their experiences
of being required to provide urine or blood samples for drug testing. Individuals of non-major-
ity background and those who have grown up with low-income parents or who live in the most
socially disadvantaged areas run about twice the risk of others of being tested for narcotics use.
Secondly, there are smaller differences in hit rates, i.e. whether the tests have confirmed or
disproved the police’s suspicion of drug use. The police are most accurate in their suspicions
when they test youths who have a record of several criminal convictions, and they are least accu-
rate when they test youths with no criminal record. However, the sociodemographic differences
with respect to the hit rate are small.
Thirdly, taken together, the higher rates of testing among certain groups point to the
fact that the risk of compulsory drug testing when innocent of drug use is clearly affected
1228 • The British Journal of Criminology, 2022, Vol. 62, No. 5
and those living elsewhere. Such differences may in the short run be misinterpreted as changes
in actual criminal behaviour. In the long run, these processes may result in stigma and affect
the propensity for crime in various groups via a process of cumulative disadvantage. Being reg-
istered for criminal activity at younger ages has been shown to negatively affect the youth-to-
adulthood transition (McAra and McVie 2005; Nilsson et al. 2013).
Funding
This research was funded by the Swedish Research Council (Vetenskapsrådet), grant no.
2015-01201.
Acknowledgements
The authors would like thank Tove Pettersson, the guest editors of this special issue and two
anonymous reviewers for valuable comments on earlier versions of this article and David
Shannon for English proof reading. Special thanks go also to Anna Jönsson and Marie-Louise
Hallingström at the Swedish National Board of Forensic Medicine, both for delivering and for
help with understanding the drug test data.
1230 • The British Journal of Criminology, 2022, Vol. 62, No. 5
APPENDIX
Table A1 Estimates from full linear probability regressions on the accumulated risk (× 1,000) for
negative narcotics test in ages 15–20 in Sweden 1995–2015. Non-significant (p > 0.05) estimates in
parentheses. N = 665,326
I II III IV
Native background 0 0 0 0
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