Cannabis Was the Most Common Drug Found in First-Time Jail Arrestees | Research

The takeaway

Among over 43,000 first-time jail arrestees screened across 25 U.S. counties in 2023, 69% of those who tested positive for any drug tested positive for cannabis, often in combination with stimulants or opioids.

Correctional health providers, public health officials, and policymakers addressing substance use in the criminal justice system.

What the researchers found

Of 43,553 urine drug screens (28.8% of total arrestees), 74.8% were positive for one or more drugs. Among positives, 69.0% had cannabis, 54.8% stimulants, 29.6% opioids, and 12.4% sedatives. Half of positive results showed multiple drugs, with cannabis-stimulant and cannabis-opioid combinations most common.

Why it matters

The high prevalence of cannabis alongside stimulants and opioids in arrested populations highlights polysubstance use patterns that matter for acute medical management in jails, where sudden cessation of all substances simultaneously creates compounded withdrawal risks.

The numbers in context

43,553 UDS cases from 25 jails. 74.8% (32,561) positive for one or more drugs. Cannabis: 69.0%. Stimulants: 54.8%. Opioids: 29.6%. Sedatives: 12.4%. 50% of positives had multiple drugs. Significant associations found between drug use and both jail characteristics and demographics.

How the study worked

Naturalistic research design collecting de-identified urine drug screens, jail characteristics, and demographics from 25 jails across the United States in 2023 via data-sharing agreement with NaphCare, Inc. Chi-square tests and standardized residuals analyzed associations.

What this study cannot tell us

Only 28.8% of arrestees were screened, introducing selection bias. Urine drug screens detect recent use but not frequency or impairment. Cannabis can be detected for weeks after last use, inflating apparent prevalence. Cannot distinguish medical from recreational cannabis use. 2023 data from a single year.

How to read the evidence

Large multi-site sample with objective biological measures, but selection bias in who was screened and cannabis detection windows limit interpretation.

When this study was published

Published 2025, using 2023 data from 25 U.S. jails.

The bigger picture

Jails are often the entry point into the healthcare system for people with substance use disorders. The dominance of cannabis in drug screens, especially combined with opioids and stimulants, suggests that jail-based health interventions need to address polysubstance use rather than single substances in isolation.

Questions still open

Whether cannabis co-use affects treatment outcomes for arrestees with opioid or stimulant use disorders
How state cannabis legalization status affected these patterns across the 25 jails

Common questions

Does testing positive for cannabis mean someone was high when arrested?

Not necessarily. Cannabis metabolites can remain detectable in urine for days to weeks after last use, unlike most other drugs that clear within hours to days. A positive cannabis screen indicates recent use, not necessarily intoxication at the time of arrest.

Why is polysubstance use important in jails?

When someone is detained, they suddenly stop all substance use simultaneously. Withdrawal from multiple substances at once can be medically dangerous and more complex to manage than withdrawal from a single substance.

Read the original research

An investigation of drug use among first-time arrestees from 25 county jails across the United States in 2023.

Addiction science & clinical practice, 20(1), 23

View on PubMed ↗Publisher’s paper ↗

Citation

Schumacher, Joseph E; Ahsan, Abdullah; Simpler, Amber H; Natoli, Adam P; Cain, Bradley J. (2025). An investigation of drug use among first-time arrestees from 25 county jails across the United States in 2023.. Addiction science & clinical practice, 20(1), 23. https://doi.org/10.1186/s13722-025-00550-5