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

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.

Schumacher, Joseph E et al.·Addiction science & clinical practice·2025·Moderate EvidenceObservational
RTHC-07602ObservationalModerate Evidence2025RETHINKTHC RESEARCH DATABASErethinkthc.com/research

Quick Facts

Study Type
Observational
Evidence
Moderate Evidence
Sample
Not reported

What This Study 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.

Key Numbers

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 They Did This

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.

Why This Research 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 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.

What This Study Doesn't 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.

Questions This Raises

  • ?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

Trust & Context

Key Stat:
Evidence Grade:
Large multi-site sample with objective biological measures, but selection bias in who was screened and cannabis detection windows limit interpretation.
Study Age:
Published 2025, using 2023 data from 25 U.S. jails.
Original Title:
An investigation of drug use among first-time arrestees from 25 county jails across the United States in 2023.
Published In:
Addiction science & clinical practice, 20(1), 23 (2025)
Database ID:
RTHC-07602

Evidence Hierarchy

Meta-Analysis / Systematic Review
Randomized Controlled Trial
Cohort / Case-Control
Cross-Sectional / ObservationalSnapshot without intervening
This study
Case Report / Animal Study

Watches what happens naturally without intervening.

What do these levels mean? →

Frequently Asked 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 More on RethinkTHC

Cite This Study

RTHC-07602·https://rethinkthc.com/research/RTHC-07602

APA

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

MLA

Schumacher, Joseph E, et al. "An investigation of drug use among first-time arrestees from 25 county jails across the United States in 2023.." Addiction science & clinical practice, 2025. https://doi.org/10.1186/s13722-025-00550-5

RethinkTHC

RethinkTHC Research Database. "An investigation of drug use among first-time arrestees from..." RTHC-07602. Retrieved from https://rethinkthc.com/research/schumacher-2025-an-investigation-of-drug

Access the Original Study

Study data sourced from PubMed, a service of the U.S. National Library of Medicine, National Institutes of Health.

This study breakdown was produced by the RethinkTHC research team. We analyze and report published research findings without making health recommendations. All interpretations are based solely on the published abstract and study data.