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Monforte and Spitz'9 con- cluded on the basis of police records and medical examiner reports in Michi- ... work with both Dade County and municipal police departments and the Dade ..... cotic abuse among homicides in Detroit. J. For. Sci.
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DRUGS AND HOMICIDE* DUANE C. MCBRIDE, PH.D., CINDY BURGMAN-HABERMEHL, M.A., JEFF ALPERT, PH.D. AND DALE D. CHITWOOD, PH.D. Department of Psychiatry University of Miami Medical School Miami, Florida

D URING the last decade, the role that illicit drug production, distribution and use have played in the occurrence of homicide has become of increasing concern. Almost daily, the media in the large urban areas of this country report homicides occurring during drug deals or as the result of conflict over the control of the distribution or importation of drugs. Few systematic studies, however, have examined the extent of drug-related homicides in a community or examined the characteristics of such homicides. In an attempt to contribute to the systematic study of drug-related homicides, it is the purpose of this paper to examine the trends in the relationship between drugs and violence; to present data on drug-related homicides in Dade County, Florida and specifically to compare drug-related homicides to all other homicides in terms of the victim's age, sex, ethnicity, criminal record, mode of death, the drug and alcohol content of the victim, and to examine some of the implications of the data for classification and epidemiological issues in homicide research and for theoretical development in examining homicidal behavior. THE SETTING

The setting of this study is Southeast Florida, specifically Miami-Dade County, Florida. A variety of general surveys, emergency room studies and other epidemiologic data have identified the Miami area as one of the major drug importation and use areas in the United States. Specifically, studies have shown that Miami has a high rate of drug overdoses and deaths, a larger number of cocaine-related emergency room appearances and deaths, as well as more cocaine arrests and confiscations than any other city in the United *Presented as part of a Symposium on Homicide: The Public Health Perspective held by the Committee on Public Health of the New York Academy of Medicine October 3 and 4, 1985, and made possible by a generous grant from the Ittleson Foundation.

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States,2'3 that the incidence and prevalence of drug use among students was higher in the Southeast Florida area than national averages,4'5 a high statistical overlap in Miami between criminal and drug-using behavior, with the majority of identified groups in both categories engaging in both behaviors,6'7'8 and that Miami has had the highest rates of homicides in the United States during two of the last five years, 1980 and 1985. These findings indicate that, because of the high degree of drug use, drug/crime relationship and violent crime rate, the Miami area is a reasonable place to examine the relationship between drugs and homicide. TRENDS IN DRUGS AND VIOLENCE

The relationship between drug using and criminal behavior has certainly been one of the most widely studied issues in criminology and one of the most widely reported stories in the media. Popular media generally portray illegal drug users as routinely engaging in violent and bizarre behavior. As Lindesmith9 has documented, the federal government effectively used the press and films such as Reefer Madness to portray marijuana, cocaine or opiate users as violent fiends. Perhaps in response to this popular and official portrayal of the illegal drug user, social scientists began to examine closely the social/behavioral world of narcotics users, particularly as it related to criminal behavior. During the 1950s Finestonel0 conducted what was to become a landmark study affecting future understanding of the impact of narcotics use on the type of criminal behavior. Finestone found that as street groups initiated narcotics use they concentrated their criminal activity on property crimes that did not involve confrontation with victims. Finestone's subjects appeared to focus on criminal activities that yielded the most monetary gain with the least risk of violent confrontation. Finestone further indicated that in areas of the community where narcotics use was increasing, crimes against persons decreased. Finestone's study tended to provide the analytical framework for many subsequent studies of the drug-crime relationship. During the 1960s and 1970s researchers generally found that all types of illegal drug users were much more likely to engage in property crime than crimes against persons, and that they were more likely to engage in property crimes than non-drug users. As a review of the literature and existing data conducted by panels formed by the National Institute on Drug Abuse and the National Institute of Justice indicated, illicit drug abuse appeared from the mid 1950s to the Bull. N.Y. Acad. Med.

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mid 1970s to be related to acquisitory property crime, not violence.11 12 Thus, the tradition of the literature and data from the 1950s through most of the 1970s generally indicated that narcotics and other illegal drug use was not related to violent behavior, but that it was, because of the need for money and the desire to avoid high risk personal confrontation, likely to be related to property crime. While most crime-drug literature focused on the relationship of drug use to property crime, some studies have examined the relationship between drugs and violence. Researchers have found some evidence that certain drugs such as LSD or PCP may produce very distorted perceptions and consequent bizarre, random violence.'3 There is also some evidence, though controversial, linking amphetamines and violence. 4 Researchers have also noted a possible drug-violence connection in the necessary daily routine of the drug abuser, that is, as ethnographers such as Agarl5 have documented, the context of obtaining quality drugs and using them without getting ripped off is a potentially violent situation. Ecological analysis has indicated that both illicit drug abuse and violent crime tend to occur in the same neighborhood milieu. 16 Increasingly, there is also evidence of considerable violence over the control and distribution of drugs or major drug shipments at every level. Within the last decade, studies indicate the role of homicide as a cause of death among drug abusers. Zahn and Bencivengo17 reported that in 1972 in Philadelphia homicide was the major cause of death among illicit drug users, exceeding overdose and all other causes of death. In a follow-up study conducted in 1979 and 1980 on a sample initially contacted from 1965-1967, Preble'8 found that about 36% of the original 78 had died and that 40% of these deaths were homicides. Additional data indicate that the conventional wisdom linking illegal drug use primarily to property crime may not be valid. Monforte and Spitz'9 concluded on the basis of police records and medical examiner reports in Michigan that there may be a greater relationship between illegal drug distribution and use and violent crime than with property crime. Stephens and Ellis20 indicate that there may be a changed relationship between drugs and violence for those initiating heroin use since 1970. Stephens and Ellis reported that those beginning heroin use after 1970 were more likely to have a history of violent behavior than those cohorts initiating use in earlier years. The work of Monforte and Spitz and Stephens and Ellis stimulated our research group in the late 1970s to reexamine the relationship between illegal drug use and criminal behavior. As a part of the National Institute on Vol. 62, No. 5, June 1986

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Drug Abuse and National Institute of Justice Task Forces on Crime and Drugs during the early and mid 1970s, we had conducted research and analysis that were used to support the conclusion of a relationship between the use of illicit drugs and property crime, not crime against persons. With the beginning of the 1980s and the suggestion in the literature that the relationship had change, we decided to reexamine South Florida jail data. In a 1974 survery in Dade County, fewer than 10% of all types of drug users were arrested for serious crimes against persons, compared to 15.6% of all those who were not using illicit drugs.7 In a 1980 survey in a nearby county, we found that 14.5% of the narcotics users, 8.7% of the cocaine users and 17.8% of the inhalant users were arrested for serious crimes against persons as compared to 5.8% of those who had not used illicit drugs.21 While these data are certainly not definitive, they support the suggestion in the literature and the recent conclusion from the National Institute of Justice22 of a changed relationship between drug use and crime and that drug users are involved in violent crime to a greater degree than earlier studies would have led us to conclude. DRUGS

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With the increased focus on the relationship between drugs and violence, attempts have been made to examine the role that drug use plays in the commission of homicides in a variety of communities. As Goldstein23 has noted, these attempts are usually based on official police records. He further found that the police do not specifically attempt to ascertain the drug relatedness of the homicide or that the local, state or national reporting system does not systematically collect data on the possible involvement of drugs in a homicide. To address some of these and other issues in homicide classification and research, a research project was begun in early 1982, designed in part to work with both Dade County and municipal police departments and the Dade County Medical Examiner's Office, to examine the context of each homicide committed between 1978 and 1982 to develop a better typology of homicides and thus to provide a stronger data base for theoretical development.24 The determination of the drug context of each homicide was thus a part of this larger project. Each homicide that occurred prior to the initiation of the study was examined by police records, medical examiner records, interviews with the relevant police officers and medical examiners and computer file searches. Data on homicides committed during the study were collected by Bull. N.Y. Acad. Med.

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the use of a survey instrument accepted by the police and Medical Examiner's Office. Homicide was defined as drug related if drug paraphernalia were found at the scene, the victim was a known drug importer or distributor or if there was evidence that the homicide occurred as a part of a drug deal or as a result of conflict over importation or distribution. While a precise definition of a drug related homicide is difficult, we believe that the preceding definition is reasonable and probably is conservative. FINDINGS

During the five-year time period of this study, 1978-1982, Miami experienced a major increase in the number of homicides. The biggest increase during this time period occurred between 1979 and 1980 when there was a 60% increase in the number of homicides. This increase corresponded to a major influx of refugees from Cuba, including apparently some offenders from Cuban jails.25 Overall, during this five-year time period 1,850 homicide victims were identified. There were more recorded probable homicides in which the body was not found or an insufficient proportion of the body was found to identify. Of these 1,850 homicides, 440 or 23.8% were classified, according to the criteria noted, as drug related. Victim's age. The data in Table I depict the distribution of the ages of the victims of drug related homicides compared to the ages of the victims of other types of homicides. The analysis shows that there is a difference between the age distribution of the two groups. Generally, drug related homicide victims have a narrower range than other victims. More than 68 % of the drug homicide victims were between 21-40 years of age, compared to about 54 % of other victims. In addition, only 3.4% of the drug related homicide victims were over 50, compared to 16.6% of the other victims. Thus, overall, the data in Table I indicate that drug related homicide victims, in comparison to other victims, were more likely to be young adults 21-40 years of age. Sex of victim. The data in Table II indicate that more than 80% of homicide victims were male. Drug related homicides were more likely to involve male victims, 89.3%, than other homicides, 81.3%. Ethnic status of victim. Data which describe the general ethnic distribution of Dade County in 1980 and the ethnic distribution of the homicide victims are presented in Table Ill. Census data are only collected in broad ethnic categories, not the specific nationalities available in homicide records. As many homicide studies have reported, the ethnicity of homicide victims is Vol. 62, No. 5, June 1986

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TABLE I. A COMPARISON OF THE AGE DISTRIBUTION OF DRUG RELATED AND OTHER HOMICIDE VICTIMS Type of homicide Other Drug related N= 1,391 N= 436 Victim's age 7.4% 6.4% 1-15 8.6 6.9 16-20 30.3 37.6 21-30 23.4 31.0 31-40 13.7 14.7 41-50 8.7 2.8 51-60 7.9 .6 Over 60

Total 1,827 7.2% 8.2 32.0 25.2 13.9 7.3 6.2

TABLE II. A COMPARISON OF THE SEX DISTRIBUTION OF DRUG RELATED AND OTHER HOMICIDE VICTIMS Type of homicide Drug Other Total related N=1,849 N=1,409 N=440 Sex 83.3% 81.3% 89.3% Male 16.7 18.7 Female 10.7

TABLE III. A COMPARISON OF THE ETHNIC DISTRIBUTION OF DRUG RELATED AND OTHER HOMICIDE VICTIMS Type of homicide County population distribution Drug 1980 census Total Other related N= 1,629,781 N= 1,289 N= 1,679 N=390 Ethnicity 46.3% All whites 22.9% 24.4% 17.3% White 34.5 40.7 13.8 Black 16.5 All blacks 1.4 1.5 1.3 Haitian 4.2 3.6 6.2 Jamaican 21.7 18.3* 32.8 Cuban 35.9 All Hispanics 9.0 9.5 7.2 Mariel Cuban Ref. 6.4 1.9* 21.0 Columbian 1.3 All others Other *Approximately 100,000 refugees arrived and settled in Dade County from the Cuban Port of Mariel during the summer of 1980. As other researchers have noted, a high proportion of those refugees appear to have had criminal records in Cuba.25 Bull. N.Y. Acad. Med.

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not normally distributed in the population. Consistently, researchers and the police report that blacks comprise a larger proportion of homicide victims than would be expected, given their proportion of the population.26'27 The Dade County statistics presented in Table III are consistent with the literature. While blacks comprise about 17% of the total county population, they account for 34.5% of all homicide victims. The data also reveal a large difference between the ethnic distribution of the drug related homicide victims and the distribution of all other types of homicides. Hispanics accounted for 61 % of drug related homicide victims, as compared to about 20% of the victims of all other types of homicides. It should be noted that about one third of all Hispanic drug related victims were Colombians. Given their proportion of the population, non-Colombian and non-Mariel Hispanics are not overrepresented in the drug related homicide category. Colombians comprised 21 % of all drug related homicide victims and 1.9% of all other victims. Most of the Colombian victims were not citizens, did not have a legal status in this country and thus were not counted in the 1980 census. While American blacks account for more of the total number of homicide victims (34.5%) than any other group, and constitute 40.7% of the homicides in the other category, they comprise fewer than 14% in the drug related category. In comparison to their proportion of the total population; whites are under-represented. They comprise only 17.7% of the drug related homicide victims, 24.4% of all other types of homicide victims and 46.3 % of the 1980 county population. Overall, the data in Table III strongly imply the significant role that drugs play in the violent deaths of Hispanics, particularly Colombians, in Dade County, and that any policy development, criminal justice intervention or theoretical explanation of homicide behavior must account for the role of drugs in Hispanic violent deaths. Victim's criminal record. In any understanding of homicide, one key variable is the victim's own criminal involvement. As researchers have noted, a significant proportion of homicide victims cannot be called truly innocent in that they may have actively participated in the events that led to their deaths, or were involved with violent groups or in illegal activities that resulted in their deaths.28 Because of the illegal nature of drug abuse and the apparent increasingly violent context of drug use, we felt it important to examine and compare the criminal records of the victims of drug related homicides and other homicides. The victims' criminal records were examined by searches of local municipality and county police records, as well Vol. 62, No. 5, June 1986

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TABLE IV. A COMPARISON OF THE CRIMINAL RECORDS OF DRUG RELATED AND OTHER HOMICIDE VICTIMS Type of homicide Total Other Drug related N= 1,848 N= 1,408 N= 440 criminal record 37.6% 37.3% 38.4% Yes 62.4 62.7 61.6 No

TABLE V A COMPARISON OF THE MODE OF DEATH IN DRUG RELATED AND OTHER TYPES OF HOMICIDES Type of homicide Total Other Drug related N=1,846 N=1,407 N=349 Mode of death 74.5% 71.1% 85.4% Gunshot 10.3 12.4 3.6 Stabbing 1.3 1.1 1.8 Multiple instruments 7.9 9.2 3.6 Battery 2.9 2.8 3.2 Strangulation 3.2 3.5 2.3 Other

as by use of data from state and national criminal record computer systems. The criminal records of the homicide victims are presented in Table IV. As the data show, more than one third, 37.6%, of all the homicide victims had at least one previous criminal conviction. The analysis also shows virtually no difference between the proportion of drug related homicide victims with criminal records, 38.4%, and the proportion of other homicide victims with criminal records, 37.3%. We were somewhat surprised by the lack of a difference, but it may be that the lack of difference is the result of the differential proportion of citizens in the two groups. Of those whose citizenship could be determined, only 38% of the drug related homicide victims were citizens of the United States. Sixty-nine percent of the victims of all other types of homicide were American citizens. The high rate of noncitizens in the drug related homicide group made it probable that some of the past criminal activity records of these individuals did not exist in the United States. Mode ofdeath. Data are presented in Table V comparing the mode of death in drug related and other types of homicides. In both categories of homicide, guns accounted for the overwhelming majority of deaths. There exists, however, a small difference. More than 85 % of the drug related homicide victims were killed by gunshot, compared to about 71 % of all other Bull. N.Y. Acad. Med.

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TABLE VI A COMPARISON OF THE DRUG AND ALCOHOL CONTENT OF THE BODIES OF DRUG RELATED AND OTHER HOMICIDE VICTIMS Type of homicide Other Total Drug related Drug content N=440 N=1,410 N=1,850 88.9% 85.0% None 72.7% 2.1 2.4 Valium 3.2 .5 .4 Marijuana .7 .6 Barbituates .5 1.0 1.2 Methaqualone 1.8 6.1 9.5 Cocaine 20X5 Narcotics 1.4 .7 .9 Alcohol Content 57.7% 58.9% None 62.7% 21.1 21.8 .01-10 24.1 17.2 15.7 .11-25 11.1 2.8 2.4 .26-.36 1.4 .37-.50 .9 .7 .2 .3 .4 .51-1.20 .4

homicide victims. Thus, drug related homicide is more likely to involve the use of guns than other types of homicide. Drug and alcohol content of victims' bodies. As discussed earlier, data suggest that the context of drug use is becoming increasingly violent. Table VI shows the drug and alcohol content of the bodies of the drug related and other homicide victims. About 73 % of the drug related homicide victims and 88.9% of the other homicide victims had none of the listed drugs in their bodies at the time of the Medical Examiner's autopsy. In both groups the drug most likely to have been found in the victim's body was cocaine. Just over 20% of the drug related victims had cocaine in their bodies, as compared to 6.1 % of the other homicide victims. The data perhaps first of all indicate that we were conservative in our categorizing of drug related victims. Clearly these data show that about 11 % of the other nondrug related homicides had various drugs in their bodies at the time of their death. The data also indicate the possible relationship between cocaine and violence. Among the drug related homicide victims, cocaine accounts for 75% of all the drugs found in their bodies. It is interesting to note that the data in Table VI indicate that the drug related homicide victims were more likely not to have any alcohol in their bodies, 62.7%, than other homicide victims, 57.7%. In addition, only 13.1% of the drug related victims had an alcohol level of greater than 0.1 mg/dl in their system, compared to 21.2% of the other victims. Vol. 62, No. 5, June 1986

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DATA IMPLICATIONS

Size of the problem and typologies. Perhaps one of the most important conclusions that can be drawn from the data is the extent of drug related homicide in a specified community. As the data showed, drug related homicides accounted for almost one quarter of all homicides committed over a fiveyear period. The extent of drug related homicides in the data certainly suggests the necessity of adding the category drug related to any classification scheme by law enforcement or criminologists. Further, the proportion of drug related homicides and the need accurately to record them also suggest the need for developing reliable and valid criteria for determining a drug related homicide and implementing the necessary criteria into routine police and medical examiner data collection and reporting systems. As indicated earlier, criteria used in this paper were probably conservative in that the determination of the drug related nature of the crime was generally constructed some time after the crime. Thus, evidence linking the homicide to drugs may not have been obtained or recorded, although, given the sensitivity of local law enforcement to drugs, this was probably minimal. However, a standard, routinized, drug related data collection procedure could contribute significantly to the accurate national recording of the incidence of drug related homicides and thus provide the database for intervention. On the federal level, the National Institute of Justice appears to be committed to funding these types of projects in the expectation that a reliable data base will result in the knowledge base necessary for intervention programs. Confirmation of existing data. These data confirm the cited existing literature in general and specifically are almost uncannily consistent with New York City data from 1983, showing that 24% of New York homicides are drug related, compared to 23.8% in Dade County. Theory. This was an exploratory and descriptive rather than theoretical study. There was no attempt in the analysis to test theory or to use theory as a guide to the analysis. Nevertheless, the data do appear to have some implications for theory building and theory testing. In theory building, the data suggest the necessity of expanding the concept of drugs' and alcohol's roles in lowering inhibitions or increasing aggressiveness further to include issues of economics and control of distribution. In addition, the large proportion of cocaine users among the victims suggest the importance of examining the psychopharmacology of long-term cocaine use as it may relate to paranoia and violence.29'30 Bull. N.Y. Acad. Med.

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Perhaps one of the major theoretical traditions in sociology used to explain criminal behavior is Wolfgang and Ferracuti's27 subculture of violence perspective. That perspective argues that homicide is more likely to occur within social and cultural groups that view violence as "tolerable, expected and required. "27 Thus, it is further argued that within these groups violence is often a first resort to a variety of situations of conflict or potential conflict. To a significant extent, available data support this perspective.3 While the data presented in this paper are not in any way a test of the subculture of violence theory, the data suggest the need to examine the pharmacological and cultural aspects of violence among cocaine using groups and the role of violence in Colombian culture. For example, the data showed that Colombians account for a very small proportion of the county's population and 21 % of the drug related homicide victims. Further, the data also indicated that of those drug related homicide victims who had drugs in their bodies, 75% had ingested cocaine. The data indicate that the drug related homicide victims were disproportionately Colombians who had ingested cocaine. The data would suggest the need to investigate the relationship between the physical effects of a stimulant such as cocaine and cultural aggressiveness in conflict management and resolution.32 ACKNOWLEDGMENTS

The authors thank the Dade County Medical Examiner's Office for their cooperation in this study. REFERENCES 1. Inciardi, J.A., McBride, D.C., Pottieger, A.E. et al.: Legal and Illicit Drug Use: Acute Reactions of Emergency Room Populations. New York, Praeger, 1978. 2. Middleman, R.E. and Wetli, C.V.: Death caused by reactional cocaine use: An update. J.A.M.A. 252:1889-93, 1984. 3. Rivers, J.E.: Drug Trends in Miami, Florida. The Community Correspondence Group, National Institute on Drug Abuse, Washington, D.C., 1983. 4. Chitwood, D.D. and McBride, D.C.: The cessation of marijuana use. Florida J. Anthropol. 10:33-47, 1985. 5. McCoy, C.B., McBride, D.C. and Chitwood, D.D.: Final Report. Center for Vol. 62, No. 5, June 1986

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Social Research on Drug Abuse, National Institute on Drug Abuse, Washington, D.C., 1978. Inciardi, J.A.: Heroin use and street crime. Crime Delinq. 25:335-46, 1979. McBride, D.C.: The Relationship Between Type of Drug Use and Arrest Charge in an Arrested Population. In: Drug Use and Crime, Research Triangle Institute, Springfield, VA: National Technical Information Services, 1976, pp. 409-418. McBride, D.C. and McCoy, C.B.: Crime and Drugs: The issues and the literature. J. Drug Issues 12:137-51, 1981. Lindesmith, A.R.: The drug addict as a psychopath. Am. Sociol. Rev. 5:914-20,

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1940. 10. Finestone, H.: Narcotics and criminality, law and contemporary problems. Narcotics 22:69-85, 1957. 11. Crime and Drugs. Springfield, VA, National Technical Information Services, 1976. 12. Gandossy, R.P., Williams, J.R., Cohen, J. and Harwood, H.J.: A Survey and Analysis of the Extant Crime/Drug Literature. In: Methodological Issues, Patterns of Drug Use and Criminal Behavior, Life Cycles, Economic Issues and Drug Treatment. Research Triangle Park, NC, Research Triangle Institute, 1980. 13. Bums, S.R. and Lerner, S.: Perspectives: Acute phencyclidine intoxication. Clin. Toxicol. 9:477-501, 1976. 14. Grinspoon, I. and Hedbloom, P.: The Speed Cualture: Amphetamine Use and Abuse in America. Cambridge, MA, Harvard University Press, 1975. 15. Agar, M.H.: Ripping and Running: A Formal Ethnography of Urban Heroin Addicts. New York, Academic, 1983. 16. McBride, D.C. and McCoy, C.B.: The ecology of crime and drugs. Criminology 19:281-302, 1981. 17. Zahn, M.A. and Bencivengo, M.: Violent death: A comparison between drug users and nondrug users. Addict. Dis. 1:283-96, 1974. 18. Preble, E.: El Barrio Revisited. Society for Applied Anthropology, 1980. 19. Monforte, J.R. and Spitz, W.U.: Narcotic abuse among homicides in Detroit. J. For. Sci. 20:186-90, 1975. 20. Stephens, R.C. and Ellis, R.D.: Narcotic addicts and crime: Analysis of recent trends. Criminology 12:474-88, 1975. 21. McBride, D.C.: Drugs and Violence. In: The Drugs Crime Connection, Inciardi, J.A., editor. Beverly Hills, Sage Publications, 1981, pp. 105-23. 22. Gropper, B.A.: Probing the Links Be-

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tween Drugs and Crime. NIJ Reports, SNI 188: 4-8. U.S. Department of Justice, National Institute of Justice, 1984. Goldstein, P.J.: Homicide Related to drug trafficking. Bull. N. Y. Acad. Med. 62: 509-16, 1986. Burgman, C.E.: Homicide Motivation: Some Social Factors. Unpublished master's thesis, University of Miami, 1983. McCoy, C.B. and Gonzalez, D.H.: Cuban Immigration and Immigrants in Florida and the United States. Implications for Immigration Policy. University of Florida Bureau of Economic and Business Research, November 1985. Garfinkel, H.: Inter and intra-racial homicides. Soc. Forces 27-370, 81, 1949. Wolfgang, M.E. and Ferracuti, F.: Subculture of Violence-A SocioPsychological Theory. In: Studies in Homicide, Wolfgang, M., editor. New York, Harper and Row, 1967, pp. 271-80. Wolfgang, M.E.: Victim-precipitated criminal homicide. J. Crim. Law Crim. Police Sci. 148:1-11, 1957. Morningstar, P.C. and Chitwood, D.D.: Cocaine users' views of themselves: Implicit personality theory in context. Human Organ. 43:453-63, 1984. Chitwood, D.D.: Patterns and Consequences of Cocaine Use. In: Cocaine Use in America: Epidemiologic and Clinical Perspectives, Kozel, N.J. and Adams, E.H., editors. National Institute on Drug Abuse Research Monograph Series #61. Washington, D.C., Govt. Print. Off., 1985, pp. 1111-28. Messner, S.: Poverty, inequality and the urban homicide rate. Criminology 20: 103-14, May, 1982. Schorr, M.: Gunfights in the cocaine corral. Newsday 11:48-57, 1978.

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