Does drug criminalization increase harmful drug use? A scoping review of underlying mechanisms

Abstract

Aims: This article discusses how unintended side effects from the international regime of drug criminalization may serve to increase harmful drug use among some population segments and performs systematic scoping reviews of two putative underlying dynamics relating to violence victimization and the forbidden fruit or psychological reactance effect. If repetitive drug use is commonly a way of coping with psychological and physiological trauma, and such trauma commonly arise as a consequence of violent crime, then an increase in violence resulting from drug criminalization should be expected to entail an increase also in drug dependence. According to the logic of the forbidden fruit dynamic, moreover, the criminalization of certain behaviors may motivate people to engage in these behaviors. Design: Eligible studies were identified via the Pubmed database from its inception to 2023. The review included both qualitative and quantitative findings but was restricted to publications written in English. Results: From 291 records, 94 studies were included. The review found convincing evidence for a victimization dynamic and general support for a psychological tendency to be attracted to behaviors that might be deemed forbidden. Conclusions: While more research is needed, these findings allow for the preliminary conclusion that drug criminalization may increase drug use among some population segments.

Keywords

Drug criminalization drug use violent crime violence victimization forbidden fruit effect psychological reactance

Introduction

The international regime of drug control, as defined by three United Nations conventions, was implemented with the intention to reduce harmful drug use. However, a number of authors have argued that this policy may have unintended consequences that compromise its intended effect. Friedman (1972) argued that the criminalization regime incentivizes people working in the illicit drug trade to produce addiction in their customers and may also increase general drug use among youths because of a forbidden fruit effect. Furthermore, he noted that drug criminalization entails a general increase in crime, which in turn increases drug harms. Subsequent work by Nadelmann (1992), Miron and Zwiebel (1995), Smith (2002), Husak (2003), Anomaly (2013), Bourgois (2015, 2018), Coyne and Hall (2017), and Earp et al. (2021) has further developed these arguments. This article discusses how unintended consequences resulting from drug criminalization may serve to increase harmful drug use, at least among certain population groups, thereby counteracting to some extent the intended effects of the policy regime. It reviews the evidential bases for the notion that violence victimization may lead to drug use and that criminalization may entice some people toward the criminalized behavior and draws the tentative conclusion that there appears to be plenty of support for the former dynamic and some support for the latter, although with the qualification that most of the identified research for psychological reactance does not pertain directly to drug use.

It should be noted that the dynamics whereby the above authors hypothesized that drug criminalization may increase drug use are not related to any inherent characteristics of the drugs themselves, but rather to the fact of their criminalization. For the purposes of this article, therefore, the operational distinction between licit and illicit drugs is simply whether or not they are criminalized and thereby may produce certain unintended societal dynamics. When it comes to violence victimization, furthermore, the dynamics that may result in increased use of illicit drugs may also give rise to increased use of licit drugs. If drug criminalization entails an increase in violent crime, the people thus victimized may be at risk for future coping-motivated use both of illicit drugs such as certain opioids and licit drugs such as alcohol. While the dynamics discussed and reviewed in this article pertain to how drug criminalization may increase drug use, there are presumably also other mechanisms in play that may work in the opposite direction; whether the increasing effects are stronger or weaker than the decreasing effects are presently an open question.

The article uses the term “drug use” to refer to use of either licit or illicit psychoactive substances. The terms “harmful drug use” and “substance (or drug) dependence” are here understood in terms of their definition in the ICD-11 (World Health Organization, 2019).

Violence victimization and drug use

The argument that drug criminalization may increase harmful drug use via violence victimization rests on two distinct causal steps. Step one is that drug criminalization leads to an increase in violent criminality, which has been argued at least since the 1970s by a number of authors (e.g. Abadinsky, 2011; Anomaly, 2013; Bourgois, 2018; Coyne and Hall, 2017; Earp et al., 2021; Friedman, 1972; Goldstein, 1985; Jacques and Allen, 2015; Kurzman and Magell, 1977; Smith, 2002; Topalli et al., 2002). As summarized in Johnstad (2023), the societal dynamics involved are often identified along the following lines: criminalization makes the illicit drug trade highly profitable and thus attractive to criminal organizations, who will compete with each other for access to the drug market. Since the illicit nature of the trade makes it impossible to resolve disputes in court, drug trade organizations instead compete using violent means (Jacques et al., 2016; Jacques and Wright, 2011). In this manner, the high profitability of the illicit drug trade both incentivizes organized crime and increases the violence related to such organizations. Furthermore, the drug trade also incentivizes intra-organizational violence for the purpose of keeping subordinates in line (Goldstein, 1985). Besides such direct effects, moreover, the high profitability of the illicit drug trade and the expansion of organized crime networks this entails also breeds community violence in a number of indirect ways. First of all, research has confirmed that people who commit violence in their working lives often do so also in their private lives (Brown, 2007; Totten, 2000; Ulloa et al., 2012; Wilkins et al., 2014). Ordinary people living in communities with high levels of organized crime therefore often have reason to be afraid, and since fearful people are probably more prone to anger (Nussbaum, 2018), this likely results in more acts of violence (Scarpa and Raine, 2000). In addition, widespread community violence may desensitize a person to violence and thus normalize it as a means to solve problems (Gaylord-Harden et al., 2017; Gorman-Smith et al., 2004), and people living in such communities may acquire firearms to protect themselves and their families, thereby also increasing their ability to perpetrate violence (Miron and Zwiebel, 1995). Finally, by increasing drug prices, the drug criminalization regime forces people with drug dependence to raise substantial amounts of money every day, likely increasing criminal acts such as robberies (Goldstein, 1985). In sum, the fact that drug criminalization renders the illicit drug trade highly profitable and thereby incentivizes the growth of drug trade organizations breeds community violence in both direct and indirect ways, not least by imposing a culture of violence on the community.

Today, the most common example used to illustrate how the criminalization regime causes violent criminality is Mexico, which saw a dramatic increase in annual homicides from about 10,000 in 2007 to almost 35,000 in 2020 after the initiation of what is known as the Mexican drug war in late 2006 (Calderón et al., 2021; Fondevila et al., 2020). Commonly attributed to the rise of the drug cartels, this violence has often impacted ordinary Mexican citizens (e.g. Kitroeff and Bergman, 2023). Similar increases in homicides commonly attributed to the illicit drug trade have been observed in Brazil (Calderón et al., 2021; Oliveira et al., 2020; Zorovich, 2015), Central America (Bobea, 2015; Rojas Aravena, 2015), Chile, Uruguay, Peru, and Paraguy (Mohor, 2022; United Nations Office on Drugs and Crime [UNODC], 2023). Outside of Latin America, examples of how the drug criminalization regime causes violent crime includes Afghanistan (Coyne and Hall, 2017) and West Africa (Werb et al., 2011), but also in countries of the Global North such as Sweden, which over the past decade has seen sharp increases in firearm-related violence and bombings that Swedish police has generally attributed to criminal gangs involved in the illicit drug trade (Khoshnood, 2018, 2019; Savage, 2019; Sturup et al., 2020).

The second step explaining how drug criminalization may increase harmful drug use is that people traumatized by violence may commonly turn to drug use in order to cope with their trauma, as indicated for instance by Kaysen et al. (2007). In the context of this analysis and review, the term “trauma” describes lasting psychological and/or physiological damage resulting from violence victimization. The psychological form of such trauma most commonly includes symptoms relating to posttraumatic stress disorder (PTSD), while physiological trauma includes pain conditions and reduced functionality.

The relationship between victimization and drug use is here supported by a scoping review of the relevant literature. Previous reviews have identified some evidence for an association between drug use and violence victimization (Bacchus et al., 2018; Devries et al., 2014; Golding, 1999; Jack et al., 2014; Schumacher et al., 2001; Stith et al., 2004; Stubbs and Szoeke, 2022). Much of this evidence pertains to alcohol use, and the review by Devries et al. (2014) identified significant associations in longitudinal studies extending both from alcohol use to victimization and from victimization to alcohol use. In Bacchus et al.'s (2018) review of past-year intimate partner violence, however, no evidence was obtained for an association with alcohol use in either direction. Nevertheless, this review identified some longitudinal evidence of bidirectional associations with hard drug use, and for an association between victimization and future cannabis use. Finally, a review by Jack et al. (2014) found that opiate use tends to increase with violent conflict.

In order to understand the societal dynamics whereby drug criminalization may increase harmful drug use, it is important to distinguish between what we may term recreational and problematic patterns of drug use. The latter term is here taken to indicate what is known as harmful drug use in the ICD-11 (World Health Organization, 2019) and substance use disorder in the DSM-5 (American Psychiatric Association, 2013), while the former indicates any form of use that does not qualify for such disorder. According to self-medication theory, drug use may be motivated by a wish to cope with mental or emotional distress (Khantzian, 1985, 1997, 2003), and such coping motives have been found to be associated with drug use disorder (Bonn-Miller and Zvolensky, 2009; Suh et al., 2008; Turner et al., 2018). It thus appears that drug use motivated by a desire to obtain a pause from underlying distress more often progresses into problematic drug use. As such drug use generally does not improve the underlying situation—commonly issues of psychological trauma and/or psychiatric disorder—people who engage in drug use from coping motives will likely feel such motivation on a frequent basis and are therefore at risk of ending up in repetitive patterns of drug use. Moreover, such patterns of drug use will often serve to exacerbate the level of overall distress, for instance by increasing the risk for poverty, unemployment, and social isolation. Ironically, therefore, the activity that allows for a temporary escape from underlying distress also, when repeated frequently, increases such distress overall and thereby prepares the ground for more coping activity in the future.

Coping behavior is not limited to psychological distress, however, but may also result from physiological issues. The use of opioids, which is a class of drugs known for its high rate of dependence formation (Anthony et al., 1994; Schlag, 2020), has thus been found to be strongly motivated by the desire to cope with physical pain (AbdelWahab et al., 2018; Cruden and Karmali, 2021; Han et al., 2018; Hartwell et al., 2012). Indeed, these studies identified pain relief as the most important motivation behind nonmedical opioid use, commonly dwarfing other concerns: in the study by Han et al. (2018), more than 63% of participants endorsed pain relief as their main motivation, while the second motivation on the list (“get high or feel good”) was endorsed by fewer than 12%. In sum, while recreational forms of drug use may be motivated by a wide range of interests and concerns—Simons et al. (1998) counted enhancement, conformity, expansion, coping, and social motives for cannabis use—the motivations for repetitive and harmful drug use tend to be more specifically oriented toward coping with underlying trauma. Of course, when dependence on a drug is established, further drug use is also motivated by the desire to cope with the pain and discomfort caused by failing to use this drug frequently.

Forbidden fruit/psychological reactance

A second dynamic through which criminalization may increase the motivation for drug use is known as the forbidden fruit effect. According to this dynamic, adolescents in particular may be enticed into experimenting with drug use because such use is illegal and therefore exciting (Friedman, 1972; Husak, 2003; MacCoun, 1993). This effect is consistent with psychological reactance theory, extending back to Brehm (1966), which posits that the removal of a person's freedom to engage in a given behavior results in a negative emotional reaction in that person. One way to nullify such unpleasant reactance, which would align reactance theory with the forbidden fruit effect, is to engage in the forbidden activity. Researchers have found support for reactance theory in relation to a range of issues (review in Steindl et al., 2015).

Research specifically into the forbidden fruit effect includes a review by Gentile et al. (2005) which identified such an effect for age-restrictive ratings of media presentations. In a recent study that did not identify an increase in postlegalization cannabis use in California, furthermore, Kan et al. (2020) saw the disappearance of the forbidden fruit effect as one of several possible explanations.

Much empirical research on the forbidden fruit effect and psychological reactance is experimental in design, and for both practical and ethical reasons it is difficult to perform experimental studies on the topic of illicit drug use. For this reason, empirical support for a forbidden fruit dynamic should be expected to relate predominantly to other forms of behavior than drug use.

Other effects

There are also several other consequences from the drug criminalization regime that may contribute to increased drug use. Although the evidential bases for these dynamics are not reviewed in the present article, this section will briefly discuss them on a theoretical basis. First of all, the drug criminalization regime clearly entails the buildup of a lucrative illicit drug market. The existence of such a profitable market provides young people, especially those growing up under poor social conditions, with drug dealing as a promising career path. As Merton (1938) emphasized, people who are hindered from achieving success through societally accepted means may choose criminality as an alternative path to success. Referred to variously as “dark social entrepreneurship” (Talmage et al., 2019), “deviant entrepreneurship” (Hesketh and Robinson, 2019), or “criminal entrepreneurship” (Gottschalk, 2019), there is growing acknowledgement among researchers that drug dealing “is in many ways an innovative, entrepreneurial, small-business venture” (Hagedorn, 1998, p. 21). In Hesketh and Robinson's (2019) words, there is a tendency for disenfranchised young males who are unable to find a job, and therefore unable to gain social recognition as a breadwinner, to “attempt to realise their potential not through legitimate employment means but through dark entrepreneurial techniques” (p. 54; see also Pihos, 2022). Because of the criminalization regime, the talents and entrepreneurship of such people are drawn into the profitable illicit drug market, resulting in criminal innovation with regard to the marketing, production, and distribution of drugs.

Furthermore, some researchers have emphasized that the state's heavy-handed attempt to suppress drug use by arresting and incarcerating users breeds social misery and psychological trauma in the dependents of the incarcerated (Bourgois, 2015; Earp et al., 2021). The incarceration of a parent may have a strongly adverse effect on children, and the mass-level arrests that drug criminalization has arguably led to especially in the United States may therefore have led to increased future drug use among affected children. Psychological trauma would here seem to be the main intermediary variable, although the incarceration of a parent may also deprive the family of income and thereby exacerbate problems related to poverty (Csete et al., 2016).

Moreover, it has been argued that incarceration for drug-related criminality is itself a contributor to future drug use for the person incarcerated, since ex-convicts may be less able to find employment or housing and are therefore at increased risk for escapist drug use (Husak, 2007). Research by Binswanger et al. (2007), which found that imprisonment incurs an increased risk of drug overdose upon release, supports this argument. The point that ex-convicts may find it hard to escape their status as criminals is reminiscent of classic labeling theory (Becker, 1963).

Furthermore, law enforcement activity may in and of itself contribute to the overall level of community violence and human rights abuses. Police violence has been pointed to as an important consequence of the drug war in Mexico (Gaussens and Jasso González, 2020; Passos, 2021; Trevino-Rangel, 2018), Brazil (Flom, 2022), the Philippines (Johnson and Fernquest, 2018; Ofreneo et al., 2022; Simangan, 2018), Bolivia (Kurtz-Phelan, 2005), Colombia (Piaggio and Vidwans, 2019), and other places. Such police violence presumably increases trauma and drug use in its victims in the same way as the discussed in the section on violence victimization.

Finally, another dynamic whereby the criminalization regime may serve to increase drug use is known as substance displacement, where police suppression of specific forms of drug use forces the people who are denied access to their drug of choice to turn to other drugs as a substitute (Global Commission on Drug Policy, 2011). The identification of a substance displacement effect goes back at least to 1977, when an interdisciplinary committee established by the Minnesota State Bar Association pointed to several instances of such a displacement effect where the successful suppression of cannabis resulted in a surge in heroin use (Kurzman and Magell, 1977). Since heroin is more susceptible to formation dependence than cannabis (Anthony et al., 1994), this is a dynamic whereby drug criminalization increases harmful drug use.

Impact of drug policy on drug use

Recent research on drug use patterns after legalization or decriminalization pertains for the most part to cannabis, for which findings indicate a moderate increase in general adult drug use without a corresponding increase in adolescent use or drug dependence among either group. In the United States and Canada, most studies have found evidence of moderate increases in adult but not adolescent use after cannabis decriminalization (Haines-Saah and Fischer, 2021; Hall and Lynskey, 2020; Hasin and Walsh, 2021; Leung et al., 2018; O’Grady et al., 2022; Rubin-Kahana et al., 2022; Sarvet et al., 2018; Smart and Pacula, 2019), while studies on the international level have often tended to find no overall association between policy regime and cannabis use (Gabri et al., 2022; Hughes et al., 2018; Kotlaja and Carson, 2019; Laqueur et al., 2020). Furthermore, most studies have not found evidence of increasing postliberalization dependence (Cabral, 2017; Fischer et al., 2021; Martins et al., 2021; Mauro et al., 2019; Myran et al., 2023; Williams et al., 2017), although some have found evidence also of moderate increases in problematic cannabis use (Cerdá et al., 2020; Hasin et al., 2015; Kerr et al., 2023).

Thus, despite some variation in findings, the overall trend seems to be that cannabis decriminalization is not associated with substantial increases in cannabis use disorder or dependence. It has been argued, however, that research findings related for the most part to short to medium-term effects from limited depenalization do not give us a clear indication of the long-term extent of drug use after full legalization (MacCoun and Reuter, 2001). Such effects could work in both directions. The consequences of cannabis decriminalization may also not be generalizable to other illicit drugs, about which there is very little available research. One exception in this regard pertains to the program of heroin-assisted treatment in Switzerland that started in the early 1990s (Csete and Grob, 2012). Reported outcomes from this program include an 82% reduction of incidence of starting heroin use (Nordt and Stohler, 2006; Uchtenhagen, 2010) that was probably related to the near collapse of the illicit market (Ribeaud, 2004).

Beyond these immediate effects from policy changes on different drug use patterns, drug policy may also affect drug use via long-term dynamics that perhaps take decades to fully manifest. This article discusses and reviews societal dynamics by which the drug criminalization regime may serve to increase problematic drug use in ways that would be largely invisible to the research on postdecriminalization cannabis use cited above. If violent crime resulting from the criminalization regime produces psychological or physiological trauma which in turn increases the risk of harmful drug use, then the people affected are not likely to snap out of their hardship-induced drug problems simply because the drugs they depend on are legalized. Instead, such people may be traumatized for life, and their desire to use drugs to cope with their trauma is likely to continue irrespective of changes to the policy regime. Over the long term, however, a policy change that serves to lower the profitability of the illicit market will also lower the extent of violent crime related to this market and thereby reduce its production of further trauma. Such a policy change, in other words, can be expected to gradually weaken the societal dynamic whereby violent criminality creates drug use motivated by coping, but it will not nullify the trauma that has already been created.

Method

Scoping reviews attempted to assess the research literature on how violence victimization and the forbidden fruit effect affect drug use. Two Pubmed searches were performed in August 2023 of English-language publications of original research covering the time period from the inception of the database up until the search was performed. Search terms were based on common conceptualizations of the relevant phenomena, using several variants when possible. The review followed standardized practices for scoping reviews (Mak and Thomas, 2022; Peters et al., 2015).

The search related violence victimization was defined as [(“violence victimization” OR “exposure to violence”) AND (“drug use” OR “drug misuse” OR “drug abuse” OR “drug addiction”)], producing a total of 181 results. A search for [“forbidden fruit” AND “drug”] produced only two results, and in order to obtain more general information about this dynamic the search was cut down simply to [“forbidden fruit”], which gave 41 results. To further extend this range of results, an additional search for [“reactance theory”] was performed in April 2025. It should be noted that research on psychological reactance and the forbidden fruit effect with regard to topics unrelated to illicit drug use can only serve as evidence for a general psychological tendency to resist restrictions on one's freedom.

The selection procedure is shown in the flow chart of Figure 1. Inclusion criteria for the reviews were that the study involved original empirical research published in English pertaining to the relevant dynamics under scrutiny. Studies in the search on violence victimization were excluded if they only reported findings related to violence perpetration or longitudinal findings on how drug use affects the risk of victimization (e.g. Eisman et al., 2018). Studies in the search on the forbidden fruit dynamic were excluded mainly for using the phrase “forbidden fruit” only as a metaphor and not investigating it as a psychological dynamic, while studies on psychological reactance were frequently excluded for investigating ways to utilize or overcome the reactance effect rather than assessing its impact on behavior (e.g. Sprengholz and Bührig, 2025). Included studies were classified according to their methodological strategy, and longitudinal, retrospective, experimental, and qualitative studies that allow for temporal directionality were considered to provide higher quality evidence than nondirectional associations in cross-sectional (including case-control) studies. Note that this classification of methodological strategy was based only on the temporal relationship between the variables relevant to the present review; thus, a study that reported data for violence victimization and drug use within the same period of time, or without specifying temporality, was here classified as cross-sectional even if it may have included longitudinal aspects relating to other issues.

Figure 1.

Flow diagram for report inclusion.

Results

Violence victimization and drug use

Table 1 provides an overview of the studies included in the review on violence victimization and drug use (including alcohol and tobacco). Three studies included measurements both of childhood and adolescent/adult victimization and have been listed both for their retrospective and their cross-sectional findings (Galano et al., 2023; Jirapramukpitak et al., 2011; Richardson et al., 2013), while four prospective longitudinal studies (Beharie et al., 2019; Menard et al., 2015; Mulla et al., 2020; Scheidell et al., 2018) also reported cross-sectional findings. In the rightmost column for evidence of a victimization dynamic, cross-sectional studies indicating an association have been labeled as such since the directionality of this association is not clear: although victimization may cause drug use, drug use may also lead to victimization (however, the evidence for this latter dynamic in longitudinal studies is mixed, as demonstrated for instance by Eisman et al., 2018 and Nowotny and Graves, 2013). Six studies (Amaro et al., 1990; Beharie et al., 2019; Fang et al., 2016; Kadra et al., 2014; Menard et al., 2015; Temple and Freeman, 2011) were, for the purposes of the present review, overzealous in applying statistical control to multivariate models, particularly by controlling one form of violence victimization for other forms of victimization, or by controlling different forms of drug use for one another. As there is no expectation in the present review that a given form of violence victimization should be associated with drug use over and above similar effects from other forms of violence victimization, or that such victimization should be associated with a given form of drug use over and above its association with other forms of drug use, bivariate associations were reported for these studies (see the note in Table 1 for explanations for the relevant studies). Furthermore, some cross-sectional studies found evidence only for an association between victimization and certain forms of drug use.

Table 1.

Chronological overview of studies on violence victimization and drug use (n = 60).

Study	Location	Population	Sample size	Strategy	Independent variable	Outcome	Victimization dynamic
Amaro et al. (1990)	USA	Pregnant women	1243	Cross-sectional	Violence victimization during pregnancy	Increased risk for drinking two or more drinks per day (OR 5.15, p < .05), weekly cannabis use (OR 2.56, p < .05) and weekly cocaine use (OR 2.91, p < .05)	Association^a
Conway et al. (1994)	USA	Patients and visitors	1196	Cross-sectional	Violence victimization	Increased risk for alcohol (OR 2.26, p < .05) and illicit drug use (OR 3.68, p < .05)	Association
Berenson et al. (2001)	USA	Adolescent girls	517	Cross-sectional	Violence victimization	Increased risk for tobacco use (OR 3.0, p < .05), alcohol use (OR 2.0, p < .05), and cannabis use (OR 3.0, p < .05)	Association
Fehon et al. (2001)	USA	Adolescent patients	89	Cross-sectional	Exposure to violence (including perpetration)	Increased risk for illicit drug use (Eta .34, p < .001) but not alcohol use (Eta .12, p > .01)	Association (Partial)
Fuller et al. (2002)	USA	Noninjection and injection drug users	270	Retrospective	Violence victimization	Increased risk for transition to injection drug use (OR 1.45–2.78, p < .05)	Yes
Cunningham et al. (2003)	USA	Adult patients	320	Cross-sectional	Exposure to violence (including perpetration)	Increased risk for past-month binge drinking (OR 3.5, p < .01) and illicit drug use (OR 4.5, p < .001)	Association
Romero-Daza et al. (2003)	USA	Women in prostitution	35	Qualitative interviews	Violence victimization	“Women who have been victimized may turn to drug use in an attempt to deal with the harsh realities of their daily lives”	Yes
Vermeiren et al. (2003)	International	Adolescents	3380	Cross-sectional	Violence victimization (severe)	Increased risk for tobacco (OR 1.56–3.21, p < .05) and hard drug use (OR 1.71–3.35, p < .05) in all countries; mixed results for alcohol and cannabis use	Association (partial)
Lagasse et al. (2006)	USA	Children exposed to drugs during pregnancy	517	Cross-sectional	Community violence exposure (including witnessing)	Increased risk for tobacco, alcohol, and illicit drug use (OR 3.2, p < .05)	Association
Morojele and Brook (2006)	South Africa	Adolescents	1474	Cross-sectional	Violence victimization	Increased risk for alcohol use (OR 1.33, p < .001); marginally increased risk for cannabis use (OR 1.14, p < .1); no increased risk for cigarette use	Association (partial)
Reid et al. (2006)	USA	Adolescents	586	Cross-sectional	Violence victimization	Increased risk for illicit drug use (beta .28, p < .05)	Association
Harris et al. (2007)	USA	Adolescent	1	Case study	Physical child abuse and neglect	Developmental difficulties, illicit drug use, drug dealing, and violent criminality	Yes
Rivera-Rivera et al. (2007)	Mexico	Youths 11–24	7960	Cross-sectional	Physical dating violence victimization	Increased risk for alcohol use among women (OR 1.63, p < .05) but not among men; no increased risk for illicit drug use among either sex	Association (partial)
Brown et al. (2009)	International	Adolescents	12,041	Cross-sectional	Physical and sexual violence victimization	Increased risk for tobacco use (OR 6.15, p < .001), alcohol use (OR 6.56, p < .001), and illicit drug use (OR 7.63, p < .001)	Association
Reed et al. (2009)	Brazil	Female prisoners	377	Cross-sectional	Violence victimization	Increased risk for illicit drug use (OR 2.4, p < .05)	Association
Hankin et al. (2010)	USA	African American women	430	Cross-sectional	Intimate partner violence victimization	Increased risk for tobacco dependence (RR 1.72, p < .01), alcohol dependence (RR 2.13, p < .01), and illicit drug dependence (RR 3.90, p < .01)	Association
Jirapramukpitak et al. (2011)	Thailand	Youths 16–25	1052	Retrospective	Physical child abuse	Increased risk for problem drinking (OR 1.7, p < .05) and illicit drug use (OR 2.0, p < .05)	Yes
Jirapramukpitak et al. (2011)	Thailand	Youths 16–25	1052	Cross-sectional	Intimate partner violence victimization	Increased risk for problem drinking (OR 3.7, p < .05) and illicit drug use (OR 5.1, p < .05)	Association
Temple and Freeman (2011)	USA	Adolescents	1565	Cross-sectional	Dating violence victimization	Increased risk for binge drinking (OR 2.901, p < .0001) and illicit drug use (OR 3.119, p < .0001)	Association^b
Stenbacka et al. (2012)	Sweden	Male military conscripts	48,834	Longitudinal	Violence victimization	Increased risk for mortality due to alcohol and drug-related causes (HR 6.58, p < .05)	Yes
Swahn et al. (2012)	Uganda	Underprivileged youths 14–24	457	Cross-sectional	Violence victimization	No increased risk for binge drinking (OR 1.49, p > .05) or illicit drug use (OR 1.13, p > .05)	No
Nowotny and Graves (2013)	USA	Female adolescents → adults	2959	Longitudinal	Intimate partner violence victimization	Increased risk for cannabis use (OR 1.9, p < .001); marginally increased risk for illicit drug use (OR 1.5, p < .1); no increased risk for binge drinking	Partial
Richardson et al. (2013)	USA	Adolescents	214	Retrospective	Childhood maltreatment	Increased risk for cannabis (OR 2.3, p < .001) and tobacco use (OR 1.58, p < .05)	Yes
Richardson et al. (2013)	USA	Adolescents	214	Cross-sectional	Violence victimization	Increased risk for cannabis use (OR 1.85, p < .001)	Association
Bellis et al. (2014)	England	Adults 18+	3885	Retrospective	Adverse childhood experiences (4+)	Increased risk for tobacco use (OR 3.29, p < .001), binge drinking (OR 2.08, p < .001), cannabis use (OR 6.20, p < .001), and heroin or crack cocaine use (OR 10.88, p < .001)	Yes
Blom et al. (2014)	Sweden	Youths 15–23	3170	Cross-sectional	Physical abuse victimization	Increased hazardous alcohol consumption (women OR 1.7, p < .05; men OR 2.3, p < .05) and illicit drug use (women OR 1.9, p < .05; men OR 2.0, p < .05); increased risk for daily tobacco use only among women (women OR 1.3, p < .05; men OR 1.3, p > .05)	Association
Gonzalez-Guarda et al. (2014)	USA	Cuban-American adolescents	82	Cross-sectional	Dating violence victimization	Increased risk for past 30-day illicit drug use (OR 12.12, p < .05) but not binge drinking	Association (partial)
Kadra et al. (2014)	England	Adults 16+	1698	Cross-sectional	Violence victimization	Increased risk for hazardous alcohol use (OR 1.86, p < .05) and lifetime (OR 2.20, p < .01) and past 12-month illicit drug use (OR 3.12, p < .001)	Association^c
Minnes et al. (2014)	USA	Adolescents	358	Cross-sectional	Violence exposure (including witnessing)	Increased risk for tobacco (OR 1.47, p < .002), cannabis (OR 1.55, p < .001) and any drug use (OR 1.24, p < .04)	Association
Chaskel et al. (2015)	Colombia	General population	N/A	Country profile	Armed insurgency	Extremely large number of trauma patients, high burden of alcohol misuse and illicit drug use	Yes
Menard et al. (2015)	USA	Adolescents → adults	1119	Longitudinal	Physical child abuse	Increased risk for adult cannabis use (females r = .158, p < .001; males r = .100, p < .05); marginally increased risk for hard drug use (females r = .111, p < .01; males r = .077, p < .1)	Yes^d
Menard et al. (2015)	USA	Adolescents	1119	Cross-sectional	Physical child abuse	Increased risk for hard drug use (females r = .282, p < .001; males r = .134, p < .002) and cannabis use for females (r = .196, p < .001) but not males (r = .049, p > .05)	Association (partial)
Parker and Bradshaw (2015)	USA	Adolescents	18,680	Cross-sectional	Dating violence victimization	Increased risk for high polysubstance use (OR 4.811, p < .001), and alcohol and cannabis use (OR 1.754 p < .001)	Association
Fang et al. (2016)	Israel	Adolescents	4733	Retrospective	Political violence exposure	Increased risk for cannabis (r = .080, p < .0001), ecstasy (r = .095, p < .0001) and inhalant use (r = .098, p < .0001)	Yes^e
Quinn et al. (2016)	USA	Black men who have sex with men	98	Cross-sectional	Exposure to community violence (including witnessing)	Increased risk for past 3-month illicit drug use (OR 6.73, p < .0), daily tobacco use (OR 3.61, p < .05) and heavy cannabis use (OR 3.87, p < .05)	Association
Abdalla et al. (2017)	Brazil	Age 14+	4607	Cross-sectional	Urban violence victimization	Increased risk for binge drinking (OR 1.68, p < .01), AUD (OR 3.65, p < .001) and cocaine use (OR 2.61, p = .07)	Association
Miller et al. (2017)	USA	Adolescents	155	Cross-sectional	Dating violence victimization	Increased risk for alcohol (OR 4.31, p < .05) and other drug problems (OR 5.58, p < .05)	Association
Sommer et al. (2017)	South Africa	Young males at risk	290	Cross-sectional	Exposure to violence (including witnessing)	Increased risk for illicit drug use (r = .34, p < .001)	Association
Assari (2018)	USA	Students	27,961	Cross-sectional	Violence victimization	Increased risk for illicit drug use (r = .09, p < .01) and problem drinking (r = .09, p < .01)	Association
Lee and Lee (2018)	South Korea	Adolescents	62,276	Cross-sectional	Violence victimization	Increased risk for heavy cigarette smoking (OR 10.52/11.94, p < .05), daily alcohol use (OR 8.71/17.53, p < .05), and current illicit drug use (OR 11.88/14.45, p < .05) among males/females	Association
Scheidell et al. (2018)	USA	Adolescents → adults	12,288	Longitudinal	Childhood traumatic experiences (4+)	Increased risk for cannabis (OR 2.23, p < .0001) and cocaine use (OR 3.06, p < .0001) in adulthood	Yes
Scheidell et al. (2018)	USA	Adolescents → adults	12,288	Cross-sectional	Childhood traumatic experiences (4+)	Increased risk for cannabis (OR 6.92, p < .0001) and cocaine use (OR 9.54, p < .0001) in adolescence	Association
Beharie et al. (2019)	USA	Adolescents → adults	12,288	Longitudinal	Violence victimization in adolescence	Increased risk for binge drinking (OR 1.69, p < .001), cannabis use (OR 1.79, p < .001), cocaine use (OR 1.62, p < .01) and methamphetamine use (OR 2.01, p < .001) in adulthood	Yes^f
Beharie et al. (2019)	USA	Adolescents → adults	12,288	Cross-sectional	Violence victimization	Increased risk for binge drinking (OR 2.58, p < .001), cannabis use (OR 2.96, p < .001), and cocaine use (OR 3.55, p < .01)	Association^f
Clayton et al. (2019)	USA	Adolescents	14,765	Cross-sectional	Physical dating violence victimization	Increased lifetime nonmedical use of prescription opioids (PR 2.56, p < .05)	Association
Goldstick et al. (2019)	USA	Adolescents → adults	850	Longitudinal	Violence victimization	No increase in alcohol or cannabis use	No
Hotton et al. (2019)	USA	Black men who have sex with men	617	Cross-sectional	Exposure to community violence (including witnessing)	Increased risk for problematic substance use (OR 1.03, p < .001)	Association
Bermea et al. (2020)	USA	Adolescents in disadvantaged communities	737	Cross-sectional	Violence victimization	Increased past 30-day alcohol, tobacco, and other drug use (r = .587, p < .001)	Association
Lowry et al. (2020)	USA	Adolescents	6082	Cross-sectional	Multiple (3 + occasions) violence victimization	Increased risk among males/females for current cigarette (PR 5.13/4.40, p < .05), alcohol (PR 2.34/2.59, p < .05), cannabis (PR 2.48/2.36, p < .05), cocaine (PR 4.35/4.66, p < .05), methamphetamine (PR 9.75/7.68, p < .05), and heroin use (PR 12.16/18.32, p < .05) as well as prescription drug misuse (PR 2.11/3.12, p < .05)	Association
Mulla et al. (2020)	USA	Adolescents	1752	Longitudinal	Dating and sexual violence victimization	Dating violence increased risk for heavy alcohol (B = .16; p < .05) and cannabis use (B = .61; p < .01); Sexual violence increased risk for cannabis use (B = .31; p < .01) but not heavy alcohol use	Partial
Mulla et al. (2020)	USA	Adolescents	1752	Cross-sectional	Dating and sexual violence victimization	Dating violence increased risk for heavy alcohol (B = .33; p < .01) and cannabis use (B = .56; p < .01); Sexual violence increased risk for heavy alcohol (B = .20; p < .01) and cannabis use (B = .42; p < .01)	Association
Pengpid and Peltzer (2020)	International	Students	18,335	Cross-sectional	Physical intimate partner victimization and/or sexual violence victimization	Increased risk for binge drinking (OR 1.88, p < .001), tobacco use (OR 2.57, p < .001) and monthly illicit drug use (OR 1.72, p < .05)	Association
Saadatmand et al. (2020)	USA	African American adults 18–25	440	Cross-sectional	Exposure to direct personal violence	Exposure to violence explained from 41.7% (males) to 81.8% (females) of the variance in ATOD (alcohol, tobacco and, other drug use) problem behaviors	Association
Goldstick et al. (2021)	USA	Youths 14–24	599	Longitudinal	Community violence and crime exposure (including witnessing)	Increased risk for DUD (OR 1.28, p < .05)	Yes
Kappel et al. (2021)	Honduras	Adults 18–24	2701	Retrospective	Physical violence victimization in childhood	Increased risk for current smoking (OR 1.4, p < .01), past 30-day binge drinking (OR 1.4, p < .01), and past 30-day illicit drug use (OR 4.2, p < .0001)	Yes
Saadatmand et al. (2021)	USA	African American adults 18–25	638	Retrospective	Child maltreatment	Increased risk for current illicit drug use and for ATOD (alcohol, tobacco and, other drug use) problems (r = .281, p < .001), but decreased risk for lifetime ATOD use	Partial
McKinley (2022)	USA	Indigenous adults	117	Cross-sectional	Intimate partner violence	Increased risk for alcohol (B = .24, p < .05) and illicit drug use (B = .50, p < .01)	Association
Picchetti et al. (2022)	Lesotho	Youths 13–24	8568	Cross-sectional	Sexual violence victimization	Increased risk for past 30-day binge drinking (OR 1.8/2.2, p < .05) but not past 30-day illicit drug use (OR 1.1/2.0, p > .05) among females/males	Association (partial)
Robles et al. (2022)	USA	Latino sexual minority cis men	530	Cross-sectional	Physical intimate partner violence victimization	Increased Alcohol Use Disorders Identification Test (AUDIT) scores (OR 1.06, p < .05) but not Drug Abuse Screening Test (DAST) scores	Association (partial)
Saadatmand et al. (2022)	USA	African American adults 18–25	638	Cross-sectional	Violence victimization	Different exposure-to-violence factors associated positively or negatively with alcohol, tobacco and, other drug use problem behaviors	No
Seff et al. (2022)	International	Youths 13–24	16,890	Retrospective	Violence victimization in childhood	Increased risk for illicit drug use among males (OR 3.48–4.62, p < .05) but not among females; no increased risk for tobacco or alcohol use	Partial
Victor and Staton (2022)	USA	Rural incarcerated women	400	Cross-sectional	Violence victimization	Increased risk for nonmedical prescription opioid (p < .001) and sedative (p < .05) use, heroin use (p < .01), and methamphetamine use (p < .001), but not cocaine use (p = .44)	Association (partial)
Axinn et al. (2023)	International	Adults 18+	18,212	Retrospective	War or civil violence exposure	Increased risk for AUD (RR 1.5, p < .05) and SUD (RR 2.0, p < .05)	Yes
Chung et al. (2023)	Taiwan	Adult patients	43,630	Cross-sectional	Violence victimization	Increased risk for tobacco use disorder (HR 1.75, p < .0001), alcoholism (HR 5.62, p < .0001), and drug dependence (HR 7.15, p < .0001)	Association
Galano et al. (2023)	USA	Students	256	Retrospective	Childhood poly-victimization	Increased risk for illicit drug use (Z = 2.47, p < .05) but not alcohol use (Z = −0.28, p > .05)	Partial
Galano et al. (2023)	USA	Students	256	Cross-sectional	Physical intimate partner violence victimization	No increased risk for illicit drug (Z = 1.33, p > .05) or alcohol use (Z = −1.35, p > .05)	No
Vidal et al. (2023)	International	Students	40,250	Cross-sectional	Violence victimization	Increased risk for cannabis use (OR 1.36, p < .0001)	Association

OR: odds ratio; RR: risk ratio; HR: hazard ratio; PR: prevalence ratio; ATOD: alcohol, tobacco and other drugs; DUD: drug use disorder; AUD: alcohol use disorder; SUD: substance use disorder.

The associations for illicit drug use lost significance when controlled for previous violence victimization in multivariate analysis.

The associations for illicit drug use lost significance when controlled for alcohol and tobacco use in multivariate analysis.

The associations for alcohol use lost significance when controlled for violence witnessing and perpetration.

The associations lost significance when controlled for witnessing violence and adolescent drug use.

Effect mediated by school support and post-traumatic stress.

The associations lost significance when controlled for child abuse.

The evidence was nevertheless quite clear, with 43 of 46 cross-sectional studies finding evidence for an association between violence victimization and some type of drug use (although it should be noted that the studies by Fehon et al. (2001) and Cunningham et al. (2003) included perpetration in their exposure to violence variable). For tobacco, 14 of 16 studies found evidence for an association (only for women in Blom et al., 2014), while 29 of 34 studies found corresponding evidence for alcohol (only for the United States in Vermeiren et al. (2003) and only for women in Rivera-Rivera et al. (2007)). Similarly, an association was evident in all 14 cannabis studies, although this pertained only to some countries in Vermeiren et al. (2003), only for females in Menard et al. (2015), and only marginally in Morojele and Brook (2006). Finally, the same was true for 35 of 41 studies of (general) illicit drug use.

Longitudinal, retrospective, and qualitative studies allow for an identification of directionality. Seven of eight longitudinal studies found evidence of a victimization dynamic at least for some forms of drug use, and the same was true for all 10 retrospective studies (the studies by Bellis et al. (2014) and Scheidell et al. (2018) measured adverse childhood experiences ranging beyond victimization, but most of the sample in their 4 + types of experiences group appear to have included violence victimization). Counting both types of studies, four of five found evidence of a victimization dynamic for tobacco use (Saadatmand et al., 2021, found increased risk for overall alcohol, tobacco and, other drug use problems but decreased risk for lifetime use), 8 of 12 for alcohol use (only for dating violence not sexual violence in Mulla et al., 2020), 8 of 9 for cannabis use, and all 15 for illicit drug use (only among males in Seff et al., 2022 and with marginal significance in Nowotny and Graves, 2013).

Only three qualitative studies were included in the review, all identifying a victimization dynamic. Romero-Daza et al. (2003) interviewed 35 women in prostitution in in inner-city Hartford, Connecticut, finding that these women commonly attributed their drug use to a need to cope with trauma resulting from violence victimization. A single case study in Harris et al. (2007) provides limited evidence in an overall sense, but their narrative of 15-year-old Andre's trajectory from child abuse to adolescent drug use, drug dealing, and psychosis offers an in-depth understanding of how childhood victimization may impact a person's life. Finally, Chaskel et al. (2015) offered a country profile of Colombia, where the decades-long armed insurgency, fueled by income from illicit drugs trafficking, has resulted in an “extremely large number” of trauma patients and a “significant burden” of alcohol misuse and illicit drug use. Thus, it appears that in Colombia, nationwide violence has been exacerbated by the high profitability of the illicit drug trade entailed by the international regime of drug control, resulting in widespread trauma and a corresponding increase in attempts to cope via alcohol and drug use. A similar observation was made for Honduras in the retrospective study by Kappel et al. (2021). (One recent longitudinal study by Borges et al. (2021), that was not included in the review also found evidence for a victimization impact on alcohol and drug use disorder in Mexico, but the impact of the Mexican war on drugs on violence victimization and drug use appears to be understudied as of yet.)

While this review has focused on direct victimization, a number of the included studies (Axinn et al., 2023; Fang et al., 2016; Goldstick et al., 2021; Hotton et al., 2019; Lagasse et al., 2006; Minnes et al., 2014; Quinn et al., 2016; Sommer et al., 2017) combined direct and indirect (witnessing) victimization in their analyses. Several other studies (Beharie et al., 2019; Berenson et al., 2001; Conway et al., 1994; Goldstick et al., 2019; Jirapramukpitak et al., 2011; Kappel et al., 2021; Menard et al., 2015; Romero-Daza et al., 2003; Saadatmand et al., 2021; Vermeiren et al., 2003) separated these two forms for victimization but found evidence also for an association between witnessing violence and drug use. Furthermore, several studies found evidence for an association between violence perpetration and drug use (e.g. Abdalla et al., 2017; Fang et al., 2016; Goldstick et al., 2019; McKinley, 2022; Stenbacka et al., 2012). Thus, there is reason to believe that violence increases the risk for drug use both among direct victims and witnesses, as well as among perpetrators.

Forbidden fruit/psychological reactance

Tables 2a and 2b provide an overview of the studies included in the reviews on the forbidden fruit effect and psychological reactance. While congruent, the studies obtained from these reviews are somewhat different in their orientation. The studies of the forbidden fruit effect specifically and straightforwardly investigate whether the prohibition of a certain behavior leads to a paradoxical increase in this behavior. By contrast, the reactance studies more generally investigate a range of hypotheses relating to various reactance effects. Focused predominantly on messaging, these studies typically analyze (1) to which extent insistent or controlling language is perceived as a freedom threat, (2) to which extent such freedom threats result in psychological reactance, perhaps with separate emotional (anger) and cognitive effects, and (3) to which extent reactance results in the unwanted behavior, which these studies sometimes refer to as a “boomerang effect.”

Table 2.

(a) Chronological overview of studies on the forbidden fruit effect (n = 10).

Study	Location	Population	Sample size	Strategy	Independent variable	Outcome	Forbidden fruit dynamic
Mann and Ward (2001)	USA	Students	162	Experimental	Prohibition of food item	Increased thinking about but not consumption of food item	Partial
Giacopassi et al. (2006)	USA	Students	48	Qualitative	Prohibition of under-age gambling	14.6% of respondents endorsed forbidden fruit motivation	Partial
Jansen et al. (2008)	Nether lands	Children 5–7	70	Experimental	Restriction on fruit and sweets intake	Increased fruit and sweets consumption	Yes
Bijvank et al. (2009)	Nether lands	Children 7–17	310	Experimental	Video game age and violent-content labels	Increased attractiveness to forbidden games for all age and gender groups	Yes
Sussman et al. (2010)	USA	Adolescents	710	Longitudinal	Perceptions of social prohibition of tobacco use	Increased intention to smoke but not past-month smoking	Partial
DeWall et al. (2011)	USA	Students	240	Experimental	Enforced limitation of attentiveness to images of attractive people	Reported less satisfaction with and commitment to relationship partner	Yes
Keijsers et al. (2012)	Nether lands	Adolescents	497	Longitudinal	Parental prohibition of friendships	Increased contacts with deviant peers	Yes
Pedersen (2014)	Norway	Adolescents → adults	2454	Longitudinal	Involvement with Christianity in teenage years	Less subsequent sexual experimentation	No
Moorman and Harrison (2019)	USA	Children 4–6	278	Cross-sectional	Use of screen media when supposed to be sleeping	Shorter duration of sleep	Association (Partial)
Binder et al. (2020)	Austria	Children 6–11	68	Experimental	Candy forbidden at home	Increased attractiveness to candy presentations	Yes

(2b) Chronological overview of studies on psychological reactance (n = 24)
Study	Location	Population	Sample size	Strategy	Independent variable	Outcome	Reactance dynamic
Clee and Henion (1979)	USA	Adults	338	Experimental	Blood bank recruitment messaging	No association between message urgency and agreement	No
Allen et al. (1994)	USA	Students	2142	Quasi-experimental	Underage vs. legal-age alcohol consumption after drinking age change	Higher consumption among underage consumers	Yes
Quick and Considine (2008)	USA	Adults 16+	247	Experimental	Forceful language in health messages	Forceful language produced reactance and reduced message persuasiveness	Yes
Quick and Bates (2010)	USA	Students	359	Experimental	Gain/loss-frame messages dissuading excessive alcohol consumption	Message frame not associated with reactance, but reactance positively associated with motivation to engage in excess drinking	Partial
Quick et al. (2011)	USA	Students	351	Experimental	Freedom-threatening language in organ donation messages	Freedom-threatening language resulted in reactance, but reactance did not result in lower donor willingness	Partial
Van Petegem et al. (2015)	Belgium	Adolescents	1472	Cross-sectional	Controlling parenting style	Controlling parenting associated with greater adolescent reactance and behavioral problems	Association
Xu (2015)	USA	Students	359	Experimental	Controlling language in antidrunken driving and antismoking messages	Controlling language reduced ad effectiveness, but only when combined with high message sensation value	Partial
Smith et al. (2016)	USA	Women on probation and parole	402	Longitudinal	Parole officer conversational or conformity (reflecting obedience to authority) style	Conformity communication resulted in higher levels of reactance and lower self-efficacy to avoid drugs and alcohol	Yes
Wehbe et al. (2017)	International	Adults	260	Experimental	Smokers’ and nonsmokers’ responses to tobacco counter-advertisements	Smokers reported more maladaptive coping responses and fewer adaptive coping responses to tobacco counterads	Yes
Han and Kim (2019)	USA	Adults 45–64 with diabetes	311	Experimental	High/low freedom threat in diabetes messaging	High freedom threat resulted in increased reactance and lower compliance with recommended behavior	Yes
Slavin and Earleywine (2019)	USA	Students and adults	388	Experimental	Message promoting cannabis abstinence or harm reduction	The abstinence message evoked greater reactance than the harm reduction message and led to less favorable attitudes toward the advocated behavior	Yes
Zhang (2020)	China	Students	402	Experimental	Freedom restoration text in messages on binge-drinking, organ donation and political consumerism	Freedom restoration reduced perceived freedom threat only organ donation messages; reactance consistently had a negative effect on attitude	Partial
Kang et al. (2021)	Republic of Korea	Adults	324	Experimental	Descriptive or injunctive normative appeal to COVID-19 prevention measures	The injunctive normative appeal provoked higher freedom threat and less positive attitude to advocated behavior	Yes
Reynolds-Tylus and Martinez Gonzalez (2021)	USA	Adults	174	Experimental	Preparedness messages with choice-enhancing or choice-restricting language	Choice-restricting language resulted in greater reactance and diminished intention to prepare an emergency kit	Yes
Sprengholz et al. (2021)	Germany and USA	Adults	2367	Experimental	Mandatory vaccination	Vaccine mandates increased intentions to take actions against the restriction	Yes
Ball and Wozniak (2022)	USA	Adults	268	Cross-sectional	Freedom threat perceptions in COVID-19 messaging	Perceived freedom threat was related positively to reactance, which was related negatively to adherence to recommended behavior	Association
Kriss et al. (2022)	USA	Students	371	Experimental	COVID-19 vaccine mandates with/without sanctions	Mandates supported by sanctions elicited more reactance and negative vaccine attitudes	Yes
Rains et al. (2022)	USA	Adults	347,596	Longitudinal	Imposition and removal of state COVID-19 mask mandates	Mask wearing increased after the imposition of mandates, but was moderated by partisanship	Partial
Barbarossa et al. (2023)	Italy	Adults 18–41	821	Cross-sectional	COVID-19 contact tracing apps (CTAs)	Young Italian adults’ opposition to CTAs is a side effect of the threatened freedom generated by government-imposed containment measures	Association
Xiang et al. (2023)	China	Adults	469	Experimental	Freedom threat in vaccine promotion messages	Low-threat messaging resulted in more successful vaccine promotion	Yes
Guo (2024)	China	Students	449	Cross-sectional	Mandatory use of sports apps	Reactance may explain students’ resistance to mandatory use of sports apps	Association
Huang et al. (2024)	USA	Adults	47	Qualitative	COVID-19 vaccine mandates	A subsection of participants felt pressured to get the vaccine, which led to weaker intentions to vaccinate	Partial
Park and Clayton (2024)	USA	Students	243	Experimental	Dogmatic/suggestive language in Christian-sourced excessive alcohol consumption messages	Dogmatic language increased intentions to consume alcohol in some but not all models	Partial
Zhang et al. (2025)	China	Students	1822	Cross-sectional	Parenting behaviors	Parental rejection associated with reactance and deviant peer affiliation	Association

Nine of these studies (Allen et al., 1994; Park and Clayton, 2024; Quick and Bates, 2010; Slavin and Earleywine, 2019; Smith et al., 2016; Sussman et al., 2010; Wehbe et al., 2017; Xu, 2015; Zhang 2020) pertain specifically to drug or substance use, and all nine found evidence or partial evidence for a psychological tendency to resist restrictions on one's freedom and act against advice. Six of these nine studies were experimental designs involving various forms of drug-related messaging, while the remaining three were classified as longitudinal (Smith et al., 2016; Sussman et al., 2010) or quasi-experimental (Allen et al., 1994). The latter study took advantage of a late-1980s policy change in the United States that raised the legal drinking age to 21 and then compared consumption patterns among legal drinkers and underage drinkers, finding higher consumption among the latter.

Of the remaining 25 studies that did not study drug use, 23 found indications of a forbidden fruit effect or reactance dynamic, although for 11 of those the effect was only partial. The only negative findings were that by Pedersen (2014), where teenage involvement in Christianity was associated with less sexual experimentation, as well as an older study by Clee and Henion (1979) that found no impact from messaging variation on recruitment for a blood bank. Otherwise, 11 experimental and 1 longitudinal studies found a clear indication of reactance and forbidden fruit effects related to COVID-19 prevention, various forms of messaging, fruit and sweets intake, violent video games, images of attractive people, and forbidden friends. Finally, a single qualitative study (Huang et al., 2024) of COVID-19 vaccine mandates found that some participants felt pressured to get vaccinated, leading to a tendency toward refusal.

A possible conclusion may be that a forbidden fruit effect seems pertinent to a wide range of issues but may not be strong enough to drive behavior in all cases; for the issue of drug use, we may perhaps expect this effect to make a difference only in combination with certain personality structures. There is only limited evidence relating specifically to drug use, but the studies here reviewed indicate that the forbidden fruit effect is a real psychological dynamic that would presumably apply also to illicit drugs, as hypothesized for instance by Friedman (1972), Smith (2002), and Husak (2003).

Discussion

This scoping review has discussed the theoretical bases and assessed the knowledge bases for two different dynamics whereby the drug criminalization regime may increase problematic drug use. Although these results must be understood as preliminary, the review found substantial support for an effect from violence victimization, which implies that any factor which increases violent crime will also increase harmful drug use. Thus, as far as the criminalization regime leads to increases in violent crime, which may seem indisputable especially in Latin America but is a growing problem also in European countries such as Sweden, this will entail increases in drug use among vulnerable population segments. Nevertheless, this scoping review has only assessed the evidence on a surface level, without performing a systematic methodological assessment. As such, a meta-analysis of research on the impact from victimization on drug use will provide more convincing evidence on how drug criminalization may increase harmful drug use via a victimization dynamic. Furthermore, it is at present unknown how this increasing effect from drug criminalization on drug use via violence victimization compares in magnitude to whatever decreasing effects criminalization may have.

The review also found general support for a psychological effect related to psychological reactance and the forbidden fruit dynamic that is probably relevant for adolescent drug use, although there are only a few studies of such an effect specifically in relation to drug use. Furthermore, some of the reviewed studies found that the forbidden fruit effect did not provide sufficiently strong motivation to affect behavior even when it did affect emotions and cognition. Thus, although this effect is theoretically and empirically supported on a general level, more research is needed on its relevance for drug use, and especially such use under a criminalization regime.

As discussed in the introduction, drug policy liberalizations in countries including Portugal, Uruguay, Canada, and the United States have spurred numerous studies on changes in drug use prevalence, with overall findings indicating moderate increases in adult but not adolescent use, and generally not in harmful levels of use. Importantly, however, the effect from violence victimization must be understood to produce coping behavior involving frequent drug use that is not reduced by legalizing or decriminalizing the relevant drugs. Over time, drug policy liberalization should be expected to reduce the generation of trauma entailed by the drug criminalization regime, as the reduction in victimization will result in a reduction also in coping behavior, but this effect might take years or decades to manifest.

By contrast, the forbidden fruit effect might be expected to respond quickly especially to full drug legalization, and the overall stability in postlegalization adolescent cannabis use may in part be attributable to the disappearance of this effect, as suggested by Kan et al. (2020). Nevertheless, it should be noted that drug legalization policies do not render the relevant drugs legally accessible to minors, and even after legalization there may remain societal norms against such drug use that perhaps suffice to trigger the forbidden fruit effect to some extent. We should therefore probably understand the perception of being forbidden not as a dichotomous yes/no but as a multilevel variable allowing for different degrees of forbiddenness. Since this dynamic also appears not to have been extensively studied specifically in relation to drug use, its impact must be regarded as tentative.

Some of the increasing effects from drug criminalization on drug use identified in this review are probably integrated in the research on postliberalization drug prevalence discussed in the introduction, while long-term effects are presumably external to what has been documented in this research. With regard to the victimization dynamic, there is reason to believe that it may have different effects on different drug use patterns, since drug use motivated by a desire to cope with trauma has a higher risk for developing into problematic drug use patterns (Bonn-Miller and Zvolensky, 2009; Suh et al., 2008; Turner et al., 2018). As discussed in Johnstad (2022), drug criminalization probably deters moderate drug use to a higher extent than it deters escapist and over-frequent drug use. People engaged in frequent drug use as a means of obtaining escape from victimization trauma are more likely to live troubled lives and less likely to have, among other things, well-functioning families and promising careers. On average, people living troubled lives are probably less risk averse than people living successful lives because they have less to lose. Such people are therefore more likely to engage in frequent drug use despite both the health risks associated with such use and the risk of getting in trouble with the police.

Different drug policies may therefore have divergent and even opposite effects on different segments of the overall population, and a given policy regime may serve to increase some forms of use at the same time as it decreases other forms of use. Specifically, drug criminalization may decrease light and moderate drug use among well-functioning citizens at the same time as it increases harmful drug use among dysfunctional people with underlying trauma. Middle-class adolescents from well-functioning families may be just as likely to experiment with illicit drugs as adolescents from underprivileged backgrounds in crime-torn neighborhoods, but they are not as likely to end up abusing drugs (Gripe et al., 2021; Legleye et al., 2012). As such, an increase in drug experimentation among well-functioning people should not be expected to entail a corresponding increase in harmful drug use, because well-functioning generally people do not generally live very difficult lives that they are constantly tempted to escape from through drug use.

Conclusion

This article has discussed the theoretical bases for a range of dynamics whereby drug criminalization may have an increasing effect on drug use among certain population segments. Two of the most prominent of these dynamics relate to violence victimization and an attraction toward “forbidden” behaviors, and scoping reviews assessed their respective evidential bases, finding substantial support for the former and some support for the latter. Because neither a methodological assessment nor a meta-analysis have been performed in this scoping review, however, conclusions remain tentative. Furthermore, no review was here performed for dynamics relating to criminal entrepreneurship, substance displacement, or the effects of incarceration upon the incarcerated themselves and their dependents.

Footnotes

Declaration of conflicting interests

The author declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Funding

The author received no financial support for the research, authorship, and/or publication of this article.

ORCID iD

Petter Grahl Johnstad

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