One aspect of the government paper, Security, crime and justice, that’s rightly received attention is the proposed shift in emphasis to focussing on prolific offenders and to try to devise strategies suitable for the individual offender in the hope of keeping him out of trouble in future. Unfortunately, there’s one reasonably simple reform that they’ve missed completely.
As is well known, drugs are responsible for a very great number of crimes, notably theft (especially shoplifting), domestic burglaries and robbery (particularly street robberies and attacks on small shops and off-licences). The addicts need their drugs, drugs cost money and this frequently the only way to raise it.
The report recognises this; it says,
2.24 Despite successes in drug and alcohol treatment, the consumption of drugs and alcohol has remained relatively steady over the past decade. Drug treatment programmes, for example, may need to ‘grip’ more individuals over the longer term in order to manage the most prolifically criminal drug users
which reads to me almost like an admission of failure; the programmes have been successful insofar as things haven’t got noticeably worse.
Unfortunately, though I suppose understandably given the timing of the two documents, the report doesn’t consider any of the far-reaching proposals contained in the Royal Society for Arts’ recent report on Illegal Drugs, Communities and Public Policy, published earlier this month. Nor, somewhat less explicably, does it anywhere allude to the National Drugs Strategy (or, if it does, I missed it), nor to the fact that the strategy is to be reviewed in 2008 (which is why the RSA produced their report when they did — to get their ideas discussed before the review is conducted). This is unfortunate, because the RSA have many useful observations and criticisms of the way the present drugs treatment and testing programme works at present.
At the moment, courts can order drugs testing and treatment programmes as an alternative to prison, either as a sentence in their own right or combined with an unpaid work requirement. Compliance is enforced, insofar as it can be, by bringing people who won’t cooperate back to court and re-sentencing them — usually to prison — or by making the programme part of a suspended sentence order, so a breach automatically triggers the prison sentence. The RSA, who want drugs to be seen more as a social and public health problem than a specifically criminal one, while applauding the idea of getting addicts into treatment, criticise (Chapter 12) the way the system means that addicts who’re referred to treatment programmes by the courts divert resources (sometimes inappropriately) from people who’re seeking treatment of their own volition and who may, in consequence, well be more likely to benefit than is someone who’s there under compulsion.
Indeed, they argue, the present system frequently creates perverse incentives for addicts seeking treatment to break the law and get themselves caught, since if they can persuade the courts to sentence them to a drugs treatment and testing order (something of a gamble, admittedly) this’ll get them into treatment far faster than would a voluntary referral from their GP.
The RSA’s proposals are far more wide reaching than simply extending access to treatment, of course; they argue persuasively (not that I needed much persuading) that treatment should have harm reduction reduction rather than simple abstinence as its goal; as they say (p 165),
Sometimes substitution treatment acts as a stepping stone towards full abstinence. For example, some people may be on substitution treatment for several years, during which time they are able to reorganise and redirect their lives to the point where they are able to achieve abstinence. For other people, substitution treatment may be an integral part of their achieving abstinence at the outset Substitute prescribing for heroin may be done, for example, on a reducing basis, with doses of methadone growing gradually smaller until the user experiences no withdrawal symptoms and is technically drug-free.Where abstinence is not a readily attainable clinical outcome, the key is to provide treatment that minimises harm. The failure to achieve abstinence does not immediately imply that treatment has been ineffective. The failure to minimise harm invariably does.
But what, though, of the offenders who cannot be dealt with other than by prison, whether it’s because they’ve failed to comply with a Drugs Treatment order or because the gravity or frequency of their offending makes custody inevitatble? The Powers of Criminal Courts (Sentencing) Act 2000 makes a three year minimum sentence mandatory for a third or subsequent conviction for dwelling house burglaries, and this applies, of course, to many drug addicts, for whom serial burglary is the main way of funding their habits.
The problem here is, in general, that everyone seems to agree prison provides an excellent opportunity to deal with someone’s addiction, but that the opportunity is taken up only sporadically because of — as always — money. As the RSA report says (pp 185-6),
Concentrating a significant proportion of the country’s most problematic drug users in a few heavily supervised locations would seem to offer a good opportunity to intervene, to reduce health harms, to reduce drug-related crime and to prepare one particular group of prisoners for release and reintegration into the community. However, the Prison Reform Trust reported early in 2006 that no more than 10 per cent of prisoners with drug problems are likely to be in intensive rehabilitation in any one year. Treatment in prison bears little relation to need but depends more on what happens to be available. Prison doctors are not uniformly trained to deal with drug misuse, and there is a heavy reliance on a few charismatic individuals to drive treatment programmes
The Government report says,
2.77 The Government will also incentivise NOMS to coordinate better the resources spent on resettling offenders on release from prison, and to target better – in the short term – the provision of high-quality and cost-effective drug detox treatment and employment and training opportunities. In the longer term, and as resources allow, the Government will look to increase the availability of such programmes, given that 75,000 prisoners each year are going into prison as drug addicts, of whom around only 50,000 benefit from clinical services (maintenance and/or detox), and only 30 per cent of prisoners receive employment, training or education arranged on release.
That is, only 10% receive intensive help and one third receive no help whatsoever.
The RSA continue (pp 186-7),
Plans have been drawn up for improving drugs treatment in prison, which since April 2006 has been the responsibility of the NHS rather than the prison service. While this makes prison treatment liable to quality control by the National Treatment Agency, it has also left it vulnerable to NHS budget cuts. At the end of 2005 the government pledged to provide almost £70 million over two years for an ‘Integrated Drug Treatment System’ in prisons that would bring together medical care and counselling to produce treatment that was comparable with services in the community and that would link up more closely with them. The integrated treatment would include more methadone prescribing and better care planning to meet individual needs. However, in November 2006 the Department of Health admitted that the budget for 2006/7 had been cut to £12 million, with no decision forthcoming on funding for 2007/8. At present only 17 prisons are due to benefit from the new programme, less than one in eight of all prisons in England and Wales.
This is particularly on my mind at the moment because of a chap who appeared in court last week. He’s about 30, been on drugs since he was a teenager, and is in and out of prison for burglary with depressing regularity. He’s apparently quite motivated to come off drugs; he always volunteers for the de-tox and drugs treatment programmes when he’s in prison and complies with them pretty well. The trouble is that, for all his good intentions, he’s back on heroin and breaking into people’s houses again within weeks of being released.
Drug addiction, like alcohol dependency, isn’t just a physical craving; it’s a way — a pretty catastrophic way, but a way, nevertheless — of coping with your problems. This chap’s life is a complete mess, and one can quite see that, when he comes out of prison and no longer has the structure, support and encouragement — such as it is — stay off drugs that they’ve been able to provide him while in prison (where it’s very easy to get illegal drugs if you want to), getting out of it for a few hours must be very tempting, particularly since that’s what all his mates do, anyway.
Now, as the judge said when he sentenced him, the course of action that would be obvious to anyone but a criminal lawyer would be to sentence him to prison — someone who repeated burgles other people’s homes has to expect to go to prison, after all — but also direct that, when he’s released on licence half way through his sentence, he goes on a continuing rehab and testing programme to help build on all the good work they’ve done while he’s been inside for the last couple of years, in the hope this’ll help him begin to put his life back together rather than go back to his old ways.
Obvious to anyone but a criminal lawyer, because that sort of sentence just isn’t available. He’ll be released into the care of the Probation Service, who’ll doubtless do the best they can, but he’ll have to make his own arrangements — if he can make them — with his GP to get on a rehab programme, which will probably take some weeks to arrange. This is, apparently, supposed to happen; the RSA report says (pp 193-4),
the importance of these ‘wraparound’ services is fully recognized at the policy level and set out on paper. But in practice such services are not being delivered consistently, if at all. A joint NTA/Healthcare Commission Improvement Review in 2006 found that 32 per cent of Drug Action Teams were ‘fair’ in providing individual care plans and 48 per cent were ‘weak’, leaving only one in five DATs meeting this particular requirement adequately.
Meanwhile, this chap, and many others like him, will continue to be out of everyone’s hair for year or so — prison works to that extent — and then, despite considerable amounts of public money being spent and everyone’s best intentions, including his own — be back on drugs and burgling people’s houses to pay for them within weeks of release.
Seems to me that fixing this would be a far more sensible use of resources than sending police officers up in helicopters with infra-red cameras to look for cannabis farms or investing in facial recognition technology that doesn’t recognise people (and, even if it did, is of little practical use). Be less dramatic, though, so I suppose that counts against it.
Technorati Tags: UK Drugs Policy, War on Drugs, Security crime and justice policy
