MEMORANDUM SUBMITTED BY HM PRISON SERVICE
DRUGS AND PRISONS
1. INTRODUCTION
1.1 On 1 February 1999 the Prison Service
submitted a memorandum of evidence to the Home Affairs Committee
for their inquiry into Drugs and Prisons (Home Affairs Committee,
Fifth Report, Drugs and Prisons, Volume II, Minutes of Evidence,
Appendix 1). This second memorandum, which supplements the original,
has been prepared in response to the request from the Committee
to update the information presented.
1.2 For completeness, the present document
takes 1 February 1999 as its starting date and records developments
since then. Some of the information will therefore be familiar
to members of the Committee from the oral evidence given by the
Director General on 4 May 1999 and the then Prisons Minister,
Mr George Howarth MP on 20 July. Further written evidence was
also submitted to the Committee in response to specific questions.
1.3 To help the Committee measure progress,
the memorandum follows the same structure as its predecessor.
Chapter 2 therefore describes the findings of the latest research
into the scale of the problem; Chapter 3 the Prison Service strategy
as a whole; and so on. The final Chapter looks forward to work
that will be undertaken in the coming months.
1.4 The main developments have been:
— the introduction of CARATs in prisons
across the country;
— an increase in the number of rehabilitation
programmes from 16 to 42;
— an increase in the number of therapeutic
communities from four to six;
— the implementation of a policy to
ban visitors found smuggling drugs into establishments; an increase
in the number of drug dogs; more CCTV in visits areas;
— the issue of guidelines on the provision
of voluntary testing programmes and the successful negotiation
of a contract to analyse the urine samples provided by inmates;
— the introduction of more targeted
mandatory drug testing and a requirement that at least 14 per
cent of tests must be conducted at weekends;
— the revision of Healthcare Standard
8 in line with NHS guidelines on detoxification;
— greater local liaison, particularly
between Area Drug Co-ordinators and Drug Action Teams (DATs),
the Drugs Prevention Advisory Service (DPAS), the Probation Service
and community drug agencies.
2. BACKGROUND:
THE SCALE
OF THE
PROBLEM
2.1 Paragraphs 5.22-5.23 of the original
memorandum referred to research commissioned jointly by the Prison
Service and the Probation Service into the nature and effectiveness
of drugs throughcare procedures. The research has been conducted
by the University of Surrey School of Human Sciences in collaboration
with Morgan Harris Burrows. Their findings were published on 24
March.
2.2 The researchers inverviewed and held
focus groups with 179 prisoners and almost 100 prison, probation
and drug service professionals. The prisoners, from 15 prisons
and two Young Offender Institutions had undergone drug treatment
in prison during their imprisonment.
2.3 Two points should be noted. To meet
the requirements of the study, the researchers focused on prisoners
with particularly acute drug addiction problems. 66 per cent had
taken heroin every day in the month prior to their imprisonment.
Second, the survey was completed before the CARATs and the new
treatment programmes were operational. CARATs aims to bridge the
gap identified by the researchers between prisons and the community
for inmates requiring continuing treatment on their release.
2.4 The researchers found that:
— Most of the prisoners surveyed had
experienced serious drug problems prior to imprisonment, spending
an average of £550 a week to support their habit.
— Half of the prisoners were offered
help to obtain treatment on release. However, only 11 per cent
had a fixed appointment with a drug agency. Most were given more
indirect help.
— Effective throughcare is reliant
on multi-agency co-operation. However, the survey identified structural
problems restricting provision, with responsibility not falling
to any single agency.
— Unless treatment is maintained in
the community, offenders are likely to relapse, returning to crime
and prison.
— Four months after release, 86 per
cent reported using some form of drug. About half were using heroin
every day, though this represents a decline of around 20 percentage
points (from 66 per cent prior to imprisonment to 45 per cent).
Spending on drugs more than halved to about £275 per week.
2.5 The report comments that evidence from
a small scale study in the US (Inciardi et al, 1998) showed that
prisoners receiving treatment both during sentence and release
were less likely to be arrested 18 months later than those receiving
treatment only in prison.
Future research
2.6 The Prison Service is committed to using
research to inform and develop its drug strategy. The details
of a research plan have still to be finalised, but four areas
have been identified for study.
— The effectiveness of mandatory drug
testing. Although two independent studies have been unable to
substantiate claims that testing encouraged prisoners to switch
from soft to hard drugs, such allegations continue. A thorough
investigation of MDT is necessary.
— The treatment needs of particular
groups. Not enough is know about the specific needs of groups
such as juveniles, young offenders, women and ethnic minorities.
Interventions may need better tuning to ensure that appropriate
treatment is provided.
— The treatment programmes being provided
under contract and by Prison Service staff adopt a number of different
approaches: abstinence, relapse prevention, cognitive behavioural
therapy. Some include a reasoning and rehabilitation module. There
is a need to compare the different approaches, in terms of who
they help, what help they provide and what impact they achieve
in reducing drug misuse and reoffending.
— Finally, the Prison Service needs
to evaluate the cost effectiveness of the strategy as a whole
and its overall impact on drug related crime.
2.7 The last piece of research is a major
study which is likely to take two or three years to complete.
The other studies should be shorter and findings could start to
emerge as early as next year.
Related criminal justice developments
2.8 Although not primarily about treatment
in custody, two wider criminal justice developments are designed
to impact on drug related offending. The first is the introduction
of Drug Testing and Treatment Orders (DTTOs).
2.9 An offender who is identified at any
stage before or during the trial process as having a serious drug
misuse problem can be referred for assessment for a DTTO. In order
for the probation service to advise the court that a DTTO might
be an appropriate sentence, an offender would have to be:
— assessed as having a serious drug
problem;
— and committing a large volume of
offences to support the purchase of drugs;
— and assessed as having the requisite
motivation to treatment;
— and before the court for an offence
that is sufficiently serious to attract a community sentence as
penalty.
2.10 The offender must express a willingness
to comply with the order's requirements and the court must be
satisfied that arrangements are in place for the offender to be
treated and that he is susceptible to treatment. In effect this
means that the court cannot make an order without the assessment
and, implicitly, the consent of the treatment provider.
2.11 Assuming the court agrees with the
recommendation (the sentence will be determined on the basis of
the seriousness of the offence rather than the offender's needs),
following sentence the offender should report either for further
assessment of the level of intervention necessary or for the treatment
identified as most suitable. This might include anything from
residential detoxification and/or rehabilitation to outpatient
methadone prescribing or a structured day programme but is likely
also to include some groupwork on offering behaviour/links between
drugs misuse and offending etc. The individual interventions are
not being separately assessed on a "horses for courses"
rationale. We would rely on probation services to refer offenders
only to interventions that are thought to be effective generally;
and to assess each individual's susceptibility to a specific treatment
approach.
2.12 Each order will include three main
requirements:
— a treatment requirement (to attend
treatment);
— a testing requirement (to provide
samples for testing); and
2.13 The first two are self-explanatory.
The third means that the court must set a minimum frequency for
the offender's progress on the order to be reviewed, at a hearing
of the court which made the order. The probation officer supervising
the order must write a report for the court including results
of urine tests and an assessment of progress. The offender must
attend court and answer for any failures. The court may also acquire
a motivational role towards offenders, which the interim pilot
evaluation assessed as a success. The court may also wish to question
probation officers or treatment providers (though not necessarily
at the hearing) about the reasons for failing to enforce an order
or whether a different/more intensive intervention might be considered.
The court has no power to breach the order at a review hearing.
2.14 Enforcement of the order is based around
attendance: eg failure to attend or provide a sample for testing
is viewed far more seriously than failing the test. That is not
to say that an order cannot be breached for persistent test failure,
when that is considered by the treatment provider and/or probation
officer to amount to a failure to comply with treatment.
2.15 Currently, courts in the pilot areas
have made around 180 orders, of which approximately one third
have been revoked. Analysis of the early orders suggests that
the average breach/revocation rate is likely to rise to closer
to 50 per cent. This should not be viewed as failure: while those
offenders have been on the order, their offending and drugs misuse
will have decreased dramatically. It is not possible to assess
for how long this effect will continue after the order is ended.
But offenders whose orders are breached/revoked can also be said
to have gone some way down the road to addressing their drugs
misuse and may well have been motivated sufficiently to have another
go at some stage.
Criminal Justice and Court Services Bill
2.16 Identifying and monitoring drug misusing
offenders at every stage of the Criminal Justice system is now
a prime objective of the crime reduction strategy and will make
an important contribution to the overall drugs strategy. The Criminal
Justice and Court Services Bill proposes to extend drug testing
for Class A drugs (specifically heroin and crack/cocaine) to those
facing charge and offenders.
2.17 These new powers would:
— allow the police to test those charged
with property crime, robbery and/or Class A drug offences (trigger
offences);
— require the Court to take a positive
drug test into account in determining whether or not to grant
bail or impose drug testing as a condition of bail;
— introduce a requirement to undergo
testing for all those on community sentences for target offences;
— introduce a new Drug Abstinence Order
for all those in the target group who are under Probation Service
supervision, but who do not merit community sentence or DTTO;
— enable a condition to undergo drug
testing to be included in the licence of those released from prison.
2.18 It is proposed that a two year evaluation
of the scheme would be undertaken, with pilots in three areas
commencing in early 2001. Evaluation would inform the value and
extent of wider implementation. If positive, it is proposed to
extend the initial pilot to nine areas (for arrest, bail and community
sentences) and nationwide (for key groups of offenders on licence)
to 2003.
3. OVERVIEW:
THE PRISON
SERVICE DRUG
STRATEGY
3.1 The Prison Service drug strategy does
not exist in isolation. It contributes to Home Office Aim 4 (the
effective execution of the sentences of the courts so as to reduce
re-offending and protect the public). It is also a key component
of the national strategy, "Tackling Drugs to Build a Better
Britain". The Prison Service has continued to work closely
with the United Kingdom Anti-Drugs Co-ordinator towards the overall
aim of reducing the level of drug related crime.
3.2 To meet this objective, the Prison Service
has a number of targets. These are:
By March 2000
— Have established CARAT's, the basic
treatment framework to improve the assessment, advice, throughcare
and support of prisoners; and put in place more and better quality
treatment programmes;
— Put in place more dogs trained to
detect drugs; and more CCTV in visits areas; obtain better information
about supply routes and availability of drugs to prisoners; discourage
families from smuggling drugs;
By March 2001
— 28,000 prisoners to sign voluntary
testing compacts over the course of the year;
— To reduce the rate of random MDT
positive tests to 16 per cent.
By March 2002
— To ensure that 5,000 prisoners per
year go through drug treatment to assess 20,000 new CARATs cases
each year;
— To deliver 30 new prison based rehabilitation
programmes;
— To provide detoxification services
to the standards of Healthcare Standard 8 in all local prisons
and remand centres;
— To provide CCTV coverage in visits
areas and at least one passive drug dog in all prisons; busy prisons
to have a second dog;
— Develop and implement a model to
assess the levels and routes of supply of drugs into prisons;
— All drug treatment programmes must
meet accreditation standards.
3.3 The targets for March 2000 have been
met and the Prison Service is on course to meet the targets for
2001 and 2002. The progress made in achieving these targets is
described in more detail in Chapters 4 and 5.
4. REDUCING THE
SUPPLY OF
DRUGS
4.1 About 11 per cent of the £76 million
received by the Prison Service from the Comprehensive Spending
Review was allocated to supply reduction measures. One outcome
of this has been an increase in the number of drug dogs deployed
by prisons. In total, the Service now deploys 121 passive and
196 active dogs.
4.2 A total of 5,149 drug finds were recorded
in 1998-99, a reduction of 46 per cent on the corresponding figures
for 1995-96. This is due to a significant decrease in finds of
cannabis and cannabis resin. The decline is consistent with the
MDT figures which also show a significant decrease in cannabis
use.
4.3 A survey last year showed that 90 prisons
were able to monitor attempts to smuggle drugs through visits
by the use of CCTV. By the end of March 2000, the figure had risen
to 118. More low level and fixed furniture has been installed
in visits areas.
4.4 New sanctions for visitors and prisoners
caught smuggling drugs were introduced in April 1999. They include:
— a power to ban visitors caught or
suspected of smuggling drugs;
— all visits for the prisoner to be
held in closed conditions for three months;
— prisoners targeted for frequent MDT;
— the prisoner's status on the incentives
and earned privileges scheme to be reconsidered;
— the prisoner's categorisation to
be reviewed.
4.5 The headline data about the use of the
sanctions continue to be very encouraging. Prisons are taking
firm action against the majority of visitors suspected of smuggling
drugs. This sends a clear message that the Service will not tolerate
such activity.
Measures to Deal with Visitors and Prisoners
who Smuggle Drugs Through Visits
HEADLINE FIGURES 1 APRIL TO 30 DECEMBER 1999
| Total 1st quarter
| Total 2nd quarter | Total 3rd quarter
| Total year to date |
| Number of incidents | 777 |
706 | 673 | 2,156
|
| Number of visitors involved in suspicious actions
| 838 | 812 | 800
| 2,450 |
| Number of visitors banned | 626
| 634 | 623 | 1,883
|
| Number of decisions not to ban a visitor |
200 | 197 | 126
| 523 |
| Number of decisions to ban a visitor for less than three months
| 24* | 52* | 33*
| 109 |
| Number of visitors made subject to closed visits instead of ban
| 101 | 84 | 76
| 261 |
| Number of visitors made subject to closed visits following a ban
| 361 | 351 | 440
| 1,152 |
| Number of visitors not banned and not made subject to closed visits
| 111 | 94 | 101
| 306 |
| Number of prisoners made subject to closed visits
| 547 | 529 | 489
| 1,565 |
| Number of prisoners found guilty at adjudication of offences involving drug smuggling through visits
| 322 | 227 | 277
| 826 |
Note: An incident can involve more than one visitor.
* These figures are inaccurate and have not been used in the
calculations. The figures for visitors banned for less than three
months were taken from Annex B, "Number of visitors banned"
section.
ADFAM
4.6 The Prison Service is keen to work with family support
groups to ensure that prisoners, their families and friends receive
information, advice and support. The Service has funded production
of the 2nd edition of the ADFAM advisory booklet "Prisons,
Drugs and You" which will shortly be made available in all
visitor centres. ADFAM and the Service jointly hosted a conference
"Partners in Prevention" to explore the concerns of
prisoners' families and develop good practice. The Drug Strategy
Unit liaises with ADFAM on a regular basis.
5. REDUCING THE
DEMAND FOR
DRUGS
Mandatory Drug Testing
5.1 The improvements to the mandatory drug testing procedures
foreshadowed in paragraph 5.16 of the original memorandum were
introduced in May 1999. Establishments with a population of 400
or more can reduce their level of monthly random tests to a minimum
of 5 per cent of the population. At the same time, they must increase
other forms of testing (eg on suspicion or frequent) to a further
minimum of 5 per cent. Smaller establishments must continue to
random test 10 per cent of their population. To counter suggestions
that many prisoners only took drugs on a Friday night in the belief
that they would not be tested until the following Monday at the
earliest, at least 14 per cent of mandatory tests must be conducted
at weekends.
5.2 The latest available figures for the rate of random
mandatory tests proving positive cover the financial year up to
the end of February 2000. They show:
| Total | 14.5% |
| Cannabis | 10.3% |
| Opiates | 4.4% |
| Benzodiazepines | 1.1% |
| Cocaine | 0.2% |
| Amphetamines | 0.1% |
5.3 Concern continues to be expressed by prison staff,
prisoners and external commentators that prisoners may be switching
from cannabis to hard drugs in order to reduce the chances of
a mandatory drug test being positive. Occasional use of cannabis
is detectable in urine for up to 10 days, although this rises
to 30 days for the chronic user. Opiates can be detected for up
to seven days.
5.4 Two independent studies in 1998 to evaluate the MDT
programme found no evidence to support the contention of switching.
Mandatory drug testing data shows no upward trend in opiate positives
to match the downward trend in cannabis positives.
5.5 Nevertheless, the Prison Service cannot afford to
ignore the possibility that switching is taking place. There would
be serious health implications if significant numbers of prisoners
did switch from cannabis to opiate use. Part of the future research
programme mentioned in Chapter 2 will therefore be to conduct
a thorough investigation of mandatory drug testing.
Detoxification
5.6 The aim of a detoxification programme is to manage
effectively the symptoms, especially physical symptoms, that arise
when withdrawing from a drug of dependence. Detoxification is
undertaken over a short period using the same or a similar drug
in reducing doses. Specific clinical treatment interventions are
available for those withdrawing from opiates, benzodiazepines
and alcohol. For stimulants, amphetamines, cocaine, LSD, ecstasy,
cannabis, and solvents, treatment, if required, is directed at
the symptoms that occur during withdrawal, such as insomnia, depression,
anxiety and a tendency towards suicide.
5.7 The greatest need for detoxification is among inmates
newly received into custody. £10.8m of the Comprehensive
Spending Review funding in 1999-2002 has been allocated to improving
detoxification services in local prisons and remand centres. A
minimum of 18,000 prisoners annually are expected to undergo drug
detoxification in accordance with the guidelines in Healthcare
Standard 8. This is being revised to bring it into line with the
latest NHS guidance published last year ("Drug Misuse
and Dependence—Guidelines on Clinical Management"),
which has been circulated to prison medical staff.
5.8 The aim is to provide prisoners with a quality service
equal to that of the community. Doctors prescribing for drug detoxification
will be expected to undergo a training update in evidence-based
management of substance misusers by 2001.
Drug Treatment Service Framework
5.9 Paragraphs 5.25-5.29 of the original memorandum described
the drug treatment service framework we proposed to implement.
Following two major procurement exercises last year, that is now
in place.
CARATs
5.10 The framework is founded on a basic Counselling,
Assessment, Referral, Advice and Throughcare service (CARATs)
which is available in every establishment. The service is provided
by external drug agencies, probation officers, prison officers
and Healthcare staff, working closely together. The balance varies
between establishments. Some are heavily reliant on outside providers,
including the Probation Service. In others, the external agencies
complement in-house provision.
5.11 To maximise the effectiveness of CARATs, prisons
were clustered in groups of up to seven establishments. Over 70
organisations expressed an interest in bidding to provide the
services. They ranged in size from large NHS Trusts to small local
community agencies employing a handful of staff. After the bids
had been assessed by Prison Service area managers, Drug Strategy
Unit and the Central Purchasing and Contracts Unit, shortlisted
candidates were interviewed by a panel chaired in most cases by
the Area Manager in June and July.
5.12 Contracts were awarded to 14 external agencies for
over 40 clusters. The annual cost of the contracts is £9m.
Work started in October, although recruitment problems have meant
that in some prisons the services are only just becoming fully
operational.
5.13 The present position is that a CARAT service is
available in all establishments. In the vast majority it is already
operating at full strength. The remaining 15 will be fully staffed
very soon.
5.14 Drug workers in the community are often ex-addicts
and some also have convictions for drug related offences. Their
history gives them credibility among drug users and enables them
to build a rapport with a group who are difficult to influence.
Traditionally, policy about the admission of externally employed
workers has been left to Governing Governors because of their
ultimate responsibility for the security of their establishments.
This has lead to inconsistency because some prisons have been
prepared to admit drug workers who have been addicts or who have
served sentences for drug related offences, whereas others have
not.
5.15 Because the new drug services are planned on a clustered
basis, greater inconsistency is needed so that a supplier can
appoint staff who will be able to work anywhere within a cluster.
This makes it easier to maintain services during temporary shortages
such as sickness and annual leave. It also reduces the cost. The
Prison Service has therefore produced guidelines to help Governors
adopt a common approach.
5.16 Previous convictions and previous drug use are separate
issues. The former can be identified and verified by the usual
external checks. Disclosure of the latter depends crucially on
the honesty of the individual. For that reason, the criteria which
have been adopted are based on convictions.
5.17 Ideally a single system would apply service-wide.
However, this would mean standardising in accordance with the
special needs of the high security estate. For the majority of
establishments, such a level of security is unnecessary and would
eliminate too many potentially good workers. Separate criteria
have therefore been proposed for the high security prisons and
the rest of the estate.
5.18 The majority of establishments will not normally
admit a drugs worker who has:
— a conviction for importing or supplying drugs;
— a conviction for any offence in the last five
years (excluding most motoring offences unless they involved death
or injury);
— been released from a custodial sentence in the
last five years;
— a conviction for a sexual offence eg rape, indecent
assault; or
— a conviction for any offence involving children.
5.19 High security prisons and core local establishments
holding category A prisoners will not normally admit a drug worker
who has:
— received any custodial sentence;
— a conviction for any offence within the past five
years;
— a conviction for any serious offence involving
drugs, eg, importation, possesson with intent to supply, cultivation;
— a conviction for any serious sexual or violent
offence; or
— a conviction for any offence involving children.
5.20 There will inevitably be individual cases where
an exception would be appropriate. Experience has shown that workers
with previous convictions can make telling contributions to treatment
programmes in prisons and we would not want to lose their proven
skills except when security dictates. It may be appropriate to
disregard a conviction or custodial history in the light of exceptional
circumstances, such as age at the time of the offence, its seriousness,
when it took place and the motive and subsequent behaviour of
the offender. Governors may disregard any offence which they consider
to be irrelevant and unlikely to present any threat to security
or control. The case for so doing will be strengthened if the
drug worker is already personally known to the establishment from
his or her days there as a prisoner.
Rehabilitation programmes and therapeutic communities
5.21 Within the treatment framework, prisoners whose
addiction needs a more intensive intervention than can be provided
by CARATs will be referred to a rehabilitation programme or, in
the most serious cases, to a therapeutic community. The 16 existing
rehabilitation programmes and four therapeutic communities are
being expanded as a result of the CSR settlement by 29 new treatment
programmes and four more therapeutic communities. A full list
of prisons running treatment programmes is at Annex A.
5.22 A similar extensive procurement exercise was conducted
as for CARATs. Nearly 50 organisations expressed an initial interest
in tendering to provide the treatment services and 16 followed
this up with specific bids to run treatment programmes (both rehabilitation
programmes and therapeutic communities) in up to nine establishments.
Interviews were held in August and September and contracts were
subsequently awarded to 9 different agencies. The annual cost
of the contracts is £5 million (rehabilitation progammes)
and£1.6 million (therapeutic communities).
5.23 Of the 33 new treatment programmes planned, 19 are
now fully operational and 9 are partly operational. These 9 and
the remaining 5 will be fully operational by September. They provide
both harm reduction and abstinence-based programmes. Some are
residential in the sense that they are conducted in a discrete
area of the prison where the prisoners are accommodated full-time.
Others operate on an outpatient basis, with prisoners attending
during the day and returning to their cells in the evening. Programme
length for the rehabilitation programmes varies from as little
as three weeks up to seven months, with an average of about 12
weeks, and for the therapeutic communities between 6 and 12 months.
5.24 All the programmes must achieve accreditation by
the joint Prison/Probation Service panel by March 2002. This will
be a challenging test. To help providers and establishments ensure
that their programmes reach the required standards, the Prison
Service intends to recruit two specialists in the design and operation
of drug rehabilitation programmes to act as treatment advisers.
Harm minimisation
5.25 Paragraph 5.47 of the original memorandum referred
to the pilot provision of disinfecting tablets in 11 establishments.
The purpose of the tablets is to encourage the small number of
prisoners who persist in injecting in prison to clean their equipment
before using it again or passing it on to others. This appears
to have worked well in Scotland for some years.
5.26 The pilot project was completed last year. The report
and recommendations of the team from the London School of Hygiene
and Tropical Medicine, which was asked to evaluate the project,
is currently under consideration.
Voluntary testing
5.27 Detailed guidance in the form of a Prison Service
Order (PSO) will be issued in May 2000. The key elements of the
PSO comprise:
— a framework for the operation of voluntary drug
testing units and voluntary drug testing programmes;
— advice on the conduct of drug testing;
— action to be taken following a positive drug test
and the limitations of drug screening tests.
This will ensure greater consistency of approach.
5.28 There is a need to draw a clear distinction between
voluntary drug testing units and a programme of voluntary testing.
A voluntary drug testing unit is defined as a discrete unit with
an infrastructure designed to provide enhanced sanctuary and support
for prisoners (particularly the more vulnerable) who make a commitment
to remain drug free. Successful VTUs offer tangible benefits to
prisoners and are an integral part of the wider drug strategy,
in particular, the treatment and support programme. Voluntary
drug testing under compact will be a condition of residence in
VTUs. In contrast, a voluntary drug testing programme has no residential
requirements. Prisoners agree to voluntary drug testing under
compact no matter where located and therefore do not enjoy the
added benefits of VTU residency.
5.29 Voluntary drug testing units provide a safe haven
away from the pressures of the drug misusing culture and encourage
prisoners to make commitment to remain drug-free. VTUs are an
essential element in the overall treatment and support framework
and therefore a key factor in achieving a number of drug strategy
objectives. It is equally important to build quickly on every
prisoner commitment to remain drug free and thereby reduce the
demand for drugs in prisons. In April 1999 (the latest available
figures) a survey showed that 64 prisons had a voluntary testing
unit or a discrete area with nearly 7,000 places in total. In
addition, 3,550 prisoners had signed a compact but remained on
normal location.
5.30 A procurement exercise for the supply of dip and
read drug testing kits has recently been concluded. This will
ensure the provision of good quality, cost-effective products.
6. TAKING FORWARD
"TACKLING DRUGS
IN PRISON"
6.1 Paragraph 6.22 of the original memorandum listed
the next steps to be taken in developing the strategy, in the
three year period to 2002. The priority over the last twelve months
has been to conduct a major procurement exercise for the provison
of CARATs and more intensive treatment programmes by external
agencies, and to ensure they started on schedule. That has very
largely been achieved. Some services have been delayed in operating
at full capacity because of recruitment difficulties, but CARATs
has started in all prisons and most of the new Rehabilitation
Programmes are now running.
6.2 Other tasks on the list which have been completed
are:
| Treatment: | creation of policies and spaces for voluntary testing;
evaluation of equipment for voluntary testing;
reviews of existing contracts;
creation of minimum standards and specifications for the main interventions. |
| Supply reduction: | analysis of effectiveness of drug detection equipment.
|
| Training: | review of existing drugs training;
training needs analysis (completed but report not yet ready).
|
Tasks which have been partially completed or are continuous:
| Treatment: | revision of health standards to bring them into line with Department of Health guidelines. |
| Supply reduction: | an audit of the use of drug dogs by the Service;
inter agency work with family support groups to provide advice
and support for prisoners' friends and families;
intelligence project on drug routes into prisons. |
| Monitoring: | creation of financial and input monitoring systems. |
6.3 The following tasks are still outstanding:
| Treatment: | development of accreditation. |
| Supply reduction: | review of visits procedures. |
| Research: | into the needs of specific groups of offenders;
into the effectiveness of the strategy;
into MDT. |
Work in these areas will continue over the coming months.
New Tasks
6.4 The Prison Service has been allocated £5 million
from the Capital Modernisation Fund for specialised hostels to
provide post-release support to prisoners who have served sentences
of up to a year and have serious drug misuse and housing problems.
Many such prisoners are repeat offenders, involved in high-volume
acquisitive crime to fund their drug misuse.
6.5 The new CARAT services can assess their needs, and
draw up a treatment plan, but such prisoners are not in Prison
Service custody long enough to benefit from the intensive drug
treatment programmes in prisons. This project aims to fill a significant
gap. As for the rest of the strategy, the key objective is a reduction
in reoffending.
6.6 The £5 million of funding is for the capital
element of this work only. Running costs have been sought via
the SR2000 process. Planning is still at the early stages, and
no sites have yet been chosen, but the money is expected to provide
up to five hostels, linked to local prisons in urban areas, accommodating
around 10ex-prisoners each. A maximum overall throughput of 250
prisoners per year is envisaged.
6.7 The target group will be short-term prisoners (under
one year sentence), with a history of opiate dependence and no
settled home to go to on release. They must have demonstrated
a desire to change. Individual treatment plans will be delivered
by hostel staff or external drug workers contracted for the purpose.
Support will also come from fellow inmates. The focus will be
on relapse prevention; building self esteem; bringing more order
to their lifestyles, and building relationships. Family links
will be fostered or re-established where appropriate. The supportive
environment should also reduce the risk of drug overdose, hospitalisation
and death, from loss of tolerance to drugs during imprisonment.
6.8 This is a partnership initiative. Not only prison
staff and drug agencies but also local authorities, social housing
landlords, probation and education staff, will all have key roles
to play. It addresses drug misuse to cut crime, but also tackles
homelessness and social exclusion.
SR2000
6.9 Although the £76 million additional funding
for 1999-2002 resulting from the CSR settlement in 1998 has allowed
the Prison Service to make substantial progress in driving forward
measures to combat drug related crime, it has been apparent for
some time that there would still be gaps in the services provided
in establishments. When Area Managers were asked to submit bids
for the CSR money, the total sought for the first year (£44
million) was almost double the amount available.
6.10 A further spending review is now in progress. The
CSR bids were prepared without the benefit of a needs analysis
and were based largely on estimates eg the cost of a CARATs worker,
the cost of analysing a voluntary testing sample. The Prison Service
now has a clearer idea what it must do to implement its strategy
and how much the various services actually cost. The Prison Service
has therefore submitted a bid for a further £88 million in
2001-04 to maintain existing services and to meet recognised shortfalls
in service provision. The funding is needed to:
— Maintain CARATs in every prison and increase both
the number of prisoners dealt with and the quality of intervention;
— Maintain rehabilitation programmes in 45 prisons;
increase both the number of prisoners dealt with and the quality
of intervention; and provide 6 new programmes;
— Maintain therapeutic communities in 8 prisons
and increase both the number of prisoners dealt with and the quality
of intervention;
— Maintain detoxification services in all remand
centres and local prisons, and increase throughput;
— Continue the MDT programme;
— Increase the number of prisoners on voluntary
testing compacts;
— Operate post-release hostels;
— Meet the additional costs arising from the introduction
of drug testing of arrestees;
— Meet the policy, monitoring and research costs
to support the strategy.
Conclusion
6.11 The last 12 months have seen major advances in the
implementation of the Prison Service drug strategy. Prisoners
now have access to basic counselling and advice through CARATs.
For those requiring more intensive treatment, about 3,500 new
places will be available this year as a result of the expansion
in rehabilitation programmes and therapeutic communities. The
revised Health Care Standard 8 will lead to improvements in the
provision of detoxification. A supportive environment for those
wishing to stay off drugs will be available to all prisoners as
a result of the extension of voluntary testing. On the security
side, the increased deployment of dogs and the greater use of
CCTV will strengthen the measures to reduce the supply of drugs
into establishments.
6.12 It is however still too soon to draw any firm conclusions
about the effectiveness of the Prison Service drug strategy. The
new treatment interventions are only just coming into full operation,
and it will be some months before it is possible even to make
a provisional judgment whether they are achieving their objective
in reducing drug-related crime. A full evaluation of the impact
of the strategy will have to be carried out over a number of years.
28 April 2000
Annex A
REHABILITATION PROGRAMMES AND THERAPEUTIC COMMUNITIES
PROVISION BEFORE
AND AFTER
CSR
New Rehabilitation Programmes
[29]
Acklington
Blundeston
Bullington
Dartmoor
Deerbolt
Dover
Drake Hall
Elmley
Erlestoke
Frankland
Full Sutton
Gartree
Haverigg
Highpoint South
Hollesley Bay
Lancaster Castle
Lindholme
Littlehey
Maidstone
Nottingham
Ranby
Reading
Risley
Rochester
Send
Shepton Mallet
Wakefield
Wealstun
Wormwood Scrubs
Existing Rehabilitations
[16]
Albany
Birmingham
Bristol
Coldingley
Downview
Long Lartin
Norwich
Parkhurst
Pentonville
Stocken
Swaleside
Swansea
Swinfen Hall
Wandsworth
Wayland
Whitemoor
New Therapeutic Communities
[4]
Garth
Highpoint North
Low Newton
Wymott
Existing Therapeutic Communities
[4]
Chaining Wood
Holme House
Portland
Wormwood Scrubs
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