Submitted by the Home Office
MEMORANDUM 1
1. INTRODUCTION
1.1 Tackling drugs to build a better
Britain (Cm 3945), which was launched in April 1998,
is a ten-year strategy for tackling drug misuse. A key theme is
to focus efforts on tackling the root causes of drug misuse proactively,
rather than reactively subsidising failure. The strategy has four
key aims, each of which is inter-linked:
young people—to help young people
resist drug misuse;
communities—to protect communities
from drug-related anti-social and criminal behaviour;
treatment—to enable people with
drug problems to overcome them;
availability—to disrupt the supply
of drugs.
1.2 The focus of the strategy is on
Class "A" drugs. Details of the legal framework can
be found at Annex A.
1.3 As part of the Comprehensive Spending
Review 2000, the four key aims, set in 1998, were rolled over
into the Action Against Illegal Drugs Public Service Agreement,
with the overall aim of creating a healthy and confident society,
increasingly free from the harm caused by the misuse of drugs.
Targets were set for each of the four key aims:
— to reduce the proportion of people
under the age of 25 reporting the use of Class "A" drugs
by 25 per cent by 2005 (and by 50 per cent by 2008);
— to reduce the levels of repeat offending
among drug misusing offenders by 25 per cent by 2005 (and by 50
per cent by 2008);
— to increase the participation of
problem drug misusers in drug treatment programmes by 55 per cent
by 2004 (by 66 per cent by 2005 and by 100 per cent by 2008);
— to reduce the availability of Class
"A" drugs by 25 per cent by 2005 (and by 50 per cent
by 2008).
1.4 Following this year's General Election,
the Home Secretary has assumed overall responsibility for delivery
of the anti-drugs strategy. The Home Secretary is also chairman
of the ministerial sub-committee for tackling drug misuse—DA(D).
Its members are: the Secretary of State for Health; the Chief
Secretary, to the Treasury; the Secretary of State for Education
and Skills; the Minister of State, Cabinet Office; and the Parliamentary
Under-Secretary of State, Foreign and Commonwealth Office. The
Financial Secretary, Treasury is invited to attend as appropriate
in view of his responsibility for HM Customs & Excise.
1.5 The Home Secretary and DA(D) are
responsible for ensuring the delivery of the Government's national
and international policies for tackling drug misuse, but a number
of Departments have a vital role to play in taking forward the
activities under each of the aims. Details of the national and
local delivery structures can be found at Annex B.
2. YOUNG PEOPLE
2.1 The strategy's first aim is to
help young people resist drug misuse in order to achieve their
full potential in society, with the key target of reducing the
proportion of people under the age of 25 reporting the use of
Class "A" drugs by 25 per cent by 2005 and 50 per cent
by 2008.
2.2 The 1998 British Crime Survey and
the 1999 Schools Survey set the baseline to measure progress on
this target. These showed: 2.4 per cent of 11-15 year olds reported
using Class "A" drugs in the previous year and 1.1 per
cent in the previous month (1999 Schools Survey); and, the figures
for 16-24 year olds were 8.3 per cent in the last year and 3.4
per cent in the last month (1998 British Crime Survey).
2.3 Results from the Schools Survey
2000 show that 1 per cent of 11 to 15 year olds have used opiates
(heroin or methadone) and 4 per cent claimed to have used stimulants
(includes cocaine, crack, and ecstasy). The British Crime Survey
2000 shows that drug use in the general population remains stable,
with some significant reductions in the proportion of young people
aged 16-19 taking drugs. However, the use of cocaine among 16—19
year olds has risen significantly, from 1 to 4 per cent between
1994 and 2000.
Evidence and Rationale
2.4 The Young People Public Service
Agreement outcome target is underpinned by activities undertaken
by the Home Office, Department for Education and Skills and the
Department of Health. The evidence base is being further developed
(see paragraph 2.13 below). Progress is being made in ensuring
that measures to tackle drug misuse are being delivered and co-ordinated
to best effect. For instance, there is evidence from the US that
prevention works best when a co-ordinated multi-component approach,
involving different interventions and settings (eg community-based,
schools, youth clubs, family) is taken. Similarly, within schools
there is Australian, US and (albeit limited) UK evidence that
an approach centred around equipping children with "life
skills" is more likely to be effective than one based on
fear-based drugs information alone.
2.5 How this evidence is being reflected
in practice is set out more fully below.
Partnership
2.6 Essential to the delivery of this
target is to ensure at both national and local level that drug
services for young people are fully integrated into the wider
provision of children's services.
Young People's Substance Misuse Plans
2.7 A major step forward in improving
the planning and co-ordination of the delivery of services for
young people are Young People's Substance Misuse Plans.
These will help to integrate the work of the Drug Action Teams,
responsible at local level for delivering education, prevention,
treatment and rehabilitation measures, with other children's services.
During the current financial year all Drug Action Teams will be
undertaking a comprehensive analysis of both the needs of children
and young people and current capacity. The Drug Action Team will
use this information to draw up a Young People's Substance
Misuse Plan. The information will also provide national measures
of coverage by type of service and vulnerable group against which
progress can be measured.
2.8 Each Drug Action Team's Young
People's Substance Misuse Plan will be required to show that
by 2004 there will be: substance misuse education and information
for all young people and their families; advice and support targeted
at vulnerable groups; early identification of need; and, tailored
support to all those who need it when they need it.
Activities in support of achieving the target
Education
2.9 The strategy aims to encourage
young people not to take drugs in the first place. It also recognises
that young people, and those responsible for them, need to be
informed about the harm that drugs can cause. This is based on
the premise that greater knowledge will have a positive effect
on young people's behaviour. This can be achieved by enhancing
the effectiveness of drug education in schools.
2.10 The Department for Education and
Skills has allocated £14.5 million (2001-02), £15.5
million (2002-03), and £17.5 million (2003-04) for drug,
alcohol and tobacco education.
2.11 All schools are required to teach
drug, alcohol and tobacco education as part of the National Curriculum.
The Department for Education and Skills's guidance on Protecting
Young People: Good practice in drug education in schools and the
youth service encourages schools to deliver drug, alcohol
and tobacco education as part of a broader Personal, Social and
Health Education (PSHE) curriculum.
2.12 The guidance also encourages all
schools to have drug education policies. In 1997, 86 per cent
of secondary schools and 61 per cent of primary schools had drug,
alcohol and tobacco education policies. Ofsted's survey: Drug
Education in Schools: an update (September 2000) showed that
this had increased to 93 per cent of secondary schools and 75
per cent of primary schools. The target for 2002 is for all secondary
and 80 per cent of primary schools to have a policy in place.
2.13 Earlier this year the Government
commissioned a long-term study on the impact of drug, alcohol
and tobacco education in schools. This will be a joint project
between the Department for Education and Skills, the Department
of Health and the Home Office. The study will look at which types
of educational input and other factors, such as socio-economic
and cultural have most impact on influencing behaviour. The project
will start in the autumn.
National Healthy Schools
2.14 The Department of Health and the
Department for Education and Skills are jointly funding the National
Healthy School Standard, of which drug, alcohol and tobacco
education is one of the key components. More than half the country's
schools now have access to a nationally accredited Healthy
Schools programme. The Government is on track to achieve its
target of accrediting every local education authority and health
authority partnership by April 2002.
2.15 There are over 50 Primary School/Primary
Care Health Links Projects operating within the Healthy Schools
Standard in a range of localities in England. These projects
are funded by the NHS. The aim of these projects is to develop
more effective preventive work around a range of issues, including
drug misuse.
Communication initiatives
2.16 The Department of Health is investing
up to £4 million a year on a number of communication initiatives.
These include £2 million a year for running and publicising
the National Drugs Helpline (0800 776600) which receives
between 250,000 and 500,000 calls a year. It also includes distribution
of two to three million publications aimed at informing parents
and young people about drugs. The Department also provides information
about its activities in this area on its internet site; and interactively
through the National Drugs Helpline www.ndh.org.uk and through
www.trashed.co.uk and www.d-2k.co.uk
Contribution to wider social agenda
2.17 The Government is committed to
developing an overarching strategy for its services and policies
for children. This is being co-ordinated by the new cross-departmental
Children and Young People's Unit. In the document Tomorrow's
Future: Building a Strategy for Children and Young People,
launched in March this year, the Minister for Young People committed
the Government to principles which would ensure that children
can grow up to play a full and vigorous role in society. Activity
in support of the drugs strategy targets for young people is being
developed to reflect those principles.
2.18 The Government is funding a number
of activities and projects which at the same time as providing
opportunities for young people to develop a variety of skills
to resist drugs also form part of its agenda for tackling wider
social issues.
Positive Futures
2.19 Positive Futures aims to
use sport to reduce anti-social behaviour, crime and drug misuse
among 10-16 year olds within selected neighbourhoods. Set up in
March 2000 and funded partly through the Confiscated Assets Fund,
Positive Futures is a partnership between Sport England,
the Home Office and the Youth Justice Board.
2.20 There are currently 24 Positive
Future projects nation-wide. Positive Futures incorporates
a number of different approaches aimed at engaging vulnerable
young people in sport. Common features throughout the projects
include coaching skills across a range of sports, mentoring using
sport as a focus, and outreach work to make contact with young
people at risk of exclusion.
2.21 Early indications show that the
projects are having a positive impact on crime and drug misuse
and participants' lifestyles. In this year's Budget, the Chancellor
of the Exchequer allocated a further £5 million over two
years to help set up an additional 40-50 projects.
Connexions
2.22 Connexions provides careers
advice and youth support service for 13 to 19 year olds. Drug
Action Teams, supported by the Drugs Prevention Advisory Service,
are working with Connexions in a three-pronged strategy
to provide: help to young people at risk of drug misuse because
of home and/or school circumstances; advice and information to
young people about the use of drugs and alcohol; an in-depth assessment
of young people's needs, including those created by drug misuse,
and a planned response. This will include brokering support from
specialist agencies when needed.
2.23 Since April 2001, Connexions
has been available in 12 areas. Three more areas started in September
2001. The service will be rolled-out across the remaining 32 areas
in England by 2003. (Areas are based on Learning and Skills Council
areas. Broadly co-terminous with local authority boundaries, the
areas comprise several local authorities clustered together.)
Health Action Zones projects
2.24 In order to stimulate new drug
prevention activity with vulnerable groups, including young offenders,
homeless young people and looked-after children, the Department
of Health has made available £7 million over four years (1998/9-2001/2)
for Health Action Zones. These are partnerships between local
agencies, community groups and the voluntary and business sectors.
Twenty-six Health Action Zones have been established in England
by the Government in the areas of greatest deprivation and poor
health to tackle health inequalities and modernise services through
local innovation.
2.25 Between them the Health Action
Zones are currently running around 130 projects and initiatives
in support of this. Some have the aim of integrating drug misuse
prevention within and across services for young people provided
by health, local authorities and other Health Action Zone partners.
Others are discrete projects dealing with a particular category
of vulnerable young person, for example children with drug misusing
parents. An evolving national evaluation of these initiatives
is underway and should be completed by 2003.
Youth Offending Teams
2.26 Youth Offending Teams were created
under the Crime and Disorder Act 1998 and implemented nationally
from 1 April 2000. Local authorities with social services and
education authorities are required to work with the police, probation
services and health authorities to establish multi-agency Youth
Offending Teams. There are 154 in operation across England and
Wales. They are central to the youth justice system—advising
courts, administering community sentences and interventions, working
with juvenile custodial establishments, and performing crime prevention
with young people at risk.
2.27 The Youth Justice Board, in partnership
with the Home Office, is providing funding for Youth Offending
Teams during this current financial year and for 2002/03 (£8.5
million) and 2003/04 (£8.5 million) to assist in the development
of drugs services for young people. Youth Offending Teams are
using the money to establish posts for drugs workers and are also
in some areas using it to fund workers in other local services
providing for young people misusing drugs.
Targeted intervention
2.28 Targeted interventions focus activities
at high-risk children or young people who have an increased risk
of substance misuse. Examples of the activities include prevention
programmes in "high risk" areas or for particular groups
of young people, individual and family crisis support, assessments
and links with more specialist drug services. The results from
work with young people in Health Action Zones will be used as
a basis for increased targeted prevention activity by health authorities
working with other community partners during 2001/4.
Young People's treatment
2.29 Treatment facilities for young
people need to be provided separately to those for adults and
tailored specifically to the needs of young people. In particular,
they need to look at how a young person's drug use might be linked
to other personal or social issues and develop multi-agency interventions
for the young person and their families. While the provision of
young people's drug treatment services is currently expanding
throughout the country more needs to be done. This will be addressed
by the National Treatment Agency (see 4.5-4.7) and within each
Drug Action Team area by the Young People's Substance Misuse
Plan.
3. COMMUNITIES
3.1 The strategy's second aim is to
protect communities from drug-related anti-social and criminal
behaviour, with the key target of reducing levels of repeat offending
among drug misusing offenders by 25 per cent by 2005 and 50 per
cent by 2008.
3.2 Drug-related crime is a social
problem, imposing serious costs, often on those individuals and
communities least equipped to cope with them. Government policy
is to ensure that the criminal justice system takes concerted
action at every stage to break the link between drugs and crime.
Helping drug-misusing offenders to tackle their drug problems
and become better integrated into society has a significant impact
on levels of crime. Local partnerships can work successfully to
tackle local drug problems, and to improve the quality of life
for communities.
3.3 The current target only addresses
the issue of drug-related crime. However our work also focuses
on the broader level of harm drugs do to communities. This includes
the need to develop community resistance to drugs and to strengthen
communities. This is particularly important in the poorest areas
where there is a strong need to build community cohesion and social
capital which is eroded by drugs. This will be achieved through
development of clear targets and objectives for broader community
approaches to drugs.
Evidence and Rationale
3.4 There is good evidence that treatment
forms an effective means of breaking the link—both from
the literature and, increasingly, the results of pilots on the
ground. Delivering the target means not only ensuring adequate
treatment provision but also ensuring effective mechanisms whereby
drug misusing offenders can be effectively channelled into these
services. The Government has introduced a number of programmes
to do that—for example, Arrest Referral Schemes and Drug
Treatment and Testing Orders, the piloting of drug testing provisions
under the Criminal Justice and Court Services Act, and the extension
of detoxification and other treatment services within the Prison
Service. A further strand of activity under this target is strengthening
communities so that they are better placed to resist the effects
of drug misuse.
3.5 Whilst community development approaches
are very important and significant within the United States drugs
strategy, the evidence base to date remains weak, both there and
in the UK. However, Home Office research under the Drug Prevention
Initiative and currently in progress will improve this.
Tackling drugs at a community level—Communities
Against Drugs
3.6 The Government announced in this
year's Budget that new resources would be allocated for Communities
Against Drugs (CAD) as part of its commitment to help local
communities mobilise against drugs.
3.7 £220 million over three years
is to be distributed through Crime and Disorder Reduction Partnerships,
working with local police, Drug Action Teams, to be spent on targeted,
locally determined measures to: disrupt drugs markets; tackle
drug-related crime; and strengthen the ability of communities
to deal with the drug problems in their midst.
3.8 The money should be used flexibly
by partnerships—above all it is to be used to back local
people in action against drugs. It can be spent on a whole range
of activities. For example: ensuring that police officers maintain
a visible presence in drug hot spots, by extending for instance,
the investment in extra visibility which has already been achieved
in five police force areas through the Government's street robbery
initiative; mobile police stations to make the police more readily
accessible to local communities; neighbourhood wardens to provide
a constant presence on housing estates and other public areas;
action to tackle drug-related anti-social behaviour, for example
through Anti-Social Behaviour Orders; and, support for community,
parents' and residents' groups.
3.9 The Home Office will be carrying
out an evaluation of some of the projects under Communities
against Drugs.
Tackling drugs and urban renewal
3.10 More generally, the impact of
drugs on the poorest communities and the relationship between
drugs and the national strategy for neighbourhood renewal is being
developed. The role of drugs in hindering efforts at urban renewal
and the creation of social exclusion is being addressed by a greater
range of joint programmes between the Department for Transport,
Local Government and the Regions and the Home Office. These include
specific guidance on aspects of regeneration and housing practice
(Managing Drugs in Rented Housing—a good practice guide)
and long-term action research into what works. This is a partnership
project with the Neighbourhood Renewal unit in the Department
for Transport, Local Government and the Regions and involves evaluation
into the effects of a wide range of community interventions across
availability, treatment and young people's work located in three
New Deal for Communities programmes. This started in April
2001 and initial reports are due by autumn 2002.
3.11 This range of programmes is designed
to look at ways in which treatment services and services for young
people, as well as action to disrupt supply as funded under Communities
Against Drugs, can be directed at those communities most affected
by social exclusion. The work also involves much greater attention
to the management of clubs, pubs, the workplace and other community
settings where drug use can be problematic.
3.12 Much of the current investment
under CAD is designed to build social capital and cohesion against
drugs. It is recognised that the presence of large and active
drug supply and use networks in deprived areas is a barrier to
regeneration and community development. But removing these is
a long-term need requiring effort across all four aims of the
strategy.
Criminal justice system
3.13 The Government has introduced
a number of measures that aim to identify drug misusing offenders,
particularly those using Class "A" drugs, in order to
provide the opportunity to intervene earlier in their drug using
career and to help them to gain access to treatment.
3.14 It has been estimated that the
cost of drugs offences to the criminal justice system is around
£1.2 billion a year (this does not include crime committed
to fund drug use). (The Economic and Social Costs of Crime—Home
Office Research Study 217).
3.15 Drug misuse and crime are strongly
connected: the New English and Welsh Arrestee Drug Abuse Monitoring
programme (NEW ADAM) found that 65 per cent of arrestees across
four sites tested positive for an illegal drug, with 29 per cent
testing positive for heroin and/or cocaine/crack; users of both
heroin and cocaine/crack represented nearly a quarter of the arrestees,
yet were responsible for more than half (by value) of acquisitive
crime in 1999-2000 (Home Office Research Study 205 NEW-ADAM).
Arrest Referral Schemes
3.16 Arrest Referral Schemes aim to
reduce drug-related crime by encouraging problem drug users to
take up treatment at the point of arrest. Ideally,workers will
be on site drug workers in police custody suites to follow up
quickly when a person expresses interest in knowing more about
the scheme. They will then undertake an assessment and be referred
to appropriate treatment and/or other programmes of help.
3.17 Extra funding from the Crime Reduction
Programme Joint Funding Initiative has helped to accelerate the
development of Arrest Referral Schemes in England and Wales, resulting
in 86 per cent coverage of custody suites by 330 drug workers
by the end of March 2001. By 2002 all police forces should be
operating pro-active arrest referral schemes.
3.18 Early Home Office pilot schemes
(1995-1998) identified the following outcome in those offenders
who had been engaged in treatment: around 60 per cent reported
reductions in acquisitive crime; 75 per cent reduced their spending
on drugs; 31 per cent said that they had reduced their drug use;
and 28 per cent said that they had stopped using heroin or their
illicit drug.
Drug Treatment and Testing Orders (DTTOs)
3.19 Available throughout England and
Wales since October 2000, the Drug Treatment and Testing Order
is a community sentence created by the Crime and Disorder Act
1998. It aims to break the link between drug use and crime. The
Drug Treatment and Testing Order is targeted at problem drug users
aged 16 or over who commit crime to fund their drug habits, show
a willingness to co-operate with treatment and are before the
court for an offence that is sufficiently serious to attract a
community sentence.
3.20 Drug Treatment and Testing Orders
enable courts to require offenders—provided they agree to
comply—to undergo treatment and other programmes, designed
to tackle their drug misuse and offending, at a specified place
for a period of between six months and three years. Under the
terms of the Order, offenders must also be tested regularly for
illegal drugs, and attend court for periodic reviews of their
progress.
3.21 Drug Treatment and Testing Orders
improve upon previous provision by requiring the court to play
an on-going role in reviewing the offenders progress on the Order
and through the mandatory drug testing of offenders.
Drug Treatment and Testing Orders pilot schemes
3.22 The "Drug Treatment and
Testing Orders: Final Evaluation Report" (Home Office
Research Study 21), published on 30 October 2000) showed major
reductions in offending and drug consumption by people subjected
to Drug Treatment and Testing Order.
3.23 The Drug Treatment and Testing
Order pilot schemes were undertaken in Croydon, Liverpool and
Gloucestershire from October 1998 to March 2000. During that period,
210 Drug Treatment and Testing Order were made. Key findings showed
that: the average weekly spend on illegal drugs by offenders on
Drug Treatment and Testing Orders fell from £400 in the month
before arrest to £25 in the first six weeks of the order—a
fall of 94 per cent; the average number of crimes committed to
fund consumption of illegal drugs fell from 137 in the month before
arrest to 34 in the first few weeks of the order.
3.24 The research showed that these
reductions in offending and drug consumption were largely sustained
over time for those who stayed on the programme.
Drug Treatment and Testing Order roll-out
3.25 £20 million was made available
for the roll-out of Drug Treatment and Testing Orders in 2000-01
(the first six months after implementation) and £40 million
for the following year (the first full year of implementation),
ring-fenced for the purpose. Under the new pooled budget arrangements,
which promote more effective joint commissioning through Drug
Action Teams, the treatment element of Drug Treatment and Testing
Order funding for 2001-02 became part of the pooled budget. This
will continue to be the case in subsequent years. Improved local
planning and commissioning of drug treatment, and the additional
funding made available by the Government for the expansion of
drug treatment services, should ensure that the needs of all drug
misusers, including offenders on Drug Treatment and Testing Order,
are met more effectively.
3.26 As at the end of June 2001, over
2,300 Drug Treatment and Testing Orders had been made, of which
336 had been terminated. After an anticipated slow start following
roll-out, the monthly number of Orders is continuing to increase
steadily. The target of approximately 6000 Drug Treatment and
Testing Orders to be made during 2001-02 is on track.
Drug Testing
3.27 The Criminal Justice and Court
Services Act 2000 contains provision to drug test persons aged
18 and over for specified Class "A" drugs, (heroin and
crack/cocaine), including: those charged with trigger offences
(property crime, robbery and/or Class "A" drug offences)
and offenders under probation service supervision (bail, community
sentence and on licence from prison) in order to identify those
misusing drugs and monitor their progress.
3.28 These new powers will: allow the
police to test those charged with trigger offences, or where they
suspect that misuse of specified Class "A" drugs is
involved in the commissioning of the crime; require the Court
to take a positive drug test into account when considering bail;
introduce a requirement to undergo testing for all those on community
sentences for trigger offences whom the Court considers are dependent
on, or have a propensity to misuse, Class "A" drugs;
introduce the new Drug Abstinence Order for all those in the target
group for whom an alternative community sentence is not appropriate;
allow a condition to undergo drug testing to be included in the
licence of those released from prison having served a sentence
for a trigger offence, with drug abuse identified as a contributing
factor to their offending.
3.29 The new drug testing provisions
will complement existing programmes for tackling drug-related
crime. These provisions are being piloted for two years from summer
2001, in three areas—Nottingham, Stafford and Hackney. The
schemes will be fully evaluated.
Prison Service
3.30 The Prison Service Drug Strategy
was introduced in 1998 and forms part of the overall anti-drugs
strategy. The Prison Service drug strategy is being implemented
with a significant investment of funding: approximately £25
million per year extra since 1999-2000 (Comprehensive Spending
Review) and a further £88 million for the period 2001-2004
(Spending Review).
Supply Reduction
3.31 The Prison Service is continuing to
improve procedures for reducing the supply of drugs into prisons.
Additional funds have been allocated to particular aspects of
security directly focused on drugs. Every closed prison is required
to have CCTV in visit areas and, since April 1999, the Prison
Service has introduced a more comprehensive and consistent framework
for dealing with visitors attempting to smuggle drugs in to prisoners.
In addition, by 31 March 2002 every prison is required to have
access to a passive drug dog, which is trained to search visitors
for drugs, and will indicate a drugs find by sitting beside the
visitor concerned.
3.32 The Prison Service is working with
the police, Customs and Excise and the Scottish Prison Service
on the development of better technology to detect drugs. Steps
are also being taken towards achieving a reliable picture of the
pattern of drug supply and availability throughout the prison
estate.
Mandatory Drug Testing
3.33 The Mandatory Drug Testing programme
was introduced in 1995 and has three aims: to deter prisoners
from misusing drugs through the threat of being caught and punished;
to supply information on patterns and levels of drug misuse; and
to identify individuals in need of treatment. In each prison mandatory
drug tests are carried out on a random proportion of either 5
per cent or 10 per cent of prisoners per month, depending upon
the size of the prison in question.
3.34 The percentage of positive results
from the random Mandatory Drug Testing programme has fallen from
24.4 per cent in 1996-97 to 12.4 per cent in 2000-01. The Prison
Service has a target to reduce positive Mandatory Drug Testing
results to 10 per cent by March 2004.
Voluntary Drug Testing
3.35 Voluntary drug testing allows prisoners
to make a commitment to remain drug free and undergo drug testing
more frequently than under Mandatory Drug Testing—typically
at least 18 times per year. The Prison Service has introduced
voluntary testing for all suitable prisoners and has a target
of 28,000 prisoners on voluntary testing compacts by 1 April 2002.
TREATMENT
Detoxification
3.36 In December 2000 the Prison Service
introduced a new standard for clinical services for substance
misusers so that detoxification services are available in all
local and remand prisons, to a level at least comparable with
that in the community, and to a standard set by the Department
of Health. The Prison Service is committed to achieving, 27,000
annual entrants to detoxification programmes by March 2004. Current
performance is in excess of this: 32,000 annual entrants assessments
in 2000-01.
CARATs
3.37 All prisons now provide CARATs (Counselling,
Assessment, Referral, Advice and Throughcare) services, which
constitute a package of support and advice services for drug misusers
throughout their time in prison. CARATs can refer prisoners to
more intensive treatment programmes if applicable, and provides
continuity between treatment in prison and that available on release.
The Prison Service has a target of completing 25,000 full assessments
annually by March 2004. Current performance is well ahead of this
target—37,000 assessments in 2000-01.
Drug Rehabilitation Programmes
3.38 These are intensive treatment programmes
for prisoners with moderate to severe drug misuse problems and
related offending behaviour. There are currently 50 such programmes,
32 more than when the drug strategy was introduced. Rehabilitation
programmes are delivered through a multi-disciplinary approach
which involves community agencies under contract to the Prison
Service.
3.39 The Prison Service target is for 5,700
annual entrants to rehabilitation programmes by March 2004. There
were 3,100 entrants in 2000-01. Delays in placing contracts and
recruiting staff have meant a slower than expected build up to
the target numbers. An additional £1.7 million was allocated
in February 2001 to provide further places.
Post-Release Drug Hostels
3.40 The Prison Service is leading a pilot
scheme to set up post-release hostels for short-term prisoners
with histories of drug misuse. There will be five hostels in the
pilot, one for women and four for men, all planned to open by
July 2002. Responsibility for this project will pass to the National
Probation Directorate of the Home Office later this year when
contracts are awarded.
3.41 There is also a need to review the
link between prison-based treatment and post-release treatment.
The Prison Service is working with the National Treatment Agency
(see 4.5-4.7) and the Home Office to ensure that ex-prisoners
have access to appropriate treatment after release. The head of
the Prison Service's Drug Strategy Unit sits on the Board of the
National Treatment Agency.
4. TREATMENT
4.1 The strategy's third aim is to enable
people with drug problems to overcome them and live healthy and
crime-free lives. This is underpinned by the target of increasing
the participation of problem users in effective treatment programmes
by 50 per cent by 2004, 66 per cent by 2005 and 100 per cent by
2008.
EVIDENCE
AND RATIONALE
4.2 Treatment works: the most extensive
evaluation of drug treatment in the UK has shown that it leads
to reductions in both drug use and offending for periods of at
least five years. Treatment was found to be cost effective—for
every £1 spent on treatment, £3 was saved in criminal
justice expenditure. (Source: The National Treatment Outcome
Research Study). There has been a steady increase in the number
of drug misusers attending treatment services—up 16 per
cent over two years, from 28,599 in April to September 1998 to
33,093 for the equivalent period in 2000. (Source: Department
of Health Statistical Bulletin, 2001).
4.3 These results are broadly reflected
across the treatment literature more widely—both here and
in other countries. Key actions in the strategy over the next
three years include: addressing performance variations within
each of the main types of treatment; reducing unacceptable length
of waiting times for entry into treatment; and, ensuring that
at least 30 per cent of GPs offer shared-care services. A target
of reducing drug-related deaths by 20 per cent by 2004 has also
been agreed.
4.4 More needs to be done. More skilled
drugs workers are needed and the availability and quality of treatment
and aftercare services need strengthening. That is why the Government
has been investing more resources in providing treatment services
and continues to do so. In total, provision for treatment of both
non-offenders and offenders is planned to increase from £234
million in 2000-01 to over £400 million by 2003-04.
NATIONAL
TREATMENT AGENCY
4.5 It is also why the Government in April
this year set up a new Special Health Authority, the National
Treatment Agency. This is a joint initiative between the Department
of Health and the Home Office. The National Treatment Agency is
responsible for overseeing the provision of drug treatment programmes
across the UK and ensuring that those who need it receive effective,
high-quality, consistent treatment no matter where they live or
where they are referred from.
4.6 The purpose of the National Treatment
Agency is to support the achievement of the Government's strategic
aims for substance misuse treatment. The Agency will initiate
research into effective practice, and translate this into standards
and guidance. The National Treatment Agency will hold Drug Action
Teams to account for their commissioning of services, to ensure
that effective treatment is available to meet the needs of the
whole population. To ensure that investment in treatment is not
wasted, Drug Action Teams will be expected to work with partners
in housing, education and employment to promote the social integration
of drug misusers following and during treatment.
4.7 To improve co-ordination, the Home Office
and the Department of Health have created a "pooled budget"
for commissioning drug misuse services. This budget is allocated
to local agencies, again on a pooled basis, so that the National
Treatment Agency can ensure better integration and improved effectiveness
of the services purchased.
HUMAN
RESOURCES
4.8 In response to the need for more suitably
qualified staff, particularly at clinical level, a national recruitment
campaign was held in March 2000 with an overwhelming response—over
50,000 calls to the central response centre and 25,000 expressing
an interest in working in drug treatment.
4.9 Additional allocation for drug treatment
in 2000-01 meant that 75 Drug Action Teams received funding to
hold recruitment events and exercises to make contact with these
potential employees. These are currently being held. A formal
evaluation is planned in the autumn. The Department of Health
has also allocated £220,000 over two years to provide training
bursaries of up to £400 per person for drug workers wishing
to acquire relevant professional qualifications.
4.10 Occupational standards for drug treatment
services are currently being developed which will foster a strategic
approach to education and training of all workers in the field.
The National Treatment Agency will also be developing a human
resources strategy as part of its remit to tackle some of the
recruitment and retention issues within the drugs treatment field.
This will build on the work already undertaken by the Department
of Health and other agencies.
IMPROVING
SERVICES
4.11 To improve the quality of services
available, clinical guidelines (Drug Misuse and Dependence—Guidelines
on Clinical Management) were published by the Department of
Health in 1999. These provide detailed guidance for doctors on
the assessment and treatment of drug misuse, including advice
on ways to prevent relapse in drug misuse.
MAXIMUM
WAITING TIMES
4.12 All Drug Action Teams are required
to establish maximum waiting times for admission into treatment
programmes by March 2002. Guidance on how best to achieve this
will be developed by the National Treatment Agency in collaboration
with others in this field.
HARM
MINIMISATION INCLUDING
REDUCING DRUG-RELATED
DEATHS
4.13 The UK adopted harm minimisation strategies
in the early 1990s, focused mainly on the provision of needle
exchange, as a preventative measure for HIV/AIDS. 99 per cent
of health authorities in England now have needle exchange programmes.
Over 27 million needles and syringes are exchanged each year.
4.14 In 2001 the Department of Health produced
Hepatitis C—Guidance for those working with drug users
for those who work with drug misusers; funded regional seminars,
supported by new health promotion materials on strategies to reduce
injecting and sharing and encouraging uptake of Hepatitis B vaccination.
4.15 The Government has a commitment to
produce a cross-Government action plan by 2002 to reduce drug-related
deaths. The Department of Health has a service delivery agreement
for achieving a 20 per cent reduction in drug-related deaths by
2004.
5. AVAILABILITY/SUPPLY
5.1 The strategy's fourth aim is to disrupt
the supply of illegal drugs on the street, with the key objective
of reducing the availability of Class "A" drugs by 25
per cent by 2005 and 50 per cent by 2008. The strategy is implemented
by a combination of direct law enforcement action in the UK and
overseas, and by funding technical and training assistance programmes
overseas.
5.2 The illegal drug trade is a global industry
estimated by the IMF to be worth some $200 billion a year. Considerable
resources are being deployed world-wide to combat this trade by
reducing drug production, processing and trafficking.
5.3 Most illegal drugs reach Britain through
organised crime. It is complex and fast moving and demands a comprehensive
response. The UK response has a number of strands:
— better strategic intelligence. Detailed
up-to-date information shared effectively between law enforcement
agencies is critical. In the UK, the National Criminal Intelligence
Service collates, disseminates and analyses criminal intelligence.
The Security and Intelligence Agencies apply their specialist
skills against organised crime at home and abroad;
— appropriate legal powers. With rapidly
changing technology and criminal practice it is essential to keep
legislation up to date;
— co-ordinated skills and technology.
A new National Specialist Law Enforcement Centre will provide
joint training in investigative techniques for officers from the
National Criminal Intelligence Service, the Metropolitan Police,
the National Crime Squad and HM Customs and Excise. It will be
launched in December 2001;
— a concerted approach to law enforcement.
Through the Concerted Inter-agency Drugs Action Group (see 5.5)
Customs and Excise, the National Criminal Intelligence Service,
the National Crime Squad and other agencies efforts, are co-ordinated
to ensure maximum impact;
— funding technical assistance and
skills training of overseas drugs law enforcement agencies. The
Home Office and Foreign and Commonwealth Office each have budgets
specifically for combating drug trafficking and related activities
(such as money laundering);
— depriving criminals of their assets.
Confiscating assets and preventing money laundering reduce the
incentives for crime and remove an important source of finance
for criminal enterprises. The Proceeds of Crime Bill will reform
and unify the criminal law on money laundering (see 5.11-5.12).
Evidence and Rationale
5.4 There has been increasing focus on proactive
intelligence-based activities aimed at disrupting the flow of
drugs to the UK; disrupting the organised criminal gangs responsible
and tackling the profitability of these activities through enhanced
forfeiture of assets. Importantly, in April this year the Government
announced targets for increasing seizures of heroin and cocaine,
between now and 2003-04, broadly consistent with delivery of the
Public Service Agreement outcome target. At the same time, targets
for disruptions of organised drugs smuggling gangs and forfeiture
of assets for 2001-02 were announced. The Government is committed
to doubling assets seized by 2004.
Availability
5.5 The Concerted Inter-Agency Drug Action
Group (CIDA) is responsible for driving achievement of the availability
reduction target. It is chaired by Customs and Excise and includes
representatives of all those Government Departments which have
a role in reducing drug availability, including: the National
Crime Squad, National Criminal Intelligence Service, the Association
of Chief Police Officers, Home Office, Foreign and Commonwealth
Office, Cabinet Office, the Scottish Drug Enforcement Agency and
other agencies.
5.6 An action plan to target middle market
suppliers selling quantities between 1 and 5 kilogrammes is being
developed. This includes, for example, the use of Confiscated
Asset Funds to support a pilot in the West Midlands to tackle
middle markets, which will be evaluated, and the development of
similar projects in other cities.
5.7 The International Group, the UK's inter-agency
co-ordinating policy group chaired by Director, International
Security (FCO) sets the overarching policy for the UK's strategy
for interdicting illegal drugs overseas.
5.8 Operational activity is also co-ordinated
by CIDA which has put in place an end-to-end multi-agency strategy
of interdiction aimed at disrupting and destroying heroin and
cocaine supply from source to UK streets. The strategy encompasses
a range of operational, intelligence and diplomatic activity in
key source and transit regions. It includes programmes aimed at
building the legal and law enforcement infrastructure of key countries,
including training and support programmes, to complement our upstream
disruption activities where traffickers are often more vulnerable
and move drugs in larger consignments.
5.9 Examples of assistance provided by the
UK under the various strategies include: drug crop and yield surveys
in the Andean Region and Afghanistan; regional law enforcement
capacity building in the Balkans and Caribbean; strategic analysis
of the drugs trade identifying intelligence gaps; intelligence
and disruption programmes in South America and against key trafficking
routes in Pakistan.
The Confiscated Assets Fund
5.10 Since 1999 the Confiscated Assets Fund
has enabled some £15 million seized from drug traffickers
to be channelled into prevention, treatment and enforcement activities
in support of the anti-drugs strategy. Following the publication
of the Performance and Innovation Unit's report Recovering
the Proceeds of Crime in June 2000, the Government has stepped
up its effort to use asset recovery and seizure as a means of
combating drug trafficking and other forms of organised crime.
5.11 The Proceeds of Crime Bill, expected
to be introduced shortly, will aim to enhance the capability of
law enforcement agencies to get at the traffickers' illegal proceeds
and disrupt their operations. This will include the establishment
of a new Asset Recovery Agency. As part of this strategy, the
Confiscated Assets Fund will, from April 2002, be subsumed into
a Recovered Assets Fund with a wider remit. As well as supporting
anti-drugs activities, the Fund will also support local crime
reduction initiatives, law enforcement and financial investigation.
International
5.12 As well as funding law enforcement
assistance projects overseas, the UK actively promotes effective
international co-operation against drugs and drug related crime
in three main ways: law enforcement activity in liaison with foreign
counterparts; bilateral diplomatic activity, backed up by assistance
to foreign governments; and, multilateral engagement, for example
via the UN, the European Union, the Financial Action Task Force
and the G8.
European Union
5.13 On 9 March 2000, the Prime Minister
announced a UK initiative to step up EU action against drugs.
This initiative's ultimate goal is to achieve drug-free societies
in an enlarged European Union. Its specific aims include: promoting
early progress toward common minimum penalties throughout the
EU for trafficking in drugs that cause the most harm; improving
the collection and comparability of EU data on drug misuse, drug-related
deaths and illness, availability of drugs and drug-related crime;
increasing exchange of information on what works in tackling all
aspects of drug misuse; and providing greater assistance to the
applicant countries to help them to tackle their drug problems.
5.14 Key elements of this initiative were
successfully woven into the EU Action Plan on Drugs 2000-04
which was agreed by EU Ministers in June 2000. Work is now under
way on common minimum/maximum EU penalties for drug trafficking;
and the European Monitoring Centre for Drugs and Drug Addiction
is making good progress on work to collect and disseminate comparable
data on drug misuse.
5.15 Many of the applicant countries hoping
to enter the EU in the next few years are on established routes
for the distribution of heroin to the UK, and therefore of vital
strategic importance to the development of the UK's policy of
upstream disruption. Help to the EU applicant countries, and to
other countries in South East Europe, to counter drug misuse and
trafficking is therefore being significantly increased. The UK
is the lead EU partner in a six million euro law enforcement project
starting this autumn across 10 candidate countries. The UK is
also involved in anti-drugs twinning projects in Bulgaria and
Romania.
5.16 The UK is playing a leading part in
a number of other EU external drugs initiatives. These include
the EU Caribbean Drugs Initiative and the EU Latin American/Caribbean
Drugs Co-ordination and Co-operation Mechanism. These initiatives
combine EU funding for technical and training assistance to the
countries in the region with activities designed to encourage
the countries to take action against their own developing domestic
drug problems, thereby contributing towards the overall anti-drugs
strategy.
Other Overseas Drugs Assistance
5.17 The UK provides significant funding
assistance and recognised expertise to other countries in tackling
their drug problems, whether it is production, trafficking or
consumption. Assistance comes from a number of sources, primarily
the Foreign and Commonwealth Office, the Department for International
Development, the Home Office and UK enforcement agencies. In 2000/01
the Foreign and Commonwealth Office contributed some £6.7
million to overseas anti-drugs projects, while the Home Office
provided just under £2 million. Budgets for 2001/02 are £7.3
million (Foreign and Commonwealth Office) and £2.1 million
(Home Office).
5.18 The UK has been a major donor to the
UN Drug Control Programme, which is the only global drug authority.
Examples of programmes supported by UK funds have been law enforcement
training in Brazil, Iran, the central Asian republics and the
joint UNDCP/EU Phare assistance programme for strengthening drugs
law enforcement capabilities in Romania, Bulgaria and Macedonia.
5.19 Other bilateral drugs-related assistance
has been targeted mainly at the Caribbean, Latin America and Asia.
Recent and ongoing assistance includes the British Military and
Advisory Training Team based in Antigua, sniffer dog training
to Caribbean enforcement agencies and training in other Customs
and Excise search techniques in Cuba and Colombia.
Preventing the diversion of precursor chemicals
5.20 Trade in precursor chemicals both within
the EU and with third countries is carefully controlled by means
of an EU Regulation and Directive, which have been in force since
1993. The aim is to prevent the diversion of precursor chemicals
used to make illicit drugs, while causing the minimum inconvenience
to licit trade. The UK fully supports international work through
the EU and UN on preventing the diversion of chemical precursors.
For example, the National Criminal Intelligence Service is taking
a leading role in a global operation to disrupt the supply of
acetic anhydride, the favoured precursor used in the production
of heroin. This important project is fully consistent with UK
strategy to reduce the supply of Class "A" drugs.
Drug Liaison Officers
5.21 Customs and Excise and the National
Criminal Intelligence Service have an extensive network of Drug
Liaison Officers posted overseas. The National Criminal Intelligence
Service is responsible for managing the European Drug Liaison
Officers. The wider global Drug Liaison Officers' network, with
officers based in the key drug producing and transit countries,
is managed by Customs and Excise. They combine to form an effective
force in the UK's action against drugs, identifying illicit drug
movements, the related financial activities and the structure
of criminal organisations involved, as well as contributing hard
intelligence for use in overseas and UK investigations.
6. RESOURCES
6.1 One of the key principles underpinning
the Strategy is changing spending priorities from reactive expenditure—dealing
with the consequences of failure to tackle drug misuse—to
proactive expenditure—preventing and tackling drug misuse
directly.
6.2 The Government has made available substantial
resources for directly tackling the problem of drug misuse. These
are planned to increase from £700m in 2000-2001 to over £1
billion in 2003-2004.
6.3 Details are set out in the tables below.
Key expenditure figures
£m
2000 Spending Review—resources directly
allocated for tackling drug misuse (by main aim of Tackling drugs
to build a better Britain)*
| | 2000-01
| 2001-02 | 2002-03
| 2003-04 |
| Drug Treatment** | 234
| 328 | 377
| 401 |
| Protecting Young People | 63
| 90 | 97
| 120 |
| Safeguarding Communities | 45
| 79 | 81
| 95 |
| Reducing Availability*** | 353
| 373 | 376
| 380 |
| Total | 695
| 870 | 931
| 996 |
* Excludes expenditure by devolved administration.
** Comprises mainstream spending by Department of Health,
local authorities and the pooled National Treatment Agency budget.
Excludes additional Prison Service treatment spend, brigaded under
Communities.
*** UK spend for 2001-2002 to 2003-2004 includes the
£90 million approved for combating organised crime.
2000 Spending Review—new resources provided for
related programmes*
| | 2001-02
| 2002-03 | 2003-04
|
| Criminal Justice System | 1420
| 2290 | 2720
|
| Neighbourhood Renewal Fund | 200
| 300 | 400
|
| Children's Fund | 100
| 150 | 200
|
| Connexions** | 77
| 177 | ***
|
* Excludes expenditure by devolved administration.
** This was added to existing provision for the careers
service. Funding will go to the careers service in areas where
Connexions is not yet running.
*** Provision for 2003-04 will be announced in due course.
Budget 2001—new resources for anti-drugs measures*
| | 2001-02
| 2002-03 | 2003-04
|
| Strengthening communities | 50
| 70 | 100
|
| Extending drug testing in the CJS | 0
| 20 | 30
|
| Providing more help to find jobs | 5
| 15 | 20
|
| Strengthening Drug Action Teams | 5
| 5 | 5
|
| Expanding Positive Futures | 2
| 3 | **
|
* Excludes expenditure by devolved administration.
** Provision to be decided in the light of other sources
of funding.
7. RESEARCH
7.1 For the Government's 10-year anti-drugs strategy
to be effective, it is crucial that clear information is obtained
on the size of the drug problem in the UK, and on which anti-drug
approaches are most successful. The strategy's research programme
therefore supports each of the four key aims. The key objectives
of the research programme are to: track the progress of the strategy's
key targets; provide evidence on the extent of drug use and drug
markets in the UK; and evaluate the effectiveness of approaches
seeking to reduce drug use.
7.2 Before the creation of the strategy, the UK evidence
base on illicit drug use was widely viewed as being very limited.
Basic information was not available on vital areas and Government
research was not well co-ordinated. The limited information sources
available to policy makers and practitioners at the beginning
of the strategy are briefly outlined below.
7.3 Young people: Prior to the introduction of
the drugs strategy in 1998, evidence of drug usage among the adult
population was provided by the British Crime Survey. Information
on young people was poor in its coverage and unreliable in its
findings. Very little information was available beyond basic levels
of drug use. UK evidence on effective ways of reducing drug use
among young people was extremely limited.
7.4 Communities: some information was available
on drug use among criminal offenders in prison. There was limited
information on drug use among the wider offender population and
on the links between drugs consumption and criminal activity.
7.5 Treatment: some clinical evidence was available
on the impact of various drug treatment programmes. However, many
therapeutic and treatment measures remained under-researched.
7.6 Availability: the main information sources
were official figures on seizures and convictions for drug possession
and supply. There were no accurate estimates of the amount of
heroin and cocaine imported or consumed in UK. There was no robust
UK evidence on the effectiveness of anti-trafficking methods or
the policing of local and regional drug markets.
7.7 The Home Office's Drug and Alcohol Research Unit
manages the budget for the strategy's research programme. The
programme's budget up to the financial year 2000/01 was £2
million per annum. It is now £3 million per annum. Details
of how this budget has been spent over the last three financial
years are outlined below.
Drug Strategy Research Budget—expenditure 1999/2000
to 2001/02
| Total expenditure | 1999/2000
| 2000/01 | 2001/02
|
| Young people | £187,000
| £243,974 | £1,215,906
|
| Communities | £353,017
| £462,911 | £574,036
|
| Treatment | £25,000
| £92,429 | £606,571
|
| Availability | £93,000
| £331,030 | £327,979
|
| Miscellaneous | £109,000
| £140,000 | £347,000
|
| Total spend | £767,017
| £1,270,344 |
£3,071,492 |
7.8 To address the gaps in the UK evidence base, a number
of key projects have been commissioned as part of the research
programme. A nationally representative school survey of 11 to
15 year olds now provides an insight into drug use among young
people, and helps track the strategy's young people's target.
Urine testing and surveys of arrestees in police custody now provide
a clearer view of the links between drug use and criminal offending,
and the extent of drug-related crime. Epidemiological work will
provide up-to-date estimates on the number of dependent drug users
in the UK and on the proportion not in treatment; estimates have
been provided on the size of the UK's heroin and cocaine market,
against which law enforcement seizures can be compared.
7.9 Drug misuse has also been prioritised within the
Department of Health's policy research programme. £2.4m has
been spent on 17 research programmes covering models of care for
drug users, dual diagnosis and co-morbidity of substance misuse
and mental health, waiting times, young people's drug use and
long-term heavy cannabis use. In addition, a further £1.5m
is being spent on research into Hepatitis C.
7.10 The strategy's research programme has led to a number
of research studies which have been published or will be published
in the near future. These include:
— E. Goddard and V. Higgins. (2000). Drug use,
smoking and drinking among young teenagers in 1999. ONS. London:
The Stationery Office.
— E. Bramley-Harker. (September 2001). Sizing
the UK market for illicit drugs. Home Office Research, Development
and Statistics, Occasional Paper No. 74.
— T. Bennett, K. Holloway and T. Williams. (September
2001). Drug Use and Offending: summary results from the first
year of the NEW-ADAM research programme. Home Office Research,
Development and Statistics, Research Findings No. 119.
— M. Ramsay, P. Baker, C. Goulden, C. Sharp and
A. Sondhi (September 2001). Drug Misuse Declared in 2000: results
from the British Crime Survey. Home Office Research, Development
and Statistics, Research Study No. 224.
— C. Goulden and A. Sondhi. (Forthcoming—November
2001). At the Margins: drug use by vulnerable young people
in the 1998/99 Youth Lifestyles Survey. Home Office Research,
Development and Statistics, Research Study.
— E. Goddard. (Forthcoming—November 2001).
The Value and Feasibility of a National Survey of Drug Use
among Adults in the UK. Office of National Statistics Website.
— R. Lupton, A. Wilson, T. May, H. Warburton and
P. Turnbull. (Forthcoming—January 2002). A Rock and a
Hard Place: the impact of and responses to drug markets in deprived
neighbourhoods. Home Office Research, Development and Statistics,
Research Study.
— G. Pearson and D. Hobbs. (Forthcoming—January
2002). Middle Market Drug Distribution. Home Office Research,
Development and Statistics, Research Study.
September 2001
| 
