Supplementary memorandum submitted by
Mr Bob Ainsworth MP, Parliamentary Under Secretary of State, Home
Office
When I gave evidence on 20 March, I promised
to provide you with additional written information on certain
aspects of the Government's Drug Strategy. These related specifically
to the latest drug treatment waiting times and details of drug
programmes in prison for women, under 18s and short-term prisoners
and how that compares with what is available for other prisoners.
DRUG TREATMENT
WAITING TIMES
Attached is a table showing the latest data
available on longest waiting times nationally and regionally.
These are taken from annual returns submitted by Drug Action Teams
(DATs) since the end of April based on a snapshot of waiting times
in December 2002. The table includes a comparison with the snapshot
taken last year—December 2001. Also attached is a chart
showing the percentage of DATs meeting the NTA 2002-03 waiting
time targets.
In summary, progress is being made in reducing
waiting times. Of course, there is still much more to do, such
as achieving greater consistency.
DRUG TREATMENT
PROGRAMMES IN
PRISONS
The numbers* of people who start drug treatment
programmes (defined as intensive rehabilitation and therapeutic
community programmes) are given below:
The figures include all who enter intensive treatment,
including women and under 18s. If short term prisoners entered
intensive treatment, they too would be counted.
**Provisional outturn figure.
The numbers of clients completing drug programmes
are not collated centrally. In line with Department of Health
targets to improve the numbers retained in treatment, the Prison
Service is currently reviewing data collection requirements. Central
data collection on programme completions will be introduced for
the financial year 2004-05. Information will be made available
for 2003-04 using mid and end year surveys.
Drug programmes in prison for women under 18s
and short-term prisoners
The Prison Service drug strategy is designed
to provide a comprehensive series of interventions to address
the very wide-ranging needs of prisoners with a drug problem.
Detoxification services are based directly on clinical need and
available in all local prisons. Immediate clinical need is defined
more by drug type than by age, gender or ethnicity of prisoners.
Although there may of course be trends of drug-taking amongst
the different groups of prisoners.
The CARAT service, which is available in all
prisons, is a gateway service. It is designed to assess need,
provide low-level support, offer harm minimisation advice pre-release
and facilitate throughcare of drug misusers back into the community.
CARATs is a flexible service designed to meet the needs of those
clients with which the Prison Service engages.
Intensive drug treatment programmes are available
in 60 out of 137 prisons including six women's prisons and two
juvenile (under 18) prisons.
Women
The Prison Service is working with the Correctional
Services Accreditation Panel to see what more needs to be done
to meet the treatment requirements of women and is considering
the potential to introduce a programme tailored specifically for
women.
Under 18s
The Youth Justice Board is currently reviewing
the drug treatment needs of juveniles and plans to introduce a
co-ordinated package of measures to address both the drug problems
and wider rehabilitation needs of the under 18s. Emerging findings
show there is much less of a need for intensive rehabilitation
programmes for juvenile offenders with a drug problem.
Ethnic minorities
The Prison Service has commissioned an independent
review to advise on the suitability of existing drug treatment
for the needs of minority ethnic prisoners with a drug problem.
Short-term prisoners
The length of time spent in prison is a key
factor in determining the treatment provision for short-term prisoners.
Due to the length of intensive drug treatment, rehabilitation
programmes are rarely available to those sentenced to two years
or less. For those in prison for only a short period of time the
main provision is focussed on detoxification and CARATs services.
Additional SR2002 funding (approximately 30% of the total additional
£31m allocation) has been made available to develop a short
intervention targeted mainly at those who spend only a short time
in prison. This will boost support available for this group and
build a platform upon which to continue drug treatment on release.
The Criminal Justice Intervention Programme
(CJIP) will also have a part to play. The throughcare/aftercare
element of this programme is designed to improve considerably
transition from custody back into the community. Enhanced throughcare
arrangements are likely to prove particularly (though not exclusively)
beneficial to short-term prisoners and will improve continuity
of treatment considerably.
How many prisoners go back to drugs on release?
Intractable hard drug misuse is by definition
difficult to address. Drug treatment is not instantaneous. Treatment
needs are often very long-term and relapse is common. However,
relapse can often result in the less frequent use of drugs and
via less harmful routes. Prisoners do go back to drugs on release
including some who have engaged in treatment. No figures on relapse
are collected routinely. The Home Office will shortly publish
a compendium of research on prisons' drugs issues, part of which
will focus on comparative levels of drug misuse prior to custody,
during custody and subsequently on release.
By placing increased emphasis on the throughcare,
the CJIP will reduce the number of prisoners going back to drug
misuse on release. By providing much needed support to the families
of drug misusers, the national charity ADFAM plays an important
part in creating an environment that encourages ex-offenders to
stay clean. The Prison Service recently agreed through grant-in-aid
over the next three years, to support the valuable work undertaken
by ADFAM with the families of prisoners.
Detoxification vs. Maintenance and the implications
for drug-related deaths on release
I touched on this during the course of my evidence
to the Committee but would like to take this opportunity to expand
on my answer.
In December 2000 the Prison Service introduced
a new standard for clinical services for substance misusers. This
will ensure that good quality detoxification services are available
in all local and remand prisons to a level at least comparable
with those in the community and to a standard set by the Department
of Health (DoH). A Clinical Adviser has been appointed to support
and audit the implementation of the standard.
Methadone is one of a number of treatments recommended
by DoH for the effective management of drug withdrawal in those
who are dependent on opiates. The Prison Service provides guidelines
on detoxification, but the clinical decision to prescribe a heroin
substitute is a matter for the responsible doctor's judgement.
He or she must assess the condition of the patient and all the
available treatments before deciding on the most suitable approach.
Whilst the Prison Service broadly favours detoxification
intervention for problematic drugs misusing prisoners, it recognises
that maintenance prescribing programmes may be more appropriate
for prisoners who are on remand or are serving short sentences
and have been maintained on methadone in the community. In such
cases, there should be evidence available that such engagement
in a community treatment programme has had a beneficial effect.
Where prisons provide methadone maintenance,
it is essential to be able to make an immediate link in the community
for the prisoner on release. The National Treatment Agency is
working towards increasing the number of specialist community
prescribers, improving prescribing skills and reducing the waiting
times for specialist prescription.
The Prison Service is acutely conscious of the
risks associated with overdosing post-release—following
a reduced tolerance to drugs and alcohol whilst in prison. For
this reason, a mechanism is in place as part of the CARATs pre-release
intervention (one-to-one counselling, overdose awareness card
and a video depicting the risks of re-using opiates) to provide
advice to prisoners and help prevent such tragedies.
NEW COMMUNICATIONS
CAMPAIGN
Finally, I would like to draw your attention
to the launch of our new drugs communication campaign for young
people, their parents and their carers.
On 23 May, the Government launched a new innovative
drugs campaign—FRANK—which aims to help tackle
drug misuse by opening doors, as well as providing accurate, confidential
and unbiased information to young people and their parents and
carers.
FRANK can put people in touch with local agencies
who can provide advice, assess needs, arrange treatment or give
drug education and harm reduction advice. FRANK will also exist
to support those in the drugs field, who already provide valuable
help, information and advice.
The campaign uses many media to get its message
across, for example: advertising on TV (terrestrial and satellite),
radio, billboard posters, leaflets, posters in toilets.
FRANK is supported by a telephone helpline 0800
77 66 00 and a website www.talktofrank.com. The primary
focus is on Class A drugs in line with the Updated Drug Strategy.
However, FRANK is about all drugs and helpline workers and the
website will have information about all illegal drugs. Also in
line with the Updated Drug Strategy, both the helpline and website
make it clear that all drugs are illegal whilst providing advice
to reduce the harms of drug misuse.
Throughout the development of the campaign,
FRANK has been carefully tested with young people and parents
from a wide range of backgrounds to make sure it has the greatest
possible impact. Past Government campaigns had pointed people
towards the National Drugs Helpline for information and advice.
However, our research showed that although it provided an extremely
useful service, it had low levels of awareness and was often perceived
as a `crisis line' or `authoritarian'. FRANK instead is a warm,
friendly, approachable, street wise and direct approach that goes
down well with parents and young people.
I look forward to FRANK being integrated into
the delivery of local initiatives and programmes, as well as seeing
the FRANK name becoming famous as the best and most reliable information
about drugs across the country. This is essential if we are to
prevent young people from becoming problematic drug users.
3 June 2003
ATTACHMENT 1
National and Regional Waiting Times
| Region | In-Patient Detoxification
| | Community Prescribing Specialist
| | Community Prescribing GPs
|
| Target |
2002-03
| 2001-02 | | Target
| 2002-03 | 2001-02
| | Target | 2002-03
| 2001-02 | |
| National | 4 | 8
| 12 | | 6 | 9.1 |
14.1 | | 4 | 4 | 5.7
| | | |
| | | |
| | | |
| London | 4 | 9.88
| 7.35 | | 6 | 5.48
| 5.77 | | 4 | 1.96
| 3.32 | | |
| | |
| | | |
| |
| East Midlands | 4 | 4.89
| 2.75 | | 6 | 8.44
| 8 | | 4 | 3.89 |
3.5 | | |
| | | |
| | | |
|
| West Midlands | 4 | 4.75
| 6.64 | | 6 | 13.5
| 9.73 | | 4 | 4.58
| 7.64 | | |
| | |
| | | |
| |
| East of England | 4 | 9.5
| 5.83 | | 6 | 7.3
| 4.67 | | 4 | 3.89
| 3.83 | | |
| | |
| | | |
| |
| North East | 4 | 4.63
| 3.86 | | 6 | 7.33
| 5.75 | | 4 | 2 |
4.25 | | |
| | | |
| | | |
|
| North West | 4 | 7.68
| 11.3 | | 6 | 8.14
| 8.62 | | 4 | 3.9
| 5.24 | | |
| | |
| | | |
| |
| South East | 4 | 7.05
| 5.94 | | 6 | 6.58
| 5.77 | | 4 | 3.19
| 3.53 | | |
| | |
| | | |
| |
| South West | 4 | 9.6
| 10.56 | | 6 | 20.4
| 17.38 | | 4 | 8
| 6 | | |
| | | |
| | | |
|
| Yorks and Humber | 4 | 4.75
| 4.31 | | 6 | 8.07
| 5.5 | | 4 | 2.4
| 2.15 | | |
| | |
| | | |
| |
| | |
| | | |
| | | |
| | | |
| | | |
| |
|
|
| Region | Structured Day Programs
| | Structured Care Counseling
| | Residential Rehabilitation
|
| Target | 2002-03
| 2001-02 | | Target
| 2002-03 | 2001-02
| | Target | 2002-03
| 2001-02 | |
| | | |
| | | |
| |
| National | 4 | 3
| 6 | | 4 | 5 |
7.6 | | 4 | 7.15 |
9.1 | | |
| | | |
| | | |
|
| London | 4 | 3.16
| 3.54 | | 4 | 2.87
| 3.12 | | 4 | 6.25
| 4.08 | | |
| | |
| | | |
| |
| East Midlands | 4 | 7.33
| 3.75 | | 4 | 2.88
| 4.25 | | 4 | 12.33
| 3.5 | | |
| | |
| | | |
| |
| West Midlands | 4 | 6.54
| 4 | | 4 | 1.43 |
4.45 | | 4 | 5 | 7.89
| | | |
| | | |
| | | |
| East of England | 4 | 9.1
| 5.2 | | 4 | 5.88
| 4.67 | | 4 | 11.1
| 5.5 | | |
| | |
| | | |
| |
| North East | 4 | 4.67
| 4 | | 4 | 2.89 |
3.25 | | 4 | 4.67 |
5.5 | | |
| | | |
| | | |
|
| North West | 4 | 3.3
| 3.47 | | 4 | 1.89
| 3.11 | | 4 | 4.45
| 11.21 | | |
| | |
| | | |
| |
| South East | 4 | 5.22
| 3.69 | | 4 | 2.39
| 4.69 | | 4 | 8.79
| 5.07 | | |
| | |
| | | |
| |
| South West | 4 | 6.47
| 6 | | 4 | 5.25 |
8.22 | | 4 | 8.93 |
8.89 | | |
| | | |
| | | |
|
| Yorks and Humber | 4 | 3.33
| 3.75 | | 4 | 2.1
| 3.64 | | 4 | 7.42
| 4.69 | | |
| | |
| | | |
| |
| | |
| | | |
| | | |
| | | |
| | | |
| |
— Figures for 2002-03 are longest waiting times,
figures for 2001-02 are non-priority waiting times. Therefore
the waiting times are not directly compatible and are for guidance
only.
— The waiting time target is the national target
for 2002-03. In some DAT areas, the NTA has established different
local targets.
| 
