Drug treatment in the community
281. The National Treatment Agency for Substance
Misuse and the National Institute for Mental Health in England
have developed a national programme to improve access to drug
treatment for drug misusers in the community. In 2004, the pooled
drug treatment budget allocated by the Government for the treatment
of drug misusers was increased to £253 million. Nevertheless,
whilst the total number of treatments has increased from 128,000
in 2001-02 to 140,900 in 2002-03, a significant gap between demand
for and supply of drug treatment programmes remains, with an average
waiting time of between 1.5 to 4 weeks for all types of drug treatment.[224]
282. The Criminal Justice Interventions Programme
("CJIP"), which was introduced in 2003 in 25 high crime
areas with Drug Action Teams, aims to "develop and integrate
measures for directing drug misusing offenders out of crime and
into treatment"[225]
and to co-ordinate the treatment of drug misusing offenders more
effectively by increasing co-operation between criminal justice
agencies and drug treatment agencies. The interventions available
under the CJIP include Enhanced Arrest Referral of drug mis-using
offenders into treatment by drug workers in custody suites, drug
testing for cocaine and opiates for offenders with 'trigger' offences
and community sentences with treatment conditions attached, such
as Drug Treatment and Testing Orders (DTTOs).[226]
It is still too early to assess the results of the CJIP initiative.
283. There remains a discernible disparity in provision
of drug treatment programmes for ex-prisoners in the community.
We have been informed of waiting lists for drug treatment for
ex-prisoners of between 6 weeks and 6 months. In comparison, 70%
of those offenders put on a Drug Treatment and Testing Order,
a community sentence for offenders who misuse drugs, see a treatment
provider within two days of the Order.[227]
The National Treatment Agency for Substance Misuse acknowledges
that "bridging the gap between prison and community has been
challenging in a number of areas".[228]
284. The CJIP Enhanced Arrest Referral provides direct
and immediate access to drug treatment services in direct contrast
to the long waiting period imposed on the majority of ex-prisoners.
One of most vulnerable times for a discharged prisoner who has
had a drug problem is the first few days after he or she has been
released. It is vital that there is a seamless transition in drug
treatment provision.
285. We recognise the significant investment that
the Government is making in drug treatment services. However,
care must be taken not to focus on the availability of treatment
to those entering the Criminal Justice System at the expense of
those with drug problems already in the prison system. As a first
step, targets for access to services for new offenders and for
existing prisoners should be aligned. The longer-term objective
should be to move towards continuity of care for released prisoners,
which is critical to avoid wasted investment.
286. We recommend that the Government work in
partnership with community providers to put in place a tracking
system to monitor prisoners' access to community drug treatment
and report to Parliament on the progress made in levelling out
access to and provision of drug treatment as part of its Reducing
Re-offending National Action Plan.
Alcohol misuse
287. Alcohol misuse and addition is widespread amongst
prisoners. HM Chief Inspector of Prisons, Anne Owers, stated that
there is "no specific funding, and no overall strategy, for
programmes to manage alcohol consumption". She commented
that in one young offender institution she visited, 42% of the
young people expected to have an alcohol problem on release.[229]
The Committee is critical of the failure to date to develop
any overall strategy for dealing with prisoner alcohol misuse
or addiction as an important element in its prison rehabilitation
strategy, particularly in light of the alarming upward trend in
alcohol-related crime. We welcome the Government's commitment
in its National Action Plan to introduce alcohol strategies for
approval by March 2005.[230]
These strategies will comprise the twin elements of treatment
interventions and alcohol testing. We urge the Government not
to let the timetable on the introduction of these strategies slip.
There needs to be rapid progress in setting up mechanisms to implement
the national strategies at the regional and local level.
211 Interview with the Director General of the Prison
Service, Mr Phil Wheatley, Independent, 1 December 2003 Back
212
According to the Social Exclusion Unit Report (2002), prison officers
at HMP Manchester have estimated that 70% of prisoners come into
the jail with a drugs misuse problem but that 80% of these have
never had any contact with drug treatment services. Back
213
Evaluation of drug testing in the criminal justice system in nine
pilot areas, Home Office Research findings 180 (2003) Back
214
Criminal Justice and Court Services Act 2000, section 57. An officer
of the rank of Inspector or above can authorise a test of an individual
charged with a non-trigger offences if there are reasonable grounds
for suspecting that the misuse of heroin and/or cocaine contributed
to the offence. Back
215
Criminal Justice and Court Services Act 2000, s 48 Back
216
Such as prisoners' rights to privacy under ECHR Article 8. Back
217
Prison Service, Annual Report and Accounts 2002-03 (2003) Back
218
Mandatory drug testing in prisons, RDS Study 189, Home
Office (1998) Back
219
Ev 137 (para 3.1.14) Back
220
Prisoners' drug use and treatment: seven studies, Home Office
Research Finding 186 (2003) Back
221
HC Deb, 15 November 2004, col 1126W. Out of the 4.703 prisoners
who entered programmes in 2003-04, there were 2,418 completions. Back
222
HC Deb, 12 February 2003 Back
223
National Action Plan, p 31 Back
224
Ev 282 Back
225
National Action Plan, Pathway 4, Drugs and Alcohol, p 27 Back
226
Introduced by the Crime and Disorder Act 1998, the Drug Testing
and Treatment Order ('DTTO') is imposed for a minimum of six months
to a maximum of three years. It requires offenders to submit to
regular drug testing, to attend an intensive treatment and rehabilitation
programme, and to have their progress reviewed regularly by the
court. It is supervised by the Probation Service. As of December
2003, the courts had made 18,414 DTTOs. In 2003-04, the Home office
allocated £53.7 million to probation areas and treatment
services to support implementation and supervision of DTTOs in
England and Wales. (See National Audit Office Report, The Drug
Treatment and Testing Order: early lessons (HC 366 of Session
2003-04), published on 26 March 2004.) The Probation Service hopes
to meet its target of achieving 9,000 DTTOs in 2004. Whilst there
is evidence of some success with a number of drug misusers in
terms of reducing drug misuse and lower reconviction rates, only
around 25% of DTTOs are completed in full, or terminated early
for good progress (see NAO report cited above). Back
227
Q 541 Back
228
Ev 282 (para 3.5) Back
229
Ev 208 (para 8) Back
230
National Action Plan, pp 29 and 32 Back