Tackling problem drug use - Public Accounts Committee Contents

2  Drug treatment and reintegration

6. The National Treatment Agency (the Agency) told us that between 2004-05 and 2008-09, about 300,000 drug users had received drug treatment—on average 80,000 problem drug users had newly entered drug treatment each year and 60,000 people had left treatment.[16] The Agency told us that drug treatment aimed to reduce problem drug users' offending against communities, to improve their health, and to reintegrate them into society through being able to care for their family and to earn their own living.[17]

7. However, a 'hard-core' of offenders, over one-quarter of problem drug users, showed a sharp increase in the volume of offending after entering treatment through the Drugs Intervention Programme, the Agency acknowledged.[18] The Department told us that it considered these to be problem drug users for whom the Programme initially, and perhaps for some time, simply had not worked.[19] It identified this category of problem drug using offenders as habitual offenders, and those who did not want to stop taking drugs, or receive treatment.[20]

8. For such problem drug users, for whom the Drug Interventions Programme and drug treatment had not reduced their offending, additional measures were necessary to protect neighbours and local communities from drug related crime.[21] The Department said that treatment trials had taken place in clinics in London, Brighton and Darlington for heroin users to attend each day to receive an injection of diamorphine.[22] This treatment may have helped protect local communities by reducing drug users' offending, although the treatment had also maintained their dependence on heroin. Evaluation indicated that this could be a cost-effective treatment for those heroin users who had not responded to other forms of treatment.[23]

9. The Agency stated that the initial treatment for heroin users was normally methadone on prescription, in line with guidance from the National Institute for Health and Clinical Excellence.[24] It told us that while other types of treatment included psychosocial interventions and behavioural therapy, the treatment system was not as good at delivering these types of treatments.[25]

10. The Department reported that problem drug users often lead chaotic lives, in an environment with other drug users, drug dealing and wider criminality. They were among the most deprived people in society, claiming benefits, in and out of prison, and not in work.[26] The Department reported that evidence shows that if it were possible to stabilise the housing situation of problem drug users as part of their rehabilitation treatment they were more likely to stop offending and to stay off drugs. It acknowledged, however, that in many areas drug users were going to be competing with lots of other people for accommodation.[27] At present there was no research on the effectiveness of the measures being used to place problem drug users in appropriate accommodation.[28]

11. The number of deaths among problem drug users has increased over the last five years to 1,620 in 2008-09. However, the Agency estimated there would have been 2,500 drug-related deaths in that year if drug treatment had not been increased over this time.[29]

12. Guidance from the National Institute for Health and Clinical Excellence stated that residential rehabilitation could be a better treatment option for problem drug users who had failed a number of times in other forms of treatment.[30] Taking problem drug users out of the environment in which they had begun drug use could help them overcome dependency until they were sufficiently strongly motivated to stay drug free when reintegrating into their local communities.[31] Bringing problem drug users to a secure place where they could receive long-term treatment could be a better and cost-effective course of action.[32] It could enable the problem drug user to get a better outcome, thereby reducing their reoffending on return from treatment, and the resultant misery to their communities.[33]

13. The Agency told us of a new type of residential facility within communities which were connected to local treatment services. Residential facilities could provide a ready route back into local support and to the drug user's family. It referred to examples in Warrington, Liverpool and Luton.[34] The Agency considered that such facilities could help problem drug users return to the community and re-establish their lives.[35]

14. The Department said that problem drug users received drug treatment while in prison and that there had also been efforts to reduce the supply of drugs in prison.[36] However, the Department reported that some prisoners quickly relapsed into further drug use on release shortly after, simply by walking from the prison gates to the nearest crack house, for instance.[37]

15. The Department aimed to tackle this problem through its Drugs Interventions Programme, which involved a 'meet at the gate' process for released prisoners. It told us that in some intensive Drug Interventions Programme areas, about 80% of such prisoners were met at the prison gates by drug key workers and taken to assessment and treatment services, to prevent them going straight to drug dealers. The Department told us that it was working with the Ministry of Justice to develop guidance for staff in prisons and in the community to improve continuity of services on release from prison.[38]

16   Qq 8 and 68 Back

17   Qq 6 and 32 Back

18   Qq 4 and 52 Back

19   Q 52 Back

20   Qq 4 and 52 Back

21   Q 46 Back

22   Pharmaceutical heroin Back

23   Q 35 Back

24   Qq 21, 50 and 72 Back

25   Q 73 Back

26   Qq 4, 11 and 41 Back

27   Q 17 Back

28   C&AG's Report, para 2.19 Back

29   Qq 23-25 Back

30   Q 21 Back

31   Q 53 Back

32   Q 21 Back

33   Q 5 Back

34   Q 53 Back

35   Q 16 Back

36   Q 7 Back

37   Q 75 Back

38   Q 75 Back

previous page contents next page

House of Commons home page Parliament home page House of Lords home page search page enquiries index

© Parliamentary copyright 2010
Prepared 7 April 2010