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
| 
