Drugs and Crime

Baroness Massey of Darwen Excerpts

Tuesday 15th June 2010 Lords Chamber

[Baroness Massey of Darwen]

My Lords, I am most grateful to the noble Baroness, Lady Meacher, for introducing this debate with such thoughtfulness. The previous speeches have been so fascinating that I am only sorry that we cannot spend more time on this very complex topic.

I begin by declaring an interest as the chair of the National Treatment Agency for substance misuse. The NTA was set up in 2001 with the aim of doubling the numbers in treatment and reducing waiting times. I am glad to say that these targets were achieved early. However, we are alive to and will address the issues that remain. As an organisation, we work across the health, criminal justice, education and welfare ministries and systems. Drug use everywhere has to be tackled across systems and not by one system alone.

Any addiction is a public health concern, and I am very interested in the coalition Government’s intention to improve public health through a new public health delivery system. Public health, of course, involves family and community issues, as well as housing, employment and education.

The UNODC paper takes a somewhat polarised view and approach, using terms such as treatment being an,

“alternative to criminal justice sanctions”.

I would say that we need effective treatment systems but that we also need effective criminal justice systems where treatment is available. I have worked in countries where the situation is polarised and where prison, labour camps and compulsory treatment centres are the norm. That is not the case in the UK and I want to give some examples.

There has been a dramatic expansion of our drug treatment arrangements over the past nine years due to more money being put into the system. The money has been there largely to fight crime but it has also benefited health. The number of people in England completing treatment and being free from dependency has increased from 9,000 to 25,000 per year. Offenders are systematically referred into treatment, preventing millions of crimes each year and saving costs. England now engages more than 60 per cent of the most problematic drug users in society in treatment, compared with less than 20 per cent in the USA. There are some success stories.

There is an emphasis on two things in the UNODC paper: one is outcomes and the other is evidence-based approaches. Many countries have not had drug strategies. England has a drug strategy against which outcomes can be measured and evidence bases set out. We know that drug users commit crimes to fund their habit; we know they often have other health, social and educational problems, as many noble Lords have said; and we know that each user is different and that successful treatment will address those differences. Recent debates in the media might suggest that treatment for drug use involves a simple choice between an abstinence-only approach and one based on methadone prescribing or other substitute prescribing. Individual users often do not subscribe to ideologies; they use.

The starting point for the NTA is that the majority of addicts want to overcome their addiction and get off drugs. We need a treatment system that helps them to realise that ambition. It may take time. It may take many attempts and different approaches in order for recovery to take place. Users want to recover from addiction. For some, this will be with the help of substitute prescribing or residential rehabilitation and for others it will be detoxification or community services. The NTA has long supported psychological and pharmacological interventions provided by multi-professional teams, as recommended in the UNODC document. Does the Minister agree that that approach is more appropriate than secure accommodation for offenders and drug abstinence orders?

I want to speak briefly of two initiatives in which the NTA has been involved where improvements have been made. One has been the development of the treatment outcomes profile. This is an individual client monitoring tool to reflect progress in an individual's drug treatment. It has received international recognition and was praised in the Lancet last year. It is a simple tool which motivates self-analysis and a change in habits.

The other initiative is the integrated drug treatment system in prison. It was developed to bring together the fragmented delivery of drug treatment in prisons and to ensure that drug misusers could access a range of evidence-based services which are clinically appropriate to the individual. As has been said already, more than half of those in prison are heroin and crack users who will remain in custody for three months or less. They are not in the system long enough to undergo abstinence-only regimes. Good clinical practice is to continue the treatment that the prisoner had before arrest, or prepare them for the treatment that they will receive on release. Not to do so leaves that population vulnerable to suicide or overdose on leaving prison, which is not a healthy option. The Integrated Drug Treatment System means that many offenders are being released into the community having been successfully engaged in drug treatment and not needing to go back to a life of crime. I have visited many prisons involved in this scheme and professionals and users alike speak highly of the system. If noble Lords are interested, there is an NHS/NTA short report called Breaking the Link, which addresses the issue.

So it is not a case of either coercion or cohesion, as suggested by the title of the UNODC paper, From Coercion to Cohesion. It is a case of having a strategy and a policy which address individual health and social needs and which, in turn, have a positive impact on crime, on families and on communities.