Drug Addiction and treatment - Huge expenditure and zero success.

Sir Gus O'Donnell, Cabinet Secretary and Head of the Civil Service has been handing out the awards and generally beaming and backslapping in the second Civil Service Diversity and Equality Awards ceremony in Birmingham.

One recipient is Senior officer Fiona Brown, HM Prison Service, Wakefield. Fiona Brown has worked on projects with elderly and disabled inmates, including a new scheme to promote a healthier lifestyle. More here.

http://www.ukdpc.org.uk/resources/RDURR_Full_Report.pdf
Without wishing to divert attention or indeed praise for the efforts of Fiona Brown and her hard working colleagues one might just wish to review again a report that was published in March this year Reducing Drug Use, Reducing Reoffending. - Are programmes for problem drug-using offenders in the UK supported by the evidence?

• At least 1 in 8 arrestees (equivalent to about 125,000 people in England and Wales) are estimated to be problem heroin and/or crack users, compared with about 1 in 100 of the general population.

• Between a third and a half of new receptions to prison are estimated to be problem drug users (equivalent to between 45,000 and 65,000 prisoners in England and Wales).

• Drug-related crime costs an estimated £13.5 billion in England and Wales alone.

Page 8 has the heading - What interventions are in place within the uk for problem drug-using offenders? and has 2 very depressing and revealing facts

• The budget for adult drug interventions within the Criminal Justice System (CJS) was over £330 million in England and Wales in 2006/07. Investment in prison treatment in England and Wales has increased from £7 million in 1997/98 to £80 million in 2007/08.

• The Drug Interventions Programme (DIP) was established in April 2003, and by January 2008 over 3,750 offenders a month were entering treatment through the programme.

There are many different types of provision for drug using inmates in Engalnd and Wales (see table Page 10)

Detoxification
Maintenance prescribing
The Integrated Drug Treatment System (IDTS)
CARAT (Counselling, Assessment, Referral, Advice and Throughcare) teams
Drug-free wings and voluntary testing programmes
12-step treatment models
Cognitive behavioural therapy (CBT)
Short Duration Programmes (SDPs)
P-ASRO (Prison – Addressing Substance Related Offending)
Therapeutic communities
The Enhanced Addictions Casework Service (EACS)
Methadone prescribing

The 80 page report from the UK Drug Policy Commission offers this bleak conclusion :

... we cannot say what the overall impact of CJS interventions has been aswe do not know the extent to which drug-using offenders would have accessed treatment in other ways. There is also no evidence that allows reliable comparisons of the effectiveness or value for money of different interventions or identifies those offenders that would benefit most from different programmes.

Page 25 - et seq

Drug use, and in particular problematic drug use, causes extensive harm to individuals and communities. It has been estimated that in 2003/04 the economic and social costs associated with Class A drug use in England and Wales were about £15 billion, with drug-related crime responsible for 90%(£13.5 billion) of this. Overall, problem heroin and crack use accounted for 99% of the total cost.

It is impossible to obtain reliable figures on the number of habitual drug users kicking the habit as a result of any of the current schemes for their rehabilitation. Figures of 3% are considered privately to be probably accurate. It provides a lot of employment for drug workers and academic researchers however - the above report concludes (amazingly) that more research is required.

The principal justification is that by treating / providing it helps the drug abuser from other forms of crime reflected in lower recorded crime levels.

Is it possible we have our priorities wrong ? Perhaps a prize of considerable monetary value to the staff of the prison that acheives the greatest success in getting inmates to kick the habit by going cold turkey ?

.... and improved controls over the way drugs find their way into prisons.

The Australian Experience

"Drug addiction has become a major taxpayer-funded industry in this country," says a former drug squad detective, John Doran. "If you calculate the costs of education, policing, courts, counselling, rehabilitation, methadone programs, ambulance and hospital emergency treatment for addicts and their robbery victims, the list and the costs go on and on …

"I found that drug addicts crave attention from, and seek to manipulate, police, welfare agencies, counsellors, health professionals, lawyers and courts. They receive immense personal attention under the current system, once they come into the system, despite being the architects of their own disasters."

See Romancing OpiatesPharmacological Lies and the Addiction Bureaucracy, by Theodore Dalrymple,(Amazon) a doctor and social commentator who reached exactly the same conclusions. Dalrymple, a practising doctor of medicine , argues that addiction is not a disease, that withdrawal (cold turkey) from opiates is not a serious medical condition, and criminality is the cause of addiction far more often than addiction is the cause of criminality.