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Collective Voice evidence to the Advisory Council on the Misuse of Drugs: Community-Custody Transitions

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In June, Collective Voice was asked to give both oral and written evidence to the Custody-Community Transitions working group of the Advisory Council on the Misuse of Drugs (ACMD), which makes recommendations to government on the control of harmful drugs.  Our evidence builds on our recent submission to the Justice Select Committee which is summarised in our previous blog post. Here are the main points.

The role of drug treatment in keeping vulnerable people alive, helping them to overcome dependence and protecting the community from crime is as important as ever. To achieve this, the Government’s 2017 Drug Strategy aspires to create an integrated, resourced and seamless treatment system accountable to local agencies working in partnership. Transitions in and out of custody are key points of both opportunity and risk in this process. However, the clear message from service users and practitioners operating in the criminal justice system is that this aspiration contrasts starkly with their chaotic, underfunded and fractured real world experience.

There is strong evidence identifying access to drug treatment as the best means to reduce acquisitive crime (burglary and theft), and the resurgence in violent crime is clearly associated with drug markets. Despite this, investment in community drug and alcohol treatment has fallen by about 25% in cash terms since 2013. Consequently, the quality of community services is in decline. Expenditure on drug treatment in prisons has reduced by about 32%. Hence, we are also facing the erosion of services in prisons, with prescribing services being prioritised at the expense of the wider range of services that enable a successful transition back to the community and the possibility of sustaining recovery on release.

Until 2013, local police commanders and chief probation officers were, together with the NHS and local authority, influential members of the partnerships which commissioned treatment services. They were also accountable to government for the public money invested.  Acknowledging the evidence linking access to treatment with crime reduction, they were powerful advocates for investment. As this is no longer the case, investment has fallen dramatically and services are no longer responsive to legitimate needs of the criminal justice system.  Commissioning is split between several public bodies, so that the services they buy are also increasingly fragmented and the close working relationships between the courts, probation service and drug treatment providers is breaking down.

Services operating at the interface between criminal justice and drug treatment, which were designed to keep people out of prison and divert them to drug treatment, such as Liaison and Diversion and Drug Rehabilitation Requirements, are severely depleted compared to a decade ago.

The overwhelming message from treatment providers operating in prisons is that the biggest barrier to the effective delivery of services is no longer shrinking resources but the cumulative degrading of the prison environment over the past decade. The prison staffing crisis limits the range and impact of drug treatment, on top of which spice constitutes a major challenge across the prison estate.

Transitions from prison back into the community depend on addressing clinical needs alongside helping prisoners to build the motivation to change and the resilience to achieve this. However, the programme designed to transform the rehabilitation of prisoners has failed and the “Through the Gate” arrangements designed to support prisoners being released have collapsed.  Prisoner contact with the Community Rehabilitation Companies set up to provide this is extremely limited.

Currently, only one in three of those discharged from prison in need of continuing drug treatment actually establishes contact with a service on release.  This undermines opportunities for rehabilitation and reducing re-offending.  Not enough has been done to improve their access to mental health treatment, employment, and stable housing, leaving them at much heightened risk of resuming their previous lifestyle. The first weeks after release are also known to be the point of maximum risk of overdose and death. The absence of effective arrangements impacts on women in particular, as they are often placed far from home, leading to delays in treatment and higher re-offending rates.

This difficult scenario is compounded by the consequences of imposing licence conditions without support, particularly on people with complex needs, a significant proportion of whom are spice users. Alongside the churn of short-term sentenced prisoners and remands, staff now also have to deal with many more licence recalls, typically in the prison for 14 days.  Sentence planning and preparation for release become impossible.

This combination of financial pressures, the demise of criminal justice service advocacy, fragmented planning and the lack of accountability means that the opportunities to help offenders at key transition points are no longer grasped.  The existing Drug Strategy remains the right approach, but the leadership and accountability role envisaged for the Home Secretary within it needs to be grasped urgently.

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Collective Voice is the national charity working to improve England’s drug and alcohol treatment and recovery systems