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This entry is our account of a review or synthesis of research findings selected by Drug and Alcohol Findings as particularly relevant to improving outcomes from drug or alcohol interventions in the UK. Entries are drafted after consulting related research, study authors and other experts and are © Drug and Alcohol Findings. Permission is given to distribute this entry or incorporate passages in other documents as long as the source is acknowledged including the web address http://findings.org.uk. However, the original review was not published by Findings; click on the Title to obtain copies. Links to source documents are in blue. Hover mouse over orange text for explanatory notes. The abstract is intended to summarise the findings and views expressed in the review. Below are some comments from Drug and Alcohol Findings.

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Reducing drug use, reducing reoffending: are programmes for problem drug-using offenders in the UK supported by the evidence?

UK Drug Policy Commission.
London: UK Drug Policy Commission, 2008.

Based on a review of the international literature, this UK report assessed the evidence for the effectiveness of Britain's response to drug using offenders. Recommendations include maximising community treatment options as an alternative to imprisonment.

Abstract The headlined report was informed by a review of the international evidence on the treatment and supervision of drug dependent offenders, and by consultations with a range of stakeholders including policymakers, practitioners and service users.

The report addressed the following key questions:
• What is the extent and nature of problem drug use among offenders and to what extent is this associated with crime and disorder?
• What interventions are in place within the UK for problem drug using offenders?
• What is the evidence for the effectiveness of these approaches and what are the key factors that impact on effectiveness?
• What are the implications of this evidence for policy and practice?

It identified reasonable evidence to support: drug courts which specialise in closely supervising and ordering the treatment of drug-related offenders; community sentences which include a treatment requirement such as drug treatment and testing orders (DTTOs) and drug rehabilitation requirements (DRRs); prison-based therapeutic communities; opioid detoxification and methadone maintenance treatment in prisons and the community; and the RAPt 12-step abstinence-based programme implemented in some UK prisons.

There was mixed evidence for: criminal justice integrated teams (CJITs) which assess and case manage drug-related offenders; the restrictions on bail order which allows for drug treatment to be a condition of court bail; and the added value of drug testing as part of a community order.

The review found no evaluations of the effectiveness of: CARAT (Counselling, Assessment, Referral, Advice and Throughcare) teams which assess, support and case manage drug users in prison and on initial release; drug-free wings in prisons; programmes based on cognitive-behavioural therapy, such as short-duration programmes and ASRO (Addressing Substance Related Offending) programmes; conditional cautions which allow for a condition conducive to rehabilitation (such as engaging in drug treatment) to be attached to a police caution; diversion from prosecution schemes to refer suspects to services to address the underlying causes of their offending when formal criminal justice proceedings are considered unnecessary; and intervention orders that can be attached to court-imposed anti-social behaviour orders (ASBOs).

The report's key conclusions were that:
• The principle of using interventions in the criminal justice system to encourage engagement with treatment is supported by the evidence.
• Following a period of expansion and a focus on quantity, attention should now focus on quality provision characterised by individualisation, reintegration services and a holistic approach, supported by a streamlined commissioning and funding system.
• 'Net-widening' to include to include less problematic drug users in criminal justice-based interventions is likely to be inefficient and could have negative consequences such as further criminalisation of these mainly younger drug users.
• Community punishments are likely to be more appropriate than imprisonment for most problem drug using offenders. Imprisonment can have unintended negative consequences for these offenders and many practical issues frustrate the delivery of successful drug treatment programmes in prisons.
• Prison drug services frequently fall short of even minimum standards.
• Given the sizeable investment in criminal justice interventions for drug dependent offenders, remarkably little is known about what works and for whom. Answers to even basic questions regarding throughput and output are not freely available and not enough is known about which programmes work best for whom. This severely hampers the development of policy and practice.

Findings logo A recent report from PricewaterhouseCoopers commissioned by the Department of Health and Ministry of Justice has investigated prison drug treatment in Britain. Its focus was the multi-stranded commissioning and funding systems which the featured report found to hamper the delivery of care packages to address the wide range of needs of problem drug using offenders. Its conclusions overlapped with those of the featured report. Government has initiated a process to consider PricewaterhouseCoopers's recommendations, agree a single set of priorities, and compile national guidance around the streamlining of the commissioning, delivery funding and performance management of drug treatment for offenders.

Last revised 15 March 2009
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