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MACCJ Assessment Front Sheet – 2018/2019

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A report on UK drug policy from a criminological perspective

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STUART BAVINGTON

Summary_________________________________________________________________________
This report aims to investigate UK Drug Policy on reducing drug-related crime from a criminal justice
and criminology perspective. Following an introduction, the main body of the report will investigate
and assess:- 1 ) the historical background of policy development , 2) UK drug- related crime policies,
provisions and interventions from 1980 to present day, 3) evidence of the effectiveness of recent UK
drug- related crime policy. The report concludes that recent drug- related crime policy in the UK is
insufficient in reducing drug -related crime and recommends:-

 A review of present UK Drug policy concerning drug related crime

 Future research into alternative provisions and interventions

 New research in to the evidence of need for Drug Consumption Rooms (DCRs) and Heroin
Assisted Treatment (HAT)

 Move back to wards a more medical focused harm minimisation drug policy

 A more comprehensive drug education programme

Introduction

Each year in the UK, drugs cost society £10.7 billion in policing, healthcare and crime, with drug-
fuelled theft alone costing £6 billion’ (Barber, Harker and Pratt, 2017:9). Bennet and Holloway (2005)
argue that dominant discourses widely believe that drug use causes crime, with illicit drug use
becoming a prominent issue within UK public policy (Reuter and Stevens, 2008).
Drug related crime can be defined as crime related to possession, supply and any criminal activity
directly or indirectly involved with drug misuse ( Home office, 1994; Bean 2008; Bennet and
Holloway 2010; Stevens et al. 2005). Further definitions of drug -related crime are categorised
within Goldstein’s (1985) tripartite framework:- 1) the psychopharmalogical use of drugs effects
metabolism reducing inhibitions and causing violent behaviour( Amen et al. 2017; Stevens et al.
2005) , 2) economic- compulsive crime committed to fund addiction, which includes acquisitive
crime (shoplifting, theft, robbery) car crimes and small time fraud ( Ball et al. 1981;Bean, 2008;
Stevens, 2007; Bennet and Holloway, 2010; Stevens et al. 2005; Parker and Newcombe 1987), 3)
systematic crime which links prohibition and violence within unregulated drug markets especially
within inner cities (Stevens et al 2005;Stevens et al. 2007; Inciardi, 1999). Gordon et al. (2007) link
this type of crime with ‘problematic drug user’ dependant on ‘high harm drugs’ predominantly
heroin and crack cocaine.
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Although focusing on illicit drug use/misuse this report will include some over with alcohol-related
crime, especially with the increasing alcohol-drug link within the emergence of the night-time
economy ( Hobbs, Hadfield, Lister and Wanslow, 2003).
For the purpose of this report illicit drugs will be those defined as ‘controlled drugs’ under the
Misuse of Drugs Act 1971, including heroin, cocaine, ecstasy, amphetamine, LSD and cannabis.
(Bennet and Holloway, 2005; Bean, 2005; Gossop, 2003).

Historical Background

Opiate use in the 1900s had become accepted and widespread amongst various members of the UK
population, used by members of the royal family, artists and writers of the time including romantic
poets including Thomas De Quincy and Samuel Taylor Coleridge (Beveridge, 1988). Gossop (1996)
argues that Coleridge’s’ famous poem Kubla Khan had been perceived under the influence of
laudanum (an opium and alcohol tincture widely available in the 19 th century). However, the
industrial revolution, child mortality and the emergence of Chinese drug dens in London began to
change public attitude. Dominant (positivist) discourse believed addiction to be a discovered
objective state, whilst a Foucauldian analysis argues that addiction is a social (discourse) construction
(Harding, 1998). Addiction is a multi- dimensional and ‘is the result of many interacting parts’ ( Glatt,
1967:2). Alexander( 2018) argues that addiction is a cause of the dislocation of populations. One of
the most prominent anti-opium movements of the time led by Quakers. ‘The Society of the
Suppression of the Opium Trade’ (SSOT) saw opium use as evil and morally wrong. Addiction was a
‘moral failing’. Backed up by health officials the SSOT promoted total abstinence which provided the
basis for future policy ( Harding, 1998; Johnston, 1975; Brown, 1973). This also consolidates the
dominant opinion that addiction is an epistemological objective state. The 1868 pharmacy act
created a more regulated environment for drug use, although a number of opium and morphine
addicts still remained until the 20th century addicts (Newburn, 1996).

By 1914 opiate use and addiction in the UK could be seen to be either a medical or the more
predominant viewpoint that addiction was ‘a vice to be controlled penally’ (Stimson and
Oppenheimer, 1982:3). The Defence of the Realm Act 2014 (DORA) implemented not only new
licencing laws but also made the possession of opium and cocaine illegal. This legislation was
sanctioned in order to control drug use amongst the armed forces and to maintain a sober
workforce for the production of weapons for WW1 (Mason, 2018; Smith, 1995)). In 1916 the DORA
40(b) prohibited the use of cocaine and opium smoking as well as making the possession of heroin
and cocaine illegal (Berridge, 1988). Increasing use of cocaine amongst returning troops from the
war, young white women and men of colour became a mounting concern for the British government,
who called for new legislation( Spear and Mott,1993 ;Kohn, 2001; Stevens, 2007; Smith,1997)). This
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resulted in the 1920 Dangerous Drugs Act which banned imports of opium and other drugs, s gave
the police more powers to stop and search and increased penalties (Bennet and Holloway,
2004;Bean, 2008). The 1928 Dangerous Drugs Act saw cannabis come under similar controls
( Smith, 1997).The 1926 Rolleston Report outlines the ‘British System’ in which opium addiction
treatment becoming available on prison and punitive settings thus becoming the first ‘drug crime
link’ provision provided (Berridge, 1988). The report also allowed doctors to prescribe to addicts and
put the control of addiction in the hands of the medical profession ( Bennet and Holloway, 2005) The
British system saw the addict as a sick person who need a minimal dose in order to maintain a state
of normality (Glatt, 1967; Stimson and Oppenheimer,1982). Those addicts not subscribing to being
addicts within the medical profession and use unregulated supplies were thus treated as criminals
(Glatt, 1967; Stevens et al. 2007) At the time of the Rolleston report the British Medical Journal
defined addiction as ‘a disease needing treatment not a vice needing punishment’ (Berridge, 1984).
The British system remained in place from 1926 to 1968 ( Berridge, 1984). During WWII the use of
amphetamines became more widespread and accepted primarily amongst the armed forces in order
to combat fatigue and remain alert ( Smith, 1995). Between 1951 and 1959 many addicts postponed
registration in fear of stigma and becoming labelled deviant, again allowing themselves to become
involved in unregulated use and supply of drugs, altering prescriptions and other criminal activities
linked to drug use (Glatt, 1967). In 1962 over 600,000 heroin tablets where subscribe by doctors in
the UK (Glatt, 1967; Bean, 2008). The late 50s began to see an increased use of amphetamine and
cannabis primarily amongst the newly established bohemian jazz, rock and roll, political black and
minority ethnic (BAME) subcultures (Smith, 1995;Incaridi, 1986). The use of cannabis had also
spread to the white indigenous population of the UK as well ( Stimson and Oppenheimer, 1982). The
first Brain Committee report of 1961 outlined that addiction is still a medical problem and the
maintenance of addiction by using a low amount of drugs is ok (Spear and Mott, 1993) The report,
although declared the UK to not have to worry about an addiction problem, outlined the emergence
of over prescription of prescribed drugs by private doctors and the use of recreational drugs within
emerging subcultures thus the state began constructing the notion of ‘moral panics’ (Cohen, 1969).
Spear and Mott (1993) describe the outrageous subscription of opioid based drugs by Lady Frankau
which led them to ask the question ‘is the UK medical profession responsible for a greater number of
drug addicts in the UK’ . The late 1950s witnessed a new breed of addicts ‘who took drugs not just
for need or personal defect, but for a case of exhibitionism’ ( Glatt, 1967:29). These newcomers
would be seen to be trouble makers thus bringing greater sanctions to all addicts ( Glatt, 1967). Drug
taking became a way of providing a sense of adventure, hedonism and kicks for not only the new
bohemian cultures but also for the emerging delinquent youth cultures seeking subterranean values
(Young et al. !971). ‘If deviant acts are repetitive and highly visible the greater the societal reaction”
( Lemert, 1951, cited in Glatt, 1967). the 1961 Brain Committee reported that the UK had no major
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drug problem, viewing addiction as “an expression of mental disorder rather than a criminal one’
( Ministry of Health, 1965:1) and more treatment centres should be provided , however the basis of
any policy would still be rooted in Victorian morality philosophies from a scientific positivist
viewpoint( ( Berridge, 1984). Berridge argues that the second Brain Committee 1965 report saw the
beginning end of the British System and a move towards more defined policy. The second Brain
report proposed that the prescription of opiate based drugs for regulated use should be undertaken
by specialist doctors with a special licence in NHS run clinics and treatment centres The second
report detailed a large increase in addicts in the UK (mainly due to over subscription of opiate based
drugs) and recommends the following ;-

1) notification of addicts to the Home Office

2) the provision of advice on addiction

3) provision of treatment centres/clinics

4) the restriction of supplies to addicts

The report also states that special restrictions should be made primarily for heroin and cocaine
( Ministry of Health, 1965). Berridge, concludes that the ‘ establishment of clinics were not grounded
in the philosophy of treatment rather than punishment but linked to the growth of rational scientific
knowledge and technology e.g. the use of the synthetic opiate methadone initially used as a ‘cure ‘
but ‘soon became substitute for heroin’( Berridge, 1997:38) .

During the early 1960s amphetamines, cannabis and LSD use became more widespread which in
turn saw the implementation of the 1964 Dangerous Drugs Act which prohibited the cultivation of
cannabis and criminalised the possession of amphetamines, especially the use of pep pills known as
purple hearts ( Stevens et al, 2007; South,1997). Cannabis use had been becoming more and popular
leading to a massive increase in convictions . The 1968 Wootten report controversially recommended
reducing the penalties for cannabis use and declared users should not receive custodial sentences.
As the 1960s became more culturally diverse (Reiner 2010) these moral panics speeded up and ‘an
increasingly amplified general threat to society is imputed to them’ (Hall et al. 1978;218). By
mapping together moral and general panics social order spirals culminating in what can be described
as a ‘Law and Order campaign’ (Hall et al. 1978;219). When two or more activities are linked or
converge the threat potential for society is therefore amplified (Hall et al. 1978). ‘Convergence, for
example, takes place when political groups adopt deviant life styles or vice versa’ (Hall et al.
1978;220). ‘Suspicion of drug use increased when it was linked with immigrants and resented
minorities’ (Woodwiss and Hobbs, 2009; 109). With more people using drugs for recreational
purposes newspapers demanded a hard line in the use of drugs in 1971 the UK government passed
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the Misuse of Drugs Act 1971 (Bean 2008). This new legislation classified illicit drugs in regard of
potential hazard caused with high risk drugs such as heroin and cocaine in Class A; amphetamine and
cannabis in Class B; other controlled drugs in Class C (Bennet and Holloway, 2005). The Misuse of
Drugs act (MDA) defined the criminal nature of drug misuse, made new distinctions between
possession and supply of drugs and increased the penalties for supply or ‘trafficking’. Within the
MDA framework the Advisory Council on the Misuse of Drugs (ACMD)evolved, which published a
report on future policy that dealt with reducing individual risk of drug taking and associated harms. (
Bennet and Holloway, 2004; Dorn, South and Karim, 1994). The British system ceased in April 1968
and throughout the 1970s clinics become the dominant intervention switching to methadone use as
a heroin substitute with heroin use stabilising in the mid-1970s ( Stimson and Oppenheimer 1982;
Wilson 1990). Clinics tended to treat all addicts in the same way forcing addicts to conform to the
new way of treatment, by setting up ‘rigid and inflexible systems’ (Gossop, 1980:3, cited in Stimson
and Oppenheimer, 1982). Methadone was to be given on short term basis in therapeutic
confrontational conditions( Stimson, ,2000 ) However, conflicts between maintenance and
abstinence arose with Stimson and Oppenheimer (1982) arguing that the late 1970s and early 1980s
marked the end of medicalisation policy and prominence given to doctors with a more law and
order and policy to be adopted ( Stimson and Oppenheimer, 1982).

Polices, provisions and interventions from 1980 onwards

Dominant discourses construct illicit drug use as dangerous, harmful, corruptive and crime-genic
( Bright, 2014; Room, 2006; Stevens, 2007). Bright (2014:7) argues ‘heroin is constructed as
oppressive and crack perverse’. Policies most likely to be enacted are consistent with the dominant
discourse (Stevens, 2011).

In 1985 the Home office, following US policy, issued a War on Drugs declaring ‘drugs were the biggest
peace time threat to society’. The Home Office committee recommended using the Royal Air Force
and the Royal Navy to intercept drug shipments at ports and air ports (Woodweis and Hobbs, 2009).
The media promoted stories of drug barons, Mr Bigs, crime cooperatives and threats to the national
security. UK drug policies shifted from medical towards the criminalisation of drug use backed up
by in the 1980s by the Reagan- Thatcher ’War on Drugs’ rhetoric. (Berridge, 1988;Bean, 2008). With
sensationalist views on drugs dominating the media and political debate those defined as criminal
and thus posing a threat to conventional society faced increased use of prisons and longer sentences
( Mac Gregor, 1998)

The document Tackling Drug Misuse: A Summary Of the UK Government’s Strategy ( Home Office ,
1985) detailed how drug misuse was to be tackled on five fronts: 1) reducing supplies from abroad,
2) making enforcement even more effective, 3) maintaining effective deterrents, 4) developing
preventions, 5) improving treatment and rehabilitation ( Bennet and Holloway, 2005:25). A similar
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document in Wales named Forward Together (1996) outlined the Welsh Drug and Alcohol Unit
Strategy as one that was committed to developing a national prevention campaign action on
treatment, rehabilitation and guidance for those involved in combatting drug and alcohol misuse.

The 1980s saw illicit drug use escalate in the UK and with high quality heroin from South East Asia
allowing heroin to be smoked and thus removing the stigma associated with injection attracted many
new users (Sweeny et al. 2010). To coincide with this new heroin ‘epidemic’ crack cocaine from the
US had also hit the UK drug scene becoming a major concern for the police and healthcare
professionals (Sweeny et al. 2008). These problems were experienced with exceptional severity in
areas of high unemployment, bad social housing and urban decay, with evidence pointing towards
the increase of drug related crime as a consequence ( Pearson, 1995). Reuter and Stevens (2010)
argue government policy assumes that there is an economic-compulsive link with drugs and the
need to steal to feed an addiction. Addictive drug use is associated with increased criminal behaviour
drug use forcing many addicts to finance themselves through acquisitive crime ( Gossop, 2015).
Three transforming forces coincided in the UK in the 1980s , the radical right government, a heroin
epidemic and the arrival of aids ( Mac Gregor, 1998). With the 1980s aids and HIV epidemic policy
shifted towards harm reduction( Monahan, 2014;Buchanan et al. 2015 ). Although harm
minimisation contradicted that of abstinence it was to be accepted by the health Minister, as well as
provisions for needle and syringe exchanges ( Stimson, 1998) Harm reduction (minimisation) aimed
to reduce negative sides of drug use which is in total contrast with the dominant discourse policy of
absenteeism which is ‘ rooted more in the law enforcement model’ (Newcombe, 1992:1). The
philosophy of harm reduction reduces the strategies reliant on ‘arbitory moralism’ ( O’Hare, 1998;
Keene, 2002).

The Criminal Justice act 1991 allowed less serious offenders to serve communities penalties, with
provision for them to undergo treatment for alcohol drug dependency . (Mc Gregor 1998). The 1995
Conservative drug strategies reversed this phase and drug related crime became the new scourge of
society( Hunt and Stevens, 2008). The 1995 strategy Tackling Drugs Together proclaimed to increase
the safety of communities from drug related crime, reduce the availability of drugs to young people
and reduce the health risks and other dangers in relation to drug use/misuse ( Mac Gregor, 1998)
Stimson (2000) saw this as the beginning of the drug crime phase and the drug -crime nexus, based
on Goldstein’s tripartite model, focused on acquisitive crime associated with high end problematic
drug use ( Stevens, 2007; Bennet and Holloway, 2005). In 1998 the UK New Labour Government
published Tackling Drugs to Build a Better Britain ( Home Office, 1998) which outlined a ten- year
strategy for tackling drugs aimed to help young people resist drug misuse, protect communities from
drug related anti-social behaviour, enable people with drug problems to over- come them and to
stifle the availability of illegal drugs on our streets, this strategy seems to be very similar to the
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previous government strategy. Along with this saw the appointment of the new drug Tsar Keith
Halliwell. In 1997 drug policy moved away from health and focused more on crime, witnessing the
introduction of more punitive and coercive measures ( Stimson, 2000) . New Labour drug policy
aimed to ‘ rid our society of the cycle of drugs and crime ‘ (Halliwell, 1998). The New policy premises
that there were links between drug use and crime, treatment works to reduce criminal behaviour
and that getting serious drug users into treatment will reduce crime. Treatment for people with drug
problems is now justified with reference to crime reduction ( Stimson, 2000). Drug policy moved
from volunteerism, that is to say treatment was available if required, to one based on quasi
compulsory treatment (QCT) whereby offenders who did not comply to treatment were tracked
down and given custodial sentences ( Monaghan, 2012). Coercion into treatment and crime
prevention became the main policy objective. Drug treatment would now be shaped by social and
community considerations would normally be ‘regarded as unacceptable for other forms of
consumption related morbidity’ ( Hunt and Stevens, 2007:338) As the 1999 compulsory drug testing
for all offenders at each stage of the criminal justice process came into being Blair continued to use
words such as ‘ menace, ‘threat’, ‘scourge ‘ ((again ) and ‘ crack down’ his sermons became based
on the following themes

 Drugs = crime

 Drugs = threats to the family and communities

 A War on Drugs ( another one) is needed to protect us from those threats.

The compulsory drug testing results could be used for determining if bail should be granted, the
length of sentences given and offenders could be tested when released on license ( Stimson , 2000)

The 1998 Crime and Disorder Act introduced provisions such the Drug Test and Treatment Orders
(DTTO) and antisocial behaviour orders (ASBOs). DTTOs imposed by courts allowed offenders with
drug problems rapid access to treatment programmes ( Mc Sweeny, Turnball and Hough, 2008).
These include rehab/detox, methadone/ Subutex maintenance, 12 steps programmes and residential
therapeutic programmes and drug courts (Best et al. 2008). Drug Intervention Programmes (DIPs)
were also set up to prevent future criminal behaviour due to drug use. The 2008 New Labour
Government strategy declared its goal to be total abstinence. The 2008 strategy enabled ‘carrots’ for
those who took drug treatment and ‘sticks ‘ ( primarily stopping benefits) for those who took no
action with the emphasis placed on changing behaviour through the benefits system(Monaghan.) In
2011 Drug recovery wings were set up to provide drug free recovery. Criminal Justice Integrated
Teams (CJIT)were to provide support from arrest to aftercare, extended to Local Drug Action Teams
to help provide accommodation, employment help and aid the transition from prison to civilian life
overseen by the National Offenders Monitoring Service ( NOMS) (NHS, 2018; Turnball and Mc
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Sweeny, 2008). claimant behaviour ( Wincup, 2011)Abstinence is now replaced with recovery with
Wincup (2011) stating that the coalition government still relied on the carrot and stick philosophy to
encourage drug users towards recovery treatment whist introducing sweeping welfare reforms in
order to tackle the dependency culture and the ’sin ‘ of worklessness ( HM, 2010). The Co-olition
2010 Drug Strategy (Home Office , 2010) declared that problematic drug users should come off drugs
in order to successfully contribute to society (Wincup, 2011). Recovery replaced abstinence as the
key word as for policy outcome.

The UK government encouraged separate policies for England , Wales, Scotland and Northern Ireland
in its bid to tackle problematic drug and alcohol use. In Wales the document Working Together to
Reduce Harm : Substance Misuse Strategy for Wales 2008-2018 ( Gov.Wales, 2015). The aims were :

 reduce harm to individuals ( particularly young people)

 improve education

 better use of resources

 enable core welsh values

In relation to drug related crime enforcement should focus on those suppling children, tackle street
dealing and support interventions in custody . In addition to these provisions the documents also
aimed to reduce harm, support substance misusers, support families, communities and protect
individuals. The Welsh Government also became the first UK Governing body to introduce Take
Home Naloxone (2009). Naloxone reverses the effect of opiate drug poisoning and is easily
administered within a community setting ( Bennet and Holloway, 2012). In 2017 the Welsh Advisory
Panel on Substance Misuse (APoSM) submitted a report based on the feasibility for the
implementation of Enhanced Harm Reduction Centres (EHRCs), term used to describe legally
sanctioned facilities for individuals to consume previously obtained illicit drugs. These centres also
known as Drug Consumption Rooms (DCRs), Safe Injecting Site and Medically Supervised Injecting
Centres (MSICs) ( May, 2017).

The Randomised Injectable Opiate Treatment Trial (RIOTT) sanctioned by the UK government
administered by Professor John Strang et al enabled unresponsive to other opiate treatment
problematic users to be administered regulated doses of heroin within clinical setting. The trial
proved successful not only in positive treatment outcomes but also in reducing acquisitive crime
similar Heroin Assisted Treatment (HAT) adopted in Swiss Clinics ( Strang et al. 2014).

More recent policy amended the 1971 Drug Misuse Act with the new Psychoactive Substances Act
2016 (Home Office, 2016) . This new Act illegalised the sale and distribution of so called ‘legal highs’
which had been the cause of recent fatalities within the UK ( Webster, 2016). In addition to this new
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act prosecutions have also been made under the Human Trafficking and Slavery Act 2015 ( Home
Office0 2015) in relation to ‘County Lines’ organised drug gangs exploiting young and venerable
members of society ( Hardy, 2019; Coomber and Myles 2018 ; Densley et al. 2019 ).

Overview of the effectiveness of drug -related crime interventions

The National Treatment Outcome Research Study ( NTORS) was set up in 1994 by Health Minister
Brian Mc Whinney on behalf of the Government Task Force on drug misuse in the UK. The idea of
NTORS was to conduct a comprehensive study of the clinical operation and cost effectiveness of drug
misuse interventions – the underlying worry was that existing treatment programmes were
insufficient in maintaining abstinence. Over a five-year period, drug users were studied whilst taking
part within four treatment programmes (modalities) : 1) in patient detoxification, 2) residential rehab
3) methadone treatment, 4) methadone maintenance . Treatment was studied on a day to day basis
( Gossop et al. 2003). NTORS findings influenced the supporting funding for treatment with the
greater focus on the reduction of crime. The main findings of the NTORS study shows: 1) the main
problem drug was heroin – with heroin use halved, a reduction in prescribed methadone was also
found, 2) abstinence should be a stringent criterion of the outcomes, 3) reductions in crime, with
many heroin addicts financing their habits through acquisitive crime- this however became
substantially reduced after one year of treatment. The NTORS follow up report also found a
reduction in shared needles, however on a less positive note drug mortality rates remained high and
the move towards alcohol use for ex-addicts increased ( Gossop, 2015). For every £1 spent on
treatment there would be a saving of £3 in cost savings to the victims of crime and by reducing the
demand on the criminal justice system ( Gossop et al. 1999)

Reuters and Stevens (2008) argue that the National Treatment Outcome Research Study (NTORS)
data used for evaluation of interventions is methodically flawed and fundamentally misleading with
drug users predominantly and disproportionally arrested for trigger offenses such acquisitive crime
Ashton (1999) declares that many interviews were taken by staff members not researchers, who
aware of the survival of services influenced the outcomes of interviews. Ashton goes on to argue that
NTORS study focused on the most criminal and denied those drug users who managed without any
criminal involvement and without intervention their drug use may escalate and therefore maybe
become involved in more serious criminal activity in order to fund their needs and therefore become
problematic. Many of the subjects may also move in between treatment modalities
( Ashton,1999:22) Bennet and Holloway (2005) also point out that policy made from the NEW-
ADAM ( New England and Wales Drug Abuse Monitoring ) which took urine samples from arrestee’s
and shows 65% proving positive for drugs, mainly cannabis should not be used for making drug
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-crime policy. Although acquisitive crime reduced by 20% re- conviction rates remained high (Bennet
and Holloway, 2005)

Turnball and McSweeney (2008) argue that a more holistic approach should be taken towards
aftercare Drug Testing and Treatment Orders (DTTOs) first introduced as part of the Crime and
Disorder Act 1998 aimed to reduce drug related offending by using structured treatment. Although
there is little evidence for Drug testing to be successful However, methadone programmes and 12
Steps seem to have some success ( Turnball and Mc Sweeny, 2008). Although evidence suggests that
there was a reduction in drug- crime offending only around 50 % of offenders completed the orders
( Mc Sweeny, Turnball and Hough, 2008). This strategy paved the way for the introduction of Drug
Intervention Programmes (DIPs) in 2003/4 as a new strategy for dealing with problematic drug users
(Bennet and Holloway, 2005; Collins, Cuddy and Martin, 2016). DIPs aim to get drug misusing
addicts out of crime and into other support using Criminal Justice Integrated Teams offering support
from arrest, beyond sentencing and resettlement in the community. In prisons this is to be run by
Counselling, Assessment Referral, Advice and Throughcare workers (CARATs), with the aim of
providing treatment management and treatment provision in order to reduce harm caused by any
drug classified under the Misuse of Drugs Act 1971 (Home Office, 2007:1). Analysis of the Quality of
Life Year (QALY) estimate from the UK Drug Treatment Outcomes Research Study (DTORS) and the
National Treatment Outcome Research Study (NTORS) suggest that DIPs have been effective ( and
cost effective) in reducing drug- related crime and improving the quality of life for offenders (Collins,
Cuddy and Martin, 2016). Reuter and Stevens (2008) argue again that NTORS evidence also fails to
include the increasing amount of acquisitive crime involved when producing its findings. There is
little evidence that DIPs are still effective in 2017 (www.London.gov, 2018). Prison based
interventions show little evidence of effectiveness with the implementation CJITs proved to be
expensive ( McSweeny, Turnball and Hough, 2008). Drug testing as a deterrent in the Criminal Justice
System also shows little evidence of effectiveness ( Holloway, Bennet and Farrington, 2005).

There is good evidence that Opioid Substitute Treatment (OST) using Methadone and Subutex is
effective in reducing crime, HIV and mortality. Heroin maintenance for those not responding to OST
also has been effective in reducing acquisitive crime. Evidence that peer self- help groups and short-
term residential care (detox) also is effective in reducing drug use and crime ( Strang et al.2012). A
review of Supervised Heroin Therapy (SHT) in the UK under the RIOTT trials saw a reduction of illicit
drug use, a reduction in acquisitive crime with no negative effects of public safety involving injecting
centres ( Strang et al.2015).

The 2013 evaluation of the Substance Misuse Strategy for Wales ( Bennet, Holloway and Maguire,
2013), recommended that educational material on drug misuse should be written in Welsh and
ethnic minority languages, development of opiate substitute prescribing and the use of supervised
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consumption rooms, consider the introduction of heroin assisted therapy, access to detox units be
improved, expansion in drop in centres with needle exchanges, drug testing at point of arrest to
identify users who misuse stimulants in which stay in the system for a short length of time, when
arrested for drug supply asset recovery is used and tackle street level dealing and anti- social
behaviour.

In the Review of Working Together to Reduce Harm In Wales (Livingston et al. 2018) the panel
concluded from a set of six questions thus : 1) services in general working well together but could
increase service user involvement, 2) Take Home Naloxone led to expansion of prevention of drug
related deaths, 3) services not well equipped to deal with N.P.S, 4) there has bene an increase in
recovery group turnout, 5) the development of drug consumption rooms to be most logical and
sensible, 6) housing issues also of great concern, 7) current strategy focuses too much on current
user rather than prevention, 8) development of single point access for all agencies, 9) improvements
for those with substance misuse and mental health issues. There was widespread agreement that
future strategy should concentrate on long term outcomes.

Reuter and Stevens (2007) tell us that drug seizures make no difference to the availability of drugs in
the UK as major drug importers see seizures as another ‘hazard of the job’. Prison also has little
deterrent effect with high profile drug users already having criminal records their demand for drugs
out way the punitive sanctions, with drug use in prisons especially high it services little purpose in
cutting off your supply.
Reuter and Stevens (2008) argue that there is no research showing that any of the ‘tougher
enforcement, more prevention or increased treatment has substantially reduced the number of
users in a nation’ ( Reuters and Stevens, 2008:474) Domestic law enforcement again seems to have
very little effect on drug use. When areas are targeted by the police to arrest dealers the dealers just
move their business elsewhere (Reuter and Stevens, 2007), The low risk factor of street dealing in
certain areas makes criminal punishment a deterrent for drug use seem unimportant( Murkin,
2016). The impact of informal social and personnel control, plus moral aspects and peer attitudes
‘were more significant than any criminal punishment’ ( Murkin, 2016). Prison also has little
deterrent effect with high profile drug users already having criminal records their demand for drugs
out way the punitive sanctions, with drug use in prisons especially high it services little purpose in
cutting off your supply. The main aim of policy should be to reduce the harm drugs cause, not to
embroil people into the criminal justice system and not be led by moral panic driven strategy
(RSA,2007) . ‘How much can drug policy reduce the crime problem in the UK ?’( Reuters and
Stevens, 2008:474)
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Conclusion

The UK government believe that drug policy has contributed in the decline of crime since 2000.
Using what is known about treatment outcomes, and although there has been positive effects on
individual offending levels, the effect of treatment expansion in reducing crime overall is likely to
have been limited ( Reuter and Stevens, 2008:461).

What are the policy options for the future in the UK ? Contemporary marginal discourse argues that
that policy on alcohol and other drugs (AOD) should be centred around medical rather than criminal
justice provisions , whilst others argue for the implementation for Drug Consumption Rooms (Jones,
2018), new research into the effectiveness of Heroin Assisted Therapy for the reduction of drug
related acquisitive crime and a move back toward the ‘British System’( Strang et al. 2015) are just
some possibilities. Others argue for not just legalisation but the unregulated use of all drugs
( Buchanan, 2018) and decriminalisation ( Transform , 2016) also see Taking a New Line On drugs –
The Royal Society for Public Health (RSPH, 2016). Stimson (2010) argues for a return to a policy of
harm reduction again with the emphasis on the health model . Fresh new research to access the
evidence of need for drug consumption rooms could provide some interesting results. And greater
drug education, and not just at school/ college level but within the general population to give some
insights to see exactly what you are taking and where it has evolved from.

With various options open for future interventions It would seem that the time is right for a radical
re-assessment of drug -crime policy in the UK.

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