Drug use among offenders is a big problem in the UK. Between one-third and one-half of people entering prison are estimated to be problem drug users. About one in eight of these have a problem with heroin and/or crack compared with about one in one hundred in the general population. There are also more people developing drug problems in prison, with rates rising 8% between 2013/14 to 2018/19 reaching almost 15%. Positive test results of random drug tests conducted in prisons have risen from 7% to 11% from 2012/13 to 2017/18.
This is a problem for those with a drug problem but also for others in the system as it contributes to violence and crime within prisons. Despite this, of the 25,000 prison leavers who need substance use treatment, 62% do not receive it. Manchester is one of the worst affected areas, with just under 24% of people who need treatment receiving it.
What is Addiction?
Addiction causes people to compulsively seek out and use the substance to which they are addicted. When people develop an addiction, they prioritise the substance over other activities and responsibilities. This could cause them to steal money to pay for it or to steal the substance itself.
There is a lot of stigma surrounding addiction. Many people blame the person with the addiction and believe that willpower will prevent and cure it. However, addiction is a chronic brain disease, which results from changes in brain chemistry and should therefore be treated with the attention and care that any other disease is. There are risk factors that make it more likely you will develop an addiction including genetics, mental health problems, childhood neglect or abuse, exposure to drugs, and previous substance abuse problems.
What is Sandwell Doing Right?
While treatment services for prison leavers in most of the country are hugely lacking, Sandwell, in the West Midlands, is doing a better job. In Sandwell, 62% of prison leavers who need treatment get it. Rates of drug misuse are now much lower than the national average with rates of 2.2 per million compared to 5 per 100,000.
This may be surprising as Sandwell has high rates of poverty, so better treatment does necessarily not boil down to better funding. Their success seems to come from their whole-system approach. The NHS, council, police, and drug specialists work together to help people overcome addiction. One actor is Cranstoun, a social justice and harm reduction charity. They are involved in pre-arrest, policy custody, and post-prison treatment.
Cranstoun is the first point of contact for offenders who use drugs when they are arrested. They are also part of a pre-arrest diversion scheme for people found in possession of drugs, and the first point of contact for offenders who use drugs when they are arrested. They are involved for people in police custody and community services which pick people up when they come out of prison. One way that they are so effective is that they have an office in a block of custody suites. This means that drug workers can meet offenders as soon as they are brought to the station, providing them with treatment from then until the point they leave prison.
How Can We Improve Addiction Treatment for Prison Leavers?
The Ministry of Justice is making moves to improve treatment for those leaving prison with drug use problems. They announced the use of £120 million to go towards eighteen abstinence-led drug wings in prison and extra staff to coordinate the transition between prison and communities. This is a start at supporting those who need help when they leave prison but the way this money is used is important.
Sandwell’s model for addiction treatment for prison leavers is making a significant difference for those in the West Midlands. However, other parts of the country are not following suit, with some saying that this system will not work in other parts of the country. While it is true that one-size-fits-all models do not work for everyone, perhaps Sandwell’s holistic approach could be adapted to suit other regions. The method is expensive; however, in the long run it may save money. In 2020, it cost around £40,000 per year to keep one person in prison. As of June 2021, there were 87,550 people in prisons across the UK, so this is a massive cost. Addiction is a complex disease so it makes sense that it will require a big investment. Making sure that the money from the Ministry of Justice is used effectively is important.
In addition to different government and social bodies dealing with problems of addiction, there should also be a more integrated approach to deal with the complex links between addiction and offending. There is evidence that there are links between homelessness, mental health, addiction, and offending. The government’s BOLD plan aims to look at the links between these and how sharing information across different government departments and social services could help to provide better support for people who have complex needs. This includes a special focus on access to addiction treatment for prison leavers. Another factor which could help is community sentences for minor offences. When people are sent to prison for short periods, they may go through detox in prison but not be there long enough to complete the rehabilitation process. When they leave prison they are more likely to overdose if they start taking drugs again because their tolerance decreases during detox. There has been a 52% decrease in community sentences for minor offences since 2010. Since there is evidence that they are both more effective and around one-ninth of the annual cost of prisons, perhaps there should be a push in the opposite direction. Treating prison leavers with addiction problems should be done in a holistic and multifaceted approach as evidenced by the success of Sandwell.
