How we manage offenders

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Drugs and alcohol

At any one time about one third of all problematic drug users in England and Wales are in the care of NOMS.

One survey showed 69 per cent of arrestees tested positive for drugs (of which 38 per cent tested positive for opiates or cocaine). In another study of 1075 admissions to treatment services, 61 per cent of new admissions reported that they had committed a total of 70,728 crimes. 

Criminal Justice services are uniquely placed to tackle offenders’ drug use.  The NOMS Drug Strategy takes advantage of this fact to help break the cycle of re-offending.

How we aim to tackle offenders' drug and alcohol problems: 

• Address the needs of problematic drug users (PDUs) when they first come into contact with NOMS, to reduce the chances of them re-offending and help prevent the harm they cause themselves and others:
  • provide end-to-end drug treatment for PDUs before, during and after sentence, co-ordinated with the Drug Interventions Programme (new window) (DIP)
  • reduce drug misusing offenders' re-offending
  • reduce illicit use of drugs by offenders
  • reduce the physical harm caused to drug misusing offenders and others
  • ensure robust links with other agencies, including DIP
  • Build on the national Alcohol Harm Reduction Strategy (new window) to improve treatment and support for offenders with alcohol misuse problems.

The Drug Interventions Programme

NOMS works with the Drug Interventions Programme (DIP), the cross-government programme to help misusing offenders into treatment and away from offending.

This work is led by local multi-agency Drug Action Teams and Criminal Justice Integrated Teams (CJITs).

CJITs encourage problematic drug misusing offenders to access treatment and provide aftercare support. Within prisons, communication and liaison with CJITs is through Counselling, Assessment, Referral, Advice and Throughcare (CARAT) teams who are the key workers to work with offenders through drug treatment in prisons.

The Voluntary and Community Sector is a key provider of many of the treatment and support services involved.  

The Drug Interventions Programme is to see its methods of working with drug misusing offenders become standard practice throughout the criminal justice and treatment services.

The programme aims to achieve the delivery of 1000 drug misusing offenders per week into treatment by 2008.

Early interventions

Treatment works. For every £1 spent on treatment at least £9.50 is saved in crime and health costs.

DIP has introduced a number of interventions such as drug testing on charge for certain 'trigger offences', a drug rehabilitative condition attached to a caution and Restriction on Bail.

Increasingly drug workers are present in all custody suites and also in courts.

New measures introduced in the Drugs Act 2005 will be implemented incrementally to give police powers to test for drugs on arrest rather than charge, so that more people who commit certain trigger offences to finance their drugs habit can be directed into treatment earlier, and to require those testing positive to undergo an assessment of their drug use.

Continuity of care

Drug Action Teams (DATs) aim to ensure services provide continuity of care for Class A drug misusing offenders from the point of arrest through to sentence and beyond.

All DATs now have a single point of contact for referrals in place and the introduction of the Drug Interventions Record (DIR) in all prisons in England and Wales and by all CJITs in England allows, with the permission of the offender, the sharing of case information across the different agencies involved.

Key developments in this area will be in tackling attrition at key stages of the assessment and treatment process and in developing the workforce of the future. 

Aftercare

Aftercare is the term used to describe what happens after drug misusing offenders are released from custodial sentences, complete community sentences and/or leave treatment.

Drug treatment itself plays only one part in supporting rehabilitation and reintegration. Aftercare is not one simple discrete process and can involve several important factors, such as housing, support with benefits, managing finances, employment, education and training opportunities, access to mental health services, and rebuilding family relationships.

CJIT workers will provide, or broker the provision of, appropriate wraparound services in relation to each of these factors for clients on their caseload.

This is done in conjunction with the Probation Officer where an offender is subject to statutory supervision.

Treatment in custody

Counselling, Assessment, Referral, Advice and Throughcare (CARAT) staff undertake initial assessments of drug-related need and create care plans based on a prisoner’s specific requirements (whether remanded into custody, or at any time during their custodial sentence).

They also refer drug misusing offenders onto drug rehabilitation programmes, offer harm-minimisation advice and establish through-care links, working with prison resettlement teams and CJITs.

CARAT teams liaise with CJITs to ensure consistency of drug treatment provision following release, and with Home Probation Areas to ensure that release plans for offenders who will be released under licence, will include work to build on any drug treatment undertaken in custody.

All local and remand prisons offer drug misusing offenders clinical services to manage substance misuse. These comprise predominantly detoxification but also maintenance prescribing programmes as a prelude to broader-based drug treatment interventions.

The Integrated Drug Treatment System (IDTS) is due to be in place in prisons nationally by end March 2008 and will introduce a wider range of treatment options – including a stabilisation period and the expansion of maintenance prescribing for opiate dependency together with more intensive CARAT interventions during the first 28 days of entry into custody.

Drug testing in prison

Prisoners are subject to mandatory drug testing. To help offenders stay drug-free, all prisoners are eligible to sign up to the voluntary drug testing programme.

Remaining drug-free can be attractive to prisoners – some may benefit from release on temporary licence, or transfer to open conditions (public safety considerations permitting) and remaining drug-free may reduce risk and contribute to a positive parole reports.

Community treatment and community sentences

Drug treatment in the community is guided by the principles of the National Treatment Agency’s (NTA) Models of Care. This evidence-based guidance has the status of a National Service Framework and outlines the optimal models of care for drug treatment services in England.

In order to improve continuity of drug treatment for drug misusing offenders between custody and the community, the Integrated Drug Treatment System is being developed.

The Community Order with a Drug Rehabilitation Requirement (DRR) is the primary intervention for addressing drug misuse for offenders aged over 18 within the community sentencing framework. Under the new Community Order, it can be combined with other requirements to be better tailored to address individual drug treatment needs.

CJIT workers and CARAT teams will work with offenders pre-sentence to raise awareness of these sentencing options and motivate offenders to consent to these Orders. On completion of a DTTO or Community Order with a DRR, the offender manager will refer the offender to the local CJIT to address any ongoing treatment needs where appropriate.

Alcohol

Strategy

The Alcohol Harm Reduction Strategy for England places joint action at the heart of measures to improve treatment and support for people with alcohol problems.

An additional £10m will be made available by the Department of Health in 2006-07 to improve alcohol treatment, with a further £15m going to Primary Care Trusts in 2007-08 for this purpose. NOMS is working closely with the Department of Health, the National Treatment Agency and other partners to ensure that the needs of alcohol misusing offenders are addressed in commissioning these improved treatment services.

The Prison Service has published an Alcohol Strategy to support this work, and the Probation Service is developing a Delivery Strategy for publication this year.

Treatment through sentencing

A Community Order (see above) can also include an alcohol treatment requirement (ATR). The ATR is targeted at much the same group of offenders who are currently suitable for a Community Rehabilitation Order (CRO) or Community Punishment and Rehabilitation Order (CPRO) with an alcohol requirement, although for an ATR to be made the offender’s dependency does not have to be linked to the offence(s).