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OFFICE OF THEDEPUTY PRIME MINISTER

ISBN 1-84082-9397

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be obtained from prolog.uk.com

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email: [email protected]

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the Home Office Drugs Strategy Directorate

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Fax: 020 7273 3821

email: [email protected]

www.drugs.gov.uk

Updated DrugStrategy 2002

252921 Updated Drug Cover 11/30/02 1:23 Page ii

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Contents

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3 Home Secretary’s foreword

4 What’s new?

6 Executive summary

14 1. Young people

26 2. Reducing supply

38 3. Communities

252921 Updated Drug Cover 11/30/02 1:23 Page iv

50 4. Treatment and harm minimisation

60 5. Delivery and resources

66 6. Delivering the Strategy across the UK: Scotland, Wales and Northern Ireland

72 Annex 1: The National Crack Action Plan:Executive summary

75 Annex 2: The evidence base in detail

80 Bibliography

252921 Updated Drug Strategy 11/30/02 2:22 Page 1

3

If there is one single change which has affected the well-being of individuals, families and the wider community overthe last 30 years, it is the substantial growth in the use ofdrugs, and the hard drugs that kill in particular. The miserythis causes cannot be underestimated. It damages thehealth and life chances of individuals; it undermines familylife, and turns law-abiding citizens into thieves, includingfrom their own parents and wider family. The use of drugscontributes dramatically to the volume of crime as userstake cash and possessions from others in a desperateattempt to raise the money to pay the dealers. In addition,otherwise decent people become dealers in pyramidselling, as they persuade friends, acquaintances andstrangers to take on the habit, so that they themselvescan fund their own addiction.

Very often jobs and homes are lost; friendships and familyties are broken. Where children are involved there is thedanger of abandonment and neglect. Day-to-day functioningbecomes a matter of good fortune in terms of income,the availability of treatment and rehabilitation, and the pointat which help is available.

Quite simply, drug misuse contributes enormously tothe undermining of family and community life - more,some may say, than any other single commodity or socialinfluence. That is why getting it right matters so much.

I am grateful to all those who worked on developing andimplementing the first fully integrated Drug Strategy,including the many front-line staff from treatment and youthworkers, to police, customs and prison officers whoseefforts are making a real difference in the way services aredelivered. Overall, Class A drug use is stable, but that is notgood enough. There are worrying increases in the use ofcocaine and crack. This is why we must have clear andunequivocal messages about cocaine, crack, heroin andecstasy; the clampdown in policing, intelligence, andCustoms to back this up; and new policies to break thetrafficking routes and the intermediate market between thedealer on the street and international criminal organisations.We must achieve real reductions in the level of problematicuse if we are to turn around the lives of individuals and theircommunities.

This Updated Drug Strategy is a chance to build onwhat we have learnt to date. Prevention, education, harmminimisation, treatment and effective policing are ourmost powerful tools in dealing with drugs.

All problematic users must have access to treatment andharm minimisation services, both within the communityand through the criminal justice system. The availabilityof treatment is growing and waiting times are comingdown. However, I share the frustration of those users andtheir families who have been waiting too long for urgentlyneeded treatment. Provision of treatment is still far toopatchy and variable and accessing rehabilitation supportafter treatment, a lengthy and difficult process. Serviceswill be expanded so those chaotic drug users seekinghelp do not have to wait.

We need also to provide direct support to parents andfamilies. My heart goes out to those who have struggledto prevent their offspring falling into addiction and to copewith the trauma and effect on the family of those addictedto Class A drugs. We will be looking to improvingsubstantially support to families at local level.

Young people are our highest priority. They need goodquality drug education, information and advice based ona credible assessment of the damage drugs do, within aframework which makes clear that all controlled drugs areharmful and will remain illegal. To prevent them fromturning to drug misuse, they must also be protected fromdrug dealers and the pressures of living in neighbourhoodswhere drugs are too often an everyday reality.

The measures we are taking to tackle demand need tobe complemented with measures to reduce supply.Our aim is to prevent drugs entering the country, to tackletheir distribution within the country and to make the UK adifficult and undesirable country in which to traffick drugs.

We are not starting from scratch. We are learning from,building on, and adapting the 10-year strategy adopted in1998. If we are to succeed, we must have continuity,persistence and the determination to make a realdifference. Future generations should never have toface the dangers and harm that drugs present to toomany of our young people, their families and theircommunities today.

David BlunkettHome Secretary

Home Secretary’s foreword


• A tougher focus on Class A drugs. The misery causedby the use of crack, cocaine, heroin and ecstasy cannotbe underestimated.

• A stronger focus on education, prevention,

enforcement and treatment to prevent and tackle

problematic drug use. The 250,000 class A drug userswith the most severe problems who account for 99% ofthe costs of drug misuse in England and Wales and domost harm to themselves, their families andcommunities.

• More resources. Planned direct annual expenditure fortackling drugs will rise from £1026 million in this financialyear to £1244 million in the next financial year, £1344million in the year starting April 2004 to a total annualspend of nearly £1.5 billion in the year starting April 2005– an increase of 44%. New areas of spend include:

• More support for parents, carers and families so theycan easily access advice, help, counselling and mutualsupport, a new education campaign for young people

based on credible information about the harm whichdrugs cause, increased outreach and communitytreatment for vulnerable young people and expandedtesting and referrals into treatment within the youthjustice system so that by 2006 we will be able toprovide support to 40-50,000 vulnerable youngpeople a year;

• Reducing the availability of drugs on our streets

through new cross-regional teams to tackle middlemarkets – the link in the chain from traffickers to localdealers, targeted policing to crack down on crack, andincreased assistance to the Afghan Government toachieve their aim of reducing opium production with aview to eliminating it by 2013. A review of the impactof interventions on the drug supply chain frominternational production to distribution within the UKby the Government’s Strategy Unit working with theHome Office and other key departments.

• Further expansion of treatment services appropriatefor individual need reduced waiting times, improvedtreatment for crack and cocaine, heroin prescribing forall those who would benefit from it and more harmminimisation – with improved access to GP medicalservices. By 2008, we will have the capacity to treat200,000 problematic drug users;

• A major expansion of services within the criminal

justice system using every opportunity from arrest,to court, to sentence, to get drug-misusing offendersinto treatment - including expanded testing, improvedreferrals, and new and expanded communitysentences. By March 2005, we will have doubled thenumber of Drug Treatment and Testing Orders;

• New aftercare and throughcare services to improvecommunity access to treatment and ensure thoseleaving prison and treatment avoid the revolving doorback into addiction and offending. By April 2005,all Drug Action Teams will have a co-ordinated systemof aftercare in place.

• Better targeting: focussing on the communities withthe greatest need.

• We will be strengthening capacity to deliverin those areas which have the greatest problems.

Although services will be rolled out across thecountry we will be piloting and developing newservices for young people and new interventionswithin the criminal justice system, first in the areasof greatest need.

• We will improve services in those communities

affected by crack. The National Crack Action Plan willlead to fast-track crack treatment programmes in theworst affected areas, new police initiatives to closecrack markets and new diversionary programmes foryoung people.

• A renewed emphasis on delivery and revised targets

which are challenging but achievable: reducing theuse of the most dangerous drugs and patterns of druguse by young people, with a particular focus on the mostvulnerable; tackling prevalence through a three prongedattack on supply, dealers and traffickers, and assets,and on working with the Afghan government to reduceopium supply; reducing drug related crime;and continuing to expand drug treatment but alsoimproving its quality.

What’s new?

4 What’s new


5

The unparalleled investment to tackle the harm

drugs cause communities, families and individuals

will be initially focused in the most damaged

communities. The full range of education,

prevention, enforcement, treatment and harm

minimisation initiatives will be brought to bear in

these communities. The vision is that these will be

extended across the country in due course.

In the most deprived areas, currently suffering the

worst drug-related crime:

• Parents, carers and families will have greater

access to advice, help, counselling and mutual

support in relation to drug misuse. A major new

national education campaign will also drive home

the risks of drug misuse.

• Those young people who are most at risk of

developing drug problems will be helped through

increased outreach and community treatment.

They will also benefit from new initiatives

extending drug testing and referrals to treatment

and care via the youth justice system. They will

have available an improved range of diversionary

activities, with opportunities, through sports and

art, to develop skills and enhance their life

chances.

• The community will be protected from the

harmful flow of drugs on to the streets. Policing

activity will include cross-regional work to tackle

middle market supply and the strengthening of

local policing to disrupt supplies on the street

and crack down on crack markets.

• The most persistent offenders will be targeted

through new pre-arrest initiatives to steer them

into treatment. Assessments will be undertaken

with local partnerships to ensure that these take

a form that meets community needs.

• Drug misusing offenders in the community will

be identified and engaged in treatment and

support at every opportunity via the criminal

justice system. For example:

• There will be an extension of drug testing in

police custody.

• Extra resources will be made available so that

everyone arrested who appears to have a drug

problem will be referred to an arrest referral

worker. A new initiative will come on stream

to allow drug-misusing offenders to be given

the choice by the courts, of entering treatment

where appropriate, or being denied bail –

a “presumption against bail”.

• Extension of availability of Drug Testing and

Treatment Orders will ensure that everyone

who would benefit will have these available.

The vast majority of people with drug-related

problems, committing less serious offences,

will be subject to new community

sentences with treatment conditions.

More drug-misusing offenders will be taken

out of the criminal justice system and provided

with the treatment and support they need –

when they need it.

• Those entering prison will benefit from

improvements in the quality and coverage of

prison-based treatment programmes which

meet national standards.

• All those in the community who need treatment

and support services will have help available

when they need it and appropriate to their

individual needs. This will include greater help for

those suffering, as dealers are removed from the

community; for crack and cocaine users; and for

those who would clinically benefit from properly

supervised heroin prescribing.

• Those leaving prison and treatment will benefit

from a new aftercare and throughcare system

to ensure they receive the support/treatment

they need and do not return to drug misuse

and offending, or start out on the whole

system again.


This updated strategy sets out a range of policies andinterventions which concentrate on the most dangerousdrugs, the most damaged communities and the individualswhose addiction and chaotic lifestyles are most harmful,both to themselves and others. We have no intention oflegalising any illicit drug. All controlled drugs are dangerousand nobody should take them.

The most effective way of reducing the harm drugs causeis to persuade all potential users, but particularly the young,not to use drugs. Success will only be achieved if we stopyoung people from developing drug problems, reduce theprevalence of drugs on our streets and reduce the numbersof those with existing drug problems by getting them intoeffective treatment.

Tackling the scourge of drugs is a challenge for us all, notjust a matter for Government or its agencies. By workingtogether and focusing on the drugs that cause the mostharm, we will:

• prevent young people from using drugs by maintainingprohibition which deters use and by providing educationand support: targeting action on the most dangerousdrugs and patterns of drug use and the most vulnerableyoung people;

• reduce the prevalence of drugs on our streets: tacklingsupply at all levels from international traffickers, toregional drug barons and street dealers, with anincreased emphasis on intelligence sharing and effectivepolicing and confiscating the proceeds of drug trafficking;

• reduce drug-related crime: providing support to drugmisusers and communities most in danger of beingdestroyed by drugs; working together to create stable,secure, crime-free lives and neighbourhoods; and takingevery opportunity within the criminal justice system andwithin the community to refer people into treatment; and

• reduce the demand for drugs by reducing the number ofproblematic drug users – those individuals who alreadyhave serious drug problems: providing effectivetreatment and rehabilitation to break the cycle ofaddiction whilst minimising the harm drugs can cause.

The current positionAround 4 million people use at least one illicit drug eachyear and around 1 million people use at least one of themost dangerous drugs (such as ecstasy, heroin andcocaine) classified as Class A. Many of these individualswill take drugs once, but for around 250,000 problematicdrug users in England and Wales, drugs cause considerableharm to themselves and to others.

Drug misuse gives rise to between £10 billion and£18 billion a year in social and economic costs, 99% ofwhich are accounted for by problematic drug users.

There are strong links between problematic drug use andcrime. Around three-quarters of crack and heroin usersclaim to be committing crime to feed their habit. 75%of persistent offenders have misused drugs and arresteeswho use heroin and/or cocaine commit almost 10 timesas many offences as arrestees who do not use drugs.

It is therefore essential that we concentrate on preventingand treating problematic drug use and working with ourmost damaged communities if we are to reduce the harmdrugs cause.

The Updated Drug StrategyIn 1998, the Government introduced the first cross-cuttingstrategy to tackle drugs in an integrated way. This updatebuilds on the foundations laid and lessons learned.

Over the last year, we have been reviewing the DrugStrategy to sharpen its focus and improve its effectiveness.The findings and recommendations of the Home AffairsCommittee and the work of the Audit Commission, theAdvisory Council for the Misuse of Drugs, the HealthAdvisory Service, the Police Foundation and others havecontributed to the review.

Substantial resources are being invested. Planned directannual expenditure for tackling drugs will rise from £1026million in this financial year to £1244 million in the nextfinancial year, £1344 million in the year starting April 2004to a total annual spend of nearly £1.5 billion in the yearstarting April 2005.

Reducing the harm that drugs causeto society – communities,individuals and their families

6 Executive summary

Executive summary


7

All controlled drugs are dangerous and no one should takethem. Universal programmes of education and informationwill give all young people and their families the informationand skills they need to protect themselves from the risksand harm of all drugs. The most vulnerable young peoplewill get support before drug problems escalate.

Since 1998, universal programmes of education andinformation have been expanded. Substance misuseeducation is now part of the National Curriculum and 80%of primary and 96% of secondary schools have adopteddrug education policies.

Much has also been done to improve how we identify andsupport the most vulnerable young people:

• 80% of England is covered by the new ConnexionsService who identify young people with drug problemsand arrange for specialist help as a part of their widerrole to support all young people.

• All Youth Offending Teams (YOTs) have named drugworkers who assess and arrange for support for youngoffenders with drug problems.

• Treatment services for young people, includingdetoxification and community prescribing are nowprovided in 80% of Drug Action Team (DAT) areas.

• Positive Futures – using sport and arts to engage themost vulnerable young people by developing skills tohelp them resist drugs and re-enter education andtraining – are available in 57 of our most disadvantagedcommunities.

16,000 young people currently receive support from localauthority and health services including 4,000 supportedby drug treatment agencies and 3,000 by Positive Futuresprogrammes.

By March 2006 we will discourage young people fromusing drugs in the first place and support parents and familymembers who are worried about drugs by:

• Expanding the provision and improving the quality

of drug education so that by March 2004 all primaryand secondary schools have drug education policies andfurther improve the quality so that by March 2006,no drug education lessons will be described as ‘poor’by OFSTED.

• Launching in Spring 2003, a major new

communications campaign driving home the risks ofClass A drugs and encouraging young people and theirparents to seek further advice and help. It is vital that themessage to young people is open, honest and credible.The reclassification of cannabis will support this.

• Clamping down on dealers who prey on the young byincreasing the penalties for dealing Class C drugs by July2003 to match the already severe penalties for dealingClass A and B drugs.

• Expanding prevention programmes so that by March2004 all young offenders and pupils attending PupilReferral Units participate.

• Improving services for parents and carers by settingclear standards for the support offered to parents whoare concerned about substance misuse or whose familymembers have a drug problem.

We will expand the provision of substance misuse

treatment within the youth justice system to:

• Introduce drug testing and referral of young peoplefor treatment following arrest.

• Give courts the power to include drugs treatment as partof community sentences.

• Pilot and roll out new programmes of treatment andwider support for young offenders.

• Provide drugs workers in all juvenile custodialestablishments to organise programmes of prevention,treatment and support on release by December 2003.

We will also invest to help local authorities support youngpeople with drug problems. This will provide specialistsupport, outreach workers, training for professionalsworking with young people and an expansion of the

Preventing today’s young peoplefrom becoming tomorrow’sproblematic drug users


Positive Futures programmes. By March 2006 thenumber of young people with drug problems receivingsupport will include:

• 12,000 supported by YOTs and in juvenile custody;

• 28,000 supported by local authorities, health servicesand Connexions;

• 5,000 supported by Positive Futures programmes; and

• 5,200 supported by drug treatment agencies.

This means that by March 2006, we will have the capacityto support 40–50,000 young people with drug problemsevery year. By 2008 this will have driven down the numberof young people who go on to become future problematicdrug users.

Action under the Young people aim is set out in more detailat Chapter 1.

Reducing the supply of illegal drugs and tackling thetrafficking of all drugs is key. Progress since 1998 includes:

• establishing the Concerted Inter-Agency Drugs ActionGroup (CIDA) to co-ordinate operational activity acrossall intelligence and enforcement agencies;

• increasing the number of drug seizures – the results for2000 show a 53% rise in the number of cocaine seizuresand a 30% increase in heroin seizures compared with1997; the amount of drug-related assets recovered hasalso increased – £18.9 million from April 2001 to March2002, almost 20% up on the previous year;

• establishing the National Crime Squad and the NationalCriminal Intelligence Service in April 1998, with keypriorities of tackling hard drugs;

• more than 60 drug liaison officers are now in post in keydrug producing and transit countries, working to identifyillicit drug movements, related financial activities, thestructure of criminal organisations involved and providinghard intelligence for use in investigations;

• assisting EU candidate countries in their developmentof drug strategies and enforcement capabilities.The UK is a lead partner in a law enforcement projectacross 10 candidate countries and also involved inanti-drugs twinning projects in Bulgaria and theCzech Republic;

• the Proceeds of Crime Bill received Royal Assent inJuly 2002, strengthening investigation and confiscationpowers, and the Recovered Assets Fund has beenestablished; and

• following the fall of the Taliban, the UK has led inco-ordinating international efforts to help the AfghanGovernment counter narcotics production inAfghanistan.

We are continuing our focus on international trafficking,with a renewed focus on middle markets, local policing andtackling crack. New initiatives include:

• Increasing co-operation with countries on key supply

routes so as to increase the quantities of heroin and

cocaine taken out en route, at the border and within

the UK. We are: setting up a joint investigation teamwith Spain to investigate organised crime networksassociated with cocaine trafficking; working closely withthe Jamaican Government to disrupt the supply ofcocaine via Caribbean countries; in close touch with theTurkish authorities, both bilaterally and through the EU,on problems associated with heroin trafficking; andhosting a conference to address organised crime in theBalkans – including drug-related organised crime.

• Working closely with the Afghan Government to

reduce opium production with a view to eliminating

production by 70% by 2008 and in full by 2013.

The initial focus will be the 2003 crop.

• Enhancing intelligence capability and working in

co-operation with EU partners to tackle the secondarydistribution of heroin and cocaine from the EU and toprevent the diversion of precursor chemicals used tomake illicit drugs, such as ecstasy.

• Reviewing the impact of interventions on the drug

supply chain from international production to distributionwithin the UK. The Government’s Strategy Unit workingwith the Home Office and other key departments willundertake a study.

Reducing the supply of illegal drugs

8 Executive summary


9

• Increasing the recovery of drug-related criminal

assets. The new Asset Recovery Agency will beestablished by February 2003.

• Targeting the middle markets. The police and otheragencies are working together to tackle one of the mostprofitable parts of the supply chain – cross-regionalmarkets. With close support from CIDA, this capacity isbeing built at a regional level. In addition to the existingteam in the West Midlands, middle market capacity willbe developed on Merseyside and in South and Mid Wales,before being spread across the rest of England and Wales.

• Strengthening policing to better disrupt local supply

markets. Police performance is being strengthenedthrough the work of the Home Office Drugs StrategyDirectorate and the Police Standards Unit. This involvesguidance, sharing best practice, developing new targetsand understanding drug markets. The Police Priority Areaprogramme supports local policing strategies to bettertackle multiple problems like drugs, addressing allaspects of policing.

• Taking high profile action against suppliers in

communities with particular problems. Recentinitiatives in Peterborough and Lambeth have shownhow working closely with local partners and thecommunity we can successfully deliver specialist actionto tackle local drug markets and associated crime. Forexample, the Lambeth initiative saw over 100 crackhouse raids, 564 searches and over 90 people arrested(see adjacent box).

• Tackling crack. Policing to disrupt crack markets willbe intensified in the areas most affected. Specialisttreatment for crack addiction will also be increased andaction taken to deter usage. Following a conference inJune 2002, a National Crack Action Plan will be publishedbefore the end of December 2002. An advance summaryis contained at Annex 1 of this document.

• Heavily penalising those caught dealing or drug

trafficking with maximum sentences ranging from14 years (for Class B and C drugs) to life imprisonment(for Class A).

Action under the Reducing Supply aim is set out in moredetail in Chapter 2.

Lambeth – an example of what canbe achievedLambeth, with the major crack market of Brixton,

was an area where crack problems had reached

crisis point early in 2002, with open crack markets

and eighty plus crack houses. Accompanying the

use of crack was open street prostitution and the

use of guns. The local community had had enough

and wanted action.

In June 2002, the Home Secretary met with local

politicians and services to help develop an action

plan for crack. This has been put into action and

since June, Lambeth has made a major start

on tackling its problems. Over 100 crack house

raids have taken place. The achievements so far

have been:

• 33% fewer robberies have been reported;

• 90 plus people arrested;

• 564 searches made;

• 148 abandoned vehicles removed; and

• 118 prostitutes arrested and referred

to treatment.

The Lambeth community now knows that selling

crack will meet with a swift and decisive police

response. Much more action is underway as part

of a comprehensive multi-agency plan to tackle the

crack problem in the borough and much more is

needed to sustain the progress made, but Lambeth

shows that community pressure, coupled with a

rapid response can make a difference.


Nothing affects the well-being of local communities asmuch as drug misuse, drug-related crime and the fear ofsuch crime. Where communities are strong, drugs do nottake a hold. The highest incidences of drug-related crime,supply and drug-related nuisance occur in the communitiesthat suffer most from social deprivation.

Since 1998:

• new programmes have been established to get drugmisusers off drugs and out of crime through effectivetreatment – the key to reducing offending. Each year,arrest referral schemes have picked up around 50,000drug misusers at the point of arrest and referred theminto treatment or other programmes of help. DrugTreatment and Testing Orders have enabled around6,000 offenders per year to address their problemsthrough intensive community based programmes,and drug testing pilots have been introduced to testarrestees and better inform bail and sentencingdecisions. Their drug misuse and related crime rateshave dropped significantly as a result;

• the Jobcentre Plus initiative progress2work waslaunched in 2001 and the first participants started in2002. It helps recovering drug users find and sustainjobs – a key way of returning to more stable andconstructive life;

• £100 million has already been made available throughthe new Communities Against Drugs fund to supporttargeted, locally determined measures designed tostrengthen communities, disrupt the local drugs marketsand tackle drugs and drug-related crime; and

• guidance, training, information and support have beenprovided on housing management, neighbourhoodrenewal, homelessness and dance club managementto enable agencies and organisations tackle drug misusein the context of wider community problems.

To break the link between drugs and crime we are investingin a major new programme of interventions for adults andyoung people, which will move offenders out of the

criminal justice system and into treatment. Using everyopportunity from arrest, to court, sentence and on release,this programme will include:

• making arrest referral schemes more proactive andeffective;

• extending drug testing to those local police force areaswith the highest crime;

• piloting the introduction of presumption against bail

where offenders test positive for drugs but refusetreatment;

• doubling the number of Drug Treatment and Testing

Orders by March 2005;

• expanding treatment provision in prisons;

• providing comprehensive programmes of

throughcare and aftercare for treated drug misusersreturning to the community from prison, including post-release hostels, and for those leaving treatmentprogrammes who have not been in prison; and

• a package of corresponding, but appropriateinterventions for juveniles.

Action under the Communities aim is set out in more detailin Chapter 3.

Treatment works. It is the key to reducing the harm drugscause to users, family and communities. Investing intreatment is cost effective – for each £1 spent, anestimated £3 is saved in criminal justice costs alone.Effective treatment includes a range of interventions andsupport: such as advice, harm reduction, prescribing andrehabilitation services tailored to individual need andsupported by general health and social care agencies.

Reducing drug use and drug-related offending through treatmentand support.

Reducing drug-related deaththrough harm minimisation.

Reducing drug-related crime and itsimpact on communities

10 Executive summary


• We are rapidly expanding services and are on track tomeet the target of doubling the number of people intreatment by 2008. 118,500 people attended treatmentservices between April 2000 and March 2001. Thenumber of people presenting for treatment increased onaverage by 8% per year from the year ending March1999 to the year ending March 2002.

• People are receiving treatment and support morequickly. The average waiting time between referral andreceipt of treatment in priority cases, reported fromlatest DAT returns for April 2001 to March 2002, was2.8 weeks (8.3 weeks for non-priority cases) acrossdifferent treatment types – such as in-patientdetoxification, prescribing, structured counsellingand residential rehabilitation.

• In November 2001, we published an action plan toreduce drug-related deaths by 20% by 2004 and toreduce the harm drugs cause. The plan covers threestrands: campaigns; better surveillance and monitoring;and research.

• 99% of health authorities in England have needleexchange programmes and over 27 million needles andsyringes are exchanged each year, reducing the risk ofdeath and the transmission of Hepatitis and HIV.

• We are getting more drug offenders out of the criminaljustice system and into treatment.

• The National Treatment Agency (NTA) was set up in2001 to oversee the expansion of high quality drugtreatment programmes in England.

Our aim continues to be to increase the participation ofproblem drug users in the full range of treatment servicesand increase the proportion of users successfully sustainingor completing treatment by 2008. There has been goodprogress but much more needs to be done to ensure thattreatment is readily available to those who need it. Throughnational and local action, this will be achieved by:

• Investing in additional and better quality treatment

services. An expansion in treatment provision will taketime to build – there is no quick fix solution. However, by2008, we will have doubled the capacity so that 200,000problematic drug users can be treated per year in thecommunity or in a residential setting, as appropriate.

• Filling the gaps in services. Drug users have differenttreatment needs, it’s not a case of one size fitting all.DATs and the NTA are committed to ensuring that allareas have access to an adequate range of services –including advice and harm reduction; GP and specialistprescribing; detoxification and rehabilitation, includingresidential services; and that new provision is evidence-based and effective.

• Services for crack and cocaine users will be expandedfrom Spring 2003 with the development of new fast-track agencies – first in areas of greatest needand later across the country – along with newguidance, improved training and support for frontline drugs workers.

• All those who have a clinical need for heroin

prescribing will have access to it under medicalsupervision, safeguarding against the risk of seepageinto the wider community.

• Reducing waiting times further. The growth intreatment capacity and improved efficiency of servicesmeans that by the end of March 2004, maximum waitingtimes from referral to receipt of treatment should be nomore than 2 weeks for in-patient detoxification and GPprescribing and 3 weeks for all other forms of treatment.

• Improving the health of drug takers through the

greater involvement of GPs. We will increase thenumber of GPs / primary care professionals workingwith drug users and improve access to healthcareservices for all problematic drug users, irrespectiveof prescribing needs.

• More referrals from the Criminal Justice System.

We will develop better links to treatment for drugoffenders in the areas with the highest levels of crime(see Chapter 3).

• Improving prison-based treatment provision.

An additional 2,000 intensive treatment programmeplaces will be created in prisons. New low intensityprogrammes will be introduced providing 17,000 placesfor those serving short sentences. The throughcareelement of the system will be enhanced to ensure bettercontinuity of treatment once prisoners leave custody.

Action under the Treatment aim is set out in more detailin Chapter 4.

11


12 Executive summary

Delivery of the Updated Drug StrategyThe problems of drug misuse are complex and requireintegrated solutions and co-ordinated delivery of servicesinvolving education, intelligence and enforcement, socialand economic policy, and health. Tackling drugs requireseffective joint working between Government Departmentsat national level and similar partnership working betweenagencies at local level.

High on the list of Government priorities, the Home Officedrives delivery of the Drug Strategy at Ministerial andofficial level, in partnership with the Department of Health,the Department for Education and Skills, HM Customs andExcise, the Office of the Deputy Prime Minister and theForeign and Commonwealth Office. Performance againsttargets is regularly monitored in formal reviews betweenthe Prime Minister and Secretaries of State and atofficial level.

The NTA drives delivery of treatment services throughoutEngland. With its regional management structure, it worksclosely with and through the Drugs Prevention AdvisoryService (DPAS) which is now integrated within GovernmentOffices in the Regions. This provides more effectivesupport at regional level for related issues such as drugs,crime, neighbourhood renewal and community cohesion.

The NTA and DPAS monitor the effectiveness of localdelivery by DATs through support and advice to ensureconsistency of approach and high quality provision.

We will work in partnership with DATs and local agenciesto develop and strengthen capacity to deliver, focusingin particular on supporting the accelerated roll out ofinterventions in areas with the greatest drug problems,to ensure effective delivery.

The delivery mechanisms are described in more detailin Chapter 5.

Action across the UKScotland, Wales and Northern Ireland use their devolvedpowers where appropriate to formulate policies thatcomplement the overall aims of the UK strategy. Anti-drugstrategies in Scotland, Wales and Northern Ireland deal withdrug-related problems specific to them. All three strategiesreflect the same four aims as the UK strategy, relatingto young people, reducing supply, communities andtreatment, but with specific objectives and action prioritiestailored to the particular problems and circumstancesin each country.

The different yet sympathetic approaches made tocombating the menace of drugs in all parts of the UK aremaking a real contribution to the continuing developmentof an evidence-based UK-wide Drug Strategy.

Action taken in Scotland, Wales and Northern Ireland is setout in Chapter 6.

ConclusionAs set out in the following chapters, this Updated DrugStrategy sets out the action that will be taken to ensurefuture generations never have to face the dangers andharm that drugs present today. It also provides a positiveroute out of addiction and crime for those whose livesare currently damaged by drugs.


13


14 Young people

Success for the Drug Strategy

means preventing today’s young

people from becoming tomorrow’s

problematic drug users. All

controlled drugs are dangerous

and young people and their

families need credible, realistic

information to protect themselves

from the risks and dangers of drug

misuse. Education is already a

central plank in the Government’s

Drug Strategy and we will

continue to expand and improve it.

But drug misuse does not occur

in isolation. It is associated with

other problems such as the

misuse of other substances (for

example, alcohol and tobacco),

youth offending, truancy and

school exclusion, family problems

and living in crime-ridden,

deprived communities. So

prevention programmes will be

targeted at the most vulnerable

young people and those who

develop drug problems will be

identified and supported early

before problems escalate.

This means that all agencies,

whether they be schools, Youth

Offending Teams or social services

departments, need to work

together to solve the whole

problem. Good progress has been

made. 16,000 young people are

already receiving support, and a

programme to more than double

this number by 2006 will drive

1. Young people

Action since 1998:• 96% of secondary schools and 80% of primary

schools have drug policies compared with

86% and 61% in 1997

• Substance misuse education is now part of the

National Curriculum

• 16,000 young people received support for drug

problems in 2000/01, 4,200 from specialist

treatment services

• All Youth Offending Teams have a named drug

worker

• Positive Futures initiative set up in 2000. Now

operating in 57 deprived areas

• 41 Connexions Services so far established.

All 47 by October 2003

• All DATs have developed Young People’s

Substance Misuse Plans to provide services

based on local need

• A major communications campaign in 2001

resulted in increased calls to the National

Drugs Helpline

Future action:• All schools to provide good quality substance

misuse education

• Prevention and Positive Futures programmes

to target the most vulnerable young people

• Support 40–50,000 young people with drug

problems every year by 2006 onwards

• New powers for drug testing and treatment

for young offenders

• New communications campaign on Class A

drug use from Spring 2003

• Clamp down on dealers who target young

people

• Improved services and better support for

parents, carers and families


The current situationTo succeed, the Government muststop young people swelling the ranksof future drug users. Treatment worksbut we will only drive down levels ofdrug crime if the number of new drugmisusers also falls. That is whyprevention and early intervention withyoung people, before problemsescalate, is the only way to make along-term difference.

Prevalence• Around 4 million people have used

at least one drug in the last yearand around 1 million have usedat least one Class A drug (Aust etal, 2002).

In 2001/02, about a third of thoseaged between 16 and 59 reportedhaving used drugs in their lifetime.However, only 12% had used themin the last year and 8% in the lastmonth. 11% had used cannabis inthe last year, 2% used cocaine, 2%

used ecstasy and fewer than0.5% used heroin or crack (Austet al, 2002).

• Drug use among young peopleaged 16–24 is higher and usagepatterns are different.

49% have used an illicit drug intheir lifetime, 30% in the last yearand 19% in the last month.Cannabis was the most commonlyused, with 27% using it in the lastyear. 5% had used cocaine, 7%ecstasy and less than 1% heroinor crack (Aust et al, 2002).

• Drug use by young peopleincreased throughout the 1980sand early 1990s. Since 1998, theproportion of 16–24 year olds usingClass A drugs in the previous yearhas remained stable at about 8%.This is an encouraging sign but areal downward shift has still tobe achieved.

The number of 16–19 year oldsusing drugs in the last year fellfrom 34% in 1994 to 28% in2001/02. However, within thesame group there has been aworrying increase in the use ofcocaine (Aust et al, 2002).

• Men are twice as likely as womento have taken an illicit drug in thelast month or year. However, thisdifference narrows for younger agegroups (Ramsay et al, 2001).

A survey of 11–15-year-old schoolchildren across England found onlya small difference in drug usebetween boys and girls (Goddardand Higgins, 2000).

• Drug use is greatest amongst thewhite population, irrespective oftheir age.

15

down the numbers of young

people who go on to become

problematic drug users.

Parents, carers and families also

need support. They experience the

problems that drugs cause at first

hand, and have a key role in

helping young people with drug

problems overcome them. They

will receive improved services

and support.


16 Young people

With the exception of crack, whitepeople consistently have higherprevalence rates for all types oflifetime drug use. Low levels ofdrug use have been foundparticularly among the South Asianand Black African communities.However, primarily due to cannabisuse, members of the African-Caribbean community have similarlevels of drug use to the whitepopulation. Qualitative data alsoindicates that problematic druguse exists in the more recentlyestablished minority ethniccommunities, based largely onrefugee migrations (Sangsteret al, 2002).

FrequencyMany young people will experimentwith substances – most commonlyalcohol and tobacco – at some point intheir lives. Around half will try anillegal drug on at least one occasion,

usually cannabis. Whilst risk-takingand experimentation are a part ofgrowing up, there are some risksthat are just not worth taking.Young people are in greatest danger ifthey do not understand the risks or donot have the confidence to protectthemselves in dangerous situations.Even relatively small amounts ofillegal drugs, if used on a frequentbasis, can have short-term effects onmemory or educational performancewhilst others (such as ecstasy) cancause severe reactions in someindividuals.

For a much smaller number of youngpeople, although possibly as many as100,000, the consequences ofsubstance misuse are much moreserious. These young people candevelop physical or psychologicaldependence on drugs, mostfrequently heroin and crack or powdercocaine, and may become trapped in

a vicious circle of substance misuse,crime or prostitution. Their families,friends and their local community canpay a heavy price.

In 2002, the percentage of youngpeople aged 16–24 reporting use ofillegal drugs at least twice a month inthe last year breaks down as follows:

• Cannabis – almost 18%• Ecstasy – 2%• Cocaine – less than 1%• Heroin – 0.5%*• Crack – 0.2%*

*Based on fewer than 20 users withinthe sample.

Among this age group, regular use ofcocaine, heroin and crack is relativelyrare. Most regular use involvescannabis, while ecstasy is the mostregularly used Class A drug.

0

2

4

6

8

10Class A drug use

Ecstasy

Cocaine

Heroin

Crack

2001/02200019981996

Drug consumption among 16-24 year olds in the last year (BCS)

Percentage

Year of survey

Source: 1994, 1996, 1998, 2000 and 2001/02 BCS (weighted) data


RiskAll drug use carries risks, but the useof Class A drugs and the frequent use(i.e. at least 2–3 times a month everymonth in the last year) of any drugcarries the greatest risk. Those youngpeople who do so are the most likelyto go on to become problematicdrug users.

Since 1998, the proportion of 16–24year olds who used Class A drugs inthe previous year has remained atabout 8%, but there has been a smallbut worrying increase in the use ofcocaine, crack and ecstasy. Around18% of 16–24 year olds use anillegal drug at least 2 or 3 timesevery month.

This means that around 1 millionyoung people are at risk of becomingproblematic drug users, and thataround one in ten of these will goon to develop longer-term addictionor health problems.

Research suggests that there areprotective factors that reduce a youngperson’s likelihood of succumbing toproblematic drug use – factors suchas effective parenting or support froma caring adult, educational attainment,a healthy lifestyle, high self-esteemand early action to tackle problembehaviour before it escalates. But theopposite is also true. Young offenders,homeless young people, schoolexcludees and young people in localauthority care, or those living in areaswith high levels of drug crime,experience much higher levels ofdrug-related harm than average. Someminority ethnic communities aredisproportionately represented withinthese groups: for example, the lateststatistics show that African-Caribbeanboys are around three times morelikely than other pupils (includingthose from other minority ethnicgroups) to be excluded from school.

These vulnerable young people,who are more at risk of developingdrug problems than others, will bea particular focus for Governmentaction.

Action to dateConsiderable progress has alreadybeen made in raising young people’sawareness about the dangers of drugmisuse and targeting support at morevulnerable young people.

Information and awarenessTo protect themselves and to enablethem to make the decision not totake illegal drugs, young peopleneed accurate information aboutthe dangers and harmful effectsof different drugs and why they areillegal. They need to know wherethey can get further information orhelp if they need it, and they need theconfidence to act on this information,resist drug misuse and achieve theirfull potential in society.

17

0

1

2

3

4

5Class A drug use

Ecstasy

Cocaine

Heroin

Crack

2001200019981996

Drug consumption among 16-24 year olds in the last month (BCS)

Percentage

Year of survey

Source: 1994, 1996, 1998, 2000 and 2001/02 BCS (weighted) data


18 Young people

Schools have a key role in achievingthis. Giving young people the relevantskills and knowledge is one steptowards reversing the terrible damageand waste caused by drug misuseand safeguarding the health and well-being of future generations.To support this, since April 2001,schools have had access to a SchoolsDrug Advisor to help them deliverdrug education and support tailored tothe needs of pupils. A drug, alcoholand tobacco education trainingpackage has been developed tosupport professionals in deliveringeffective drug education whichresponds to young people’s needs.

The proportion of secondary schoolswith drug policies has increased from86% in 1997 to 96% in 2002, while inprimary schools the figure has gonefrom 61% to 80%. Ofsted haveinspected a sample of Key Stage 2primary school substance misuse

education: the proportion rated as“poor” improved from 16% to 10%between 2000 and 2002. To improvethe quality of substance misuseeducation, the National HealthySchool Standard has been establishedand substance misuse education isnow part of the National Curriculum.Additionally, the Home Office,Department of Health and theDepartment for Education and Skills(DfES) have initiated a long-termresearch programme (Blueprint) toprovide a rigorous evaluation of whatworks in drug education, in schoolsand in communities.

Support for familiesDrug misusers blight not only theirown lives, but also those of theirfamilies and others close to them.The impact of drug misuse on theparents, siblings, partners and childrenof drug misusers can include violence,neglect, mental illness, as well as all

the side-effects arising from thepoverty associated with drug misuse.

Parents, carers and families have avital role to play in reinforcing whatyoung people learn at school. This isespecially important in some minorityethnic communities where drug usersare particularly stigmatised, and theissue needs to be handled sensitively.Parents’ attitudes to alcohol andsubstance use, and the extent towhich they feel able to discuss thesewith their children, help young peopleform their own attitudes to substanceuse. Young people who feel able totalk to their parents about drugsare much less likely to becomeproblematic drug users, and parentscan play a major part in helping youngpeople with drug problems get overthem. Information for parents onsubstance misuse is now provided inmost schools, health centres, policestations and libraries. The first stage

Ecstasy is a dangerous drug that

can, and does, kill unpredictably:

there is no such thing as ‘a safe

dose’. There is still much to

learn about the harm ecstasy

can cause, and the Government

is clear it should remain as a

Class A drug. The number of

people taking and dying from

ecstasy must be reduced.

Ecstasy was one of the drugs on

which the Government focused

in the communications

campaign launched at the end of

2001. Through youth media and

for those travelling abroad,

the Government continues to

publicise the risks and dangers

of all Class A drugs including

ecstasy. Guidance such as the

recently published Safer

Clubbing encourages

co-operation and information

sharing amongst key agencies,

club owners and promoters to

reduce the prevalence and

danger of drugs in clubs.


of a major communications campaign(focused on the risks of using ecstasyand cocaine by challenging youngpeople’s understanding of the harmdrugs cause) was launched inDecember 2001, targeting youngpeople, their families and carers.It resulted in an encouraging increasein calls made to the National DrugsHelpline – 0800 776600.

Targeted actionAlthough drug education andinformation must be universallyavailable, targeted action is alsoneeded to prevent the most vulnerableyoung people from getting involved indrugs. Young people living in highcrime areas – particularly areas whereClass A drugs are widely available –can easily get caught up in a youthdrugs culture. In response to this,in 57 areas the Government has set upPositive Futures Initiatives, using sportand art to engage the most vulnerable

young people by developing skills tohelp them resist drugs and re-entereducation and training. Many of the 26Health Action Zones’ Drug preventionprojects working with vulnerableyoung people, initially funded until2001, are continuing, whilstCommunities Against Drugs (CAD)funding has been used, and willcontinue to be used, to fund youthprojects in many other communities(see Chapter 3).

By identifying those with drugproblems before they escalate, youngpeople can be helped to avoidspending years of their lives trappedin a cycle of addiction.

Connexions Partnerships, which arecurrently being established acrossEngland, aim to provide all 13–19 yearolds with access to the support theyneed to take part effectively inlearning and make a successful

transition to adulthood. In some casesConnexions will identify and referyoung people with drug problems tospecialist support. The majority ofConnexions Partnerships are alreadydelivering support to young people,and all 47 Partnerships are due tobecome operational in 2003.

ConnexionsSummer Plus A strand of the Street Crime

Initiative aimed at young

people aged 8–19 most at

risk of committing crime,

including drug-related

offending, the scheme offered

key worker support and access

to a full-time programme of

activities during the 2002

summer period.

19


Most young people with drugproblems do not need specialist drugtreatment. Their drug misuse is notyet entrenched and reflects otherpersonal and social problems, whichare best met within mainstreamchildren’s services.

Learning mentors are helping youngpeople overcome drug problems andreturn to full-time education. Learningmentors are based in schools includedwithin the Excellence in Citiespartnership, many of which haveclose working relationships with DATs.

Given the strong links between drugsand crime, since 2002 all YouthOffending Teams (YOTs) have anamed drug worker to oversee theassessment, case management andtreatment of young offenders withdrug problems.

Young people with more complexdrug problems may need to bereferred to a young people’streatment service. These have alsobeen expanded with 80% of DATareas now providing detoxification and76% community prescribing for youngpeople. In 2000/01, 4,200 youngpeople received specialist treatmentor other support for drug problems(DAT returns, April 2002).

Working togetherClose working between departments,combined with the Government’srecent cross-cutting review of childrenat risk, has helped to ensure thattargets and initiatives from the DrugStrategy underpin other Governmentaction on children and young people.At a local level, local authorities,Primary Care Trusts, YOTs and theConnexions service are all involved indelivering the Drug Strategy withimportant support from the voluntarysector and community organisations.

To ensure that both universal andtargeted services are provided in allareas, all DATs have developed YoungPeople’s Substance Misuse Plansworking in close partnership with localchildren’s service planners. Theseplans have played a major role inimproving the planning and delivery ofservices to ensure that young people,their parents and carers are identifiedand supported through effective co-ordination between the variousagencies involved.

Lessons learnedSince 1998 a good deal has beenlearned about how to deliver joinedup services which really make adifference to young people and theirfamilies. Tackling substance misusemust be an integral part of theGovernment’s agenda to tackle widersocial problems, while preventionneeds to be focused on vulnerableyoung people and more deprivedcommunities. It is also clear that adult

20 Young people

When Terry first started he wasexcluded from school and bannedfrom every single youth club.

Positive Futures was the onlyprogramme and initially he wasinvolved only in the kick-aboutsessions. Then, through the PFprogramme, he became involved in afootball team, first playing, then ascaptain. This brought him a lot closerto the whole project. He began

attending a broader range ofprogrammes and helped set up anexchange with Norway and theCaribbean. At 16, he gained aCommunity Sports Leader Award,got the FA Junior Team Manager’sCertificate and is currently studyingfor the FA’s Coaching Certificate whileattending the local college where heis working towards a BTEC in Sportand Leisure. Having worked on avoluntary basis for the last year, he is

being paid to coach the under-12ssoccer school. He is also looking atuniversity courses.

Case history: Positive Futures


treatment services do not work foryoung people, who need tailor-madesupport fully integrated within thewider provision of children’s services.

Providing substance misuse educationis not enough. Information for youngpeople needs to be accurate andcredible and young people need theopportunity to talk about what theyare being taught. To ensure that drugeducation is effective, schools need totailor their approach to pupils’ needs.It is up to teachers and schools, whoknow the needs and circumstances oftheir pupils best, to decide whichapproaches and resources to use.

An extensive consultation andplanning exercise aimed at exploringways of improving the planning andcommissioning of young people’sservices found that existingarrangements made it difficult toidentify and allocate funding and

discouraged integrated approachesto service delivery. Those consultedsupported the simplification of fundingarrangements by bringing togetherfunding streams into a pooled budget,ring-fenced for use by young people’ssubstance misuse services.

The 1998 target to reduce Class Adrug use by 50% by 2008 wasaspirational. The Government’sreview found that this target wasnot achievable. Neither did it focuson those most at risk fromproblematic drug use – the very fewwho use drugs on a more frequentbasis and are often the mostvulnerable. In this Updated Strategy,changes have been made to thetarget to reflect this reality.

Achieving the Drug Strategy alsodepends on reducing the number ofyoung people who go on to becomeproblematic drug users. Targeting the

most vulnerable young people early,before problems escalate, is the mosteffective way of doing this. It isestimated that each successfulintervention with a juvenile wouldsave £56,000 in social costs.

Identifying and supporting youngpeople with drug problems is bestachieved by complementingmainstream children’s services(including local authorities, YOTsand Connexions) with specialistprevention and treatment services.

What next?The Government’s revised target isto have reduced the use of Class Adrugs and the frequent use of all illicitdrugs by all young people and,in particular, by the most vulnerablegroups by 2008.

21


This will be achieved by:

• ensuring that all young people

understand the risks and

dangers of drugs and their use,

and know where to go for advice

or help;

• protecting young people by

clamping down on dealers;

• providing improved services and

better support for parents, carers

and families;

• expanding prevention

programmes and placing more

emphasis on early interventions

with vulnerable young people:

expanding outreach work,

developing more places in

community treatment and care;

extending diversionary activities

like Positive Futures;

• introducing drug testing and

treatment of young people on

arrest, in youth custody or as

a condition of community

sentences;

• targeting communities with high

crime or drug problems

including a focus on the areas

affected by crack;

• maintaining the emphasis on

joined-up children’s services; and

• providing support for 40–50,000

young people with drug

problems each year from

2006 onwards.

Significant additional funding is beingmade available over the period2003/04 to 2005/06 to supportinitiatives for young people.

Information and awarenessThe Government will support teachersand local education authorities toimprove the quality of substancemisuse education by producingrevised DfES guidance, which willbring together the best of the currentguidance into one consolidated sourceof information. This will includeinformation on how to use harder-hitting images, such as those thatdepict the impact of drug misuse onfamily and friends, without youngpeople rejecting them as unrealisticor misleading.

The Government is also consideringhow substance misuse educationcan be provided in post 16-year-oldeducation settings, when statutorydrug education ends.

A 3-year communications campaignwill be launched targeting youngpeople and their parents to further

22 Young people

It is vital that the Government’s

message to young people is open,

honest and credible. Drug laws

must accurately reflect the

relative harms of different drugs

if they are to persuade young

people in particular of the

dangers of misusing drugs.

Cannabis is unquestionably

harmful but does not destroy

lives in the same way as heroin,

crack, cocaine and ecstasy.

To ensure that this aim is met,

the Government will reclassify

cannabis from Class B to Class C

under the Misuse of Drugs

Act 1971.

Reclassification should not detract

from the simple message to all –

and to young people in particular –

that all controlled drugs are

harmful and no one should take

them. For this reason the

Government will launch a

campaign to educate young people

and the public about cannabis, to

ensure that the clear message that

all controlled drugs are illegal and

harmful continues to be heard and

heeded by all. Information about

changes in the legal status of

cannabis and the health risks

associated with its use will be

widely distributed to young

people, their parents and teachers.

Reclassification of cannabis


raise awareness about the risksand dangers of drug taking andto encourage discussion ofsubstance misuse.

Support for parents and carersFamily members are usually the firstto spot that a young person is havingproblems and the first to providesupport, and can influence thesuccess of any drug intervention theirchild receives. Parents are also a keygroup needing support in their ownright, often experiencing enormousfear and concern and feeling they aredealing with problems alone.This situation cannot continue andthe Government is committed toextending provision for parents andfamilies. The Government will besetting standards for local support forparenting across a wide range ofissues, including substance misuse,within a proposed NationalFramework for Parenting Support.

Parents caring for a young personwith a substance misuse problem willhave access to a range of servicesincluding information, first aid trainingand advice on treatment options.Delivering this range of servicesneeds close co-ordination betweenmainstream and specialist services.

Targets have been set for DATs toensure that support for families isaddressed through the developmentof substance misuse services foryoung people. Parents will also beconsulted on the development andprovision of young people’s substancemisuse services and service qualitystandards. Mainstream services arealso being encouraged to provideinformation and support for parentsconcerned with substance misuse.Young people, too, will be encouragedto involve their parents withinprogrammes of treatment wherepossible and/or appropriate.

Targeted actionVulnerable groups of young people,such as school excludees or youngoffenders, are more likely to miss outon drug education lessons at schooland often feel much less able to ask foradvice or support on drug issues.By spring 2004, all young offendersand those attending Pupil ReferralUnits will benefit from substancemisuse education and preventionprogrammes. Positive Futures andother prevention and diversionprogrammes will also target youngpeople in high crime areas whilst newresearch to be published in spring 2003will help those working with vulnerableyoung people provide preventionprogrammes based on evidence of‘what works’.

23

It is important to leave no one

in any doubt that the supply

and possession of cannabis is

illegal and will remain illegal.

A new Association of Chief Police

Officers enforcement model will

be issued to all police forces so

that the law is applied

consistently, enabling the police

to prioritise scarce resources on

tackling traffickers and dealers –

those peddling misery and death

to others – making hard drugs

the target.


Working togetherYoung people’s substance misuseproblems cannot be tackled inisolation. From 2003, young people’streatment services will be expandedand new guidance on the screening,treatment and care of young peoplewith substance misuse problems willbe published and implemented.To ensure that young offenders withdrug problems get treatment as partof a wider programme of support andrehabilitation, the Government willexpand and develop interventionswithin the criminal justice system toensure that action on drugs forms partof the sentencing of young offenderswith substance misuse problems.

To drive forward the integration ofyoung people’s substance misuseservices within the wider provision ofservices for young people, a pooledbudget simplifying the way theseservices are funded will be piloted in

25 areas from April 2003. If the pilotsucceeds pooled budgets will be rolledout nationally from April 2004. Newtargets, combined with training forthose involved in commissioningservices, will result in the delivery ofuniversal, high quality services at locallevel. To ensure that services aremeeting the needs of all young people,DATs that have not already done so willassess the needs of young peoplefrom minority ethnic communities.

Integrating action on substancemisuse within wider Governmentprogrammes will deliver reductionsin substance misuse alongside highereducational achievement, betterhealth and less crime.

New ProgrammesAdditional funding between 2003–6from the 2002 Spending Review inthe youth justice system will provide:

• Arrest referral schemes for

young people. This initiative willsee the extension of the arrestreferral approach to young peopleon a pilot basis in areas with highlevels of drug-related crime.

• Community sentencing for

young people. This will provide forfeasibility studies and set up coststo establish by 2004/05, a systemfor providing courts with a range ofdisposals for young people in areaswith high levels of drug-relatedcrime.

• Drug testing for young people.

This will provide for the extension,on a pilot basis, of drug testing toyoung people.

• Drug workers in juvenile

custodial facilities. Funding willprovide for 100% coverage ofjuvenile custodial facilities, which

24 Young people

Hannah is 16 years of age. Beforejoining her current school in Year 11and working with a learning mentorHannah rarely attended class due toa serious drug problem. In addition toher drug problem, Hannah sufferedfrom low self-esteem and cared littleabout others or herself. As a result ofher drug habit, Hannah began toexperience epileptic attacks. Shebecame very ill and had seizures ona regular basis. The epilepsy causedHannah to miss a lot of school.

When Hannah finally balanced hermedication she moved to a newschool in a new area in an attempt torehabilitate herself. Hannah’s start atthe school was quite difficult.However, she soon met her learningmentor. Although Hannah was notfamiliar with the Learning Mentorprogramme, her mentor quickly madeher feel very much at ease andwelcome. In her own words,“She treated me not as a child or apupil just as a normal individual and

she did not judge me.” Hannah wassurprised by the treatment shereceived as in her knowledge and pastexperiences she found that theteachers and staff did not express thewish to develop a friendship orrelationship with their pupils.

A year ago Hannah could not haveimagined that she would be sitting herGCSE’s but as a result of the supportand encouragement from her learningmentor she has been able to do so.

Case history: Learning mentor


is estimated to impact on 4,500young people per year.

Additional funding between 2003–6from the 2002 Spending Review willalso be allocated to local authoritiesand spent in line with their PreventiveStrategy and Young People’sSubstance Misuse Plans to provide:

• Support for young people at

most risk. Prevention and earlyinterventions within mainstreamservices for 15,000 young peoplemost at risk of becoming PDUs.

• Specialist support and training.

To enable mainstream services(including local authorities, YOTs,Connexions) to achieve this,including detached drug outreachworkers where this is needed.

• An expansion of Positive

Futures.

• Crack. A focus on crack in areas ofhigh crack use.

Funding for specialist treatmentservices for young people throughthe pooled treatment budget will beexpanded by 30% from April 2003 andall areas which do not already do so,will be required to provide separatetreatment services for young people.

Together these programmes willmean that, by March 2006, 40–50,000young people at risk of becomingproblematic drug users will receivesupport through the youth justicesystem (12,000) and local and healthservices and Connexions (28,000)including over 5,000 through PositiveFutures and 5,200 from specialisttreatment services.

25

Her mentor always listened and offeredadvice, whether the matter waspersonal or educational. She helped settargets for Hannah that she neverthought she could achieve. They tookone day at a time and managed toreach all their goals.

Currently Hannah is back at schoolstudying GNVQ Health and Social Care.She is very happy and her home life haschanged dramatically. For the first timein years she has a family and friends

who are proud. Hannah would like tosee a lot more Learning Mentors in theUK. “But without the support and careof my learning mentor I would not bestanding here today and I would nothave achieved those things.”

Hannah is at present studying asAssistant Learning Mentor and haschanged courses to study Psychologyand Sociology in the sixth form.She has successfully recovered fromher drug habit.


26mReducing supply

Supply-side activity is a vital part

of the overall Drug Strategy and

complements efforts to reduce

demand through education,

treatment and harm minimisation.

A co-ordinated multi-agency

strategy to tackle drug supply at all

stages of the supply chain – from

the farmer growing the crop from

which the drugs are made, through

to the international trafficker

and the street dealer in the UK –

is already in place, and could have

a significant impact on the supply

of heroin and cocaine to the UK.

The strategy also looks at ways

of developing the law enforcement

capabilities of source and

transit countries.

Substantial quantities of heroin

and cocaine destined for the UK

market are successfully being

taken out, but the impact of the

international drug trade on the

UK market needs to be explored

further. There are gaps in our

knowledge of how the drug

trafficking business works and

the routes and methods used to

supply the market, especially

within UK borders, and these

must be addressed.

The focus on international

trafficking will continue. There will

be particular emphasis on

tackling the flow of heroin from

Afghanistan and enhancing

2. Reducing supply

Action since 1998:• Creation of the Concerted Inter-Agency

Drugs Action Group (CIDA) in 1999 and

comprehensive multi-agency action plans

in 2001

• Increases in the number of Class A drug

seizures and the amounts of drug-related

assets recovered

• National Crime Squad and National Criminal

Intelligence Service established

• Since the fall of the Taliban, UK responsible for

co-ordinating international assistance to help

Afghanistan’s counter-narcotics effort

• A strategy to tackle drug-related crime in the

Caribbean developed in 2002

• Assistance provided to EU candidate countries

in their development of drug strategies

• Strengthened provision gained through

the Proceeds of Crime Act 2002 for the

investigation and confiscation of criminal

proceeds

• Funding provided for projects aimed at

tackling middle market dealing

Future action:• Increase co-operation on key supply routes so

as to increase the quantities of heroin and

cocaine taken out en route, at the border and

within the UK

• Develop a strategy to address the supply

of other Class A drugs such as ecstasy

• Continue to work closely with the Afghan

Government to reduce opium reduction with

a view to eliminating it by 70% by 2008 and in

full by 2013

• Increase the recovery of drug-related

criminal assets

• Target the middle markets by expanding

regional activity to tackle one of the most

profitable parts of the supply chain

• Strengthen policing to better disrupt local

supply markets, increasing the focus on Class

A drugs and taking high profile action in

communities with particular problems

• Intensify policing to tackle crack in the areas

most affected

• Amend trafficking sentences to ensure those

caught dealing are heavily penalised


The problemThe drugs principally associated withproblematic drug use – heroin andcocaine – are made from opium andcoca crops grown in areas of theworld where they are indigenous.Cocaine for the UK market isproduced in Colombia, Peru andBolivia. Opium produced inAfghanistan is the source of 90%of the heroin that reaches the UK.It is estimated that up to 30 metrictonnes of heroin and 40 metric tonnesof cocaine are used in the UK annually.

Drug supply involves a wide rangeof people, from organised criminalgroups trafficking in large quantitiesthrough to opportunistic criminalsdealing in smaller amounts. The tradegenerates millions of pounds of profitseach year for those in the business ofsupplying illegal drugs.

Action to dateInternational and national levelThe creation in 1999 of the ConcertedInter-Agency Drugs Action Group(CIDA) brought together the agenciesresponsible for combating the supplyof drugs to the UK market. In April2001, comprehensive multi-agencyaction plans were implemented totackle heroin and cocaine supply.The end-to-end approach outlinedin these plans builds on the capacityof the CIDA agencies to attack thedrug trade at every stage of thesupply chain.

Much has been done to improve ourknowledge of heroin and cocainesupply, those involved in traffickingand UK supply, and the money flowsthat finance such operations.

Working with colleagues overseas,the UK agencies have combineddisruption activity in the key source

and transit regions with action in theUK. Work has also been undertaken,both bilaterally and through the UnitedNations Drug Control Programme(UNDCP), to help drug production andtransit countries improve theeffectiveness of enforcement activityby providing training and equipment.The following list shows keyachievements in this area in 2001/02:

• A total of 10.9 tonnes of cocainewas taken out from the supplychain to the UK market, exceedingexpectations by more than 50%.This included interdiction in theCaribbean, on the Atlantic and inEurope and operations against keydrug supply groups.

• 3.4 tonnes of heroin were takenout by attacking the main heroinsupply routes to the UK.

27

enforcement activity in and around

the region. This will be combined

with international action

co-ordinated by the Foreign and

Commonwealth Office to ensure

a sustainable reduction in Afghan

opium cultivation and trafficking.

We will make full use of new

powers introduce by the Proceeds

of Crime Act 2002 to maximise the

recovery of profits from those

convicted of drug supply offences

and to act as a disincentive to

those contemplating becoming

involved in the illicit drugs trade.

There will be a renewed focus on

middle markets to address a critical

point of supply to UK streets, and

on local policing and tackling crack.


• A further 29 tonnes of cocaine and0.5 tonnes of heroin were takenout from international supply asa result of UK action. The finaldestination of these drugswas unknown.

• Support was provided for theAfghan Interim Administration’s(AIA) drug control efforts. The AIAestimates that its programmeof compensated eradicationdestroyed about 17,200 hectares ofopium poppy, capable of producing76 metric tonnes of heroin.

• 343 Class A drug trafficking ormoney laundering groups weredismantled or disrupted – 10% upon 2000/01.

• £18.9 million in drug-related assetswere recovered from criminals bythe CIDA agencies – almost 20%up on 2000/01.

Regional and middlemarket levelThe middle market is the criticalsupply link between the illegalimportation of drugs into the UK andtheir sale at street level. Distributionand dealing at middle market leveltypically involves drugs in quantities ofbetween 1 and 5kg. It is widelyrecognised by the enforcementagencies that the absence of coherentaction to tackle the marketing of drugsat this level represents a large gap inthe enforcement strategy.

However, a project has recently beenset up in the West Midlands toanalyse the key dynamics of dealing atregional or middle market level, and

develop strategies and best practicefor disrupting supply betweenimportation from overseas and supplyat street level. The project involvesjoint working between the WestMidlands, West Mercia, Warwickshireand Staffordshire police forces withsupport from HM Customs andExcise, the National Crime Squad, theNational Criminal Intelligence Serviceand the Forensic Science Service.The project will be fully evaluated.

Community and street levelThe police have a vital role to play intackling drug dealing on our streetsand combating the problems causedby drug markets. However, asdescribed in Chapter 3, their effortswill only be effective if they have thefull support of other agencies andpartners at a local level. This isnecessary not only to bolster theenforcement effort itself, but also to

28 Reducing supply

At 7am on April 24, 2002, after manymonths of surveillance by MerseysidePolice, a major drugs raid in theHuyton area in Knowsley ledeventually to 51 arrests from 35premises for charges of supplyingClass A and B drugs, theft, burglary,handling stolen goods and vehiclecrime. 258 charges were broughtagainst those arrested. As of 29thNovember, 2002, 23 convictions hadbeen made with prison sentencing

totalling 54 years including 2individuals receiving 5 years each.

The total value of drugs and stolenproperty recovered was in excess of£140,000 including Class A drugs,cannabis, CS gas canisters and afirearm. 70 stolen credit cards werealso recovered and eventually 75% ofthe stolen property was repatriated.This work came about as a result ofthe first instalment of the funding

from Communities Against Drugs of£149,700 supported by KnowsleyDrug Action Team and Crime andDisorder Reduction Partnership.The Drug Action Team notified allpartner and statutory agencies within2 hours of the raid and ensuredtreatment services were in place forthose wishing to enter. A workingparty called “Operation Resolve”involving local agencies andmembers of the community was

Case history: Operation Arizona wins local support on Merseyside


provide support in the form ofbetter prevention and educationalprogrammes and, through these,to build community resistance todealers and their crimes. Actionthrough the Communities aim of theDrug Strategy will focus activity bylocal partners to tackle drug supply atstreet level. This has included a rangeof work to offer funding (through theCommunities Against Drugs fund),new targets, advice and guidance onbest practice.

PrisonsA comprehensive framework ofmeasures is in place to stiflethe supply of drugs in prisons.These continue to be strengthenedand include:

• the mandatory drug testingprogramme, which also providesa means of monitoring levels ofdrug misuse;

• perimeter security;

• making passive and active drugdogs available across the service;

• installing CCTV in visit areas; and

• making sure measures are in placeto deal with visitors who attemptto smuggle drugs through visits.

Internationalco-ordinationDrug misuse is a huge global problemwhich poses a threat to people inmany countries worldwide. As part ofthe end-to-end approach, UK agencieshave worked closely with internationalpartners in key heroin and cocainesource and transit countries to helppromote and enhance effectiveinternational co-operation againstall aspects of the drug trade.By providing training and equipmentin places such as Afghanistan, theBalkans, Iran, Turkey, Central Asia,

Pakistan, Latin America and theCaribbean, international capabilityto disrupt the flow of Class A drugs,dismantle trafficking groups andrecover drug-related assets hasbeen improved.

AfghanistanOver 90% of the heroin reaching theUK originates from Afghan poppies.The UK has taken responsibility forco-ordinating international assistanceto help the Afghan Government’scounter-narcotics effort. Starting firstwith tackling the 2003 crop, the aimover time is to reduce opiumproduction and to eliminate it by70% by 2008 and in full by 2013.A combination of measures willbe employed. They will includeimproving security and lawenforcement capacity, andimplementing reconstructionprogrammes which encouragefarmers away from poppy cultivation.

29

developed in response to the raid,looking at a variety of regenerationand renewal options.

Operation Arizona made headlinenews in the Liverpool Echo and onlocal radio. A debriefing meeting washeld with the public within 48 hours ofthe event, and there was very visiblepolicing, including neighbourhoodofficers and mounted police, on thestreets where the raids were made.

The initial feedback from thecommunity was exceptionally positive– residents gave the police a round ofapplause after the raid.


The CaribbeanA strategy to tackle drug-related crimein the Caribbean has been developed,with a particular focus on disruptingthe supply of cocaine that feedsthe crack market in the UK.A Memorandum of Understandinghas been signed between theGovernments of the UK and Jamaicasupporting joint action to stop airpassengers smuggling cocaine intothe UK concealed in their bodies.Jamaican law enforcement isintercepting traffickers before theydepart for the UK. Action under theMemorandum started in June 2002and a significant reduction has alreadybeen seen in attempts to smugglecocaine from Jamaica using so-called‘swallowers’.

The European Union As a member state of the EuropeanUnion (EU), the UK also works in closepartnership with other member statesto deliver the EU Drug Strategy(2000–2004). The strategy is wide-ranging, covering actions againstsupply and demand both within theEU and internationally, as well as thedevelopment of comprehensiveevaluation mechanisms. It isimplemented on the ground by meansof the EU action plan on drugs(2000–2004). The key principles area balanced approach, multi-agencypartnership, looking at the relationshipbetween drug misuse and widersocial disadvantage, and using carefulevaluation of drug projects to guidefuture action. Subject to the scrutinyof Parliament, a number of elementsof the EU strategy will be incorporatedinto UK law.

The action plan, which is currentlyundergoing a mid-term review, takesinto account the effect of the removalof internal borders between existingmember states and currentmembership candidate countries.It includes a commitment to ensuringthat candidate countries develop andimplement drug strategies andpolicies that are in line with existingEU standards. To this end, the EU isproviding pre-accession assistance tocandidate countries through locallybased pre-accession advisers andtwinning projects.

The UK is closely involved in thiswork, helping the BulgarianGovernment establish a national DrugStrategy and improve co-ordinationbetween its law enforcementagencies, and assisting the CzechRepublic to strengthen its institutional

30 Reducing supply


capability to counter the threat oforganised crime. The UK has alsoconducted a review of the progressmade by each of the candidatecountries in developing thesestrategies and the infrastructures tosupport them. The findings formedthe basis of a conference involvingEU states and institutions and thecandidate countries, held in Madridin June 2002.

The action plan also takes intoaccount the crucial role of precursorchemicals in drug manufacture.Monitoring the licit and illicit trade inthese chemicals can impact directlyon production itself, lead lawenforcement authorities to illicit drugproducers, and provide valuableinsights into how the world drugtrade functions.

In the light of the increasingsignificance of synthetic drugs suchas ecstasy, the EU is working closelywith the US Drug EnforcementAgency and the InternationalNarcotics Control Board. They arejointly sponsoring a project to developand implement standard mechanismsand operating procedures which willenable enforcers to control andmonitor the international trade anddomestic distribution of precursors tosuch drugs more effectively. Work isalso in hand to develop effectivefollow-up investigations into seizuresof these substances with the aim oftracking them back to their sources.

The UK has co-sponsored withBelgium, France and Spain aEuropean Union Framework Decision(FD) on joint investigation teams,which brings into advance effect,

commencing 1 January 2003, Article13 of the EU Convention on mutualassistance in criminal matters. The FDprovides a formal basis for closerco-operation between EU memberstates’ competent authorities incriminal investigations requiring jointplanning and co-ordinated executionof operative actions. The EU Justiceand Home Affairs Council adopted itin Luxembourg on 13 June 2002.The necessary legislation to enablethe UK to operate the FD is insections 103 and 104 of the PoliceReform Act. These deal with civiland criminal liabilities in relation toforeign members of joint investigationteams, and came into effect on1 October 2002.

31

Operation Fanbelt was a ground-breaking operation between HMCustoms and the Turkish nationalpolice. Involving joint surveillanceoperations in London and Istanbul,the operation resulted in the seizureof 24kg of heroin and the dismantlingof a major organisation responsible forsmuggling heroin from Afghanistan tothe UK. Six people were sentenced to15 years each at the Central Court inIstanbul for their part in the plot tosend heroin to the UK.

Case history: Operation Fanbelt


ColombiaIn Colombia the UK is providingtraining and equipment to build locallaw enforcement capability. Thiscomplements the UK’s contribution tothe EU’s work on alternativedevelopment programmes. Financialsupport has also been provided to theUNDCP to monitor coca production,and the UK has contributed toNGO-run projects working to reducedemand locally.

Lessons learned Measuring success from supplydisruptions is a complex process andit has proved difficult to establish arobust baseline against which tomeasure performance against the1998 target of reducing the availabilityof illicit drugs.

However, law enforcement is havingan effect. There is strong evidence toshow that seizures of Class A drugsand the disruption of drug trafficking

organisations are increasing at asignificant rate. There are alsoincreases in the price of heroin atwholesale level and indications ofa reduction in purity caused by theabsence of poppy cultivation inAfghanistan in 2001.

Attacking drug supply at all stages isthe best way of disrupting the tradeand supply patterns. Combining thiswith an attack on drug-related moneydeprives traffickers of their illegalprofit and removes the incentiveswhich drive them.

There is still much to learn about thedrug trafficking business: about how itworks, the routes and methods usedto supply the market, how the tradereacts to interventions and who thekey players are.

Monthly intelligence assessmentsare being produced examining anychanges in the supply of heroin

and cocaine, including anydevelopments likely to haveimplications for treatment and harmminimisation activities.

What next? Targets have been updated to reflect anew focus on reducing the supply ofClass A drugs rather than theiravailability, with the overall aim ofreducing the amount of Class A drugsreaching UK streets. This will be doneby increasing the proportion of ClassA drugs supply to the UK markettaken out, disrupting and dismantlingthose criminal groups responsible forsupplying substantial quantities ofClass A drugs to the UK market, andrecovering increasing amounts ofdrug-related assets.

The revised targets will be deliveredby driving forward the impact of thenew multi-agency operationalstrategies to ensure effectiveness ismaximised. Action will be taken to:

32 Reducing supply

On 4th July 2001, the

Metropolitan Police Service

(MPS) introduced a pilot scheme

in the borough of Lambeth for

issuing on the street warnings

to people found in possession of

small quantities of cannabis for

their personal use. Under the

scheme, the cannabis was

seized and a formal warning

was given to adults who

admitted this offence and an

informal warning given to those

who did not. These warnings

were given instead of people

being arrested.

The objective of the pilot was to

give officers more time to deal

with robbery, burglary, violent

crime, Class A drugs and to

respond to calls from the public.

The pilot ran until 31 July 2002

and key results were:

• Police time was saved. The

scheme saw a 110% increase in

the number of interventions for

cannabis possession with a

total of 1390 warnings given, in

contrast to the 661 arrests

in the preceding year. Each of

these warnings resulted in a

time saving of 3 hours, which

equates to 4,170 hours saved

or 2.75 officers per annum.

Lambeth Cannabis Warning Pilot Scheme


• reduce the quantity of heroin

and cocaine available for export

from source regions to the UK

and European markets;

• increase the quantities of heroin

and cocaine taken out in transit

to UK and European markets;

and

• increase the quantities of heroin

and cocaine seized at the border

and within the UK.

CIDA’s heroin and cocaine strategieswill be reviewed, strategies will bedeveloped to address crack and otherClass A drugs such as ecstasy, and themulti-agency end-to-end approach willbe built on to increase the proportion ofClass A drugs supply to the UK beingtaken out. This will be done by:

• increasing levels of co-operative

activity to support overseas

disruption in heroin and cocaine

source and transit countries.

This should increase the quantitiestaken out from the UK andinternational drugs supply, and helpidentify trafficking organisationsimpacting on EU and UK markets;

• working closely with the

Afghan government to ensure

a sustainable reduction in opium

production by providing alternativelivelihoods to Afghan poppyfarmers and by developingAfghanistan’s law enforcementagencies;

• enhancing intelligence capability

and working in co-operation

with EU partners to tackle thesecondary distribution of heroin andcocaine from the EU – an area thatled to significant seizures in2001/02;

• reviewing the impact of

interventions on the drug supply

chain from international productionto distribution within the UK.The Government’s Strategy Unitworking with the Home Office andother key departments willundertake a study;

• targeting the middle markets

There will be a new emphasis onco-operation by, and between,police forces and other agencies totackle one of the most profitableparts of the supply chain – crossregional, or middle markets.In addition to the current project inthe West Midlands, we will roll outnew middle market capacity in theMerseyside area and South andMid Wales, and develop similaroperational and intelligencecapacity in all English regions andWales by April 2005;

33

• Improved performance against

crime was achieved. There was

an increase in police activity

in relation to Class A drug

trafficking in Lambeth, which

increased by 19%. The total

number of drug offences,

which denotes arrests,

increased from 1,367 to 1,733

(26%) during the period from

April 2001 to March 2002 when

compared with the same

period the previous year.

Arrests for drug trafficking

also increased from 288 to

344 (16%) during this period.


• tackling crack. Policing to disruptcrack markets will be intensified inthe areas most affected. Specialisttreatment for crack addiction willalso be increased and action takento deter usage. A National CrackAction Plan will be published toaccompany this strategy before theend of December 2002. Anadvance summary of the plan iscontained at Annex 1of this document;

• continuing to act in a concerted

fashion against cocaine being

supplied via Caribbean countries

using a range of development,education and enforcementoperations supported by action inrelated communities in the UK;

• setting up a UK/Spanish joint

investigation team under theEU Framework Decision (FD).The team will be investigating

organised crime networksassociated with the illegaltrafficking of cocaine fromColombia into Spain and onwardsinto Northern Europe and the UK.Discussions on a formal agreementbetween Spain and the UnitedKingdom, in conformity with therequirements of the FD, are atan advanced stage; and

• improving the quantification of

baselines to enhance the picture

of the supply structure for the

UK market and to obtain a clearerassessment of the impact ofanti-drug activity. A programmeof research will be implementedto reduce the margins of error inestimates of supply so that theimpact can be readily assessed.

Asset recoveryThe Government’s new assetrecovery strategy has been agreed

with law enforcement andprosecution agencies, and is aimed atincreasing the recovery of criminalassets and thereby depriving drugtraffickers and other major criminalsof their working capital. The strategyincludes a target of doubling theamount of criminal assets recoveredfrom £29.4 million in 1999/2000 to£60 million by 2004/05.TheGovernment has embarked on acomprehensive programme of actionto bring about a step-change in assetrecovery. The programme comprises:

• the establishment of an Assets

Recovery Agency, provided forin the Act;

• a Recovered Assets Fund, whichrecycles up to 50% of criminalassets into initiatives which supportthe Government’s anti-drugs andasset recovery strategies, into bidsfrom local crime reduction

34 Reducing supply

In June 2002, one of the largest andmost complex money launderingcases to be prosecuted in the UKended with the conviction of the lastof 13 defendants being sentenced to5 years’ imprisonment. The London-based Colombian money launderinggang was responsible for launderingover US$70 million from the sale ofClass A drugs to the UK throughbureaux de change on behalf of

Colombian drug cartels. This was anorganisation at the white-collar endof drug trafficking – businessmen andwomen who do not dirty their handswith drugs, only the money.

Case history: Operation Uproar


partnerships and communityregeneration initiatives, or intoinnovative methods of lawenforcement;

• a grant scheme for police forces

in England and Wales, introducedin autumn 2001 and runninguntil March 2004, to help forcesrecruit 86 additional financialinvestigators; and

• strengthened provision through

The Proceeds of Crime Act 2002

for the investigation and

confiscation of criminal

proceeds.

The Act introduces new civil recovery,cash forfeiture and taxation powersaimed at criminal proceeds andapplies equally to local drug dealersand drug cartels. Where there hasbeen a successful criminal conviction,the Director will be able to exercise

powers of criminal confiscation.Where there has been no conviction,civil recovery powers may be used,provided that the total value ofrecoverable property is not less thanthe minimum financial threshold,which is to be set at £10,000. If civilrecovery is not possible or practicable,and there are reasonable grounds tosuspect that income or gain wasderived from crime (including drugdealing), a tax assessment maybe raised.

The powers of the Director and theAgency form only part of the range ofmeasures in the Act. The Act providesother powers to recover criminalproceeds. The Act gives powers topolice and Customs to seize cash over£10,000 derived from crime orintended for use in crime, and tosecure its forfeiture in magistrates’court proceedings. This should resultin more effective disruption of criminal

enterprises, which continue to relyheavily on cash transactions. Therewill also be a new power to searchfor cash.

The Act will also create a single set ofmoney laundering offences applicableto the proceeds of all crimes. Therewill also be new offences for failing toreport suspicious transactions.

The Concerted Inter-agency CriminalFinances Action group (CICFA) wasformed in June 2002 to lead theoverall operational attack againstcriminal finances, in direct support ofthe UK asset recovery strategy. CICFAis developing an operational strategyfor multi-agency action and will workin conjunction with CIDA to addressdrug-related criminal finance.

35


PrisonsA programme of research has beencommissioned to gain a betterunderstanding of the patternsof supply into prisons. The PrisonService is also developing a goodpractice guide to supply reduction forprisons. The guide will draw on theexperience of those prisons thatperform best by showing decreasingpositive test results from randommandatory drug testing.

PolicingLinked to the Communities aim ofthe Drug Strategy, action is beingtaken to:

• further improve the delivery

of policing at street level byproviding more guidance andsupport, coupled with bettertargets and guides to measuring

impact. This will help the policefocus their efforts on the marketswhich pose the greatest harm.Additionally policing in PolicePriority Areas will be strengthenedwith support from the Home OfficePolice Standards Unit; and

• support the aim to disrupt thesupply of illegal drugs, providing

guidance for partners of the

police to tackle drug related

anti-social behaviour and

nuisance in public places.

CannabisOne of the objectives behind thedecision to reclassify cannabis from aClass B to a Class C drug is to free upthe considerable amount of policetime currently spent in dealing withminor cannabis possession offences.Most of these offences lead to small

financial penalties – in 2000, 19,000cannabis possession offences wereprosecuted resulting in finesaveraging £80. A new cannabisenforcement model being developedby the Association of Chief PoliceOfficers will provide police with aclear and firm steer on dealing withcannabis possession, including anyaggravating circumstances. Policetime saved as a result can then beredeployed, supporting the widerstrategy objective of refocusingefforts – including enforcement action– on the drugs that cause the mostharm, i.e. heroin and cocaine.

The maximum penalty for thepossession of cannabis will go downto two years’ imprisonment. Mostfirst offences of cannabis possessionwill be dealt with by the police by wayof a warning and confiscation of the

36 Reducing supply


drug. The police will retain the powerof arrest to be used where there areaggravating factors, such as flagrantlydisregarding the law.

Supply offencesHeavily penalising those caught

dealing or drug trafficking.

The Government takes the supplyand dealing of cannabis very seriously.It therefore intends, subject toparliamentary approval, to increasethe maximum penalty for supplyingand dealing in Class C drugs from 5to 14 years’ imprisonment. This willmaintain the maximum penalty fordealing in cannabis at its level asa Class B drug and will enablethe courts to continue to imposesubstantial sentences for seriousdealing offences involving cannabis(see adjacent box).

37

Offence

Production of a

controlled drug

Supply of a

controlled drug

Possession of a

controlled drug

Class A

Life or a fine or both

Life or a fine or both

7 years or a fine

or both

Class B

14 years or a fine

or both

14 years or a fine

or both

5 years or a fine

or both

Class C

current – 5 years or

a fine or both

proposed – 14 years

or a fine or both

current – 5 years or

a fine or both

proposed – 14 years

or a fine or both

2 years or a fine

or both

Penalties


38 Communities

The cohesion and well-being of

local communities are vulnerable to

the corrosive effects of drug misuse

and the misery it causes. This is

particularly true of communities

located in deprived areas. Drug-

related crime lies at the heart of

the problem. This is why the

Updated Drug Strategy focuses

on strengthening communities,

through action aimed at reducing

drug-related crime and supply. The

Updated Drug Strategy also links

more effectively with the

neighbourhood renewal strategy

in the area of drug-related crime

and anti-social behaviour.

The strong emphasis placed on

promoting effective action by the

police, and other partners, to drive

out street dealing and drug

markets will continue, with a new

focus on the growing problem of

crack. This will be linked to action

within police programmes to

improve police performance

generally (see Chapter 2). Future

work will also seek to maximise

the opportunities created by the

criminal justice system to get

drug-misusing offenders into

treatment and out of crime. There

is clear evidence to show that such

interventions work and that they

provide a good return on the

investment from both a social

and economic point of view.

3. Communities

Action since 1998:• All police forces have arrest referral schemes

covering their custody suites

• Drug Treatment and Testing Orders have been

available to the courts since October 2000

• Pilots for drug testing are running in nine sites

• progress2work launched in 2001

• Communities Against Drugs fund set up

in 2001

• Guidance published on housing management

and drugs, and on drugs in clubs

• Crack conference held in 2002, looking at the

impact of crack on local communities

Future action:• Use every opportunity within the criminal

justice system to identify and help move drug-

misusing offenders into treatment

• Provide a comprehensive package of

rehabilitation and aftercare for those leaving

prison and returning to the community

• Increase the accommodation available to drug

misusers through the Supporting People

programme

• Develop a business engagement strategy and

establish a new charity in partnership with the

business community

• Increase the number of people arrested and

charged for supply offences

• Further enhance the synergy between the

Drug Strategy and the neighbourhood renewal

strategy to improve delivery in deprived areas

• Implement the National Crack Action Plan

• Publish new guidance on prostitution and

begging linked to drug misuse


The current situationDrug misuse and the associateddealing has a corrosive effect on thecommunities in which they aresituated. In 2000, over 30% of BritishCrime Survey respondents identifieddrugs as a serious problem in theirarea. The impact ranges from thenuisance and anti-social behaviourassociated with drug dealing and theactivities of those under the influenceof drugs (not least the dangers ofdiscarded syringes) to criminality,including robbery and the violenceassociated with organised crime.

There is a strong link betweendrug misuse and crimes such asshoplifting, burglary, vehicle crime andtheft. Heroin, crack and cocaine usersare responsible for 50% of thesecrimes and around three-quarters ofcrack and heroin users claim to becommitting crime to feed their habit.Evidence on links between drugs and

other crimes is less clear cut butoverall, crack and cocaine users aremore likely to be involved in assaultsand wounding.

The links with re-offending are alsostrong. Of the estimated 100,000persistent offenders, 75% havemisused drugs, whilst arrestees whouse heroin and cocaine commitalmost ten times as many offences asarrestees who do not misuse drugs.Urine testing of arrestees has shownthat 65% tested positive for one ormore illegal drug and 29% testedpositive for opiates or cocaine.

The Prison Service has to care for thebiggest simultaneous concentration ofdrug misusers to be found either inthe criminal justice system or thehealthcare system. 50% of maleremands and 43% of male sentencedprisoners admitted to drugdependence in the year prior to

imprisonment. The figures for womenwere 54% and 42% respectively(Singleton et al, 1999).

Links with deprivationDrug problems are most serious inthose communities where socialexclusion is acute, and where peoplelack the will or the resources tocontrol or manage drug problems.Where people are grouped together inareas of high unemployment, crime,fractured families and poor housing,drug misuse grows and its effects aremagnified. Drug markets develop toserve the demand for drugs createdby people who have no vision of orhope for the future.

Communities where demand is highand drugs are widely availableperpetuate the problem. Users buydrugs locally and support their habit bycommitting offences within theircommunity. They may leave behind

39

This work will, for example,

provide a significant enhancement

in arrest referral schemes; provide

a rapid expansion in drug testing at

the point of charge; make Drug

Treatment and Testing Orders

available for all who need them;

and tailor the current interventions,

which are primarily targeted at

adults, to those under 18. The

package of additional measures

will also include, for the first time,

dedicated and systematic support

for those drug-misusing offenders

leaving prison and the introduction

of a single generic community

sentence.

Alongside this substantial

programme of measures to

identify and engage drug-misusing

offenders, work will continue,

with renewed vigour, to assist drug

misusers with housing, educational

and employment needs. Linking

with neighbourhood renewal

strategies, we will provide, along

with treatment, a route for users

out of dependence and social

deprivation into a more secure and

stable life. By contributing to work

on community regeneration and

cohesion we will address the

links between prostitution,

homelessness, begging and other

problems closely related to

undermining community

confidence and morale.


debris from their use, visually scarringthe neighbourhood. Users get intodebt and turn to crime, and soon ahigh percentage of the communityis affected by the loss of stolenproperty. By then a large proportionof the community’s available financialresources is disappearing,unproductively, into drugs.

Established drug markets are animpediment to regeneration,damaging community confidence andadding to the poor reputation of thearea (Lupton et al, 2002). Drugs erodethe social capital of the estate,sapping the will and energy ofcommunity leaders to enact change.For example, mothers who want tosee change because their ownchildren are users often find theirenergies diverted into the day-to-daystruggle of helping theirchildren overcome dependency.Threats from dealers, crimes againstproperty, and the sheer scale of the

challenge also have a seriousdemoralising effect.

Some drug-related problems, likehomelessness, prostitution andbegging, impact on the daily lifeof everyone in the community,breeding fear and anxiety andhindering regeneration. Research hasshown the links between organisedprostitution and drug markets, andbetween prostitution and drug use.Women engaging in such activity arelikely to jeopardise both their healthand their chances of leading a normallife as a member of the community.

Society as a whole pays a high pricefor drug misuse. The total economiccost each year, including the cost tothe health service, courts, prisonsand other parts of the criminal justicesystem, and to the benefits system,is estimated at between £2.9 and£5.3 billion.

When social costs, such as the coststo crime victims, are added, the totalrises to between £10.1 billion and£17.4 billion. Problematic drug usersare estimated to account for 99%of these costs.

The cost is not just financial. Drugmisuse adds to the pressure onalready hard pressed health servicesand police forces and diverts themfrom other priorities. These prioritiesmust, of course, include addressingthe full range of drug-related problemsincluding use of other damaging ClassA drugs, such as ecstasy.

Action to dateCriminal justiceConsiderable progress has beenmade in recent years in establishingdrug interventions at key stages inthe criminal justice system anddeveloping community-basedprogrammes aimed at tacklingdrug-related anti-social and criminal

40 Communities

Economic costs of Class A drug misuse, England and Wales 2000

GP

A&E

Hospital

Outpatient mental health

Inpatient mental health

State benefits

Police: drug offences

Police: acquisitive crime

Police: custody

Court

Prison

1%

2%

4%

1%

2%

21%

14%

16%

1%

13%

25%


behaviour and thereby strengtheningcommunities. Key achievementshave been:

• All police forces in England andWales now have arrest referralschemes covering their custodysuites. These schemes arepartnership initiatives betweenpolice, drug agencies and DrugAction Teams (DATs) aimed atidentifying drug misusers at thepoint of arrest and referring theminto treatment or other programmesof help. Between October 2000 andSeptember 2001, arrest referralworkers screened 48,810 arresteesin England and Wales. Over half(51%) of those interviewed hadnever previously accessed drugtreatment.

• Drug Treatment and Testing Ordershave been available to the courts inEngland and Wales since 1 October2000. These community sentences

are designed to help problematicdrug users address their problemthrough intensive programmes oftreatment and testing. Between1 April 2001 and 31 March 2002,4,851 Orders were made.

• Pilots for the drug testing provisionsintroduced by the Criminal Justiceand Court Services Act 2000 arenow well established in three sitesand were recently extended to anadditional six sites. The provisionsenable the testing in police custodyof those arrestees charged withtrigger offences – crimes which arestrongly linked to drug misuse ordrug offences involving certainClass A drugs. The test results helpinform bail and sentencingdecisions. The new powers alsoprovide for testing as part of a newcommunity sentence, the DrugAbstinence Order, or as part of aDrug Abstinence Requirementattached to a community

rehabilitation or punishment orderand for testing as a condition ofrelease on licence for prisonersconvicted of trigger offences.The second interim report outlininginitial outcomes from the pilots isdue in spring 2003.

• As part of the Street CrimeInitiative, street crime offenderswith drug problems are fast-trackedto drug services within 24 hours oftheir arrest or release from custody.

• The Prison Service has in placea framework of treatment andsupport to address a wide range ofdrug misuse problems:

• detoxification services –available in all local and remandprisons;

• Counselling, Assessment,Referral, Advice andThroughcare (CARAT) services

41

The Salisbury scheme offers accessto assessment and treatment. It ispossible that a client seen in the cellsby the arrest referral worker onMonday could be seen by a treatmentworker on Wednesday, discussed at ateam meeting on Thursday and be ona prescription by the followingMonday. This system works wellfor intravenous heroin users withchaotic lives, as treatment andcounselling could usually be offeredwithin seven days.

The scheme has one full-time arrestreferral worker and one part-timetreatment worker, with directaccess to a prescribing doctor.

The arrest referral worker visits thecustody suite twice a day fromMonday to Friday, attends drop-incentres locally to remind clients aboutappointments, and is on call from8am to 4pm, and by arrangement atother times.

In the scheme’s first year 119 clientswere given a brief assessment, and67% of those referred to treatmentattended.

Case history: Salisbury arrest referral scheme


• a gateway service available inall prisons which meets thenon-clinical needs of the greatmajority of prisoners and is thefoundation of the prison drugtreatment framework, providinglow threshold, low intensity, andmultidisciplinary drug misuseintervention services;

• 50 drug treatment programmes,including seven therapeuticcommunities; and

• voluntary drug testing.

Work-related • The Jobcentre Plus initiative

progress2work was launched in2001 and the first participantsstarted in 2002. It helps recoveringdrug users find and sustain jobs –a key way of returning to morestable and constructive life.

• A consortium of drug specialistshas been commissioned to developresources and training for DATs toimprove the support they are ableto offer to business.

Action in communities In partnership with the Office of theDeputy Prime Minister (ODPM), theHome Office has provided a range ofguidance, training, information andsupport to tackle those problemswhich cause the greatest harm tocommunities, including housing,neighbourhood renewal andhomelessness. Recent and currentwork has included the following:

• A national conference onthe impact of crack on localcommunities was held in June2002. The conferenceconsidered all aspects of crack use,focusing on what works and alsolooking at some promising newinitiatives. A clear message

emerged on the best ways ofdealing with such problems ata local level.

• A wide range of activity linkingaction under the neighbourhoodrenewal strategy with action ontackling drugs, aimed at ensuringthat drug misusers get theguidance and help they need toescape the drug problems thataffect their communities.

• DATs have been given newfunding to increase their capacityto manage drug problems ata community level.

• Research and guidance into whatworks in tackling drug problems indeprived areas, and what impactdrug markets have on deprivation,has recently been completed andpublished. The next step is forregional Government Office staffto assess current DAT and Local

42 Communities

C2AD (Clapton Communities AgainstDrugs) brings together agenciesincluding the police, the primary caretrust, the probation, education, socialand youth services and the PeabodyTrust, a long established housingcharity.

Its aim is to improve life for peopleliving in the Lower Clapton Trianglein East London, particularly on thePembury Estate, which was recentlytaken over by the Peabody Trust.

The first six months of the project,which has guaranteed funding forthree years, focused on reducing drugdealing and drug misuse and closingcrack houses on the estate. BetweenMarch and September 2001 therewere 190 arrests, and large quantitiesof drugs and firearms were seized.

The second phase of the project wasofficially launched in June 2002. Thiscentres on building confidence andself-esteem in the community, with

particular attention paid to providingchildren and young people withalternatives to drug use and crime.

Case history: Communities against drugs project in the Lower Clapton Triangle


Strategic Partnership (LSP) plansagainst this template, checking thatthey contain effective proposals forworking together to tackle drugsin deprived areas.

• Guidance on managing drugsin public sector rented housinghas been issued to all housingproviders; and new guidance onproviding supported housing fordrug misusers has strengthenedlinks between the SupportingPeople initiative and existing drugsstrategies. The result will be anincrease in the number of units ofsupported housing available fordrug users and better managementof drugs in public housing.

• To reduce the potential for harm,new guidance on managing dancevenues associated with the use ofecstasy-type drugs was published.The guidance is being enforced byDATs, and is supported by police

and local authority action onclubbing safety.

• New guidance has beencommissioned on responses tohomeless drug users and theproblems associated with roughsleeping, in partnership with theODPM. Responsibility for pump-priming services for homelessdrug misusers has now passedfrom ODPM to DATs, and thisguidance and accompanyingtraining will ensure theirperformance is raised and theneeds of this client group met.

• Guidance has been issued to thepolice and Crime and DisorderReduction Partnerships (CDRPs) onbest practice in tackling local drugmarkets. This will be strengthenedby additional work on crack andpolicing markets in ethnic minoritycommunities. These initiatives arelinked closely to broader

programmes of police reform andstandards, and will be measuredagainst Police Best Valueperformance indicators. This workhas already begun to have a majorimpact on the style and context oflocal market policing, as shown bythe high profile action againstsuppliers in many areas, mostnotably in Peterborough andLambeth.

• The Communities Against Drugs(CAD) programme has helpedsupport action at a local level,including to turn guidance intopractice. Funding made availablethrough the CAD programme canbe used at local discretion for awide range of drug-relatedinitiatives at the community level,such as supporting parent groups,providing neighbourhood educationabout drugs, and encouragingpolice and partner action to disruptand close drug markets.

43


Lessons learned Criminal justice Interventions at an early stage inthe criminal justice system havecreated opportunities to engagedrug misusers who have not beenin contact with treatment before.Recent published data from theNational Arrest Referral MonitoringSystem shows that Arrest Referralschemes are successfully targetingproblematic drug-using offenders,particularly users of opiates andcrack/cocaine. Users of heroin,methadone, crack andbenzodiazepines were more likely tobe referred and make a demand fortreatment than other types of drug-misusing arrestees. They are alsomore likely to be injectors, have ahigher weekly drug expenditure andadmit to shoplifting in the previous30 days.

Appropriate treatment can reduceboth drug misuse and relatedoffending. Problematic drug-usingoffenders referred through thecriminal justice system to treatment,and then retained in treatment, reportsignificant reductions in drug-relatedcrime, spend on drugs and useof drugs.

Evidence from the US, which haslonger-established drug treatmentprogrammes within its prisons,suggests that intensive drugprogrammes can reduce drug misuseand offending by up to 15%,particularly where high qualitypost-release aftercare is available.Preliminary research into theeffectiveness of the RAPtrehabilitation programme, running inseven prisons in England and Wales,shows that over a period of two years40% of programme graduates hadbeen reconvicted compared to an

expected rate of 51% (Martin et al,forthcoming). Further outcomeresearch will be undertaken to ensurethat high quality treatmentprogrammes are delivered.

A comprehensive system orprogramme of aftercare andresettlement provision designed tomeet the needs of those problematicdrug-using offenders leaving custodialestablishments or treatmentunplanned is not yet in place. This hasbeen identified as a major gap in theDrug Strategy. The transition ofprisoners back into mainstreamcommunities needs to be bettersupported through the delivery ofa holistic programme of help,appropriately case managed, tominimise any likelihood of relapse,related re-offending or re-conviction.This gap will be filled.

44 Communities


Work-related The business community has animportant role to play, and much togain, as a partner in delivering thisStrategy. The impact of drugs on localbusiness and local economies shouldnot be underestimated. To implementeffective work-related drug policiesrequires Government and business toengage both at national and locallevels. A number of DATs havedeveloped successful localprogrammes in partnership with thebusiness community, and with otheragencies, to tackle the problems ofdrugs in the workplace. Businesseshave the potential to create a realimpact on the Drug Strategy, byfunding local drug projects, helpingsupport DATs, addressing drugmisuse and supply by employees,designing out opportunities for crimeand providing work opportunities forrecovering drug misusers.

Action in communitiesWays to further strengthencommunities, especially in deprivedareas, and enhance their capacity toget involved, will be explored.Particular efforts will be made toengage ethnic minority communitieswho are likely to be disproportionatelyrepresented in such neighbourhoods.Police and their local communitypartners will need to allocate the levelof resources and funding required tomake a difference, following guidanceon what works best and using triedand tested techniques. Action will betargeted at those with acuteproblems, such as the homeless andprostitutes, and at hotspots wheresuch problems, often linked withdealing, are most visible. All theseactions will have a clear impact on theway that local people view theircommunities and on reducing thevisible impact of drugs on people’slives. It is clear that action needs to be

linked and co-ordinated strategically,with action to tackle poverty anddeprivation.

What next?Evidence suggests that the actioncurrently being taken to tackle drugmisuse problems at a communitylevel is having a positive effect. Still,more needs to be done to engageproblematic drug users by enhancingthe coverage and effectiveness ofinterventions within the criminaljustice system, and strengtheninglocal partnerships and actions aimedat addressing the underlying causes ofdrug misuse within communities. Thecycle of persistent offending and drugmisuse must be broken. To break thelink, additional resources will beinvested in a major programme ofinterventions, for adults and youngpeople, which will move offenders outof the criminal justice system and intotreatment. This will enable rapid

45


movement towards the vision of:

• every offender arrested and chargedfor a drug-related offence beingtested for heroin or cocaine use;

• all those testing positive beinginterviewed by an arrest referral

worker and referred to treatmentwhere appropriate;

• all those coming to court beingoffered a straight choice betweentreatment, where appropriate, orbeing remanded in custody;

• community sentences with drugtreatment conditions beingavailable for all that would benefit;and

• support for all drug-misusingoffenders leaving prison.

Based on this vision, the programmewill focus initially on:

Criminal justice• Making arrest referral schemes

more proactive and effective byimproving their quality andcoverage, drawing on the emergingevaluation findings.

• Extending drug testing to thoselocal police force areas with thehighest levels of drug-relatedcrime.

• Piloting the introduction of a

rebuttable presumption against

bail for those arrested for andcharged with a trigger offence, whotest positive for a Class A drug, andrefuse assessment by a suitablyqualified practitioner as to theirsuitability for treatment or, havingbeen assessed as suitable, refuseto undergo treatment.

• Improving the quality and

coverage of prison-based

treatment programmes.

• Doubling of the number of Drug

Treatment and Testing Orders

(DTTOs) by March 2005 toprovide for all those who willbenefit from them (until they arereplaced by the new genericcommunity sentence).

• Creating a single generic

community sentence made up

of specific elements which will

replace all existing community

sentences, including the DTTO.

The Criminal Justice andSentencing Bill contains newpowers which will provide Courtswith the option of making a drugrehabilitation requirement part ofthe sentence for all those aged 16or over, with a drug dependency orpropensity to misuse drugs,convicted of an offence sufficientlyserious to merit a communitysentence. Like the DTTO,the requirement will have amandatory treatment, testing, and

46 Communities

Information and educationfor all young people

Treatment for young people whoare problem drug users (PDUs)

Treatment for adult PDUs

Arrestreferral 18+

Drugtesting18+

DTTOsGeneric CommunityCounselling

PrisondrugprogrammesAftercare on release;

Probation programme

Research indicates

there are some

250,000 PDU's in

England and Wales

Children of drug misusingparents are one of the knownrisk groups for drug misuse

Repeat drugmisusing offenders

Young peopleDAT returns for 2001/02 suggests there are 35,000

young people in England in need of specific drug

misuse prevention/treatment services

Breaking the cycle

Targeted prevention activities for young people at risk eg. young offenders, truants, school excludees and children of drug misusing parents


in the case of those sentences upto 12 months or more, court reviewcomponent. The main differencewill be that courts will have thediscretion to decide whether or notto include a mandatory courtreview element in the requirementof those sentenced to less than 12months. This change will have theeffect of widening the range ofthose receiving treatment as part ofa community sentence from themost serious drug-misusingoffenders, currently catered forby the DTTO, to those with lesssevere drug misuse andoffending. As with the DTTO, theoffender will need to consent toa drug rehabilitation requirement.

• Providing throughcare and

aftercare for those in treatment

and those coming to the end of

treatment, including better

management of the needs of

drug-misusing offenders who

leave prison and return to the

community. This will includeimproving the availability ofsupported housing under theSupporting People programme tohelp ex-offenders find secure, safesupported homes to move to fromprison, and helping ex-misusersrebuild their lives.

• Implementing a package of

corresponding, but appropriate

interventions for juveniles

(See Chapter 1).

Work-related • Developing a business

engagement strategy andimplementation plan encouragingthe business community tobecome more involved in deliveringthe Drug Strategy. The strategy willseek their support for anti-drugprojects both nationally and locally,

in turn supporting them inimplementing effective policiesto tackle drugs in the workplace.

• Establishing a new charity in

2003/04 in partnership with the

business community to support

delivery of the Drug Strategy.

This will aim to raise awarenessabout the dangers of drug misuse,support anti-drug community-basedprojects and work with youngpeople to help them stay clearof drugs.

• Continuing the progress2work

(p2w) initiative. Contracts arebeing awarded for phase 2 whichwill mean p2w activity in around 60of the 90 Jobcentre Plus districtswith contracting for the remainingareas beginning in April 2003.Building on the success of p2w,progress2work-LinkUP will bedeveloped in some districts.

47

The NEXUS project was establishedin 2001 to tackle problems faced bywomen leaving prison, especiallythose who had been imprisoned fora few months, the majority of whomhad a history of problematic drug use.

Working with established projects inBirmingham, Coventry, Walsall andWolverhampton, NEXUS has built abridge between Brockhill Prison in theWest Midlands and the community.

Rattling, a theatre production basedon the experience of women enteringprison and coming off drugs is usedto encourage participation. This isfollowed by eight weeks of groupwork which encourages women tothink about lifestyle changes. Supportis maintained by the communityprojects following release.

Case history: NEXUS helps women prisoners


This uses a similar model but isavailable to alcohol misusers, ex-offenders and people at adisadvantage in the labour marketthrough homelessness to helpmany people at risk of becomingdrug misusers.

Action in communities• Setting a new target for DATs,

working with the Supporting

People partnerships in their area,

to increase the number of units

of accommodation available for

drug misusers locally through

Supporting People by 10%

annually from 2003/04. The linkbetween this major programme,which offers help to those whohave most difficulties in managingtenancies, and the Drug Strategyoffers major advances in meetingthe needs of drug misusers,including those leaving prison.

• Creating a new target for local

partnerships to increase the

number of people arrested and

charged for supply offences

within each CDRP/DAT, as part ofa range of initiatives to stimulateaction on supply and its effect onlocal communities. This will helpimprove local policing of drugmarkets and reduce the harm theycause communities, in line withpolice targets on the supply ofClass A drugs. This forms part of amuch wider programme of support,funding, guidance and training toimprove the quality and range ofpolicing of drug supply by thepolice at the local level. Thisincludes specific publications,conferences, a new award forexcellence in drug marketdisruption and a new requirementfor DATs to set out their plans foraction on supply which will beassessed rigorously. This work will

link very closely to the wider actionbeing taken on supply issuesdescribed in Chapter 2. In turnconcerted and co-ordinated actionby the police will work in a strategicand comprehensive way to tacklesupply chains operating in localcommunities.

• Working closely with local

partners to deliver specialist

action to control supply hotspots

and reduce the impact on the

local community; that is, wherethe problems of supply are mostacute. For example, this is oneaspect that the high level NationalCrack Action Plan, to be publishedbefore the end of December 2002aims to address (see Summary atAnnex 1). The Plan covers allaspects of the problem, fromsupply to treatment, and helpsshape local planning and action.

48 Communities


49

• Further enhancing the synergy

between the Drug Strategy and

the neighbourhood renewal

strategy. A series of regionalconferences for those developingneighbourhood renewal strategiesand DATs is currently being rolledout, and evidence from a recentstudy of what works in deprivedareas will be disseminated by theHome Office and the ODPM.This work is aimed at improvingdelivery in deprived areas andincreasing local access to services.

• Reducing the negative impact

on communities of prostitution

and begging linked to drugs.

New guidance for police, localauthorities and DATs on suchactivities will be introduced,showing how these could betackled using the funds available.

• Addressing areas of particular

concern in relation to drug

misuse within minority ethnic

communities. The national crackconference has begun the processof establishing dialogue andbuilding effective partnershipsparticularly with the African-Caribbean community. This will bebuilt on both nationally and, throughthe service specification referredto above, at local level. The HomeOffice will also look at thedynamics of supply within otherminority communities and at whatcan be done to disrupt supply andengage community support forefforts to tackle drug markets,especially where drug problemshave contributed to communityunrest and lack of cohesion.


50 Treatment and harm minimisation

Action since 1998:• The NTA established in April 2001

• Introduction of pooled treatment budgets

• 8% year-on-year increase in the numbers

attending treatment services

• Waiting time targets established and waiting

times for priority cases coming down

• Improved access to treatment through the

community and through the criminal justice

system

• Action plan to reduce drug-related deaths

published in 2001

• Expert group set up to develop best practice

guidance on the treatment of crack

• NTA review, with expert input, of heroin

prescribing practices

Future action:• Year on year, continue to increase community-

based treatment provision, improving quality

and access

• Expand and improve the quality of prison-

based treatment and rehabilitation provision

• Ensure access to effective treatment for crack

and cocaine users

• Increase the availability of heroin on

prescription to all those who have a clinical

need

• Provide rehabilitation support for all those

going through treatment and on leaving

treatment, including those leaving prison

• Improve the health of drug misusers and drive

forward action to reduce the risk of death

• Improve access to treatment in deprived

communities

Treatment works. Getting drug

misusers into treatment and support

is the best way of improving their

health and increasing their ability to

lead fulfilling lives. Treatment breaks

the cycle of drug misuse and

crime, and investing in treatment

reduces the overall cost of drug

misuse to society.

Planned annual investment in drug

treatment services will increase. For

community and prison treatment

services, an extra £45 million has

been allocated for spending in the

next financial year, £54 million for

the year starting from April 2004,

and £115 million from April 2005

bringing the total direct annual

spend on treatment up to £573

million by 2005. There is good

evidence available on what works

and on how services can be

improved, and the National

Treatment Agency (NTA) has been

established to ensure that

investment through the pooled

treatment budget results in the

growth of high-quality services in

the areas of greatest need.

Only about half of the UK’s

estimated 250,000 problematic drug

users are in treatment and women

and minority ethnic drug misusers

are particularly under-represented.

Increasing the number in treatment

to 200,000 per year by 2008 will

require substantial investment and

bring new challenges, particularly if

services are to target those who are

unable or unwilling to seek help.

4. Treatment and harm minimisation


51

The current situationThe individuals who suffer the mostharm are those that becomeproblematic drug users. It is estimatedthat there are more than 250,000problematic drug users (Godfrey et al,2002), who are dependent on Class Adrugs and who are most involved incrime. Known facts about this groupinclude the following:

• They are often addicted to heroinand/or crack/cocaine and leadextremely chaotic lives, creatinga high level of risk to themselvesand others.

• Their drug misuse severelydamages their health. There were1,562 reported drug-related deathsin 2000 (Health Statistics Quarterly13, Spring 2002), as well as deathsand substantial ill health arisingfrom blood-borne viruses such ashepatitis and HIV. They can alsosuffer from illnesses and traumaassociated with accidents, poor

diet and personal neglect, as wellas depression, paranoia and otherforms of mental illness.

• They are unable to take fulladvantage of educationalopportunities or to obtain and retainfulfilling employment, oftendamaging their life chances andfailing to realise their full potential.

There is now more drug treatmentand support available than everbefore. A recent survey by DrugScopeindicates that the number of drugtreatment services has increased byover a third since 1997. Substantialadditional investment is leading to thedevelopment of new services, andwaiting times for treatment arestarting to come down. But there arestill not enough services of the righttype in the right place for allproblematic drug users. In recentyears, changes in the pattern of drugmisuse have also placed additionalpressures on services. For example,

there is insufficient provision for crackusers; and not all who might benefitfrom prescribed heroin and otherinterventions at present have accessto it. In addition, as the AuditCommission showed in its reportChanging Habits, those with the mostcomplex needs find it most difficultto get help.

Women who are problematic drugusers tend to seek treatment lessfrequently than their malecounterparts and opiate users fromminority ethnic groups are less likelyto engage in drug treatment thanwhite opiate users. Women who doaccess services often find that thereare significant shortcomings in thesupport they receive in terms ofchildcare and transport facilities,women-only services, specificprovision for minority ethnic womenand services within the criminaljustice system.

The Updated Drug Strategy will

tackle this.

Treatment and support need to be

accessible to those who need them,

regardless of ethnic origin, gender,

sexual orientation or source of

referral. Although waiting times are

getting shorter, in some areas and

for some services they are still too

long. There are also gaps in service

provision: in particular, treatment

for crack users is not available for all

who need it. There also needs to be

greater consistency across the

country in provision of services,

such as heroin prescribing. More

needs to be done, and will be done,

to ensure that people living in

deprived areas have access to

treatment, as part of the wider

process of neighbourhood renewal.

Harm minimisation will ensure

that drug users receive good

basic healthcare, helping to

reduce the risks arising from

drug misuse, including the risk

of drug-related death.

Helping drug misusers achieve and

maintain drug free lives does not

stop at the clinic door. Those

recovering from addiction or other

drug problems need ongoing

rehabilitation support and help,

for example with housing and

employment. This is a challenge the

Updated Drug Strategy will meet.


Services are also criticised for failingto meet the needs of minority ethniccommunities. This failure is partly dueto the way the services developed.Many services emerged out of theheroin epidemics of the mid-1980sand were particularly concerned withthe way in which injecting provided apotential route for HIV transmission.Many services, therefore, havedeveloped largely around the needsof the white males who tend todominate this category of drugmisuse. Ethnic differences in patternsof drug misuse suggest that theneeds of some minority ethnic groupsare marginalised by existing services,which tend to focus on injecting ratherthan smoking.

Those living in the most deprivedareas often suffer most from healthinequalities and may also havespecific drug treatment needs.The ready availability of drugs,

coupled with a lack of suitabletreatment, undermines initiativesaimed at neighbourhood renewal.

The challenge is to rapidly expanddrug treatment capacity to meetexisting and emerging demands at thesame time as improving the quality ofservices.

Action to dateAdditional resourcesIn 1998, the National Drug Strategyset a target of doubling the numberof people in treatment by 2008.The 2000 Spending Review deliveredsignificant financial support for thisobjective. Pooled treatment budgetshave been introduced at local level toensure better co-ordination ofplanning and provision, avoiding theduplication and diseconomies that canoccur when agencies anddepartments operate in isolation.

The National Treatment Agency In April 2001, the NTA was set upto oversee the development of drugtreatment in England and to ensurethat those who need it receiveeffective, high-quality servicesregardless of where they live or theirsource of referral. The NTA hasestablished waiting-time targets fordrug treatment, piloted a co-ordinatedsystem of treatment delivery in eightareas (to integrate all supportservices), and promoted a shared-careapproach to enable GPs to work moreeffectively with specialist services anddrug misusers in their areas.

Treatment provisionThe treatment target is currently ontrack. The number of peoplepresenting for treatment increased onaverage by 8% per year from the yearending March 1999 to the year endingMarch 2002. Nearly all DAT areas(97%) have harm-reduction services


Treatment type (P=priority, NP=non priority)

Inpatient detox (P)

Inpatient detox (NP)

Community (P)

Prescribing (NP)

Prescribing GP (P)

Community prescribing GP (NP)

Structured counselling (P)

Structured counselling (NP)

Structured day care (P)

Structured day care (NP)

Residential rehab (P)

Residential rehab (NP)

Treatment waiting times (DATS)

2000/01 2001/02

15129630

252921 Updated Drug Strategy 30/11/02 19:07 pm Page 52

and 87% provide access to drugprescribing services, for example,but there are gaps. Improvements tomonitoring systems are generatingmore accurate information about whattreatment is being provided at a locallevel and, importantly, indicating wherethe system is coming under pressure.

There is now more treatmentavailable for drug misusers in thecommunity. A range of interventions,such as arrest referral schemes andDrug Treatment and Testing Ordershave been developed to ensure thatdrug misusers are being identifiedand referred to treatment at eachpoint of the criminal justice system,thus helping to break the link betweendrugs and crime.

As part of the Street Crime Initiative,street crime offenders with drugproblems are fast-tracked to drugservices within 24 hours of their arrestor release from custody.

Research published by the HomeOffice in July 2002 provided anoverview of the issues concerningthe provision of drug services towomen and minority ethnic users,and identified specific areas thatneed attention.

Harm minimisation Many DATs have introduced initiativesaimed at improving the health ofthose who are still using drugs andreducing drug-related deaths, such asa network of needle exchangeschemes providing clean syringes andpractical health advice to drugmisusers. There are also programmesthat provide first aid courses andoverdose prevention training for drugmisusers and agency staff, work totackle hepatitis B, and a strategy toaddress hepatitis C was published forpublic consultation in August 2002.

Lessons learnedEvidence shows that treatmentworks. It helps users overcome thehealth and social problems that drugscan cause and reduces the cost tosociety of drug misuse.

EvaluationThe most extensive evaluationof drug treatment to date in the UKhas shown that treatment leads toreductions in both drug use andoffending for at least five years.The National Treatment OutcomesResearch Study showed that aftertreatment, abstinence rates for illicitopiates more than doubled amongclients in residential and communitysettings. There were also significantreductions in the regular use of illicitopiates and crimes committed to funddrug taking. For every £1 spent ontreatment, £3 are saved in criminaljustice costs.

53

Nottingham’s Double Impact projecthelps to integrate former drug usersinto work, training and education,using inter-agency guidance,counselling, housing and vocationaltraining provided by the People’sCollege, the Nottingham Drug ActionTeam and the YMCA. It also attemptsto meet housing needs, providing upto 15 emergency bed spaces atNottingham YMCA and other sharedaccommodation.

All those on the project are currentlyeither undergoing treatment to end orstabilise their drug use, or are drug-free and want to play a positive partin society. The project’s work includesbuilding skills and confidence,improving health and preventinga relapse into crime.

Double Impact has been running fornearly five years and has workedwith more than 400 recovering andstabilising drug misusers. It is fundedand supported by a range of statutoryauthorities including health, socialservices, the police, and City DAT.

Case history: Double Impact project


Gaps in provisionThere is a great deal of good practiceon which to build. Different drugmisusers have different needs andrequire a wide range of services in allareas from harm minimisation throughspecialist medical and social supportto aftercare designed to get formerdrug misusers back into thecommunity. As the Audit Commissionreport showed, there is currentlysome variation across the country inthe provision of these services: theUpdated Strategy aims to fill thesegaps and reduce waiting-times to getmisusers into treatment while theirmotivation to change is still strong.

DATs need support in thecommissioning of services. The AuditCommission identified disjointedcommissioning and fundingarrangements as a barrier to theprovision of effective services at alocal level. The NTA will work withDATs to build more efficient ways ofcommissioning local and regional

provision, to ensure that Governmentfunding streams are more coherentand easier to understand and toguarantee minimum levels of service.

• Heroin and crack users: moretreatment provision is needed forheroin users – still by far thebiggest group of problematic drugusers. This includes the provisionof heroin on prescription as atreatment option for those forwhom it is appropriate. Currentlybetween 300 and 480 patientsreceive heroin treatment for opiatedependence each year and there issome variability in access acrossthe country. Better services areneeded for crack and cocaineusers, who account for one in fiveof those referred for treatment.

• Aftercare: users will often say thatstaying off drugs is much harderthan coming off in the first place.Ex-users need aftercare once theyhave stopped using drug treatment

and rehabilitation facilities tohelp them build new lives.Improvements to housing supportand other initiatives for usersovercoming drug problems (seeChapter 3) will support the work ofthe treatment providers by makingit less likely that people will starttaking drugs again. Housing andwork-related help for those whohave drug problems, or arehomeless, or involved in sex workor begging, will support treatmentprovision for these special high-need groups.

• Harm minimisation: Improvingthe basic health of drug usersbenefits them and the widercommunity. GPs have a key role toplay in attracting drug misusers intoservices and in treating drugmisusers through shared careschemes where they work inthe context of a local networkof treatment provision.


0

10

20

30

40

50

60

70

80Reg heroin use (res)

Reg herion use (com)

Regular crack cocaine use (res)

Regular crack cocaine use (com)

Acquisitive crime (res)

Acquisitive crime (com)

4-5 years2 years1 yearIntake

Key findings from National TreatmentOutcomes Research Study (NTORS)

Percentage

Year of surveySource: NTORS at one, two, and five years (Gossop et al).


55

• Women and minority ethnic

communities: There is a range ofreasons why women and ethnicminority drug misusers do notaccess drug treatment services.They are often reluctant to makeinitial contact with drug serviceswhen they have a problem,perhaps due to the risks and stigmaattached to being identified as adrug misuser or a drug-misusingmother. They are also less likely tobe retained in treatment by drugservices, either for practicalreasons such as the lack ofchildcare provision, or because ofthe lack of services aimed at theirspecific form of drug misuse, forexample the smoking of heroin andstimulant misuse (Sangster et al,2002). Research highlights theneed for Government departmentsand the NTA to co-ordinate anddevelop an effective responseto the needs of women andminority drug users. In particular,it is recognised:

• that mainstream and specialistdrug service agencies mustengage more effectively withwomen and minority groups andthe organisations whichrepresent them, in order tobetter understand their needsand ensure that the servicesthey provide are targeted asappropriate to meet thoseneeds; and

• that drug services must be moreflexible and willing to developmethods for first attractingwomen and minority ethnicusers and then maintaining themin treatment. This meanswidening the range of drug-specific services offered andextending and combiningservices, where necessary, toprovide alternative therapies,such as acupuncture andcognitive behavioural therapies,and support services, such aschildcare provision, transport,

outreach services, flexibleopening times, support formental health problems andwomen-only and culturallysensitive services.

Workforce developmentA barrier to increasing treatmentcapacity and improving its quality isthe shortage of suitably qualified andexperienced drug workers. Measureswill be implemented to retain anddevelop existing drug workers, attractnew workers to the field and ensurethat other professionals who comeinto contact with people with drugproblems are given suitable training.

Deprived communitiesThere is a real need to ensure thattreatment is available and taken upby residents of the most deprivedcommunities. Action will be takento ensure treatment is madeaccessible locally.

Nilaari is a voluntary drug servicefocusing on the needs of Black andother minority ethnic communities inall districts of Bristol.

The service sees about 55 crack usingclients each month and is designed to:

•T react quickly;• be culturally appropriate in its

counselling;•T give intensive support;

•T provide advocacy;•T provide outreach;•T work with families; and•T focus on harm minimisation.

Nilaari has proved popular with clientswho appreciate its friendly and caringstaff and find it easy to return afterrelapse.

Case history: Nilaari

252921 Updated Drug Strategy 30/11/02 19:07 pm Page 55

What next?An additional £45 million has beenallocated for spending in the nextfinancial year, £54 million from April2004 and £115 million from April2005. This will bring the total directannual spend on community andprison treatment to £573 million fromApril 2005, to support a significantincrease in high quality servicesmeeting local and prison needs andbased on evidence of effectiveness toensure that providers can plan withconfidence.

It is for Drug Action Teams tocommission the drugs treatmentservices that will meet the needs oftheir local communities.

In overall terms, we would expect tosee a doubling in treatment capacityover the lifetime of the strategy toensure that drug users are able to getthe help they need, when they needit. There will be an emphasis on

ending the postcode lottery byensuring that all areas have access toa range of provision from advice andharm reduction services, throughspecialist prescribing anddetoxification provision to residentialrehabilitation. GP prescribing and daycare provision are services that mayrequire particular attention at locallevel, while DATs will need to workmore closely together to fill thesignificant gaps that exist in theprovision of in-patient and residentialrehabilitation services.

• Specialist training and supportprogrammes will continue to beprovided to encourage GPs to treatdrug misusers through shared careschemes. This supports the targetof increasing the proportion of

shared care schemes to 30%by March 2003.

• Improved and expanded

treatment for cocaine misusers.

New guidance on cocainetreatment for practitioners will beissued later this year, along withimproved training and supportto help them implement it.The majority of services providesome treatment for primarycocaine misusers, but only aminority provides specialisedtreatment for this group. TheGovernment is supporting workto improve this through researchinto the most effective responsesand services.

• Improved and expanded

treatment for crack misusers.

The spread of crack misuse is amajor challenge and it is essentialthat people seeking help for crackmisuse get the treatment andsupport they need. Delegates at a recent Home Officeconference heard that there isevidence that treatment for crackmisusers is effective, but that such


To complement the development

of existing services, heroin

should be available on

prescription to all those who

have a clinical need for it. The

number of people receiving

heroin will increase as overall

numbers in treatment grow.

An expert group is reviewing

the reasons for current regional

variations in the take-up of

heroin treatment and looking

at how suitable support services

can be developed and funded.

A work programme, led by

the NTA, is under way, drawing

together evidence of good

practice from those currently

delivering heroin on prescription,

with the aim of producing

updated guidance later in

2002. The guidance will be

accompanied by a plan

containing advice on

dissemination and sharing

best practice.

The administration of prescribed

heroin for those with a clinical

need will take place in safe,

medically supervised areas

with clean needles. Strict and

verifiable measures will be in

place to ensure there is no risk

of seepage into the wider

community.

Heroin prescription


treatment should focus on socialrather than medical interventionsand on assisting misusers to dealwith both the psychological andpractical impact of the drug on theirlives. As part of the National CrackAction Plan the NTA is givingpriority to a new crack workprogramme which aims to spreadgood practice, develop andevaluate specialist crack provisionand expand the capacity ofmainstream drug services torespond to users’ needs.This will link in with other actionto tackle supply and strengthencommunities (see Chapter 3).

• Expanded and improved

treatment provision reaching

all who need it.

• The NTA has developeda workforce strategy todevelop training andaccreditation programmes forexisting and new drug workers

with the aim of bringing 2000extra workers into the drugtreatment workforce by 2006.More sustained funding shouldhelp agencies’ long-termplanning and reduce levels ofstaff turnover.

• The Department of Healthcommissioned the developmentof Models of Care – guidanceon optimal models of care fordrug treatment services.This guidance is based on theprinciples of National ServiceFrameworks (embracingstandards, models of goodpractice, clinical and costeffectiveness and value formoney) and will act, in effect,as a National Service Frameworkfor substance misuse.

• To ensure that drug treatmentis provided more effectively andmore accessibly to areas of

social deprivation, the synergy

between the neighbourhoodrenewal strategy and the DrugStrategy will be furtherenhanced.

• It is crucial that the Governmentand other organisations workingin the drug field engageeffectively with women and

minority ethnic communities.Work to take this forward,as part of a wider diversitystrategy, will also take intoaccount the provisions of theRace Relations (Amendment)Act 2001. The NTA is committedto ensuring equal access torelevant and appropriate servicesfor the whole population and willcontinue to work with keystakeholders to establish waysof improving and enhancingthe delivery of drug servicesto women, ethnic minoritycommunities and other hard-to-reach groups.

57

Walsall DAT is working in partnershipwith the Health Action Zone, theteenage Pregnancy Working Groupand the Domestic Violence Forum toimprove the lives of children whoseparents or siblings use drugs.The project, which is in its first year,will combine fun activity days for thewhole family with needs assessmentresearch using informal conversationswith parents, carers and the childrenthemselves. A plan of action has been

drawn up: the aim is to give thesechildren, who range in age from twoto late teens, the confidence and self-esteem to break the chain of drugabuse in their families.

Case history: Helping children of drug using parents


• Expanded and improved prison

programmes. The Prison Servicewill work closely with the NTA toensure that Models of Care andStaff Standards are reflected inprison treatment interventions.The Service will continue to seekaccreditation to ensure thatrehabilitation programmes aredelivered to the highest possiblestandard. The Service will expandsupport for short sentenceprisoners for whom access tointensive interventions is limited bytime spent in prison. Additionalresource is being made availableover the period 2003/04 to 2005/06to support prison-based initiatives:drug testing, CARATs, treatmentand rehabilitation (see alsoChapter 3).

• New throughcare and aftercare

support. A holistic programme ofhelp, appropriately case managed,for problematic drug users leaving

prison or cutting short theirtreatment will be developed anddelivered (see Chapter 3).The Prison Service plans to reviewthe CARAT service, looking again athow best to cement the links withcommunity agencies, whether thebalance of service provision isproperly focused or whether moreemphasis should be placed on pre-release preparation andpost-release links.

• Improved health and fewer

drug-related deaths. Drug-relateddeaths are often the final tragicresult of years of risky patternsof use and poor health. Harmminimisation is given a higherprofile as reducing drug-relateddeaths by 20% by 2004 becomesa key element of the UpdatedDrug Strategy.

Programmes will focus on the keyrisks to health, reaching out on to

the street and other places totarget drug users in crisis. Actionwill include:

• Continuing initiatives to reducethe harm caused by drugmisuse, such as training backedup by high quality materials andvideos for drug treatment staffin injecting, syringe sharing andoverdose prevention andresuscitation, and programmesto tackle hepatitis B and C.

• Government-backed campaignsto promote harm minimisationmeasures and reduce the risk ofaccidental overdose.

Allowing drug misuse on premises:In 2001, section 8 of the Misuse ofDrugs Act 1971 was amended bysection 38 of the Police and CriminalJustice Act 2001, making it an offenceto allow use of controlled drugs onany premises. The amendment, which


Reassuring drug users that dialling999 for an ambulance in overdosesituations will not necessarily leadto police involvement is part of awide-ranging initiative to reducedrug-related deaths in Walsall.Contrary to common belief amongusers, the police will only be involvedin an ambulance call-out if someone isalready dead, child abuse is involvedor there is a possibility of violenceagainst ambulance staff.

Harm reduction work also includeseducating users about the short-termeffects of the drug Naloxone, anopiate blocker, which is administeredin A&E departments after heroinoverdoses. Users often feel betterand discharge themselves fromhospital, only to overdose later as theeffect of the Naloxone wears off.

The DAT has also produced accreditedtraining for tattooists and piercers inthe area in order to educate them andtheir clients on viruses transmittedthrough the blood, including hepatitisB and C and HIV/AIDS.

Case history: Reducing drug-related deaths in Walsall


covers the use of all controlled drugs,was required to strengthen policepowers to deal with the proliferationof crack houses. It is recognised thatthe strengthening of the law couldraise concerns amongst thoseworking in the care sector who arecarrying out legitimate harm reductionactivities. Parliament therefore agreedthat, before the amendment wasbrought into effect, guidance wouldbe published outlining how it shouldbe enforced. This guidance wasrecently made available in draft formfor consultation.

Supplying injecting paraphernalia toaddicts: Those who work with drugmisusers have been pressing forsection 9A of the Misuse of Drugs Act1971 to be amended to allow thesupply of swabs, sterile water andother items of drugs paraphernalia todrug misusers for harm minimisationpurposes. Section 9A enables drugworkers to supply sterile syringes and

59

needles to drug misusers butcurrently provides that it is unlawfulfor them to supply other articles ofdrug paraphernalia such as sterilewater, mswabs, citric acid sachets,filters and tourniquets.

Nevertheless, drug workerssometimes supply these other itemsto drug misusers for harmminimisation purposes. Although thepolice and the Crown ProsecutionService do not generally prosecute insuch cases, as a prosecution wouldnot normally be in the public interest,drug workers are still placingthemselves at risk of prosecution. TheAdvisory Council on the Misuse ofDrugs (ACMD) was therefore asked toconsider the various items of drugparaphernalia and look at the extent towhich they actually helped to reduceharm. As a result, the ACMD hasrecommended that the legislationshould be amended to permit thesupply of those items of drug

paraphernalia that help to reduceharm. The Government has agreed tothis, and is currently consulting onamending the law to permit thesupply of additional items ofequipment.

Cannabis-basedmedicineThe Government is

encouraged by the results

recently published by GW

Pharmaceuticals of the clinical

trials into the development of

a cannabis medicine.

Application to the Medicines

Control Agency for a product

licence is now to be made by

the company. If this is

successful the Government

will make the necessary

legislative changes as quickly

as possible to allow doctors to

prescribe the new medicine.


TargetsTargets which are challenging butachievable will drive delivery of theUpdated Drug Strategy. They are:

• Reduce the use of class A drugsand the frequent use of any illicitdrug among all young people underthe age of 25 especially by themost vulnerable young people.

• Reduce the availability of illegaldrugs by increasing: the proportionof heroin and cocaine targeted onthe UK which is taken out; thedisruption /dismantling of thosecriminal groups responsible forsupplying substantial quantities ofclass A drugs to the UK market;and the recovery of drug-relatedcriminal assets.

• Contribute to the reduction ofopium production in Afghanistan,

with poppy cultivation reduced by70% within 5 years and eliminationwithin 10 years.

• Reduce drug related crime,including as measured by theproportion of offenders testingpositive at arrest.

• Increase the participation ofproblem drug users in drugtreatment programmes by 55% by2004 and by 100% by 2008, andincrease year on year the proportionof users successfully sustaining orcompleting treatment programmes.

Delivery mechanismsNational delivery mechanisms Delivering the Drug Strategy is across-government initiative. Followingthe 2001 General Election, the HomeSecretary took over lead responsibilityfor driving forward delivery of the

Drug Strategy, as Chair of the CabinetMinisterial Sub-Committee on DrugsPolicy. The committee includesministers from the Department ofHealth, the Department for Educationand Skills, the Office of the DeputyPrime Minister, the Cabinet Office,the Treasury and the Foreign andCommonwealth Office.

The Drug Strategy targets areexpressed in departments’ publicservice agreements and supportingservice delivery agreements. Theseare embedded in delivery plans whichare drawn up in conjunction with thePrime Minister’s delivery unit and keptunder regular review by ministers andofficials.

The Strategic Planning Board supportsthis structure at civil service officiallevel. Membership reflects that of theCabinet Sub-Committee. In addition,

60 Delivery and resources

5. Delivery and resources


61

there are cross-departmental groupsfocusing on each of the currentstrategy aims – for example, theConcerted Inter-departmental ActionGroup (chaired by a senior officialfrom HM Customs and Excise) isfocusing on reducing supply – as wellas local delivery and communications.These delivery groups includerepresentatives from a wide range ofagencies and stakeholders.

The Government set up the NationalTreatment Agency (NTA) as a SpecialHealth Authority on 1 April 2001,although staff were not in place untilthe autumn of that year. The NTA’scurrent priorities are to ensureequality in drug treatment; increasethe capacity and competence of thedrug treatment workforce; increasequality and accountability at all levelsof the drug treatment system;

improve the availability andaccessibility of drug treatment in allareas of the country; and increase theeffectiveness of drug treatment.

Regional and local deliverymechanismsAt local level, agencies working inpartnership through 149 Drug ActionTeams (DATs) deliver the DrugStrategy. DATs were initially set up in1995 and have been aligned with localauthority boundaries since April 2001.They bring together representatives ofkey local agencies, such as health(Primary Care Trusts), social services,the police, probation, education, thePrison Service, and housing. EachDAT is supported by a co-ordinatorand is accountable to the HomeSecretary. Some include alcohol andsolvent misuse within their remit.DATs are supported by one or more

drug reference groups, whosemembership includes key localprofessionals involved in the deliveryof drugs services.

DATs are supported at regional levelby Home Office drug teams (DrugsPrevention Advisory Service,or DPAS). In recognition of the needto operate more effectively at regionallevel, Home Office teams, includingthe nine DPAS teams, are beingintegrated into the regionalGovernment Office structure. This willsupport closer links between thosesupporting regional activity on crime,drugs, community cohesion, raceequality, active communities and otherHome Office priorities such asneighbourhood renewal, and thewider Government Office agenda.


Performancemanagementand monitoringDelivery of the Drug Strategy dependson agencies working effectively inpartnership to make a real differenceto local communities. Home Officeteams support partnership working ina variety of ways, including settingand monitoring standards ofperformance, and assessment ofpartnerships’ plans through a processwhich includes the NTA and otherregional representatives (for example,the Youth Justice Board, theConnexions Service and the SocialServices Inspectorate).

Recommendations for action are thenagreed between the DAT and theHome Office team; and progressis monitored and reported on aquarterly basis.

Annual ReportEach year DATs report on their workby providing statistical and qualitativedata on young people, treatment,communities and supply. From April2001 DATs have given this informationelectronically. This in itself is asuccess story for the Government’s e-business strategy, and hasgenerated a database, which includesthe most comprehensive localinformation available to date on thedelivery of the Drug Strategy and thetracking of expenditure. The databaseallows comparison of DATperformance across “families” andregions, providing DATs with anopportunity to share good practice.

DAT returns for 2001/02 show realimprovements in performance inkey areas of the Strategy. DATs arebuilding closer links with otherpartnerships such as Connexionsand Crime and Disorder Reduction

Partnerships (see Chapter 3).However, there is still scope forestablishing better links between theStrategy and other related regionaland local initiatives such asneighbourhood renewal, communitycohesion and the wider crimereduction agenda.

What next? Local partnershipsIn view of the close links betweendrugs and crime, the Police ReformWhite Paper, published in December2001, proposed creating newpartnerships to bring together thefunctions of DATs and CDRPs. Therewere specific reasons for streamliningHome Office delivery mechanisms:

• To reduce local bureaucracy.

• To avoid duplication of effort –local agencies sit on both DATsand CDRPs.


Bournemouth DAT allocated £20,000on 2002/03 to the Service UserForum. This money not only fundsservice users to attend meetings, butpays for an independent telephonehelpline which they run for severalhours each week, and a newsletter.The DAT itself has representationfrom a service user, who attends boththe full Drug Action Team and jointcommissioning group meetings,giving feedback from other clients aswell as his own views. This service

user has also helped the NationalTreatment Agency develop its Guideto involving and empowering drugusers, and sits on the NTA’s useradvisory panel.

Involving service users in provisionand planning has become an integralpart of Bournemouth’s DAT. Theybring a unique perspective to theservice, help to ensure its relevance,and act as advocates for any otherusers who have complaints.

Case study: User involvement in service planning


• To ensure more effective targetingof resources: rationalise fundingstreams; bringing together crimereduction teams and DPAS; andcloser working at central HomeOffice level.

Following a full consultation process,new and closer working arrangementswill be put in place from April 2003.This will ensure that the overlappingdrug and crime agendas have a clearfocus on delivery; will strengthenthe partnership structure; and alignthe drug and crime agendas withthe overarching neighbourhoodrenewal agenda.

The Police Reform Act will put theDrug Strategy on a statutory footingby placing a statutory responsibility onlocal authorities and the police and (byno earlier than April 2004) PrimaryCare Trusts to formulate andimplement a drug strategy.

The resources going to provideadditional services at a local level,especially in the areas with thegreatest drug problems, place evenmore importance on the need for highstandards of delivery. Home Officeteams will work with the partnershipsand agencies involved, identifyingproblems and ways of tackling them.These will include better mechanismsfor supporting effective delivery suchas improved systems for monitoringand evaluating progress and the useof resources; strengthening capacity;and developing a greater focus onoutcomes.

The Inspectorates (and the AuditCommission) already play a key roleoverseeing the work of DAT partneragencies and their work deliveringthe Drug Strategy. Their role will befurther developed in the context ofa wider review of inspection and the

criminal justice system to supportthe performance management ofthe Drug Strategy.

ResourcesOne of the key principles underpinningthe Updated Drug Strategy is the needto change spending priorities fromreactive expenditure, i.e. dealing withthe consequences of failure to tackledrug misuse, to proactive expenditure,i.e. preventing and tackling drugmisuse directly.

The Government has madesubstantial resources available fordirectly tackling the problem of drugmisuse. They will increase from aplanned £1026 million in this financialyear to £1244 million in the nextfinancial year, £1344 million in the yearstarting April 2004 and a total annualspend of nearly £1.5 billion in the yearstarting April 2005 (see table overleaf).

63


New areas of spend include:

• more support for parents, carersand families so they can easilyaccess advice, help, counsellingand mutual support, a neweducation campaign for young

people, expanded outreach andcommunity treatment forvulnerable young people andexpanded testing and referrals intotreatment within the youth justicesystem so that by 2006 we willbe able to provide support to40–50,000 vulnerable young peoplea year;

• tackling prevalence throughnew cross-regional teams to tackle“middle markets”, the link in thechain from traffickers to localdealers, and increased assistanceto the Afghan Government to

achieve their aim of reducing opiumproduction with a view toeliminating it by 2013;

• further expansion of treatment

services, improved treatment forcrack and cocaine, heroinprescribing for all those who wouldbenefit from it and more harmminimisation – with improvedaccess to GP medical services;

• a major expansion of services

within the criminal justice

system using every opportunityfrom arrest, to court, to sentence,to get drug misusing offendersinto treatment. Includingexpanded testing, improvedreferrals, and new and expandedcommunity sentences; and

• new aftercare and throughcare

services to improve communityaccess to treatment and ensurethose leaving prison and treatmentavoid the revolving door back intoaddiction and offending.

The programme will be kept underreview, particularly with regard to itsimpact on the prison population andthe availability of treatment.


2002/03 2003/04 2004/05 2005/06

Protecting young people 102 149 155 163

Reducing supply 376 380 380 380

Safeguarding communities* 110 212 297 367

Drug treatment** 438 503 512 573

Total 1,026 1,244 1,344 1,483

Direct annual expenditure for tackling drugs

* Includes expenditure strengthening delivery** Includes mainstream spending, prison treatment and pooled budgets


65


The Scottish Executive set out itsdrugs strategy in “Tackling Drugs inScotland: Action in Partnership”. Thekey achievements to date include:

• Provision of new funding totalling£128 m over three years from2001. This supports a range ofinitiatives including treatment andrehabilitation, training andemployment, drugs education,communications, research andcriminal justice interventions.

• Launch of the “Know the Score”communications campaign tohighlight and provide relevant, non-judgmental information on drugsissues. This has included a nationaltelevision advertising campaign andthe creation of a dedicated helplineand website.

• Publication of information on,amongst other things, cannabis,hepatitis C and hepatitis B.

• Provision of drug education in 98%of Scottish Schools.

• Establishment of drugs courts inGlasgow and Fife and theintroduction of Drug Treatmentand Testing Orders.

• Creation of an EffectiveInterventions Unit (EIU) withinthe Executive to identify anddisseminate good practice, supportDATs and co-ordinate the drugresearch programme. Keypublications have included a reporton “Integrated Care for DrugUsers”, a guide to “Supportingfamilies and carers of drug users”and “Moving On”, a review ofeducation, training and employmentfor recovering drug users.

• Launch of the Scottish DrugEnforcement Agency in June 2000.The number of offences recordedby Scottish Police forces for supplyor possession with intent to supplydrugs has increased from 9,024 in2000/01 to 10,135 in 2001/02.

• Strengthening of the role of DATs indelivering services at local level bysetting three year budgets,providing guidance on jointcommissioning and partnershipworking, co-ordinating corporateaction plans and funding a nationalofficer post within the DATAssociation.

• Provision of multi-disciplinarytraining throughout Scotlandthrough Scottish Training on Drugsand Alcohol (STRADA).

In November 2001, the Executivepublished its first annual report tohighlight the progress that hadbeen made in deploying its drugstrategy. Examples of localinitiatives included in thatreport were:

• Activity by Glasgow City Council tobuild up a range of services whichwill lead to 1200 young people peryear accessing specialist servicesdealing with their addictionproblems; 400 parents of youngchildren per year receivingspecialist treatment and familysupport services to help them dealwith their drug problems whilstsafely caring for their children; and500 respite care placements peryear for children who are beinglooked after by grandparents orextended families due to parentaldrug addiction.

6. Delivering the Strategy across the UK

The formulation and delivery of

the Drug Strategy reflects the

devolution of powers to the

Assemblies in Wales and

Northern Ireland and the

Parliament in Scotland. The UK

Government is responsible for

setting the overall strategy and,

in the areas where it has reserved

power – for example, the work of

HM Customs and Excise – for

delivery in the devolved

administrations. Each devolved

administration exercises its

delegated powers to shape the

strategy to address local

circumstances.

66 Delivering the Strategy across the UK

Scotland


• Signpost Forth Valley, agroundbreaking service whichwill give drug misusers in theClackmannanshire, Falkirk andStirling areas easy access toadvice, information and supportfrom next year.

• Grampian NHS Boardestablishment of new drug misusespecialist community midwifepost within the drug misuseantenatal clinic.

• Dumfries and Galloway DrugAction Team use of Executivefunding to develop a Small GrantsScheme for rehabilitation services.The Scheme aims to helpindividuals overcome financialbarriers to accessing training andalternative activities.

• The development by Highland DATof an arrest referral scheme inInverness and Nairn, Ross,Cromarty, and Skye to tackle thelink between drug misuse andcrime. As part of this approach,a social worker offers supportservices to individuals who havebeen interviewed, arrested and/orcharged by the police and whomay have a drug misuse problem.

The Scottish Executive continues tofocus upon drug misuse as a keycross-cutting issue. The Ministeriallead rests with the Deputy Ministerfor Justice with cross-Governmentfocus provided by a dedicated cabinetsub-committee chaired by the DeputyFirst Minister. Future plans include:

• Continued roll out ofcommunications activities includingthe publication of new informationon psycho-stimulants andstrengthening of links betweennational and local communicationsactivity.

• Piloting of a new treatment servicefor psycho-stimulants users withinthe Aberdeen region to help shapetreatment strategies in the face ofa potential growth in the use ofcocaine and crack cocaine.

• A range of actions to deploy therecommendations of on EIU reportinto Integrated Care for DrugUsers.

• The publication of a second annualreport on the drugs strategy.

• Ongoing support for acomprehensive multi-disciplinarytraining programme including theprovision of leadership training forDAT members.

• The use of £180,000 of recoveredcriminal assets to help familysupport groups across Scotlandincluding the development of anational network.

• Undertaking a second nationalprevalence survey in 2003 whichwill identify trends in drug use.

Case history: Scotland’s drug

misuse communications

strategy

With funding of £6.3million for2001/02 to 2003/04, the ScottishDrugs Communications Strategywas launched in March 2002and takes a three-tier approachto tackling drug misuse underthe overarching slogan “Knowthe Score”:

Nationally: A new mass mediacampaign was launched includingTV, cinema, radio, posters andbillboard advertising, along withthe “Know The Score” websiteand an information line (linkedto the National Drugs Helpline).The Executive has also distributeda series of “Know the Score”materials on cannabisreclassification, a guide for parentsand information for young people.A suite of harm reduction materialshas also been distributed todrug agencies, service providersand prisons.

Locally: While the ScottishExecutive adopts an ‘all drugs’approach at national level, at a locallevel communications are directedby the needs of the local DAT andmay target specific groups, forexample injecting drug users. Harmreduction materials on injectingpractices, avoiding overdose, andHepatitis B and C have also beendistributed by the Executive todrugs agencies across Scotland.

Media relations:

The third tier is focused onimproving media relations tobring about more balanced andinformed coverage.

67


Wales has its own distinctivesubstance misuse strategy, “Tackling Substance Misuse in Wales:A Partnership Approach”, which waslaunched in May 2000.

Responsibility for substance misusepolicy within the Welsh AssemblyGovernment rests with the Ministerfor Finance, Local Government andCommunities and substance misusesits alongside crime reduction in theCommunity Safety Unit. The Ministeris leading the refocusing of thestrategy towards delivering improvedservices intended to tackleproblematic drug use.

As a consequence of Healthrestructuring in Wales the 5 existingWelsh Drug and Alcohol Action Teams(DAATs) are being abolished. FromApril 2003 the function of DAATswill be integrated into the 22 WelshCommunity Safety Partnerships.The Partnerships will be responsiblefor the formulation andimplementation of local substancemisuse plans. A strategic level of co-ordination will be established in thefour Welsh police areas and will bedelivered by Welsh AssemblyGovernment staff.

Treatment and rehabilitation services,particularly relating to Class A drugsare the priority and despite previousincreases in funding for substancemisuse treatment, there are stillconcerns over increased heroin andcrack use and the availability of,and access to, treatment services.Increasing the number of substancemisusers in treatment remains a keyobjective. The Minister has agreedthat substantial new funds are tobe provided to improve services.This amounts to an additional£18 million over the next three years – an additional £3 million for 2003/04,£6 million for 2004/05 and £9 millionfor 2005/06.

In the first year this growth will allow£2 million to be invested in front linecommunity services. The emphasiswill be on strengthening coretreatment services across Wales andbuilding capacity particularly in relationto treatment targeted on problematicdrug users. Community detoxificationand rehabilitation provision will beextended. These provisions will befurther expanded in the following twoyears in line with increased funding.

Case history: Strengthening

ties between community

and police

The Melin Against Drugs campaign,based in the Melin district of NeathPort Talbot, targeted drug dealingand related crime in a heroin hotspot. Local councillors were closelyinvolved in planning and supportingthe campaign alongside the policeand other agencies.

Leaflets were delivered to everyhousehold, giving numbers for apolice hotline for reporting drugdealing and a counselling andsupport helpline. There were speciallessons in schools, a parents’evening and a crime preventionevent outside the localsupermarket.

All major dealers were arrestedand removed from the communityas a result of the campaign.To date eight convictions have beenobtained with an average sentenceof four years’ imprisonment.Additional police activity resultingfrom the large amount ofintelligence received was fundedthrough Communities AgainstDrugs monies.


Wales


The NHS in Wales is currentlyspending around £12 million a yearon treatment for substance misusers.However, the spending varies acrossWales and does not necessarily fitwith demand. The Minister thereforeintends to ring-fence this element ofNHS funding, which will grow in linewith the general increase in WelshNHS funding, so that it can be moreeffectively targeted on treatmentpriorities.

The availability and demand for bedspaces for inpatient detoxification andresidential rehabilitation will be givencareful consideration and identifiedneeds for expansion in this sector willbe taken into account in the secondand third year growth in investmentin treatment services.

Providing prisoners with support ontheir release from prison is a priorityfor development. Support workerswithin local communities will beprovided, specifically to address theneeds of discharged prisoners withsubstance misuse problems.The intention is to prevent relapseand the potential for drug relateddeaths, and to facilitate access toemployment and education byworking with other governmentinitiatives. A priority will be to workwith health agencies to ensure thattreatment is available followingdischarge. Support will be providedthroughout Wales for this group.

Support will also be increased withinprisons to develop the key life andsocial skills of prisoners who haveundergone treatment for substancemisuse whilst in custody. This willbetter equip them to make use ofpost discharge support to cope withre-entering society.

Timely and accurate managementinformation from the localpartnerships will be essential toensure that the substance misusestrategy is being delivered effectivelyat the local level and that theAssembly is obtaining value formoney for the new investments.In 2003–04 the Assembly will besetting up new data collectionarrangements and work will begin ondeveloping a research programme.

The approach to tackling substancemisuse in Wales is focused on thetwin goals of promoting communitysafety and the provision of timely andappropriate treatment. The case studyillustrates how policing to stiflethe availability of drugs can besuccessfully integrated together withencouraging misusers to accesstreatment services.

69


Since the Executive approved themodel for the joint implementation ofthe Drug Strategy and the strategy forreducing alcohol-related harm, worktowards targets in both strategies hasbeen progressing rapidly.

Priority has been given to getting theimplementation structures right, atregional and local level. This isessential to ensure coherent andconsistent delivery of the strategiesacross all departments and theiragencies, in partnership with thecommunity, voluntary and businesssectors. The importance of anintegrated approach based onpartnership working has been learnedfrom experience, so the newimplementation model is fullyinclusive and gives the voluntary andcommunity sector the lead role in theCommunities Working Group.

At ministerial level, the remit for theStrategic Steering Group alreadyestablished under the leadership ofthe Minister for Health, SocialServices and Public Safety to addressdrug misuse has been extended toinclude alcohol issues. The group alsoincludes the Ministers for Education,Employment and Learning, theEnvironment, Culture, Arts andLeisure, Enterprise, Trade andInvestment and Social Development.The Northern Ireland Office Ministerresponsible for criminal justice meetswith the ministerial group on a regularbasis to ensure co-ordination betweenthe devolved and reservedresponsibilities and to address issuesthat cut across boundaries.

The involvement of ministers froma range of departments ensures co-ordination across the devolved andnon-devolved areas in taking forwardinitiatives such as developingworkforce policies on drugs andalcohol, encouraging the involvementof the sport and leisure sector in thedelivery of relevant sections of thestrategies, tackling drugs, and drinkingand driving.

At official level, the Drugs and AlcoholImplementation Steering Group(DAISG) meets regularly to reviewprogress on the strategies and ensurea co-ordinated approach to tacklingdrug misuse. This group includessenior representatives from thedepartments represented on theStrategic Steering Group as well asfrom the criminal justice agencies, theHealth Promotion Agency, the Drugsand Alcohol Co-ordination Teams andthe voluntary and community sector.

Six working groups, coveringcommunities, treatment, educationand prevention, research andinformation, social legislation andcriminal justice, have been created todevelop these specific areas of thetwo strategies. Responsibility forissues relating to enforcementremains with the Northern IrelandOffice, which is represented by theCriminal Justice Working Group.

Case history: Community

response in County Down

Reaching Everyone and CreatingTrust (REACT) is an organisationcommitted to improving communityrelations in the Kilkeel area ofCounty Down.

REACT’s ‘Don’t Blow It’ project wascreated in response to theincreased availability of drugs andrising levels of drug and alcoholmisuse among young people in thearea. It was launched in November2000 and its aims are to provide:

• community-wide, impartialinformation;

• effective confidential one-to-oneand/or family counselling; and

• education and trainingprogrammes and workshops tosupport increased choice foryoung people.

The project has developed a uniquecommunity-based model focusingon contact, collaboration andsustainability in its attempt toaddress the problems in the area.


Northern Ireland


The working groups have developedaction plans for their specific areas.These have now been combined toproduce a regional action plan listingover 115 recommended activities,which received ministerial approvalin April. Based on this regionalplan, the four Drug and Alcohol Co-ordination Teams have developedlocal action plans and will beprogressing this work at local level.

The Chancellor announced thatadditional resources of over £9 millionwould be made available in NorthernIreland from April 2002 to takeforward work in both the devolvedand non-devolved spheres. Of this,£6.23 million was transferred to theExecutive for allocation throughDAISG. Most of this allocation is beingused to resource the regional andlocal action plans.

The previous package of funding toimplement the Drug Strategy andtackle drug-related issues ended inMarch 2002. Over £4.5 million of thismoney was allocated to 36 projects tohelp deliver on the objectives of thestrategy. These projects includededucation and awareness raising inschools and community groups; drugeducation for parents; improved andexpanded treatment, rehabilitation andcounselling services for drugmisusers; and action to reduce drugmisuse in prisons and amongoffenders. The Department of Health,Social Services and Public Safety hasfound the necessary funding tosustain 23 of these projects, while theremaining projects will be funded bythe relevant department.

Case history: Youth group

volunteers deliver drug

education

The DrugWiser project, based in theAisling Centre, Enniskillen, providesdrug education workshops andtraining programmes both at thecentre and via outreach to schools,youth clubs and communityorganisations.

The overarching aim is to protectyoung people from the harmresulting from illicit drug usethrough a comprehensiveprogramme of drug and alcoholawareness training for all youngpeople and their parents. Theoriginal target group has now beenextended from 11–14 year olds toinclude the 14–17 age group.

From September 2000 to February2002, 54 workshops were held inschools. Youth group volunteers,who have undergone accreditedtraining, facilitated much of theprogramme. Around 100 workshopshave also been delivered to youthand community groups in the area,reaching a combined audience ofmore than 2,600.

71


72 Annex 1

Executive summaryThe reason for action1. Crack use is steadily increasing throughout the UK.

Evidence and feedback from a number of police forcesand treatment agencies suggests this. On the basis of arange of available data, a significant sub-section of allDAT areas have a significant problem with crack use andcrime. On the basis of this we can identify those areaswhere crack is most acute and where a higher level ofresponse is needed. Whilst the majority of users arepoly-drug users, using crack alongside heroin, just over30 areas (about half of them in London) a significantnumber use crack as their primary drug of choice. Wherethis is the case, and especially where crack marketshave grown up to support their use, problems related tocrack are acute and demand urgent action.

2. Crack problems have not always been dealt with asefficiently as problems with heroin; partly because crackmarkets are difficult to handle and users difficult toengage in treatment. Action will be taken to increase theability of services under all four aims of the strategy torespond effectively.

The problems crack brings3. Crack is produced in the UK from imports which derive

mostly from bulk shipments via the Channel ports.A much smaller quantity arrives via couriers, by air.

4. Primary crack use sometimes leads to greater levels ofviolence and acquisitive crime and has been linked toguns and sex work. In all cases, whilst treatment canbe effective and lead to behavioural change, serviceshave not always been able to respond to the needs ofusers effectively.

5. Crack markets have a damaging effect on localcommunities, especially deprived ones, and havedisproportionately affected the African-Caribbeancommunity.

6. Crack dealing, linked to gun use, is seen by some youngpeople, as an attractive career option.

What will we do?7. Action is under-way across the four aims of the Strategy

– this will be increased and advanced more quickly andmore effectively, delivering a higher level of service in allareas. There will also be an intense focus in those areas

most heavily affected – high crack areas (or HCAs) whichwill be expected to deliver a much more comprehensiveset of services.

• On supply, major new action to stem the trafficking ofcrack to the UK through work in producer and transitcountries to close trafficking routes.

• A major programme of action by police in a number ofkey force areas to close local crack markets, such asis happening in Lambeth (see Executive Summary).

• A new capability of all drug services to meet theneeds of drug users backed by around twentyspecialist programmes for crack users servingthe HCA.

• New programmes to divert young people at risk fromusing crack and getting involved in related culture.

• New media and communications campaigns in HCAto raise awareness of gun crime and crack risks.

• New criminal justice interventions and increasedservices for offenders in HCA, making arrest referralservices more able to track crack users into treatmentand offer flexible, crack specific DTTO programmes.

• New research into the effectiveness of treatment.

• New programmes to meet the needs of special clientgroups most affected by crack, such as sex workers.

What will be the result from these actions?8. There will be measurable change:

• An increase in the number of people arrested forcrack supply.

• An increase in the number of people convicted forcrack supply offences.

• A reduction in crack-related gun crime.

• An increase in the amount of cocaine removed fromthe supply route to the UK.

• An increase in the number of people accessing drugtreatment.

Annex 1: The National Crack Action Plan


73

• An increase in awareness of crack issues amongstyoung people.

• A reduction in the number of young people starting touse crack.

• A reduction in local availability.

• An improvement in public perception of actionin HCAs.

And as well:

• Services will address the needs of the most deprivedareas as a priority.

• The needs of ethnic minority users will be met moreeffectively.

When will this happen?9. The timetable will be as follows:

• Identification of the HCA by December 2002.

• Creation of a high-level programme management groupby December 2002.

• Guidance to DATs on how to tackle crack problems byDecember 2002.

• Focused action by police in key areas against marketsstarting January 2003.

• Introduction of new specialist crack treatment servicesby April 2003.

• Introduction of new schemes for vulnerable youngpeople at risk of crack use in HCAs, amongst otherdrugs, by June 2003.

• Introduction of new criminal justice interventions,aimed at getting crack users and other drug users intotreatment. These will begin to come on stream inApril 2003.

• Measurable improvements in all areas, on supply, youngpeople, treatment and crime by June 2003.

How we will co-ordinate this ingovernment10. The Home Office will set up a high level strategic

programme management group involving key agencieslike the NTA and ACPO, alongside delivery agentsin government, to drive action across the strategy.This will commission activity and delivery on crack inkey areas:

• We will ensure that there is effective local co-ordination by DATs and reporting on progress tothe centre.

• DATs will be given specific guidance on how theycan locally gear up services to meet this challenge.

11. The following chart provides an outline of theaction plan.


Action ontrafficking

Middlemarket supply

Streetsupply

Youngpeople

CriminalJustice

TreatmentEffect on

Communities

Exam

ple

acti

vit

ies

Reduce the amountof cocaine reachingthe UK

• Work withproducer countriesto reduce areas ofcocaine incultivation

• Intercept cocainein transit countriesand en route

• Intercept cocaineat point ofimportation

Interrupt middlemarket distributionin the UK

• Targeted policeoperations

• Building of relevantintelligence

• Develop regionalcapacity tointercept dealers

Close local crackmarkets and makeselling crack verydifficult

• Close crackhouses

• Close streetmarkets

• Reduce thenumber of placeswhere crack mightbe sold throughenvironmentalmeasures

• Tackle relatedcriminality – eg gun crime

Reduce the desireto use crack

• Developdiversionaryprogrammes foryoung people atclear risk

• Ensure all childrenreceive crackspecific education

• Address specificrisks – eg sexwork, gun crime

• Local mediacampaigns riskassessmentservices

Speedy referral ofcrack relatedoffenders intotreatment

• Ensure arrestreferral identifiescrack users

• Develop relevantDTTO programmes

• Ensure prisonprogrammesaddress crack

• Develop persistentoffender schemes

Availability offlexible, appropriatetreatment forprimary crack users

• Ensure flexible,responsiveservices for all drug users thatmeet the needs ofcrack users

• Offer specialistservices toparticular clientgroups – eg BME,prostitutes

• Set up specialistservices whereproblems are acute

A reduction in allthe indicators ofcrack related harmin a community

• Reduction inoffences to payfor crack

• Reduction in cracksupply

• Rapid access totreatment servicesfor users

• Young people whoreject the offer ofcrack

• Sex markets areless visible andsex workersget help

Annex 1: The National Crack Action PlanO

bje

cti

ve

25

29

21

Up

da

ted

Dru

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trate

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1/3

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74

Young peoplePosition in 1998The British Crime Survey (BCS) has been used to assessthe level of drug use among the general population inEngland and Wales. The results from the 1998 surveyformed the baseline for Class A drug use by young peopleaged between 16 and 24. The schools survey of drug useamong 11–15-year-olds in England provides an additionalindication of progress towards the young people’s target.

However, there were limitations in the range of peoplecaptured by the surveys, the information produced, thefrequency of reporting, and the extent that change could bedetected. There was also a lack of robust evidence on theeffectiveness of drug prevention work.

Progress since 1998The following measures have been implemented in orderto improve the evidence base for assessing drug use inyoung people:

• The sample size for the BCS has been increased, and abooster sample of 16–24-year-olds has been added toallow more precise measurement of changes in Class Adrug use. From 2002 onwards, BCS respondents will beasked about the frequency of their drug use.

• Studies have been commissioned which examinegroups of young people vulnerable to problematic druguse, e.g. those leaving care, sex workers, youngoffenders and homeless young people.

• A new Crime and Criminal Justice Survey will provideinformation on the links between drugs and crime, andwill provide much better information on the nature andpatterns of drug use among young people, than iscurrently possible through the BCS.

• Scoping work will be undertaken on the use of surveysto establish trend data on drug use among the mostvulnerable young people.

• Evaluations of the school-based ‘Blueprint’ programme,and the Youth Justice Board’s ‘Named Drug Worker’initiative will provide evidence of the effectiveness ofdrug prevention/reduction work with young people ineducational and youth justice contexts.

• Research is in hand to estimate the number ofproblematic drug users in specific geographical locations.

The major sourcesThe British Crime Survey and Schools Survey on

Smoking, Drinking and Drug Use

The BCS is a representative survey of the general public inEngland and Wales. It asks those aged between 16 and 59about their use of drugs, and acts as the main measure forthe Young People’s target by estimating Class A drug useand frequent drug use among 16–24 year olds.

The schools survey measures the prevalence of drug use,smoking and drinking among young people aged 11–15in England. Questions about illegal drug use wereintroduced in 1998 and since then the survey has beencarried out annually.

Crime and Criminal Justice Survey

This new survey will interview a representative sampleof approximately 10,000 people aged between 10–59,including 5,000 young people aged between 10–25years. A range of questions specifically on drug use isto be included in the new survey. In addition to generalprevalence figures, the survey will explore the linksbetween substance use and offending, as well as exploringthe nature and patterns of drug use in much greater detailthan the BCS is currently able to do. The first findings fromthe survey will be available for analysis in autumn 2003.

Surveys of vulnerable young people

Reflecting the need to better understand substance misuseamong the most vulnerable young people, work is currentlybeing undertaken to assess the scope for collecting trenddata on vulnerable groups between now and 2008.This work will explore a number of approaches toaccessing vulnerable young people, including through PupilReferral Units, Youth Offending Teams, and young peopleidentified as ‘at risk’ through their contact with theConnexions Service.

Evaluation of the Youth Justice Board’s ‘Named

Drug Worker’ initiative

The Youth Justice Board has invested £24 million to ensurethat all young offenders in contact with YOTs are assessedfor substance misuse and referred on to services asappropriate. A number of models of working are beingimplemented across all 154 YOTs. The evaluation of thisinitiative will significantly boost the evidence base aroundeffective practice with substance misuse among youngpeople in a youth justice context.

Annex 2: Overview of improvements in the evidence base 1998–2002

75


76 Annex 2

Evaluation of Blueprint project.

Blueprint is a an initiative that will deliver drug educationto young people through work with schools, families andparents, the media, communities and health policies.By evaluating the success of the programme, Blueprintaims to create a model of best practice for future drugeducation. The programme has been developed after areview of materials from ‘what works’ programmes in theUnited States (e.g. Life Skills Training and Project STAR).The programme is targeted on young people aged 11 to 13.

Reducing supplyPosition in 1998In 1998 there was very little evidence to draw upon.No attempt had been made to estimate the size of the UKdrugs market, apart from some exploratory work carriedout by the Office for National Statistics (Groom et al, 1998).However, statistics on drug seizures, offenders and streetprices were available, and these were used to provide abaseline as at 1998.

Progress since 1998A study designed to estimate the size of the UK drugsmarket was carried out by the National Economic ResearchAssociates for the Home Office in 2001 (Bramley-Harker,2001). This study used a ‘bottom-up’ approach, whichestimates the value and size of the market by identifyingthe prevalence of different types of users. Work is in handto further refine the methodology and to update estimatesfor later years.

Another approach has been to ask key individuals abouttheir perspectives on trends in supply. This Key InformantStudy (KIS), carried out in England, Wales, Scotland andNorthern Ireland during 2000 and 2001, provided someinteresting observations. A new national perceptual surveyis under consideration and this will draw on projects suchas the US Pulse Check survey in its methodology.

A study has also been completed on the middle marketarea of the drug distribution system in the UK. This waspublished in 2001 and provided information on thestructure, commodities and personnel involved in middlemarket networks. Since then a police operation targetingmiddle level drug dealers has been undertaken. A finalreport is due early in 2003.

A review of research evaluating actions against local drugsmarkets has been carried out (Mason and Bucke, 2002).

A number of literature reviews on supply side issues willbe commissioned over the coming months.

The major sources• Sizing the Market Study (Bramley-Harker, 2001).

• Middle Market Drug Distribution (Pearson and Hobbs,2001).

• Evaluating actions against local drug markets(Mason and Bucke, 2002).

• Drug Seizures and Offenders Statistics.

Other sources: generalThe economic and social costs of Class A drug use

A study was commissioned which aimed to provide anestimate of the economic and social costs of Class A druguse in England and Wales in 2000 (Godfrey et al, 2002).Three groups of users were identified – problem drugusers, young recreational users and older regular users.Five cost consequences were identified – health, work,driving, crime, and other social impacts. Six groups bearingthese costs were considered – users, family/carers, otherindividuals directly affected, wider community, industryand the public sector. Total social costs were estimatedto range between £10 billion and £18 billion. 99% of theeconomic and social costs were attributable to theproblematic user group.

CommunitiesPosition in 1998The major sources of information on drug-related crime in1998 were a developmental survey of those arrested by thepolice in five areas in England and Wales (NEW-ADAM) anda longitudinal study of addicts in treatment (NTORS).

Progress since 1998Following early development work, the NEW-ADAM surveywas extended to a rolling programme covering 16 locationsin England and Wales, starting with the first 8 sitesin 1999–2000 and a further eight sites in 2000–2001.A baseline report covering the 16 sites is due to bepublished in 2002. The first eight custody suites wererevisited in the third and final year of the programme,and a trend report is due to be published early in 2003.

Analysis of the first year of data from NEW-ADAMsuggests that it is users of heroin and cocaine (especially


77

crack) that are most likely to be prolific offenders.Users of both heroin and cocaine/crack make up almost aquarter of the arrestees surveyed in 1999–2000, but theirself-report information suggests that they are responsiblefor a disproportionate amount of crime. Around 75% ofarrestees who report using heroin and/or crack/cocainethought that their drug use and offending behaviourwere connected.

Following an internal review of the NEW-ADAM survey,work has recently been completed to assess the feasibilityof extending the survey to provide nationally representativeinformation. As a consequence of this, a new ArresteeSurvey will be launched in Spring 2003 and will providearrestee information from a much larger sample ofcustody suites.

In the absence of arrestee information since data collectionfor NEW-ADAM ceased, research in the use of theOffenders Index as a measure of drug-related crime wasundertaken in 2002.

NTORS has continued to follow-up a cohort of drugmisusers in treatment and has shown that reductions inoffending and drug use have, in the main, been sustainedafter five years.

The major sourcesNew English and Welsh Arrestee Drug Abuse

Monitoring (NEW-ADAM)

The aim of NEW-ADAM was to provide basic intelligenceon drug use at the point of entry to the criminal justicesystem and on the links between drugs and crime. Theresearch consisted of interviews with and drug tests ofadult offenders arrested by the police in 16 custody suites.NEW-ADAM is to be replaced with the Arrestee Survey,which will involve interviewing arrestees using Computer-Assisted Self-Interviewing and requesting a sample of oralfluid that will be subject to an on-site drug-screening test.Respondents will be asked about their offending and drugabuse history, sources of illegal income, and whether ornot they are or have been in treatment.

The Offenders Index

The Offenders Index is a database containing informationon all convictions passed in adult or youth courts in Englandand Wales, and therefore represents that proportion ofcrime that is proceeded against by the Criminal JusticeSystem. However, it can be used to provide a measure of

the volume of crimes committed by convicted drug users.The feasibility and sensitivity of this measure of drug-related crime is currently being explored.

Other sourcesArrest referral monitoring and evaluation

All police forces in England and Wales now have proactivearrest referral schemes covering their custody suites.These schemes are partnership initiatives between police,drug agencies and Drug Action Teams aimed at identifyingdrug misusers at the point of arrest and referring them intotreatment or other programmes of help. Routineinformation on arrest referral is collected by a nationalepidemiological surveillance programme providing dataon the number and characteristics of arrestees screened,referred and accessing specialist drug treatment.

Evaluation of Drug testing pilots

The Criminal Justice and Court Services Act 2000 gave thepolice the power to drug test detainees in custody and thecourts the power to order drug testing of offenders underthe supervision of the probation service. Three pilot siteswere launched in July – September 2001. The drug testingpilot programme was extended to an additional six sitesin Summer 2002. Evaluation will assess effectiveness ofreductions in offending and drug consumption, and willinclude cost-benefit analysis. It will also audit operationalprocesses and organisational structures used tosupport testing.

Drug Treatment and Testing Orders

Drug Treatment and Testing Orders (DTTOs) have beenavailable to the courts in England and Wales since 1October 2000. These community sentences are designedto help problematic drug users address their problemthrough intensive programmes of treatment and testing.A DTTO requires convicted offenders to participate intreatment, and to undertake regular testing for use ofdrugs. Between 1 April 2001 and 31 March 2002, 4851Orders were made. Routine process data are collectedincluding the number and proportion of positive urine testsby area.

Communities Against Drugs Evaluations

External researchers have been commissioned to lookat the impact of Neighbourhood Wardens and CCTVat specific CAD funded sites. Research has also beencommissioned to develop a clearer understanding of themechanisms and processes within rural drug markets.


78 Annex 2

TreatmentPosition in 1998Information on drug users presenting for treatment wasroutinely collected by the Regional Drug Misuse Databases(RDMDs) from 1990 until March 2001. Any first face-to-faceattendance (or re-presentation after a break in contact of atleast six months) at a wide range of drug agencies for atreatment demand was counted as a new ‘episode’.

Progress since 1998Following the Department of Health’s strategic reviewof drug treatment surveillance data the RDMDs wererelaunched in April 2001 as the National Drug TreatmentMonitoring System (NDTMS). One of the key differenceswas the introduction of a client review component thatreports on the treatment received during the year (Aprilto March); whether or not the client was still in treatmentat the end of the year (March 31); and, if not, the reasonfor leaving.

The major sourcesThe National Treatment Outcome Research Study

(NTORS)

NTORS examined outcomes in drug use, health andcriminal behaviour for up to five years after treatment entry.At five years the study found that:

• abstinence rates of illicit drug use increased;

• frequency of drug use reduced (although earlierimprovements in crack use had lessened after five yearsand alcohol use still remained prevalent);

• crime reduced; and

• health improved.

The study also identified a small cohort of drug users whohad not responded to treatment: one-fifth continued to useheroin daily, and after five years around 40% of residentialand methadone clients were still using heroin weekly.

Other sourcesA study on the drug-related mortality of ex-prisoners willhighlight the risk factors associated with those leavingprison and make recommendations for future interventions.

Two studies of drug treatment services have beencommissioned which look at issues surrounding theprovision of treatment for women drug users and blackand minority ethnic drug users (Becker and Duffy, 2002;Sangster et al, 2002). Both reports explore ways inwhich generics can be improved for these particulargroups of users.

DAT returns 2002 – a brief synopsisMethodology

Information was compiled by the Home Office based on atemplate completed by local DATs. DATs report annually,and the first data gathering exercise, using electronicallyprovided information was completed in 2002.

Key messages

Policing and enforcementThere appear to be substantial increases in action againstcocaine and crack but limited evidence of a shift frompolicing cannabis to Class A drugs. Around 40% of forcesreported an increase in actions against heroin supply.However, 41% reported a decrease. The reasons for thisare unclear. Police should therefore be further encouragedin this area. More research is needed concerning effectivepolicing methods. 72% of forces report efforts to tacklemiddle market supply. 54% of DATs had a target on tacklingmiddle market supply. Overall, considerable funding wasbeing allocated to tackling drug supply through CAD (66%of DATs) and mainstream police funding. However, this hasnot yet translated into increased prosecution of suppliers –this may be evident in next year’s assessment.

Community-level interventionsOverall, it would appear that CAD is being used tofund a wide range of local projects. However, housing,homelessness, regeneration and parental support remainunderdeveloped. 47% of DATs had allocated funding towork with young people.

Services and treatmentEvidence suggested a tendency for DATs to spend onclinical interventions rather than holistic responses thataddress broader aspects of drug users’ lives. For example,the lack of attention to housing, homelessness andemployment interventions for drug users is of concern.


79

There was also considerable regional variation in servicecoverage (in both drug treatment and other supportservices) with something of a postcode lottery taking place.Evaluation appears limited and, where implemented, oftenextends no further than gathering simple monitoring data.

Future developmentAreas in need of concentrated development include:

• encouragement for the police to target heroin supplyin a more effective way;

• greater linkage between the Drug Strategy andneighbourhood renewal strategies;

• better deployment of funds to address the specificneeds of deprived communities;

• greater consistency across the country in termsof service coverage; and

• greater development of holistic services for drug users.

Data limitationsData was not analysed using systematic researchmethodology. This makes it impossible to get an accuratenational picture. Some template questions were open towide interpretation, which compromised comparability.Templates were completed by individuals with differentroles and varying levels of seniority and experience,leading to a lack of consistency in perspectives. In addition,responses were based on subjective impressions ofthe local situation, which may not be accurate orcomprehensive. There was also no baseline data withwhich to compare or examine trends.

We have reviewed the template and, as a result, DATshave been given greater clarification about the centre’sinformation needs; we have identified which data sourcesshould be accessed; and we have streamlined the numbersof questions we are asking, ensuring that the questionshave a specific link to the national targets. This has animmediate impact on the Annual Return for 2002–2003.

For the future, we are working with colleagues to identifynew information needs as a result of the SR2002settlement, the developing research on Problem DrugUsers and the new partnerships formed from DAT/CDRPintegration. Above all, the template will form the backboneof the work being taken forward to develop a robustperformance management framework for the NationalDrug Strategy.


80 Bibliography

Aust R, Sharp C and Goulden C (2002). Prevalence of DrugUse: Key Findings from the 2001/2002 British CrimeSurvey. Research Findings. London: Home Office.

Becker J and Duffy C (2002). Women Drug Users andDrugs Service Provision: Service level responses toengagement and retention. Drugs Prevention AdvisoryPaper 17. London: Home Office.

Bennett T, Holloway K and Williams T (2001), Drug useand offending: Summary results from the first year of theNEW-ADAM research programme. Home Office ResearchFindings 148. London: Home Office.

Bramley-Harker E (2001). Sizing the UK market for illicitdrugs. RDS Occasional Paper 74. London: Home Office.

Goddard E and Higgins V (2000). Drug use, smokingand drinking among young teenagers in 1999. London:The Stationery Office.

Godfrey C, Eaton G, McDougall C and Culyer A (2002).The economic and social costs of Class A drug use inEngland and Wales, 2000. Home Office Research Study249. London: Home Office.

Goulden C and Sondhi A (2001). Drug use by vulnerableyoung people: results from the 1998/99 Youth LifestylesSurvey. Home Office Research Findings 152. London:Home Office.

Lupton R, Wilson A, May T, Warburton H and Turnbull P(2002). A Rock and a Hard Place: Drug Markets in DeprivedNeighbourhoods. Home Office Research Study 240.London: Home Office.

Martin C, Player E and Liriano S (forthcoming). ‘Results ofevaluations of the RAPt drug treatment programme’,in Ramsay M (ed), Prisoners’ Drug Use and Treatment:seven research studies. London: Home Office.

Mason M and Bucke T (2002). Evaluating actions againstlocal drug markets: a ‘systematic’ review of research.The Police Journal, 75, 1.

Pearson G and Hobbs G (2001). Middle Level Drug MarketDistribution. Home Office Research Study 227. London:Home Office.

Ramsay M, Baker P, Goulden C, Sharp C and Sondhi A(2001). Drug Misuse Declared in 2000: results from theBritish Crime Survey. Home Office Research Study 224.London: Home Office.

Sangster D, Shiner M, Patel K and Sheikh N (2002).Delivering Drug Services to Black and Minority EthnicCommunities. Drugs Prevention Advisory Service Paper 16.London: Home Office.

Singleton N, Farrell M and Meltzer H (1999). SubstanceMisuse among Prisoners in England and Wales. London:Office for National Statistics.

Sondhi A et al (2002). Arrest Referral: emerging findingsfrom the national Monitoring and Evaluation Programme.Drugs Prevention Advisory Service Paper 18. London:Home Office.

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