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Reports are only available as downloads and cannot be ordered in hard copy. The views and conclusions of reports commissioned by UKDPC are those of the authors and not necessarily those of the Commission.

SINNING & SINNED AGAINST: THE STIGMATISATION OF PROBLEM DRUG USERS

This report by Charlie Lloyd (University of York) aims to summarise what the research evidence has to tell us about the stigmatisation of problem drug users; to explore the nature of this stigmatisation, its impacts and why it happens. These considerations raise some fundamental issues about the nature of addiction and the extent to which it is seen as a moral, medical or social issue. They also raise important questions about autonomy and the blame attached to addiction.

The report is the first instalment of a wider research project, funded by the Paul Hamlyn Foundation with additional funding from the Scottish Drug Recovery Consortium, which will also include: i) a public attitudes survey (modelled on the Department of Health annual attitudes to mental illness survey) ii) with a study of the experiences of users and families iii) an analysis of how drug users are portrayed in the media.

The report can be downloaded here:
   Sinning & Sinned Against: The Stigmatisation of Problem Drug Users [PDF 564 KB]


DRUGS & DIVERSITY: THE IMPACT OF DRUGS ON DIFFERENT MINORITY GROUPS 

These wide-ranging reports describe what is known about treatment and prevention within diverse communities, including LGBT groups, disabled people and BME communities. The aim of the review was to encourage greater consideration of the needs and challenges of drug problems for minority groups, by bringing together a variety of evidence in one place

The study suggests that mainstream services are not always meeting the needs of diverse communities. The reports present challenges for commissioners of and practitioners within drug services, as well for the criminal justice system and wider drug policy makers.

The findings from the study together with key implications for policy and practice can be found summarised in the four briefing papers below:

Drugs and Diversity: 
     An overview of implications for policy and practice [PDF 987 KB] 
     Ethnic minority groups [PDF 263 KB] 
     Lesbian, gay, bisexual and transgender (LGBT) communities [PDF 1058 KB] 
     Disabled people [PDF 995 KB]

and the full research findings in the four background research reports here:

The Impact of Drugs on Different Minority Groups: A Review of the UK Literature
     Part 1: Ethnic groups [PDF 522 KB] 
     Part 2: Lesbian, Gay, Bisexual and Transgender (LGBT) groups [PDF 544 KB] 
     Part 3: Disabled people [PDF 295 KB] 
   The Impact of Drugs on Different Minority Groups: Ethnicity and Drug Treatment [PDF 567 KB]

Funding for the study was provided by the Home Office and the background research was undertaken for the UKDPC by the Office for Public Management.

SUPPORTING THE SUPPORTERS: FAMILIES OF DRUG MISUSERS

This study has estimated that in the UK, at the very least:
  o nearly 1.5 million adults will be significantly affected by a family member’s drug use;
  o the cost of the harms they experience as a result amounts to about £1.8 billion per year; and
  o the support they provide would cost the NHS or Local Authorities about £750 million to provide if it was not
     available.

These figures are minimum estimates, but nevertheless demonstrate the enormous impact of drug use on adult family members and the value derived from the support they provide and highlights the importance of identifying and supporting this often unrecognised group. To build on the welcome increase in focus on families of drug users in national drug policies across the UK and the guidance that has been produced, action is required in the following areas to deliver the desired benefits to families:
  1. Improving the level and quality of direct support to help families in their own right
  2. Challenging the stigma associated with drug dependency
  3. Making the drug treatment system more supportive and inclusive of families
  4. Leadership – responsibility for driving forward an agenda to enhance support for families needs to be placed
      with an identified champion at national and local levels.
  5. Information/knowledge development is essential for ensuring the adequacy and appropriateness of service
      provision – currently even the most basic data is lacking.

There are two reports based on this study: the first is a short briefing aimed at key strategy and policy makers and practitioners:

  UKDPC Supporting the Supporters Policy Briefing  [PDF 124 KB] Policy Briefing

The second is the full research report which describes the detailed findings, including estimates for all the countries in the UK and the methods used:

  UKDPC Families of drug users research report [PDF 425 KB] Research report



REFOCUSING DRUG-RELATED LAW ENFORCEMENT TO ADDRESS HARMS .

It must not be assumed that arrests of dealers and traffickers and drug seizures will automatically have a positive impact on communities. Although drug laws reinforced by a level of enforcement appear to have contained the illicit drug market to some degree, ‘more’ enforcement generally does not lead to ‘less’ availability because established drug markets are too resilient and adaptable.

However, there is an opportunity for enforcement to impact on reducing drug-related harms even when drug markets are entrenched and no reduction in supply is observed. This is because not all drug markets are equally harmful, and the very adaptability of drug markets that frustrates efforts to eradicate supply can provide enforcement with the potential to reshape the market into less ‘noxious’ forms. Enforcement can, for instance:

  • crack down on particularly harmful behaviours such as gun violent, sexual exploitation or use of children as lookouts or couriers;
  • close open (flagrant) drug markets that erode community confidence;
  • push markets out from particularly damaging places e.g. residential areas;
  • ensure addicted users and dealers get treatment and support.
A focus on the real impact of drug-related law enforcement on communities would help to ensure there was a net-benefit associated with enforcement activity. This approach would include a comprehensive assessment of the types of harms caused by drug markets, an understanding of the market characteristics that are causing these harms, and good evaluations which look to measure both intended and unintended impact of interventions.

By consistently curtailing the most harmful aspects of drug markets, this approach may have a more sustainable impact. Traditional enforcement does not deter a significant number from trafficking and dealing as for some, the risk is always worth the gain. However deterring particularly harmful practices may be a successful approach as it is only necessary to make them too risky (with little extra gain) compared to other, less harmful practices.

There are two reports which summarise this review: The first is a short briefing aimed at key strategy and policy makers and influencers:

 Moving towards Real Impact Drug Enforcement [PDF 183KB] - Briefing Paper

The second is a full review report which includes desk research, case study examples and practical tools for adopting a harm-focussed approach:

 Refocusing Drug-Related Law Enforcement to Address Harms [PDF 660KB] - Full Review Report

For more information see:
    '2009 Tackling drug supply awards: Case studies' (a report for the Home Office)
     'How can enforcement agencies reduce drug harm?' (Police Professional, September 2008)
     'UKDPC Special Edition of 'Safer Communities'' (January 2009)

WORKING TOWARDS RECOVERY
Getting problem drug users into jobs

Studies have shown that up to 80% of problem drug users (PDUs) are unemployed, yet work has been shown to be an important component of rehabilitation and reintegration into society, reducing the likelihood of relapse. More PDUs in work should mean more people successfully achieving recovery and exiting treatment, and a reduction in crime. PDUs on welfare benefits also cost the UK many tens of millions of pounds. Perhaps more importantly, most unemployed PDUs want to work and recognise its significance for building a ‘normal’ life. Once in work, recovering PDUs have been found to be good employees.

It can be a significant and long-term challenge to get some PDUs ‘fit for the job’. Many will have a range of ‘primary needs’ such as poor physical and mental health and suitable accommodation, which need to be addressed at an early stage. Many employers are extremely reluctant to recruit PDUs, even those who have the right competencies for the job. The ‘two years drug free’ rule which is sometimes applied is arbitrary and creates a significant barrier to rehabilitation for PDUs who are stable, on substitute medication or otherwise, before reaching that time period. However, employment opportunities can be increased by enabling employers to manage the perceived risks and addressing the stigma that is ass ociated with problem drug use.

The review reaches a wide range of conclusions on getting problem drug users ‘fit for the job’ and addressing employers’ concerns. It also raises the possibility of more radical measures such as legal protection and small financial incentives for employers.

 Working Towards Recovery (summary) [PDF 176KB]

 Working Towards Recovery (full report) [PDF 748KB]

Film to accompany the review  [new web page]

BACKGROUND PAPERS TO INFORM ‘WORKING TOWARDS RECOVERY’

To help inform our report we commissioned the University of Manchester to carry out some research. This is presented in two parts. Part One examines social security and relevant aspects of employment law and policy, and Part Two uses desk research, qualitative interviews and a survey of employers to focus on barriers to employment and on effective support structures and mechanisms.

 Part One Background Research [PDF 592KB]

 Pa rt Two Background Research [PDF 480KB]



TACKLING DRUG MARKETS AND DISTRIBUTION NETWORKS IN THE UK
A review of the recent literature

Summary of report findings:


  • Latest figures (for 2003/04) estimate the size of the UK illicit drug market to be £5.3 billion and is considered to pose the single greatest organised crime threat to the UK. 
  • About one-quarter of the total cost of delivering the drug strategy has been dedicated to reducing supply (£380 million in 2005/06). 
  • Drug markets have proven to be extremely resilient. They are highly fluid and adapt to law enforcement interventions. 
  • While the availability of controlled drugs is restricted by definition, it appears that additional enforcement efforts had had little adverse effect on the availability of illicit drugs in the UK. 
  • The available evidence suggests that street-level drug law enforcement should focus on forging productive local partnerships and not rely solely on police crackdowns. 
  • The authors were unable to locate any comprehensive published UK evidence of the relative effectiveness of different enforcement approaches. They were also not able to identify any published comparative cost-benefit or value-for-money analysis for different interventions within the UK. 
  • Enforcement can have a significant and unintended negative impact on the nature and extent of harms associated with drugs and this should be recognised and minimised.
 Tackling Drug Markets and Distribution Networks (executive summary) [PDF 98KB]

 Tackling Drug Markets and Distribution Networks (full report) [PDF 632KB]



REDUCING DRUG USE, REDUCING REOFFENDING (MARCH 2008)

Are programmes for problem drug-using offenders in the UK supported by the evidence?

Summary of report findings:

  • The principle of using CJS-based interventions to encourage engagement with treatment is supported by the evidence.
  • Following a period of expansion and a focus on quantity, attention should now focus on quality.
  • "Net-widening" to include additional groups of drug-using offenders in CJS‑based interventions may have negative consequences.
  • Community punishments are likely to be more appropriate than imprisonment for most problem drug-using offenders.
  • Prison drug services frequently fall short of even minimum standards.
  • Given the sizeable investment in CJS interventions for drug-dependent offenders, we know remarkably little about what works and for whom.
There is reasonable evidence to support:
drug courts; community sentences such as DTTOs and DRRs; prison-based therapeutic communities; opioid detoxification and methadone maintenance within prisons and the community; and the RAPt 12-step abstinence-based programme.

There are no evaluations of the effectiveness of:
CARAT interventions; drug-free wings; programmes based on cognitive behavioural therapy, such as short-duration programmes and ASRO (Addressing Substance Related Offending) programmes; conditional cautions; diversion from prosecution schemes; and Intervention Orders.

There is mixed evidence for:
Criminal Justice Integrated Teams; Restrictions on Bail; and the added value of drug testing as part of a community order.

 Reducing Drug Use, Reducing Reoffending (summary) [PDF 116KB]

 Reducing Drug Use, Reducing Reoffending (full report) [PDF 532KB]


BACKGROUND PAPERS TO INFORM 'REDUCING DRUG USE, REDUCING REOFFENDING'
 
To help inform our report we commissioned the Institute for Criminal Policy Research (ICPR) at King’s College London to review the international evidence and their peer-reviewed report is available below. We also consulted with a range of stakeholders including policymakers, p ractitioners and service users and a summary of their feedback has been compiled into a short paper.

 A review of the evidence by the Institute for Criminal Policy Research [PDF 560KB]

 Consultations with key stakeholders [PDF 125KB] 


 

AN ANALYSIS OF UK DRUG POLICY (APRIL 2007)

Summary of report findings:

  • Britain has an unusually severe drug problem compared with its European neighbours - it has the highest prevalence rates of problem drug use (although use appears to have broadly stabilised), rates which are double those found across Europe.
  • However the international evidence suggests that drug policy appears to have very limited impact on the overall level of drug use. The authors argue that this is more influenced by wider social, economic and cultural factors.
  • The government has successfully increased the number of dependent drug users entering treatment. Research suggests that this will have led to substantial reductions in drug use, crime and health problems at the individual level.
  • Where drug policy makes its most valuable contribution is in reducing the damage and harms to individuals and communities which result from problem drug use. Here UK policy has scored some significant successes, including a level of HIV among injecting drug users lower than in most of Europe. However, there is now emerging evidence which indicates that this area of policy could benefit from re-examination and reinvigoration.
  • General drug education and prevention efforts in schools and through campaigns appear to make little difference to risk behaviour among the young.
  • We know very little about the effectiveness and impact of most enforcement efforts either in reducing supply or demand.
  • There is little transparency in the allocation of resources although it is clear that the lion's share goes to enforcement.
  • The UK invests very little in independent evaluation of the impact of drug policies (especially enforcement). Unsurprisingly, therefore, the evidence base in the UK is remarkably underdeveloped.
 An Analysis of UK Drug Policy (executive summary) [PDF 93KB]

 An Analysis of UK Drug Policy (full report) [PDF 1.6MB]
 
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Photo collage: UK drug policy - a complex issue