Nothing short of a ‘revolution’ is required both in terms of healthcare services and throughcare and aftercare management of offenders. Reforms should be underpinned by a principle that the CJS has a duty to facilitate the recovery of people from addiction.
The nature of addiction has implications for all policy responses but particularly those involving a level of compulsion (e.g. compulsory use of DRRs), incentives (e.g. ‘Earned Release’) and sanctions (e.g. reducing welfare benefit) which may not deliver the desired results. Not all problem drug-using offenders are ready or indeed able to achieve long-lasting recovery, although all can be helped towards that goal in some way. Instead, a problem-solving, flexible approach as exemplified by drug courts and the use of ‘contingency management’ approaches in recovery services should be expanded.
For the same reason, broad outcome goals for services linked to payment by results risk creating perverse incentives to focus on those who are easiest to fully rehabilitate. We support an accountable outcome-focussed system that also recognises progress with those who have a longer and more complex rehabilitation journey.
We would suggest that, alongside introducing honesty in sentencing, there should be a goal of “appropriate, proportionate and effective sentencing”. The evidence suggests that community sentences would meet such criteria for many drug-related offenders and should be the assumed form of disposal for most, less serious, offences linked to addiction. Short prison sentences are less effective and can be disruptive to recovery.
There should be equivalence of care between CJS and non-CJS drug programmes. This is particularly needed within the prison estate where service provision is below “minimum standards”. This would also require a diverse range of services including public health interventions to reduce harm, substitute medications (e.g. methadone), psycho-social
interventions, abstinence orientated programmes and reintegration services. A one-size-fits-all approach (e.g. only abstinence-based programmes) is destined to fail as it does not acknowledge there are many different types of problem drug users.