HOW BRITAIN IS LOSING THE DRUGS WAR

Today, the Guardian launches the biggest investigation of the criminal
justice system ever conducted by a British newspaper.

Beginning a series which will run throughout the year, Nick Davies
looks at the government's attempt to deal with the most prolific of
offenders - the drug users who commit an estimated 7.5 million crimes
a year.

Richard Elliott couldn't stand it any more. For nearly two years, he
had been acting as the government's drugs envoy in Bristol, running
the city's drugs action team, handling millions of pounds a year,
linking together police, health and social workers and voluntary
agencies into one big drive against drugs, but earlier this year he
realised he couldn't stand it any more, so he quit. In fact, for most
of that time he wasn't supposed to be running the drugs action team
(DAT), but his coordinator had quit a year earlier because she
couldn't stand it any more either and so Elliott, who was supposed to
be the commissioning manager, had taken on her job as well.

He didn't want to do that; he knew of at least four other DAT
coordinators in the area who had gone off sick in the previous 12 months.

He did at least have some help but his new colleague was soon working
so hard that he started getting chest pains and, when he carried on
regardless, his left arm started tingling and going purple until
finally he couldn't stand it any more and went off sick. Then he quit
too.

Elliott could no longer bear the waste.

He had six staff and a budget of UKP3.5m a year. He had a potential
client group of 25,000 recreational users of cocaine and amphetamine,
ecstasy and cannabis; plus a further 12,500 chaotic drug users who buy
heroin and crack cocaine on the city's open drugs market, centred on
St Paul's. He focused on the 4,500 chaotic users who live in Bristol
but at the end of all his work and all that public money, the total
number of NHS detox beds which he was able to provide to help any of
those users was five, one of which was reserved for those with mental
illness.

Even more than that, what Elliott really couldn't stand was the
bureaucracy - the 44 different funding streams, each one with its own
detailed guidance and micro targets from the centre, each one with its
own demand for a detailed business plan and quarterly reports back to
the centre; the endless service agreements he had to sign with every
local provider with their own micro targets and a demand for quarterly
reports back to him so that he could collate them and pass them back
to the centre; the new annual drugs availability report to the centre;
the annual treatment plan to the centre over 68 pages and nine
planning grids with 82 objectives (that's what Elliott's colleague was
working on when his arm went purple); the funding announced too late
for planning and then handed over too late to be spent and finally
spent for spending's sake to prevent it being reclaimed by the centre;
the staff hired and trained and then suddenly sacked when funding or
targets were switched by the centre, (or just quitting because they
couldn't stand it any more). He reckoned he and his staff spent only
40% of their time organising services for drug users - the rest of
their time was consumed by producing paper plans and paper reports for
Whitehall.

Elliott wrote a resignation memo for a colleague with the heading
"Ravings of a burned-out mind". He described the culture of control in
Whitehall, their "monitoring fetish" and their short-term thinking,
and he wrote: "Monitoring has become almost religious in its status,
as has centralised control ... The demand for quick hits and early
wins is driven by a central desire analogous to the instant
gratification demands made by drug users themselves ... The criminal
gangs that control the market are laughing all the way to the bank and
beyond, as we tie ourselves in knots with good practice guidelines and
monitoring. It's like trying to fight with one hand tied behind your
back, a boxing glove on the other and strict instructions not to punch."

When the government declares its intention to attack the causes of
crime, it signals its intelligence - its understanding that it cannot
control crime simply by using the ancient and inefficient levers of
conventional criminal justice.

When it goes on to identify those causes, it can see through the
endless confusion two huge social turbines generating criminality. One
of them is the boom in child poverty during the Thatcher years with
all of the profound and intricate damage which that inflicted
physically and emotionally, socially and spiritually, and the
government can see that, to undo that damage, it will need to invest
several generations of intense and skilful political effort.

It may decide (as it has) that it is worth doing, but it takes that
route knowing that it will be long and uncertain.

But the second great engine of crime is different - the war against
drugs. That is finite and tangible, with drug users blamed for 7.5
million offences a year, up to 90% of all property crime in some areas.

And any government can see that, by taking finite and tangible steps
on drugs, it can score a real impact on crime and disorder and, what
is more, it can save lives and restore communities.

In 1998 the government launched a national campaign of treatment,
creating a network of 149 drug action teams, reinforced since the
autumn of 2001 by a new national treatment agency (NTA), fuelled by
the belief that by promoting treatment alongside law enforcement it
could finally generate success where criminal justice alone had failed.

But if the drug action teams collapse, then that collapse is on the
same spectacular scale - a disaster for the whole strategy on crime
but a disaster too for black market drug users and for the communities
they have wrecked.

The reality is that, after five years of effort and with a budget now
topping UKP400m a year, despite relentlessly hard work from some 5,000
dedicated people on the ground, there is an alarming shortage of
effective treatment and no sign of a reduction in demand for drugs.

Richard Elliott describes an organisation which is being managed to
death, where centralised direction has mutated into systematic
suffocation.

The government says the DATs must do the work; so the DATs must prove
they are working; and very quickly the proving becomes their work.

Elliott's explanation is simple: "They don't know very much about
drugs, but they do know about management and monitoring and data
collec tion. So that's what they do."

In early 2000, the Home Office decided to spend UKP5m on Prospects
hostels so that drug users leaving prison could have a bed with
special treatment. Since then, the Home Office's Prison Service have
a) chosen five pilots areas, including Bristol, b) set up a new team
to manage the project, c) gone through a rigorous tendering process to
select providers, d) produced a detailed specification for the hostel
regime, e) transferred "ownership" of the project to the national
probation directorate who set up a new team to manage it who, f)
converted the regime into a set of operating manuals and g) held
numerous meetings with DATs to monitor progress, and h) asked DATs to
develop "a methodology for site search and selection", and i) to set
up local planning teams to draft, consult on and agree referral
protocols, after which, j) they set up local project boards and k)
this February they held a press launch.

But there was nothing to launch.

After three years of work, they have consumed hundreds of hours in
meetings, spent hundreds of thousand of pounds but have not yet
provided a single bed for a single drug-using ex-prisoner in Bristol
or anywhere else. They say it may happen "as early as 2004" although
only in the five pilot areas which will then be subject to a
three-year evaluation.

Just before Christmas last year, a 20-year-old prisoner named Sean
Wildman, who had been sent to Exeter prison with a drug problem, died
on the streets of Bristol, homeless and stuffed full of black market
heroin.

Over and over again, Elliott found that a problem was confronted not
with a solution but with a bureaucratic process.

Problem: there are not enough
detox beds. Solution: pay for some more. What the DAT had to do: rewrite
the service level agreements with local providers; increase their targets
by 10%; conduct an audit to measure the gap between the detox they had and
the detox they needed; cut the funds to meet an NHS efficiency target.
Outcome: no change yet.

Problem: there are not enough rehab places.

Solution: pay for some more.
What the DAT had to do: audit and review existing rehab places; join a
regional review of rehab places; hand over UKP5,000 from their treatment
budget, along with all the other local DATs, to fund a new regional offical
to take over central purchasing of rehab; set up an inquiry into the need
for special rehab places for black, Asian and women users - and, of course,
all this had to be recorded on planning grids, most of which then had to be
rewritten to improve its performance score.

Outcome: no change yet.

Problem: users come out of rehab with nowhere to live. Solution: find them
somewhere to live. What the DAT was required to do: conduct a review of
residential treatment services in Bristol; set up a special integrated care
pathways group to liaise between agencies; develop a new protocol between
treatment and housing; set up a waiting times group to monitor waiting
times and the implementation of the protocol.

Outcome: no change yet.

The result on the ground is that the government has created a
multimillion-pound collection of signposts.

There are 15 different agencies in Bristol swapping referrals, making
assessments and providing leaflets.

There is a specialist agency for black people and another for Asians
and five for particularly troubled estates.

There is no shortage of information for drug users.

There is masses of advice and support.

There is anger management and debt management and counselling, both
group and individual. There is aromatherapy and acupuncture and
careers advice and nutritional advice.

This could help new users or old users who have given up. But where on
this tragic roundabout is the treatment which is going to transform
the life of a career criminal who has spent the last 10 years on heroin?

The answer is that down on the ground floor of the vast edifice of
drug treatment, there is a small door which occasionally opens to
allow a handful of users to proceed down a corridor of smaller and
smaller doors. The first door is marked "detox" and, in Bristol, it
leads to a room which has five beds in it, from the National Health
Service. A simple detox takes a fortnight, so on the face of it, each
of these beds can handle 26 patients a year, a total of 130. In
reality, however, one of the beds is always reserved for drug users
who are mentally ill; the other four beds may sometimes be used as an
emergency overflow for mentally ill patients who are drug free; and
any of the beds can be used for more than two weeks if the user has
extra problems (Aids, hepatitis, other addictions). In reality, in a
year, they expect to admit only 96 drug users.

A little further down the corridor, are two even smaller
doors.

One leads to the Salvation Army who keep five more detox beds which
are purchased by the DAT, potentially serving a further 130 drug users.

But one of these is reserved for alcoholics. And the other four are
reserved only for those who are "vulnerable and entrenched rough
sleepers". Those who can get through this door tend to have more
problems than the NHS users and occupy each bed for longer and so, in
a year, they expect to admit only 80 drug users.

The second small door leads to "home detox", where the user is visited
by a nurse and given medication to help. Eighty users a year can
squeeze through here.

So, from the 4,500 chaotic users with Bristol addresses who are
targeted by the DAT, only 256 will have access to detox.

And the doors beyond this are smaller still.

Detox is not magic; it can be very hard, and some of the detox beds
nationally are in grim mental health wards.

With the NHS and Salvation Army beds, at least 40% will fail to
complete their detox.

With home detox, 60% are expected to fail. On that basis, of the 256
who start, no more than 138 will stay the course and be ready for rehab.

But the fact that they are ready does not mean they will reach the end
of the corridor.

The two main rehab houses in Bristol require total abstinence, not
only from illegal drugs but also from prescribed drugs, like
anti-depressants, and also from alcohol; some simply cannot face it.
Those who remain will have to wait up to 20 weeks for a place; some
will give up and go back to their drug. Those who persist must be
assessed and means-tested by community care ; some will fail to meet
the criteria.

Some of those who survive will be mothers with children.

Until last year, they could take their children with them to rehab,
but then they changed the accounting rules so that the child's part of
the budget was allocated to the children's directorate which refused
to pay, which means some mothers cannot take the place they have been
offered.

Last year, the Bristol DAT finally placed only 55 of its detoxed drug
users in rehab.

Sixteen dropped out before their course was completed. Twenty-nine
completed the course and, at the time of writing, nine were still there.

For this maximum of 38 drug users who complete rehab, one more narrow
door remains.

Will they remain drug free? This last door leads nowhere. They may get
support from their family or from Narcotics Anonymous but, so far as
the state is concerned, there is effectively no more help. Past
experience suggests that within six months, 45% will be back on their
drug. On that basis, only 21 of these users will reach the end of the
corridor of narrowing doors.

Using DAT funds, Bristol social services will send some of their
top-sliced from the treatment budget.

In Bristol, Richard Elliott has now been replaced by a new coordinator
and a temporary manager.