ROUTES TO TREATMENT THAT ARE LITTLE USED

Even if the treatment were available on the ground, the drug-using
offenders who are its primary targets would not be reaching it in any
numbers. In theory, there are new bridges feeding offenders into the
treatment regime - the idea of using the criminal justice system as an
outreach network is one of the core ideas of the drugs strategy. The
government has spent UKP106m to build these bridges. In reality, they
carry almost no traffic.

The first and most important bridge is arrest-referral: anybody who is
arrested and who has a drug problem is interviewed by an
arrest-referral worker who will offer them an appointment. The problem
is that, according government research, 97% of those who are
interviewed fail to make it into effective treatment: nearly half
simply reject the approach; of those who accept an appointment, 78%
never turn up; of those who do turn up, an estimated 45% drop out
within a fortnight and 72% within six months. Home Office researchers
found that in 12 months, 48,770 users were screened by arrest-referral
workers; only 5,520 subsequently turned up for an appointment; only
1,545 in the whole country in all the 12 months continued to turn up
for at least six months.

In Bristol last year, they screened 2,300 users on arrest; only 177
showed up for their first appointment. The reality is that, after
three years of arrest-referral, the Bristol DAT has no evidence that
even one user from arrest-referral has completed treatment. But, when
the government wanted to tackle street crime last year, it sent down
extra money which was earmarked for the hiring of yet more
arrest-referral workers. The Home Office, sensing disaster, has
reorganised the arrest-referral workers to introduce a new system of
monitoring.

The second bridge from criminal justice into treatment is DTTOs - drug
treatment and testing orders - which allow courts to order an offender
to go for treatment. In February, the probation inspectorate reported
that their operation was "extremely uneven" with "an unacceptably low
level of achievement" which included "very disappointing" drug test
results. Last year, only 6,186 orders were made nationwide; there were
5,419 proceedings against users for breaching them.

According to one Whitehall source: "Breach is the norm with DTTOs." In
Bristol, courts last year issued only 48 orders and Elliott reckons
almost all of them are being breached by offenders who do not accept
the treatment available and who are willing to take their chances if
the court decides to punish them.

The government has come up with a remedy: regardless of the failure,
Downing Street last year asked the Treasury to fund yet more DTTOs;
the Treasury agreed to put up an extra UKP25m but only if the
probation service agreed to increase their targets by 50%; probation
had no chance of hitting the targets, but the Home Office accepted and
rewrote the rules to produce a new DTTO which imposes only minimal
requirements on offenders (dubbed DTTO-lite by drug workers).

The Home Office cannot be surprised by the failure of these bridges.
They knew very well that both were fragile when they introduced them,
because they tested them in pilots. Both of them produced alarmingly
weak evidence of effectiveness. But the government pushed ahead with
arrest-referral because, according to Whitehall sources, it was a way
of channelling extra money to the police at a time when the chief
constables were rebelling over their budgets.

In the case of DTTOs, the early pilot results were so bad that Home
Office ministers, anxious that they might lose the money promised by
the Treasury, simply rolled them out nationally before the final
results came through and lied about the pilots.

The Department of Health and the Home Office are blaming each other
for the failure of the schemes. The reality is that they have failed
as a route to abstinence, because there is a limit to the number of
addicts who will give up their drugs without wanting to; and they have
failed as a route to maintenance, because of the lack of
well-supported prescription, particularly of heroin.