Don't Tell Tory Voters!

Oh look, the government are about to launch a new drug policy, accepting it's a health condition not a criminal justice problem, but really hope voters, especially Tory ones, don't notice. This from the BBC:-

Government to overhaul drug policy to focus on getting users healthcare

The government will announce a new drugs strategy on Monday overhauling the drug recovery and treatment system, the BBC has learned. The announcement is expected to pledge £700m over three years to tackle problem drug use. Measures will include a large focus on diversion, a tactic designed to remove drug users from the criminal justice system and get them into healthcare. Ministers are also set to announce investment to tackle drug gangs.

The overhaul has been drawn together by at least six government departments, the BBC understands. It will form part of a wider week of law and order announcements for the government, which a source involved in the drug strategy said had frustrated some of those who worked on it - who wanted to make clear these measures would lead to fewer crime-focused drug policies. The government has been asked to comment.

The diversion strategy is expected to be twofold - short prison sentences for drug use will be largely replaced with court orders putting users into recovery programmes and there will be less emphasis on prosecuting people caught with substances. 

In Scotland, prosecutors can refer people accused of drugs offences for "diversion" and their Lord Advocate said people caught with Class A drugs could be given a police warning instead of facing prosecution - a move the Conservatives had previously said amounted to "de facto decriminalisation."

'Chronic health condition'

In his party conference speech, Boris Johnson accused Labour of "decriminalising" hard drugs after the Labour leader Sir Keir Starmer said Scotland's decision was "probably the right thing to do" but was an "independent decision." 

It is understood there will also be more emphasis in the strategy on helping drug users leaving prison to find work and safe housing. The Times newspaper has reported drug treatment courses could be offered to those whose offending was fuelled by drugs, giving people the option of changing their behaviour or facing tougher punishments. 

One source heavily involved in forming the review told the BBC "ministers have now accepted this [problem drug use] is a chronic health condition". However, they added that because of concerns over how that would be viewed by the public and Conservative voters, it was unlikely the government would want it to be the focus of the announcement. The Home Office have been asked to comment.

As well as an overhauling of drug treatment plans, ministers are expected to outline more investment to tackle county lines drug gangs - urban drug dealers who sell to customers in more rural areas via dedicated phone lines.

The strategy has been drawn up as a response to the Dame Carol Black review of drugs, which reported in the summer and made 32 recommendations. The BBC understands the government has accepted at least 31 of these. The Times also reported the government was seeking to amend its Police, Crime, Sentencing and Courts Bill to give judges extra powers to order drug testing of anyone serving a community sentence. It said drug testing could be required on arrest for all crimes, and the government could outline plans to use drug dealers' phones to identify and support addicts - and warn people they were not anonymous when buying drugs.

The BBC has been told there will be no announcements on heroin-assisted treatment or drug consumption rooms. Politicians in Scotland have been pushing for the latter to be introduced but a source involved in forming the drugs strategy said Number 10 and the Home Office were "very against" them and a move in that direction may have needed a change to the Misuse of Drugs Act. Both departments have been asked to comment. 

Those drawing up the drug strategy were instructed to find ways of introducing new policies without having to make major change to legislation. It's also understood there will likely be no specific funding in this strategy for prisons to replace methadone with "abstinence-based rehab", a plan reported by The Telegraph newspaper earlier this week. However, Dominic Raab, the justice secretary, is expected to publish a separate strategy on problem drug use in prisons in a government White Paper.

A government source told the BBC this would allow governors in prison to be more empowered to take action against drug use. The Times reported it could also involve further "airport-style" security in prisons for visitors and staff to prevent drug smuggling.

A Good News Story

Although this from Scotland's Herald on Sunday is a particularly good example of crass 'journalism' that simply regurgitates press releases - and then not very well - it is very much a good news story and long overdue:-  

First ever drug rehabilitation village opens its doors

Scotland’s first ever long-term “drug rehabilitation village” opens its doors today. The River Garden Auchincruive project, near Ayr, is a groundbreaking residential project to help those recovering from drug and alcohol addiction. Run by charity Independence from Drugs and Alcohol Scotland (IFDAS), the programme is inspired by a number of radical rehab programmes from around the world. It will initially provide accommodation, training and support for up to 40 former addicts who will live there for up to three years.

Director of Development at IFDAS, Mark Bitel said the three year programme was unlike any other type of service currently available in the UK. The 48-acre site acts as a residential training and social enterprise development where the community will grow food to supply an onsite shop and café, and run a bakery. The programme will be free while residents are volunteering - expected to be for an average 15-month period - but they will pay for their accommodation once they are employed by the centre.

Mr Bitel added: "We aim to demonstrate that there is a different approach with good outcomes for individuals who complete their programmes, their families, communities and, ultimately, the wider society."

Scotland currently has among the worst drug and alcohol problems in Europe, with 867 drug-related deaths reported in 2016 -- double the amount reported in 2015. The average rehab programme in Scotland lasts three months. Although 97 per cent of people leaving residential drug treatment programmes are clean, about 80 per cent have relapsed within a month.

--oo00oo--

Had the 'journalist' at the Herald bothered to dig a bit further, they would have discovered this:-  

Description

River Garden will be a residential training and social enterprise development centre for people in the early stages of recovery from drug and/or alcohol addiction modelled on the three most successful and transformative self-help organisations for people in recovery across the globe: San Patrignano (Italy), Basta (Sweden) and Delancey Street (USA), which have been producing successful results helping people into long-term recovery, reintegrating into employment and mainstream society (70%-80%). Love and solidarity, boundaries, and training and employment for social enterprise activities We have been inspired by these successes to set up a recovery community in Scotland that supports people to live a drug and alcohol-free life. River Garden will be based on the same principles of abstinence, trust, firm boundaries, mutual support, social enterprise, respect for life, and responsibility. Participants will receive training and social support in a range of social enterprise activities to create a visitor destination using the existing refurbished gardens, and establishing a café, bakery, garden nursery, and fresh food for sale and processing, alongside other craft industries on site, and eventually expanding our business activities to the wider community.

Our extensive research has helped us to create a model that is culturally appropriate for the UK. Our aim is that River Garden will serve as a prototype which will be a transformational model for improved outcomes for people with drug and/or alcohol addictions. It is radical and different from any other type of service currently available to this group of people in the UK. We aim to demonstrate that there is a different approach with good outcomes for individuals who complete their programmes, their families, communities and ultimately the wider society. Initially, River Garden will support 30-40 individuals at any one time, but our strategic intention is to use the learning to replicate and set up other recovery communities in the UK to give people whose lives have been blighted with drug and alcohol addictions a real route out of their dependence and the opportunity to build a meaningful drug and alcohol-free life for themselves, with associated benefits to their families, communities and wider society.

Although abstinence is a requirement for entry, we will work with applicants and their treatment providers to begin the admissions process while they are reducing any substitute prescribing, so that there is a seamless transition from treatment to River Garden, minimising the chances of relapse between completion of treatment and becoming a volunteer trainee. For the past 2 years we have been in a process of learning about the admissions process by assisting people from Scotland in need of the type of support that IFDAS will offer to access the San Patrignano community in Italy. We have undertaken more than 20 assessments and to date have helped 3 people from Scotland (two male and one female) to gain places in San Patrignano and supported them to travel to Italy. This has been a useful learning process that has informed our own assessment methodology. This has included involving family members in the admissions process. We have secured planning permission for our centre and the purchase of the land will complete at the end of September 2017. We hope to begin preparation for our first 10 residents for admission in the Spring of 2018.

With an estimated 59,500 dependent drug users, Scotland has one of the worst drug problems anywhere in Europe. In total, 867 drug-related deaths were registered in Scotland in 2016. This was the largest number ever recorded, 23% more than in 2015, and double since 2005. Meanwhile liver disease now accounts for one in fifty of all Scottish deaths, and alcohol-related deaths in Scotland have increased by 100% since 1994 and are now officially the highest in Europe (1,265 alcohol-related deaths in 2016, up 10% on the previous year).

--oo00oo--

For those readers who've been around from the early days, they might recall we covered this topic here on Saturday, 7 May 2011:- 

Food for Thought

I don't normally do tv cookery programmes, but somehow found myself watching a new series called 'Two Greedy Italians' on BBC1 last Wednesday. It's the latest offering of that genre where to be frank the cooking is very secondary to the characters, the stories and the fabulous landscape. After some 45 minutes, I found myself being gently seduced by the scenery, the banter between the two main characters, the classy classic car and then suddenly when least expecting it - bham - a smack in the face and work! The viewer suddenly becomes aware that our two characters are not visiting just any old vineyard and winery, but rather we have entered the utterly surreal world of drug rehabilitation, Italian style.

The San Patrignano project near Rimini is truely amazing in terms of scale, aspiration and concept. A massive 1,000 bed therapeutic residential community, funded entirely by charitable giving and the sale of some of the most mouth watering food and wine you could ever hope to sample. Throughout my entire career I have bemoaned the lack of residential drug rehabilitation beds and instead our reliance on community-based methadone prescribing. This one-size-fits-all approach simply doesn't work and is so narrow and unsophisticated in concept.

Well here in stark contrast we have an absolutely fabulous example of how the whole person can be treated in a truly holistic manner and helped to achieve their full potential as human beings irrespective of their backgrounds and in a drug free environment. Not a hint of methadone anywhere, the residents are asked to sign up to a determination to work towards a life without drugs. Quite clearly many residents have significant criminal backgrounds in addition to addictions and emotional problems, but seemingly benefit from quite lengthy stays measured in years rather than months. And who couldn't benefit from a lengthy stay in such beautiful surroundings living on fine food and wine?

Until I saw this, I had been pretty impressed with the Clink Restaurant experiment at HMP High Down, but this Italian project is something else and I would urge anyone vaguely interested in the mostly depressing subject of drug addiction to have a look at episode one which I gather will remain on i-player until the end of May. As you watch, just absorb the fantastic attention to the design detailing of the whole facility and ask yourself if it looks like a drug rehab to you? Having recently been on holiday to Italy, I have to say that their flair and skill in design is something to behold and should put us all to shame back here. This programme shows that good Italian design encompasses more than just the fabric though. A real lift to the spirit!

The Prisoners 2

I think most people would agree that these fly-on-the-wall documentaries about prisons make for particularly depressing viewing, and episode 2 of the BBC1 series The Prisoners didn't disappoint in that regard. To the uninitiated, it should give a degree of insight into the scale and scope of some of the problems probation have to try and deal with on a daily basis. 

This episode featured heavily two female prisoners at HMP Holloway, one of the largest women's prisons in Europe we were told. Jayde, although only 18, has apparently spent most of her formative years in the care system and hence a variety of institutions. Emotionally she has been clearly damaged by her experiences and now adopts a pattern of dangerous attention seeking behaviour involving applying ligatures to her neck. Her binge-drinking only makes her violent tendencies even worse when back in the community and frequent breaches of her stringent PPO licence conditions only mean regular recalls. Ironically it's only prison where she feels cared for and safe.  

What always depresses me the most about clients like Jayde, or Crystal the 23 year-old who poignantly recounted how 'some of her best times' had been in prison, is that this didn't suddenly happen over night. Each has been through a range of statutory agencies before arriving at our doorstep, but we are expected to try and fix the problem. It seems that Crystal was diagnosed as being bi-polar some time previously, but for what ever reason this hadn't been treated successfully in the community. In her case, following a near-successful suicide attempt, it seems that only being 'sectioned' under the Mental Health Act enabled her to be stabilised on medication. 

It was sad to see Crystal feeling obliged to give up her tenancy in Southend, and I did wonder what if any support she'd been getting there. Of course it doesn't help with 'through-the-gate' support when the prison is some considerable distance away, potential probation bidders please note. I also notice that a residential rehab place was found for her. This is an incredibly expensive and rarely available opportunity, but not surprisingly it didn't work. We have a lot to learn regarding drug and alcohol treatments and I found myself daydreaming about the amazing Italian San Patrignano project that works holistically with people and was featured on tv in 2011.       

I don't want to repeat what I said following the first episode, but each of the clients featured here, including Jason the 27 year-old crack cocaine user, would benefit from counselling in one shape or another. You only have to watch how Jayde responds to the care and concern of officer Kelly to see how each is yearning to be understood and listened to. I suspect the two women may well have suffered some form of abuse earlier in their life and one of the results can be constant episodes of self-harming or other seriously reckless behaviour. Talking about such things is extremely difficult of course and can only happen within an established and trusting professional relationship.

A measure of the degree of institutionalisation can be glimpsed when Crystal observes that 'if only we were allowed out now and then to get some clothes and do some shopping, I don't think I'd ever leave'. She felt 'looked after inside. Was clean, well fed, happy and healthy. It's like home with friends'. What a sad indictment and something to ponder on. 

This series should be required viewing for any organisation considering bidding for our work on a Payment by Results basis. Is it really any wonder that reoffending rates are so high when one sees the reality of the problem posed by such chaotic offenders? There is no quick fix to such entrenched behaviours and problems. It takes a great deal of patience, time and effort and not at all conducive to Payment by Results. 

Sign the No10 petition here.

Tide is Turning on Drugs

I guess Tim Hollis, the soon-to-retire Chief Constable of Humberside, felt there was no harm in firing a broadside at his political masters at the Home Office before he hung his hat up. He speaks for the Association of Chief Police Officers on drug matters and feels the time has come to move responsibility for drug policy back to the Department of Health, ironically from whence it came. He feels that continuing to wage a 'war on drugs' alone is not working and another approach is necessary.  

It will come as no surprise that such a sensible suggestion has absolutely no support from the Home Office or indeed right-leaning outfits like the Centre for Policy Studies. But not surprisingly the British Medical Association are pretty keen on the idea and have recently published a report Drugs of Dependence : the Role of Medical Professionals that makes a strong case for treating drug issues as a health matter. The BMA wants:-

• A debate on the most effective approaches to preventing and reducing the harm associated with illegal drug use and drug-control policies, based on an independent and objective review of the evidence contained in the report
• To encourage dialogue between the medical profession and policy makers, legislators, the police, service providers and academics who have knowledge and expertise in this area
• To examine the doctor’s role in the medical management of drug dependence and the ethical challenges of working within the criminal justice system.

All this activity has to be seen in the context of Nick Clegg's recent very public statement that he feels the war on drugs is not working, together with the House of Commons Home Affairs Select Committee work on drug policy and their recent report. 

At long last we are beginning to see evidence that some politicians are 'seeing the light' and are starting to talk sensibly about drug policy here in the UK. In particular I note that the penny is finally dropping that methadone is not the only answer to dealing with heroin use and that a return to limited prescribing might be a good idea, ie as the situation was prior to the Misuse of Drugs Act 1971. The Select Committee report states:- 

"We recommend that a proper evaluation is conducted of diamorphine prescribing for heroin addiction in the UK, with a view to discovering its effectiveness on a range of health and social indicators, and its cost effectiveness as compared with methadone prescribing regimes."

"New evidence which has emerged in the decade since our predecessor Committee's Report on drugs suggests that diamorphine is, for a small number of heroin addicts, more effective than methadone in reducing the use of street heroin. It is disappointing therefore that more progress has not been made in establishing national guidelines for the prescription of diamorphine as a heroin substitute. We recommend that the Government publish, by the end of July 2013, clear guidance on when and how diamorphine should be used in substitution therapy."

Just like buses, reports all seem to come along at the same time with this contribution from the All-Party Parliamentary Group on Drug Policy Reform and a report on their inquiry into 'legal highs'. It seems we really are seeing some common sense emerging on the subject of drugs. There is no doubt in my mind that the whole probation landscape would change dramatically if our drug policies were revisited as a matter of urgency. From the APPG, this is just a taster of how the tide is turning :- 

"For forty years drug policy has been driven by the Misuse of Drugs Act.  Possession, use and supply of cannabis, ecstasy, amphetamines, cocaine and heroin are criminal offences, all potentially carrying lengthy prison sentences.   There was a consensus amongst many of the experts presenting evidence to the Inquiry that the Misuse of Drugs Act is urgently in need of reform.  Of its 40 sections, only 10 remain in use, but those ten are causing serious risks to the many young people, (though not only young people) who are determined to experiment with drugs.  Almost all the rest of us depend upon our own drugs of choice, whether alcohol or tobacco, both of which are far more dangerous than ecstasy."

Politician Talks Sense - Shock!

As we all know, and I've commented on before, politicians rarely talk sense about drugs. In the wake of the House of Commons Home Affairs Committee publishing their first report last week on UK drug policy, I think I heard Deputy Prime Minister Nick Clegg say something sensible. He said the war on drugs had been lost and it was time to review strategy - a view that I entirely support. 

"If you were waging any other war where you have 2,000 fatalities a year, your enemies are making billions in profit, constantly throwing new weapons at you and targeting more young people, you'd have to say you are losing and it's time to do something different. I'm anti-drugs - it's for that reason I'm pro-reform."

He went on to fully endorse the Home Affairs Committee call for an urgent Royal Commission on drug policy, only to be quickly shot down by Prime Minister David Cameron. Typically he says that current policies are working and that we don't need a Royal Commission. 

Sadly there is a long-established tradition in this country of politicians sounding relatively sensible on drug policy in opposition, only to go all tough-sounding when in government and pretend the situation is improving. 

The fact is the whole situation is far from rosy. Yes heroin use is falling, especially amongst young people, but we have no idea why. More people than ever, especially in prison, are being 'parked' on methadone for years just as a way of trying to keep prisoners off illegal substances. There is absolutely no way of stopping drugs getting into prison, not least due to the huge sums of money to be made by corrupt prison officers.  

Just to put the tin hat on the whole sorry state of affairs, I'm repeatedly told by clients that weaning off methadone is much harder than heroin and in fact deaths from methadone overdose in the community now far exceed those for heroin use. So, in effect, more people are dying of the cure than the disease.

I find him a hugely irritating politician, but in this instance Nick, you are indeed talking sense. It's just such a shame that I doubt you have a long term political future. The awful thought occurs to me that the two just might be linked. Such is our democracy here in the UK. 

Methadone Deaths

The Office for National Statistics have recently published figures for drug-related deaths and although those for heroin show a marked decline, somewhat bizarrely those connected to the so-called treatment have rocketed. The 2011 figures for heroin or morphine overdoses were 596, compared to 791 in 2010. In 2008 there were nearly 900. 

According to the ONS, these figures reflect a reduction in the total number of hard drug users in the UK, together with a 'heroin-drought'. This shortage, caused mostly by poor weather conditions in Pakistan and disruption of supplies from Afghanistan, has led to heroin supplies drying up on the street and made finding any of high quality extremely difficult. 

Conversely, if the disease is not killing people, the treatment certainly is. Methadone deaths have risen from 355 in 2010 to 486 in 2011. It will be recalled that the Chairman of the Royal College of General Practitioners, Dr Clare Gerada, recently re-assured Russell Brand in his tv documentary that methadone prescribing was 'the gold standard' in drug treatment. In reality it's just a cheap treatment option and many people tell me much harder to withdraw from than heroin.

As an aside, I found it fascinating how the discovery of the substance came about in 1937 as a result of a German military search for an opiate substitute. It will be noted that they decided not to use the substance due to the significant number and character of side-effects, a situation confirmed to me on a regular basis by current users. 

PS Since publishing the above, I've been looking around further on the subject and found this response to an article in the British Medical Journal from 2009. In addition to highlighting just how dangerous methadone is, the author mentions something I was loathe to as possibly being in bad taste. They ponder the possible perverse incentive of such a treatment policy "as death is without doubt a drug free state."     

  

Brand on Addiction

A reader asked what I thought of the recent Russell Brand BBC 3 documentary 'From Addiction to Recovery' so I thought I'd better get around to watching it on i-player before it disappears next week.

Now I have to say first off that the guy irritates me, and even though I can't abide the supremely smug and pompous chair of the House of Commons Home Affairs committee Keith Vaz, I think Russell's appearance and demeanor did nothing to help his message. Anyway, back to the documentary and Russell's case for abstinence. I quite agree, but it won't work for everyone, not least because to be most effective as a treatment model it really has to be delivered in a residential setting away from negative community influences.

In recent years, apart from the rich and famous, residential drug treatment is about as likely as winning the lottery. In theory there are NHS beds available of course, but getting your local health commissioning body to agree to funding is nigh on impossible. It will come as no great surprise that the real reason why the government and National Treatment Agency are so keen on community methadone prescribing is because it's cheaper. It doesn't work of course, but since when does a small matter like that affect social policy?

What really shocked me about this film was Russell's encounter with Dr Clare Gerada, chair of the Royal College of General Practitioners no less. I'm pretty sure I heard her enthusiastic and ringing endorsement for an utterly failed prescribing policy described as "the gold standard" FFS! During a short and understandably tetchy engagement she went on to compare methadone the 'medicine' as being akin to insulin for diabetics! Speaking, as she presumably does, for General Practitioners nationally, we really are all doomed.

Upon reflection I've been unfair to Russell in the past and this film is to be welcomed as shedding a bit more light on the whole sad and depressing business that drug policy has become. Politicians still dare not speak openly on the subject for fear of public and media outrage, so the charade continues in the form of an unwinnable  'War on Drugs' coupled with a failed prescribing regime of legal opiate substitutes. But as I've said before, there is no magic bullet solution. 

Common sense should dictate that there has to be a range of responses that include a return to legalised and controlled prescribing as prevailed prior to the Misuse of Drugs Act 1971. A quick perusal of wikipedia on the subject throws up this:- 

"Before 1971, the UK had a relatively liberal drugs policy and it was not until United States influence had brought to bear, particularly in United Nations circles, that controlling incidental drug activities was employed to effectively criminalise drugs use." 

I seem to remember that the US had a go at alcohol in the past too, and just look what prohibition led to - a massive boost to criminal activity - hang on a minute........            

Still Barking Up the Wrong Tree

So it's official. Justice Secretary Ken Clarke has told the House of Commons Home Affairs Committee that 'the UK is plainly losing the war on drugs'. 


"We've engaged in a war against drugs for 30 years. We're plainly losing it. We have not achieved very much progress. The same problems come round and round but I do not despair. We keep trying every method we can to get on top of one of the worst social problems in the country and the single biggest cause of crime."


The best he could offer the committee was that "there was better co-ordination between government departments".


So since when do intelligent people just carry on doing the same thing, when clearly as Ken confirms "nothing seems to be working". If he was a probation client and displayed such obvious cognitive deficits, we'd put him on an Enhanced Thinking Skills course. You'd think that the time had come to consider other options, a different approach perhaps, but not at all. What the government is actually doing is carrying on with the same failed policies and just 'reshuffling the deckchairs' by paying drug treatment providers differently.


As I have discussed previously, the government is convinced that introducing Payment by Results to whole swathes of public service provision will miraculously deliver better value for money by encouraging better outcomes. In April this year this new miracle accountancy device was rolled out in eight areas who bid to be guinea pigs under the grandly titled Payment by Results for Recovery Pilot Programme. From the initial twelve applications,  Bracknell, Enfield, Kent, Lincolnshire, Oxfordshire, Stockport, Wakefield and Wigan were selected, not to do anything substantially different, just carry on with failed policies like community methadone prescribing. This initiative follows on from the previous one entitled Drugs System Change Pilot Programme that involved lots of accountancy changes, but kept delivering the same failed treatments.


Confident in the knowledge that the war is being lost, I nevertheless forced myself to read some of the impenetrable crap that the new PbR industry has spawned and in the process provided  lots of jobs for bean counters. This is typical from Enfield:-


 In 2009 the DAAT  was keen to develop a revised commissioning framework to
embrace the wider Personalisation Agenda and Department of Health’s World Class 
Commissioning Vision. This included tendering for a new contract  that required
applicants to submit proposals for a mixed outcome and activity service level 
agreement against a capped annual contractual value of £1.35M. Tender applicants 
were also tasked with driving up performance against previous activity levels to
ensure that the DAAT Partnership was able to evidence value for money. The tender 
applicants had to submit two separate weekly unit costs: one for people in treatment
in receipt of prescribing services; the other for those in treatment but who were not 
receiving prescribing services. The new contract was awarded to a third  sector 
provider and came into effect on 1st January 2010, running for 5 years. The DAAT, 
therefore, has obtained set weekly tariffs with the prime provider for processing
individual community treatment budgets.


Reading this stuff you could be fooled into believing that it might represent a policy that could lead to better services for alcohol and drug dependent people. Instead we all know it will just lead to cynical creative accounting on an industrial scale. What's needed of course is a change in policy, away from methadone or abstinence for everyone, to a real personalised agenda that includes heroin prescribing and residential treatment. Just imagine what a difference it would make if a heroin addict could be assured of regular, quality assured, free doses in a safe environment and without the risk of contaminated needles or the imperative to go out stealing. It would reduce crime at a stroke and make our job a damn sight easier.      

Dinosaurs Clash!

Every blogger loves to be read and in my experience comments are avidly welcomed. Sometimes a contribution is received that is particularly challenging and hence in my view deserving of some extra careful consideration in response. A case in point concerns, as it happens, my most widely read post, somewhat provocatively entitled 'Punish Less : Understand More'. The issues raised by Brontosauras are so varied and fundamental that I'd like to address them individually and by way of a dedicated post. Those who wish to follow the argument might like to read the original post here.

I am sorry but your views epitomise almost everything that is wrong with our criminal justice system, including the Probation Service. In another post you lament the days when Probation were effectively Social Workers. 100 years of experience counts for little if you are wrong. Government changed the role of Probation officers because they didn't want them to be Social Workers.

On the contrary,100 years of experience may well indicate that we got it right. In fact I'd go so far as to say that Probation was one of the few bits of the Criminal Justice System that worked well, that is up until the government decided to change our role and before the present headlong rush into privatisation. The problem is that our work has always been difficult to explain, tailored as it should be to an individuals behaviour and needs. Each client should have a personalised approach designed to challenge particular behavioural traits and rectify impediments that might inhibit a crime-free future.

Unfortunately nowadays this type of provision is regarded as novel and expensive. Probation was encouraged down the groupwork 'treatment' route to limited effect because  of course offenders are not amenable to being 'processed' as generic entities. There is a huge range of offending and each requires an individually-tailored 'intervention' by well trained and qualified staff. Only yesterday HM Chief Inspector of Probation bemoaned the inappropriate and frequent use of standalone curfews for leading to widespread breach. As punishment goes it's supposedly cheap, but lacking any attention to underlying issues, often totally ineffective. There are no 'cheap fixes' to these issues and the magic bullet will continue to elude successive governments until such time as there is recognition that underlying issues have to be addressed, be they drug and alcohol treatment, education, housing, training, employment or counselling to name but some.
   
As I have explained previously, just because Probation Officers were trained as Social Workers, did not mean that they only ever concerned themselves with an offenders welfare issues. This is a gross distortion of the truth and demonstrates a profound failure to understand the role and responsibilities of a Probation Officer. Irrespective of what type of training we received, there has always been a concomitant responsibility to protect the public and reduce crime. For some it might be difficult to comprehend that both functions can be successfully undertaken at the same time, but it can and only now is it being fully appreciated that changing our role was a serious mistake on the part of ill-informed politicians wishing to curry favour with the Electorate.  

I understand all the social welfare issues that many offenders have. Co-ordinating that assistance and support is important but so are consequences. There are no consequences in our justice system. I have seen young probation officers told to fuck off by their charges. No breach. They don't know what to do about it.

Well first off I'd have to say that a client swearing at an officer says more to me about the officer than the client. It says that they have almost certainly misjudged a situation and need to take urgent action to recover it. I've been wracking my brains and that of colleagues. I'm sure I must have been sworn at over the years, but none of us could remember, it not really being worthy of note. People under a great deal of stress might well say all kinds of things, but I think it would normally be treated as being similar to what a child might say. It's laughable to suggest that it's breachable behaviour on it's own. There would have to be evidence of a continued failure to co-operate in order to trigger a return to court.

Now threats to kill is a different matter. I can recall at least two instances, neither of which resulted in prosecution because in the final analysis I did not feel they were likely to be carried out, but they did have consequences. In one case the client was 'sectioned' under the Mental Health Act and in the other the child was still removed into the Care of the Local Authority, but supervision of the client was transferred to another officer.      

On what evidence do you state that sentencing has no effect on deterrence? Utter rot.

I don't think I ever said that. Of course it has some effect, but it must be remembered that some sentencing, such as to imprisonment, has significant negative side effects and I wanted to highlight the need to address the underlying issues that led to the offending in the first place. In the end this is the only really effective way of encouraging a change in offending behaviour. Punishment alone, in my experience, is only likely to work in a minority of instances. I repeat - getting caught is much more likely to have an effect than the sentence itself.   

You then claim that the chances of getting caught has most effect on crime. How? When offenders are caught there is no effective consequences for persistent offenders including deterrent sentencing and no effective rehabilitation.

What a wonderfully sweeping statement that I fear is borne more of prejudice than insight. Getting caught is somewhat akin to gambling behaviour. In the case of the former, being arrested could be construed as just bad luck as in many instances the offender will know full well that other offences have gone undetected, and in the latter, losing is also just 'bad luck' because they had an earlier win. It's all effectively a gamble, but unfortunately partial re-enforcement can be a powerful driver for repeat behaviour. Our job is to try and counter these disjointed and misguided thought processes by various means, not least because as professionals we know only too well that further down the line consequences will follow. Driving Over the Prescribed Limit or Driving Whilst Disqualified will mean crippling insurance premiums. Indecent Exposure will mean no employment with children. Theft will mean you can't get that job in a bank. 

In truth, trying to measure 'effective rehabilitation' is difficult and probably one reason why it is so hard for us to get our message across. An absence of further convictions might not mean there has been no further offending. It might just be that they haven't been caught. If it's difficult to measure, it's also difficult to deliver. Getting a sex offender to accept their offending, possibly deal with their own abuse, change distorted thinking built up over time and effect sustainable alternative behaviour, could take years of an officer's time. Ever longer prison sentences on their own are unlikely to alter behaviour, but rather provide an environment for the consolidation of distorted criminal views. Given that we can't lock everyone up for ever, it should be obvious which approach is more likely to have a positive effect, even if it can't be measured accurately. Anecdotally, I know it works. 

It has become fashionable to say that high reconviction rates prove that Probation hasn't been working and therefore requires comprehensive 'reform'. This is to completely miss the point by punishing the doctor without dealing with the disease. Over the last 30 years it has been our absurd drug policy that has fostered and failed to deal with the explosion in drug-related crime. Of course the Probation Service has had to try and cope, but it is a losing uphill battle when we don't have access to treatment models that are effective and have to rely instead on discredited methadone prescribing. Reconviction rates would plummet if we returned to other options such as controlled heroin prescribing as in other countries.        

It is impossible to do anything but gloss over the arguments here. I strongly recommend you read a book by David Fraser, a former senior probation officer. It is called A Land Fit For Criminals. He has woken up and understands the justice system for the complete sham it is. 

I agree that the arguments are complex and the solutions considerably nuanced and is one reason for this blog. I was not aware of the book by David Fraser, but have been doing some research and unearthed some reviews. I have to say that Mr Fraser does not come over as someone who was ever really a conducive candidate for his chosen profession and of course his elevation to SPO would have meant that he was well removed from client contact, possibly for much of his career. He took part in the BBC Radio 4 programme 'The Moral Maze' following the riots last year, but did not acquit himself well in my view. I could shell out 20 quid and buy a copy of the book, but I don't feel inclined to make the investment in something I know I will find highly irritating. Yes of course it leaves me wide open to criticism as someone not willing to open their mind to conflicting evidence, but as it says on the tin, it's my blog and my experience tells me something very different.       

Drug Treatment Isn't Working

I've been saying it for ages and pretty well every Probation Officer has known it for ages too. Our one-size-fits-all approach to drug dependency by prescribing methadone isn't working. The utterly flawed case for this treatment method is comprehensively demolished in a recently published report by the right-wing think tank Centre for Policy Studies. The whole policy has been a disgraceful waste of time, money and effort and done nothing to reduce the problem - in fact it's almost certainly made the whole situation worse. 

During the period that the Labour government was imposing this strategy through the National Treatment Agency, they oversaw the disgraceful demise of almost all residential rehabilitation facilities, thus leaving prison as the only 'residential' drug treatment facility available. Of course this is nonsensical, both in terms of cost and the need to commit offences in order to get a prison 'rehab' bed. But sadly in prison there will invariably be little counselling and only prescribed methadone as an alternative to illegal drugs that are widely available. Despite this, many people find it a viable and preferential option and some do manage to detoxify or become 'stabalised' on a methadone script. 

In addition to ridiculing the accepted professional view that methadone prescribing works and is cost-effective, the report makes it clear that in their view the only answer is to work towards total drug abstinence. Whilst not cheap as it would involve the financing of new residential bedspaces, they make the point that if the outcomes are improved, it would be money well spent.

Whilst I agree fully with this view and have long-lamented the disappearance of residential treatment places, I think I need to sound a note of caution. This report is in danger of falling into the same trap of believing that there is only one answer to the drug problem and that it lies with total abstinence. Every person is different and their drug problem and attitude to substance misuse will differ. The solution therefore has to be tailored to that individual and it might involve the opposite option of prescribing heroin, rather than encouraging total abstinence. Understandably perhaps this gets no mention in a report advocating abstinence, but there is evidence that such a policy can work well for some people. It seems that in some instances heroin can be less addictive than methadone and ironically can be easier to withdraw from.   

This report is extremely important and timely in serving to highlight how the situation might well get worse due to impending changes being introduced by the coalition government. Whist the new government accepts that current policies are not working, their answer is to change the payment method to drug agencies rather than change the underlying policy. The report explains that 'Payment by Result' experiments will begin in October this year tailored to proxy outcomes such as housing or employment, but specifically excluding projects that wish to pursue an abstinence route. This is completely misguided and I agree entirely that such agencies ought to be included in PbR schemes with their payment linked to rewarding evidence of abstinence outcomes. That seems a sensible idea to me, rather than just rewarding the present methadone treatment industry differently.

Dispatches from Bristol

The latest episode of Channel 4's 'Dispatches' screened on Monday 13th June and entitled 'The Thief Catchers' helped shed a bit more light on what dealing with chronic long term users of heroin was like when they're not a rich banker or wealthy bond trader. In order to feed their habit, each has to steal a small fortune on a regular basis either through shoplifting, street robbery or burglary. There is a general trend towards escalation in offending as their faces get well known to shopkeepers and they get moved on. Lying to all and sundry becomes automatic and consummate, even to friends and family in order to satisfy the constant craving for another fix.

In Bristol this type of offender comes within the remit of a Safer Community Partnership
initiative called IMPACT, but run in close co-operation with the local Drug Intervention Programme. The documentary served to illustrate just how the police have become key players in the whole 'offender management' business as a result of the last Labour governments 'tough on crime, tough on the causes of crime' policy. I know partnerships are a much vaunted thing nowadays, but it still struck me that PC Dave was just doing PO Declans job.

The film followed the fortunes of three long-term male drug users, each of whom had earned the title 'prolific offender.' I found this slightly confusing because I don't think IMPACT is a Prolific and other Priority Offender project (PPO), but there are so many acronyms in offending nowadays it might be. Such schemes are similarly made up of all relevant agencies and undertake to offer clients a so-called 'premium' service. The IMPACT initiative did seem to be run on similar lines as supported accommodation appeared to be on offer pretty quickly, as did drug treatment or 'rehab' as it was continually referred to. 

Unfortunately the makers of the film never told us exactly what sort of drug treatment the three guys received. My guess is that it would have been methadone replacement and I don't call this 'being in rehab'. The trouble is that definitions have changed as proper residential drug rehab beds have become like hens teeth. A place in a hostel and community prescribing through DIP I guess now counts as 'rehab, but as Shaun's case in particular demonstrates, changing entrenched attitudes and long-term addictions is a mighty uphill struggle and failure is routine. Well it is when we insist on not using alternatives like prescribing heroin. I suspect Shaun wouldn't have felt quite the need to blow his entire Community Care grant of £2,000 on street gear if he could get a script.

Actually Shaun highlighted how the whole person and all their needs have to be addressed in order to try and effect change. His arm-slashing whilst in prison was not so much a mental health issue as an emotional issue, but this is often misunderstood as the recent 'Strangeways' documentaries showed on ITV. 

Overall a useful insight I suppose into just how difficult and depressing the whole subject of drug-abuse is. I did chuckle at one point early on though when we saw a typical new-looking probation officer, or probation services officer, walk into the interview room with several large ring binders, one of which looking suspiciously like an OASys manual. We watched her telling the guy that she wanted him to do a victim empathy test and place various offences in order of seriousness. Unfortunately we didn't hear how she dealt with his reasoning that maybe murder was quite understandable in certain circumstances and possession of a firearm wasn't that serious.      

Food for Thought

I don't normally do tv cookery programmes, but somehow found myself watching a new series called 'Two Greedy Italians' on BBC1 last Wednesday. It's the latest offering of that genre where to be frank the cooking is very secondary to the characters, the stories and the fabulous landscape. After some 45 minutes, I found myself being gently seduced by the scenery, the banter between the two main characters, the classy classic car and then suddenly when least expecting it - bham - a smack in the face and work! The viewer suddenly becomes aware that our two characters are not visiting just any old vineyard and winery, but rather we have entered the utterly surreal world of drug rehabilitation, Italian style.

The San Patrignano project near Rimini is truely amazing in terms of scale, aspiration and concept. A massive 1,000 bed therapeutic residential community, funded entirely by charitable giving and the sale of some of the most mouth watering food and wine you could ever hope to sample. Throughout my entire career I have bemoaned the lack of residential drug rehabilitation beds and instead our reliance on community-based methodone prescribing. This one-size-fits-all approach simply doesn't work and is so narrow and unsophisticated in concept.

Well here in stark contrast we have an absolutely fabulous example of how the whole person can be treated in a truly holistic manner and helped to achieve their full potential as human beings irrespective of their backgrounds and in a drug free environment. Not a hint of methadone anywhere, the residents are asked to sign up to a determination to work towards a life without drugs. Quite clearly many residents have significant criminal backgrounds in addition to addictions and emotional problems, but seemingly benefit from quite lengthy stays measured in years rather than months. And who couldn't benefit from a lengthy stay in such beautiful surroundings living on fine food and wine? 

Until I saw this, I had been pretty impressed with the Clink Restaurant experiment at HMP High Down, but this Italian project is something else and I would urge anyone vaguely interested in the mostly depressing subject of drug addiction to have a look at episode one which I gather will remain on i-player until the end of May. As you watch, just absorb the fantastic attention to the design detailing of the whole facility and ask yourself if it looks like a drug rehab to you? Having recently been on holiday to Italy, I have to say that their flair and skill in design is something to behold and should put us all to shame back here. This programme shows that good Italian design encompasses more than just the fabric though. A real lift to the spirit!   

Professional Dilemma 3

The following happened several years ago when probation officers still enjoyed a mixed bag of cases to supervise, by which I mean we were not restricted to just high risk cases, but some that might have a significant 'welfare' dimension as well. It was also a time when typically you would have written the PSR, decided what the key issues were, what the recommendation would be, how the supervision plan would look and would have taken the case when sentence was passed. All this was regarded as completely normal and in fact was extremely good practice for the time. The ground work had been done, building a relationship had started and the person wasn't passed around like a parcel. Sadly it is most unusual nowadays if the author of a report subsequently ends up supervising the case. But that's another story.

The client in question was a young woman of about nineteen years of age. She had lost touch with her family, been in care, suffered sexual abuse, had a string of unsuitable boyfriends who introduced her to heroin and had already accumulated an offending history that had led to several periods in custody. This is a scenario that will still be very familiar to probation officers nationwide and usually signals a rapidly descending spiral of decline. If I remember correctly I interviewed her on remand for a whole string of shoplifting offences whilst on licence.  

The young woman was homeless and in a sense the report was fairly easy to write because the disposal appeared so obvious to me. She clearly needed help and a Probation Order seemed the most appropriate way to try and give her a fresh start, as long as a hostel place could be arranged. I felt it appropriate to attend court on this occasion so as to be able to convey her to the hostel if an Order was made. It duly was about 3pm, but unfortunately no provision had been made by the prison to supply a methadone script so that her treatment could continue straight away when released. This is not that unusual, even though prisoners attending court are routinely 'discharged' with their belongings. It represents but one of those very irritating lack of joined-up parts of the Criminal Justice System.

We arrived at the hostel at about 4pm and I stayed to chat with the staff and make sure she settled in ok. I remember we were in the middle of a conversation in her room when she suddenly announced 'Look Jim you're a nice bloke, but if I you don't give me a lift into town now so I can graft it'll be too late.'  It's one of those absolutely classic defining moments in your career. What the hell do you do? There was no hope of getting any methodone legitimately at that time of day. This woman is going to be 'rattling' shortly and could only think about how to avoid it. She had told me too much information and was effectively inviting me, her probation officer, to assist in the commission of criminal activity by giving her a lift into town. My career could be ending with a headline in the local paper. I could refuse, give her a lecture or worse in my view, money. Of course parents of drug-using children are often faced with a similar dilemma. Throw them out, or give them money for drugs.

This is a difficult job at the best of times and sometimes decisions are just not clearcut. I had to carry on working with this person and help her turn her life around. In order to try and fulfill that longer term aim, my decision was to reluctantly give her that lift on this occasion.  

Common Sense on Drugs

For years I've been hoping that we could have a common sense discussion about drugs in this country, but the trouble is no politician dare start it. Well, not one with any commonsense or a career to think about, hence my heart sank when I heard Bob Ainsworth MP of all people daring to put his head above the parapet last week in an interview with James Naughtie on the BBC Radio 4 'Today' programme. 

A lot of what he had to say I agree with, but why, oh why did it have to be this former deeply uninspiring Defence Secretary? Under some reasonably gentle questioning it was obvious Bob hadn't really thought through the consequences of his general hypothesis that the War on Drugs was completely futile and decriminalisation was a better route. Now this is a huge topic and deserved something rather better than this half-baked 5 minute interview. I know it will be the subject of a Westminster Hall debate, but even so.....

Of course all Bob has succeeded in doing is getting the right wing press over-excited, as with Simon Heffer in the Daily Telegraph. I try not to read such stuff because it only gets me very annoyed, but I was pleased to read a comprehensive dismantling of Heffers article by Jackhart on his blog here. The sad fact is that the changes made to legislation in the 1960's and which removed drug issues from GP's and the medical profession have been a complete disaster and pretty much resulted in the massive crime wave of the 1980's. For years shoplifting has been synonymous with drug addiction and all the effort put into treatment regimes based on methadone prescribing have failed. The present government have conceded the latter point, signalling an end to 'maintenance' methodone prescribing, but are completely unrealistic in thinking addicts can be persuded to come off everything quickly.

Part of a better answer lies in experiments authorised by the last government into trials involving a return to the prescribing of heroin under medical supervision. If this sounds uncannily familiar, it is and mirrors success in places such as Switzerland where evidence shows addicts are far more likely to make a transition to a drug-free lifestyle under such a system of phased withdrawal. For some though it might mean a maintenance 'script for heroin, but again evidence shows such people can often hold down jobs and carry on with settled lifestyles. There are none of the serious health risks associated with street drugs such as cutting agents and the ever present risk of an unintended overdose with unknown purities. Finally of course, all of the activity is legal, regulated and most importantly beyond the scope of criminal involvement at any stage. 

Even this doesn't solve all the problems though. There would remain the issue of how experimentation could be handled. Sophisticated drug gangs are not just going to throw the towel in and go back to other less lucrative activity like extortion or prostitution, they would put renewed energy into recruiting young users and that must remain a big concern. Having said that, most so-called drug dealers that have come my way are in fact people heavily addicted themselves and fund their use typically by supplying small groups of friends and associates. The only real suspected 'Mr Big' that I've ever dealt with was for violence and he never got any conviction for drug-related offences. So much for the 'War on Drugs' and I suspect this is not atypical. 

I have deliberately not addressed cannabis here because I'm completely with Professor Nutt in reminding people how vastly more harmful alcohol is. Throughout my career I have never written a report concerning an act of violence committed under the influence of cannabis. There are some dangers of course, but as a society lets tackle the main issue, not the side show.   

Prisoners on TV

Having just returned home I was encouraged to tune in to the BBC i-player and watch Tuesday nights edition of 'newsnight' recorded at HMP High Down. I would recommend it to anyone interested in the subject of prison and rehabilitation generally, not least just for the chance to hear contributions from inmates for a change, even though sadly virtually all were somewhat befuddled by the effects of methodone.

For me the programme very graphically illustrated what all probation officers have known for ages and that is that as a society we simply do not have an intelligent way of dealing with illegal drugs. The subject was mentioned either directly or indirectly all the way through and it once more serves to remind me that politicians must get the public to accept that our present policies simply don't work and we must therefore change our response to the whole drug problem. I repeat what I have said before, namely that methadone is not the answer. It's being used in prison as a sort of chemical cosh to keep prisoners calm and obtained by them automatically by dispensing machines. If you deal with the drug issue more intelligently, re-offending will reduce and the prison population will go down. It is the key to the whole problem.

The programme was also interesting in serving to highlight just how complicated a subject this is with Ken Clarke confirming that there are no quick fixes. In fact he had an air of resignation about him, even backtracking on his earlier stated aim of reducing the prison population by 3,000. I think Tim Brain the former Chief Constable ably demonstrated his limited contribution to a serious debate and there were similar underwhelming contributions from the Magistrates Association and Peter Hitchins of the Daily Mail. The CEO of St Giles Trust simply stated the blindingly obvious and the policy wonk from Policy Exchange seemed a little inexperienced to me, but where was probation?

Our absence from a major discussion on prison and rehabilitation, our field of expertise after all, is extremely worrying. It's noticeable that we didn't get a mention at all until right at the end. Ken did allude to probations philosophical objection to Payment by Results though and wondered why anyone could object to getting a return on investment if it delivered a reduction in re-offending. I say again, we need a more sophisticated response to this.

Anyway, a programme worth catching before it disappears off i-player, but before I sign off, was I the only one to do a double-take at the prisoner who had a charge of aggravated burglary reduced to fraud? It makes you think doesn't it?!            

A Cunning Plan

It has been obvious to me for ages that our policy on drugs is simply not working. Any probation officer who has been around for any time will be aware of the phenomenon whereby a drug dependent client will beg you for a period of time in custody. I'm sure magistrates will be aware of this too because I've heard heart-felt pleas of 'please lock me up' from the dock on more than one occasion. The same goes for solicitors and it is hard not to be moved by the sheer desperation and hopelessness of such an individuals situation. This has come about basically because it is virtually impossible to obtain an in-patient bedspace for drug treatment. If by some miracle one was located, funding would be an impossibly bureaucratic nightmare. 

One might be tempted to ask how this has come about? The answer is partly the sheer numbers involved, but also that the politically correct, and by happy coincidence cheapest form of drug treatment, is by means of so-called community-based methadone prescribing. It's politically correct because the ethos says it enables the client to remain in their home, possibly employment and maintain their community support networks. The only trouble is the people I'm talking about are invariably homeless and 'sofa-surfing' hopelessly unemployable and all their mates are on drugs as well. So, in a situation like this, a request to be either remanded in custody or serve a sentence is an extremely rational decision. In the old days the itinerant town drunk would lob a brick through a shop window in order to spend Christmas eating HM Prison's festive turkey. Nowadays offences such as shoplifting are frequently committed deliberately by drug users as a route to residential drug treatment provided by HM Prison.

Again, one might be tempted to point out that prisons are hardly drug-free environments. I've certainly had clients go in clean and come out addicted and vice versa, but the key thing is the degree of motivation. Many clients have told me that it's much easier to get clean and stay clean in prison if you are minded to. It obviously helps if your 'padmate' is similarly inclined and you're on a drug-free wing, enforced by the inmates by the way, not the staff. Prisoners can be the best form of support for each other, or the worst of bad influences, such is the reality of incarceration.

Apart from cost and the absurdity of it, the main problem with this way of society dealing with the chronic drug problem is the length of sentence. Even with a record and history of failed community sentences, a string of new shop lifting offences will not often result in more than 6 months, and usually much less given an early guilty plea. Now the punitive amongst us might be surprised to hear that many clients would dearly love longer behind bars because they know a release in just a few weeks isn't enough to detox completely or to make the most of treatment that's on offer.

The answer to this has to be a bit more sophisticated than longer prison terms, essentially for drug treatment. We need a way of providing residential drug treatment facilities that are sufficient in number, relatively easy to access and affordable. But we're in a recession and government has no spare cash. Having read further about Social Impact Bonds and the project at HMP Peterborough, I think this could be a possible funding route with payment made on results.

We are all aware that many of our prisons hold inmates who have drug problems and I have outlined how many choose custody as a way of dealing with their addiction. If a way could be found to fund a network of residential treatment facilities, I feel there would be merit in exploring a radical alternative for low level drug dependant offenders that diverts them from the Criminal Justice System completely. I envisage such people being offered the opportunity of a residential treatment place as a possible alternative to a conviction and sentence following an admission of guilt. I suppose technically it could be viewed as a Deferred Sentence with a return to court should the placement break down for any reason. Successful completion would ideally in my view result in no conviction being recorded. I'm fairly sure this wouldn't be possible at the moment and might therefore require legislation, or at least some better qualified legal opinion than mine. 

What is obvious to me is that drug policy is failing completely at the present time and therefore some radical thinking might be appropriate. I think a scheme like this could deliver better treatment and lower prison numbers, with capital funding for the centres off the Public Sector books, and all with the prospect of real savings to the taxpayer. The Holy Grail and a cunning plan I think.     

Time to Rethink Drug Treatment

It seems incredible, but there was a time when heroin did not have such a strangle hold on certain parts of society. When I started out in 1985 there was some glue sniffing, abuse of cough mixture (still containing opiates) and some cannabis use, but the main drug problem was alcohol. In those days drug addiction of any serious nature was referred to a Regional NHS unit, complete with admission and treatment beds - oh how things changed over the following years when widespread heroin use and associated offending began to be the predominant feature of the majority of probation work. I remember a senior police officer telling me it arrived in my small town in the boot of a black BMW in 1991. Sadly, as the problem grew exponentially, the resources to deal with it have proved woefully inadequate. Residential treatment beds became as scarce as hens teeth, and if located, funding proved a bureaucratic nightmare. For whatever reason the answer was felt to be methadone treatment in the community - cost must have been a factor, but it soon became clear to me that this 'one size fits all' approach was clearly not working. Client after client would describe to me how much more difficult it was to come off methodone than heroin. They said things like 'it gets into your bones' and many chose the nightmare of 'cold turkey' from heroin rather than go back onto a methodone script. As the years have rolled on, I've become aware of increasing numbers of clients on maintenance doses of methodone, rather than the reduction programmes that have clearly failed - and yet as a society we remain wedded to this failed model.

I once had the chance to speak to Hilary Benn when he was probation minister - he was lamenting the state of many neighbourhoods littered with sharps when I said 'well why don't we prescribe heroin?'. He said 'you know, you're the third person to have said that to me today'. Sadly he was soon promoted to Overseas Development and you have to start again with another minister. The reason we don't of course is because all ministers are scared witless of public opinion and especially by the right-wing press such as the Daily Mail. Nevertheless, there have been quiet prescribing experiments taking place in a couple of cities and the results are confirming what has been found to be the case in Switzerland - it works in weaning off those that are well motivated, is safer for those maintained and offending dramatically reduces. So, the question is, does the new coalition government have the bottle to finally signal a rethink on drug treatment - and sod the Daily Mail?