Drugs

1
Drugs CrimeA journey through the treatment
pathway

• Paul Ivetic Substance Misuse Nurse
• 30th April 2014

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Introduction

• Substance misuse nurse working with service users
  involved in all parts of the criminal justice
  system
• Benefit those doing a placement in a community
  drug and alcohol team
• Examine the way in which dependent problemmatic
  substance abusers access treatment through the
  stages of the CJS

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Drugs Crime

• Explicit Relationship between drug use crime
• Late 1990s ½ of all property crime blamed on
  drugs
• In fact 70 of all crime was thought to be drugs
  related
• NTA (2012) Average cost of crime per dependent
  drug user was 26,000 per year if they were not
  in treatment
• NTA (2012) Annual cost of drug related crime
  13.9 billion

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What Crime?

• Problematic substance misuse associated with
  crime
• Drug Use
• Acquisitive Crime e.g. shoplifting, burglary,
  robbery, fraud, sex working
• Alcohol Use
• Committing crime under the influence e.g.
  domestic violence
• Anti-social behavior

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Arrest

• Drugs Act (2005) Tough Choices
• Acquisitive Crimes became Trigger Offences
• DIP Teams established in custody suites
• Committing a Trigger Offence results in a Drug
  Test
• If ve for Class A (opiates, cocaine)
• Required Assessment
• Restrictions on Bail
• If DNA RA appointment warrant for arrest could
  result in a fine or 3 months custody

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Arrest

• Drug Test on Arrest becomes the norm
• Inspectors Agreement
• Definition widening e.g.DV
• Positive for Class A substance
• Bail assessment R.A.
• If ve to opiate refer to prescribing service
• Conditional Caution by Police

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CUSTODY

• Police Custody
• Prison
• IDTS
• Integrated Drug Treatment System for Prisons
• CARAT
• Counseling
• Assessment
• Rehabilitation
• Through care

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Treatment in Custody

• Substitute prescribing for those on opiates
  (Methadone, Buprenorphine)
• Detoxification
• Abstinence based therapy RAPT
• Prison Release
• Confirm It (SPOC, call the prison, get a fax)
• Confirm client is in treatment
• Urine sample (It confirms treatment and confirms
  any illicit drug use)
• Give Naloxone

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Community Punishment

• DRR (replaced DTTO)
• Reducing trend starts not happening for opiate
  users
• Frequent Drug Testing
• Supervised Oral Fluid Testing
• Treatment
• Can not force medication
• Specified Activity
• Day program
• Review

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Community Punishment

• ATR (Alcohol Treatment Order)
• DAO (Drug Abstinence Order)
• Sobriety Bracelets
• Lewisham Pilot?
• Drink Banning Order

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Community Supervision

• Priority Prolific Offenders (PPOs)
• Multi-agency approach
• Integrated Offender Management
• Prolific Offenders
• Repeat DIP testers
• Domestic Violence cases
• Funding Changes
• Public Health England
• Change to DIP funding
• Privatisation of Probation

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Why do we do this?

• Maximum Benefit
• Minimum Harm
• Cost Effective
• Patient Choice
• Provision of Naloxone
• Problem of OD in abstinent offenders who use
  heroin on release
• 1st 4weeks of freedom the risk of OD is 7X higher
  than other heroin users

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Why do we do this?

• Every 1 invested in drug treatment saves 3 in
  other costs
• Every 100 invested in treatment prevents a crime
  committed
• NTA (2012) Current drug treatment prevents 4-9
  million crimes per year saves 960 million in
  other costs
• 100,000 fewer burglaries
• 1.1 million fewer shop thefts
• 350000 fewer acts of prostitution