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Drug Treatment and Testing Orders: Evaluation of the Scottish Pilots

CHAPTER ONE: INTRODUCTION AND BACKGROUND

INTRODUCTION

1.1 Drug Treatment and Testing Orders (DTTOs) - which are aimed at providing courts with a further community-based option to deal more effectively with some serious drug misusers who commit crimes to fund their habit - have been introduced in the UK through provisions in the Crime and Disorder Act 1998. The limited effectiveness of community based supervision and testing with drug misusers in the absence of access to relevant treatment services has been highlighted in studies in North America (McIvor, 1990). Although there has been some debate with respect to the effectiveness of drug treatment in a mandatory context, Hough (1996) has concluded that legally coerced treatment need not be less effective than treatment which is free of such pressures, arguing that many people in treatment are often ambivalent about their drug use and many are coerced into treatment and kept there by pressure from partners, family or employers. Indeed, the experience of Drug Courts in the United States and elsewhere suggests that mandated treatment can result in reductions in drug use and associated offending (e.g. Belenko, 1998, 2001; Gebelein, 2000; Goldkamp, 2000).

1.2 Under the relevant legislation, courts can require an offender to undergo treatment for drug misuse, subject to the offender's consent to such an order being made. Drug treatment and testing orders - which can be for a minimum of six months and a maximum of three years - can be made as a 'stand alone' option or in conjunction with another community based disposal such as a probation order. They differ from existing provisions insofar as the role of the supervising officer is limited; mandatory drug-testing is an integral component of the order; and the courts have powers to review orders on a regular basis. The interaction and dialogue between the offender and the bench in the contexts of reviews (which are intended where appropriate to be facilitative and encouraging) is a distinctive feature of DTTOs which they share with the Drug Courts that have been established in other jurisdictions and, more recently, on a pilot basis in Glasgow.

1.3 While further offending during an order constitutes a breach of a probation order, reconviction for a further offence will not automatically result in breach and revocation of a DTTO ¹. DTTOs can be imposed upon offenders aged 16 years and older whose assessment by the local authority DTTO team indicates that there is a dependence on or propensity to misuse drugs which requires and is susceptible to treatment and that the offender is motivated to undergo the treatment required (Home Office, 1998; Glasgow City Council, 1999).

THE ENGLISH PILOTS

1.4 DTTOs were first introduced in the UK in three pilot schemes in Croydon, Liverpool and Gloucestershire. The evaluation of the DTTO pilots (Turnbull et al., 2000) showed that a total of 210 DTTOs were made across the three schemes during the 18-month pilot period. Although many of the tests that were conducted on offenders showed positive results for opiates and cocaine, the rate of positive tests for opiates decreased over time. The revocation rate varied from 28 per cent of orders made in Liverpool to 42 per cent in Croydon and 60 per cent in Gloucestershire. Offenders given DTTOs reported substantial reductions in drug use and offending compared with before they were placed on an order, with reductions largely sustained over time. Even those who failed to complete their orders reported having benefited from being on a DTTO, though the researchers note that the non-completers could probably be best described as 'partial failures' and that those non-completers whom they were unable to recruit into the study were likely to have fared much worse.

1.5 The evaluation of the English pilots concluded that DTTOs had only been successfully implemented in one of the pilot areas and it identified a number of issues that needed to be addressed prior to any national rollout of orders. These included: ineffective inter-agency working; lack of knowledge of DTTOs among potential referrers; inefficient screening processes at the assessment stage; a lack of consistency in the matching of offenders to interventions; a lack of clarity regarding the objectives of intervention; differing expectations of progress towards abstinence; marked variations in frequency of urine testing; difficulties in ensuring continuity of sentencers across successive review hearings; and a lack of consistency in enforcement practices across the pilot sites. The evaluation also pointed to a need for schemes to implement monitoring arrangements to gather data on the referral and assessment process, offenders' level of contact with the programme and enforcement. As we shall see, the Scottish pilots were able to learn from the experiences of the pilot DTTO schemes in England and Wales and, consequently, avoid many of the problems they encountered.

THE SCOTTISH PILOTS

1.6 In Scotland DTTOs were introduced through the provisions of the 1998 Crime and Disorder Act. The first pilot scheme was established in Glasgow in October 1999 and orders became available to the Glasgow Sheriff, Stipendiary Magistrate and, subsequently, the High Court. Initial implementation and uptake was slower than expected, with the first order being made in February 2000. The second pilot area began in Fife in July 2000 when DTTOs were made available to Cupar, Dunfermline and Kirkcaldy Sheriff Courts. The first order in Fife was made in August 2000 at Kirkcaldy Sheriff Court. In Scotland, unlike in England and Wales, the use of probation orders with additional conditions to attend for drug treatment was already well established. In 1999-00, for example, 429 orders of this type were made in Scotland, representing the most common type of additional requirement after unpaid work (Scottish Executive, 2001a). However the two DTTO pilot sites differed in the use they already made of this option, with usage being well established in Glasgow but not if Fife. This reflected the existing availability of treatment services that could be accessed by offenders subject to court orders.

1.7 Offenders who were potentially suitable for a DTTO were identified either through a Social Enquiry Report (SER) or at the point at which the court requested an SER. A further continuation would be granted by the court to enable an assessment to be undertaken by the DTTO unit. Offenders who were made subject to DTTOs were subject to regular mandatory drug testing and were provided with treatments deemed necessary to reduce or eliminate their dependency on or propensity towards misusing drugs.

1.8 The DTTO scheme in Glasgow consisted of a manager and two DTTO social workers who were based in the city centre plus four addiction workers who were based in local offices in Drumchapel, Easterhouse and Pollok. The workload was divided between the social workers equally, and between the addiction workers depending on the area of Glasgow in which the offender lived. The social workers were responsible for preparing reports for the courts, supervising offenders on orders and participating in court reviews. Addiction workers were responsible for providing one-to-one counselling for clients, for undertaking groupwork with methadone users and for linking offenders to other types of groupwork provision. They also undertook other tasks related to the offenders' addiction problems or needs. Urine testing was undertaken by treatment providers: Glasgow Drug Problem Service (GDPS) and Phoenix House.

1.9 The DTTO scheme in Fife consisted of one manager, three social workers, two addiction workers and 2.5 drugs workers. A consultant psychiatrist provided services to the pilot but was not formally part of the team. The drugs workers were health care professionals, employed by Fife Primary Healthcare Trust and their role was to provide urine testing and general healthcare to DTTO clients. The DTTO staff were based in two teams (in Buckhaven and Kirkcaldy) each of which had a social worker, addiction worker and drugs worker. The workload was allocated across the teams according to the area of Fife in which the offender resided. The tasks of the social workers and addiction workers were broadly similar to those in Glasgow, though in Glasgow addiction workers were also responsible for the offenders' overall care plans.

OBJECTIVES OF THE RESEARCH

1.10 The evaluation of the pilot DTTO schemes in England (Turnbull et al., 2000) provided a range of information that can inform conclusions about the operation of DTTOs both in that jurisdiction and more generally. However, the DTTO pilots in Scotland have features that differentiate them from their counterparts in England ² and the characteristics of the populations in respect of whom DTTOs might be imposed are also likely to be different. Indeed, the study conducted by Turnbull et al. revealed wide variations in the operation of the three pilot schemes in England. It cannot be assumed, therefore, that lesson learned from the implementation of an innovative sentencing option in one jurisdiction can be readily transferred to another jurisdiction. Whilst the Scottish pilots did learn from the experiences of the earlier pilots in England and Wales and were, as a result, able to circumvent some the difficulties that the latter had encountered, the Scottish Executive considered it crucial that the Scottish experience of implementing DTTOs should be the subject of separate research. The findings of that research would be of particular value in informing any subsequent national rollout of orders in Scotland.

1.11 The Department of Applied Social Science at the University of Stirling was commissioned by the Scottish Executive to undertake an evaluation of the pilot schemes. The aim of the research was to evaluate the effectiveness of the pilot DTTOs in reducing drug misuse and associated offending and to assess the costs of DTTOs and alternative disposals. The specific objectives of the research were to:

• evaluate the processes involved in implementing the pilot
• examine assessment, referral and take up rates for DTTOs
• examine the characteristics of the cases in which DTTOs and combined DTTOs and probation orders were imposed
• assess the impact of DTTOs on the frequency and nature of drug misuse and re-offending
• assess the contribution which DTTOs may make to other aspects of offenders' lives
• investigate the appropriateness and integrity of the treatment provided
• investigate the role of drug testing in relation to assessment, monitoring progress and securing compliance
• assess the role of court reviews and the frequency and reasons for variations to orders
• analyse breach and completion rates including reasons for and outcomes of breach applications
• where possible, compare the characteristics and outcomes of those given DTTOs and those assessed as suitable but given alternative community disposals
• identify the position accorded by sentencers to DTTOs in the sentencing framework and,
• assess the costs of DTTOs and alternative community based disposals and identify the cost implications of making DTTOs available nationally.

1.12 This report addresses each of the objectives outlined above. However, delays in the development of a computerised monitoring database in both pilot sites meant that comprehensive information - particularly about offenders assessed for a DTTO but given an alternative sentence - was not available. Furthermore, the initial, relatively slow take-up of orders in Glasgow and the relatively recent introduction of the second pilot site in Fife meant that by the conclusion of the main fieldwork period (in April 2001) very few orders (two in Glasgow) had been completed. This, as we explain in Chapter Two, places some limitations upon the conclusions that can be drawn about the operation and effectiveness of the Scottish DTTO pilots.

ORGANISATION OF THE REPORT

1.13 The remainder of the report is organised into six chapters. Chapter Two discusses the research methods adopted and the sample sizes achieved in different elements of the study. In Chapter Three the procedures involved in the selection of offenders for orders are examined and the characteristics of offenders given DTTOs are described. The services provided to offenders on DTTOs are discussed in Chapter Four while Chapter Five focuses upon drug testing, reviews and enforcement. Chapter Six considers the effectiveness of DTTOs with particular attention to their impact upon drug use and drug-related offending. In Chapter Seven we assess the costs of DTTOs and alternative disposals and in Chapter Eight we conclude with some observations about the implications of the findings for the further development of DTTO schemes in Scotland.

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