This month I will give oral evidence to the Advisory Council on Drug Misuse (ACMD). What I say is nothing new, it is a scandal and it leaves many dead and puts many other vulnerable people with a recognised mental health disorder at significant risk.
I will be raising with ACMD our concerns over two principle issues surrounding our service users being released from custody.
I will raise our concern at the high levels of drug related deaths in the immediate post custody period.
I will raise the fact that service users are dropping out of treatment, or probably more accurately being dropped by the treatment system at a critical time. This renders them both more vulnerable to overdose, harm and relapse and undermines positive treatment and rehabilitation both in the community and in custody.
I will highlight the recurrent practical barriers to continuity of care and to bring it to the ACMD’s attention a range of positive practices to address these. These issues are not new, report after report has raised them, I am desperate to see a solution but fear the work of the ACMD will gather dust on a shelf whilst people continue to die and miss opportunities to change their lives for the better. Why is this allowed to continue? It is simple in my view, society does not care enough about people who have been in prison with drug problems and agencies have failed to focus on people rather than paperwork.
I will highlight the growing international evidence about the high risk of overdose and death of opiate using prisoners in the period immediately after release. Key government agencies are aware of this and I have personally sat in on briefings detailing the huge increase in the risk of death and overdose in the UK. I will point out that recent UK research has found the first week following prison release was the period of highest risk of mortality with drug related deaths the main cause. A Norwegian study found in the first week post release overdose accounted for 85% of all deaths of those transitioning back into the community. This will come as no surprise to anyone working in the sector.
National drug treatment figures produced by the National Drug Treatment Monitoring System (NDTMS) show the shocking figure of just 30.3% of those in treatment in prison are in treatment 21 days after release. Even more alarming is the fact that 38% of those seeking continued treatment upon release are either not on medication or did not get the type or quantity they felt they required.
The long standing failure to address this has been made worse by the changes in probation provision since the Governments Transforming Rehabilitation project in 2015, something Blenheim fought hard in Parliament to prevent. The depletion of criminal justice work within substance use treatment services following the cut in the Drug Intervention Programme (DIP) funding supporting it has further hampered the capacity to address this long standing issue.
There are significant barriers to resolving these issues, not only the reduced funding at every point of the justice and treatment systems, but arguably a more significant barrier is the confusion and miscommunication caused by frequent realignment of services.
There are excellent examples of good practice across the UK but good quality supported transitions between custody and community for people dependent on drugs are the exception rather than the norm.
If we are to change this both criminal justice and treatment services it needs to be adequately resourced. We also need to see a returned to a proactive case management approach focused on people not paperwork.
At Blenheim we are doing what we can to reduce these risks. The Grove in Haringey remodelled last year and their strategy works towards helping people that get stuck in the cycle of offending break free by working in partnership with the police, courts and prisons to identify those at high risk and put individual plans and interventions in place to best support them.
Dave had been in and out of prison over the last 10 years and was stuck in a cycle of offending, homelessness and drug use. The Grove’s Prison Link Worker started working with Dave early on in his last sentence and they met regularly working on building coping techniques often used in the community, such as; relapse prevention, motivation, life skills and reconnecting with people. Dave wanted to attend rehab when he was released so Yvonne sought funding for this and arranged transport to the centre on his release day.
Dave completed rehab, is abstinent six months on and has reconnected with some of his family.
This sounds simple but if this was being done consistently across the UK then we wouldn’t be where we are today.
I dream of a day when every prisoner has a successful transition from prison to community treatment. Having worked in the criminal justice system and drug misuse sectors for thirty years I know the barriers, I also know it is possible where there is a will there is a way.