Crime and Disorder Scrutiny Topic Group 1 and 2 March 2011

HERTFORDSHIRE COUNTY COUNCIL

CRIME AND DISORDER 2011 SCRUTINY TOPIC GROUP

TUESDAY 1 MARCH 2011 AND WEDNESDAY 2 MARCH 2011

Report author: Brian Gale, Strategic Manager (Drugs Strategy)

Lead officers: Brian Gale, Strategic Manager (Drugs Strategy)

Gary Ray, Deputy Head of County Community Safety Unit & Strategic Performance Manager for Safer Communities

This paper aims to provide the Crime and Disorder Topic Group with information about drug and alcohol using offenders in Hertfordshire, and an outline of some of the interventions that are available.

1.Problems associated with drug and alcohol use

1.1Drug and alcohol use is a key issue in Hertfordshire, just as it is in other places in the country and throughout the world, and the links between alcohol and drug use and crime are well-documented.

1.2However, whilst we usually think about dependent users of drugs like heroin and crack cocaine who commit crimes such as theft, burglary, fraud and shoplifting to get money to buy drugs, alcohol and drugs and crime are also linked in a number of other ways including:

• People who use or supply illegal drugs getting caught
• People who commit violent offences while under the influence of drugs, particularly alcohol. Drunkenness is associated with a majority of murders, manslaughters and stabbings, and half of domestic assaults.
• Alcohol and drug-related driving offences.
• Violence involving drug dealers who may clash with rival gangs or be violent towards drug users who owe them money.

1.3Some research studies have found that significant proportions of acquisitive crime (which includes burglary, robbery, shoplifting, motor vehicle crime, but also offences relating to prostitution, fraud and handling stolen goods) is committed by dependent users of heroin and crack cocaine trying to pay for their drugs. Some studies show a high proportion of people arrested for a range of offences test positive for drug use.

1.4Offences relating to possession and supply of illicit drugs in Hertfordshire have been steadily increasing since 2002/03 (1,553 recorded incidences in 2002/03 to 4,903 in 2009/10). Drug possession and supply offences are most prevalent in Watford, Broxbourne and Hertsmere.

2.Cost of drug-related crime

2.1Examples of users needing £15,000 to £30,000 a year to fund drug habits have often been given. To make such amounts of money from stolen goods, police often suggest multiplying by three – on the basis that stolen goods will fetch about one third of their normal value.

2.2There are estimates of between 130,000 and 200,000 problematic drug users[1] in the UK, which amounts to significant amounts of theft, burglary, fraud or shoplifting. Suggestions have been made that well over half of all acquisitive crime is drug-related and that the market value of goods stolen involved could be between £2-2.5 billion each year.

2.3This can all seem frightening to the general public, and has often been sensationalised in the media. The picture given may be exaggerated for a number of reasons:

• Many people who are dependent on drugs like heroin and crack cocaine were involved in criminal activity before becoming dependent on drugs, so the drug use may not be the cause of the crime.
• Poverty, unemployment and social exclusion are often underlying factors rather than the drug use itself.
• Many people commit crimes in order to feed, clothe and house themselves and their families.
• Some users have jobs, benefits or other forms of income that are used to purchase drugs.
• Many users do not use large amounts of street drugs all the time. Dosage and frequency of use may go up or down, and users may also have access to other substitute drugs, such as heroin users being prescribed methadone.
• Most people who use illegal drugs (the majority are non-problematic users) do not commit crime to get money to pay for their drugs.

2.4Taking these factors into account researchers have estimated that between 1% and 21% of the total cost of acquisitive crime is associated with people who were dependent on heroin.

3.Profile of drug/alcohol users in treatment

3.1The use of drugs and alcohol is difficult to measure because of the hidden nature of substance misuse, issues around addiction and stigmatisation, and the prohibitive policies around illicit drug use. However, the University of Glasgow produces estimates of the number of opiate and crack users in all regions in the United Kingdom.

3.2The latest estimates, published in October 2010 and covering 2008/9 show that there are approximately 3,391 problematic drug users (PDUs) using opiates and / or crack in Hertfordshire, with a confidence interval of 95%[2].

Table 1: University of Glasgow Prevalence Estimates

3.3The numbers of opiate and/or crack users in treatment as at 31st March 2010 was greater than the proportion of those who were estimated to be using heroin and/or crack but were not known to treatment services. This is positive in comparison to the last full Hertfordshire Drugs Needs Assessment, written in December 2007, when the numbers not known to treatment was double those in treatment.

Table 2: Population of adult drug users in treatment in Hertfordshire

3.4This chart shows that Stevenage, making up the smallest percentage of the population in Hertfordshire, makes up the highest percentage of adults receiving drug treatment[3]. Therefore, that area is significantly over-represented, as is Watford.

3.5Welwyn Hatfield’s representation in treatment services is consistent with 10% of the population in Hertfordshire and 10% of the adult drug users in treatment in Hertfordshire. Many other areas, though, are under-represented meaning that their percentage of adult drug users in treatment is significantly lower than the percentage of overall population for that area in Hertfordshire. Notably Three Rivers and St Albans are under-represented.

3.6In August 2010 the there were 4,230 women in prison in England and Wales. In the last decade the female prison population has gone up by 33% - in 1995 the mid year population was 1,979, whilst in 2000 it stood at 3,355.

3.7There are many women in prison for whom prison is both disproportionate and inappropriate. Many suffer from poor physical and mental health or substance abuse or both. Large numbers have endured violent or sexual abuse or had chaotic childhoods, many have been in care.

4.Profile of offending population

4.1Prison

4.1.1In January 2011, 773 offenders from Hertfordshire were in prison, 734 of these were male. Of these, 493 are shown as being released into the county – whilst the remaining 280 currently unknown release addresses, they all had addresses in Hertfordshire when they were sentenced.

4.1.2Hertfordshire offenders are spread widely across the country’s prisons, but the largest number of Hertfordshire offenders are in:

• HMP Bedford, Bedford: 126 offenders
• HMP Littlehey, Huntingdon: 46 offenders
• HMP The Mount, Bovingdon: 41 offenders
• HMP Wayland, Thetford: 41 offenders
• HMP Peterborough: 30 offenders (16 male, 14 female)
• HMP Highpoint, Newmarket: 25 offenders
• HMP Spring Hill, Aylesbury (21 offenders)

4.1.3Other key prisons for Hertfordshire offenders include HMPs Blundeston (Lowestoft), Bure (Norwich), Edmunds Hill (Newmarket), Ford (Arundel, Sussex), Hollesley Bay (Woodbridge, Suffolk), Onley (Rugby), Pentonville (London), Stocken (Rutland), Wakefield (W Yorks), Wandsworth (London), Wellingborough, Whatton (Nottingham), and Woodhill (Milton Keynes).

4.1.4The number of Hertfordshire prisons is generally consistent, but their locations vary depending on a number of factors. There has been an increase in Hertfordshire offenders being located in prisons in Suffolk and Norfolk, and a reduction in those located in prisons in Sussex and Buckinghamshire.

4.2Probation

4.2.1Hertfordshire Probation Trust currently has approximately 3,434 offenders on its caseload, 2,891 in the community and 543 in custody[4].

4.2.2Whilst drug misuse is recognised as closely linked to offending and in particular the profile of Prolific and other Priority Offenders, analysis of the Probation caseload suggests that alcohol misuse is recognised as a higher criminogenic need: 13% alcohol compared to 5% drugs.

4.3Profile of drug using offenders

4.3.1There are a number of data systems relating to criminal justice and health services, and none particularly identify the true proportion of offenders who use drugs and/or alcohol, and the proportion of drug and alcohol users who are offenders. Offenders may use drugs and/or alcohol, just as drug and/or alcohol users may be offenders, but neither is definite in all cases.

4.3.2However, research conducted in 2003-04, showed that 38% of people arrested for any offence reported having used heroin, crack or cocaine in the previous 12 months, rising to 55% for those people arrested for acquisitive crime.[5]

4.3.3An analysis of the Offender Assessment System (OASys)[6] across 41 probation areas found that 32% attributed violent behaviour to their alcohol use and 56% of offenders stated they were likely to re-offend, with 27% referring to drugs as the main factor. However, this only relates to those adult offenders with a statutory responsibility to engage with Probation[7].

4.3.4The most recent information from the Eastern Region Public Health Observatory shows that, from the 12 months to June 2010, Hertfordshire had 335[8] adult offenders in effective treatment[9].

4.3.5The majority of offenders arrested for drug possession and supply offences are male, with an average age under 26 years, with almost 76% being between the ages of 17–30 years.

4.3.6Analysis of adult drug using offenders in treatment shows that 83% of those in treatment are male, compared to 85% of the overall adult treatment population. 17% of offenders in treatment are aged 18-24, compared to 20% of the wider treatment population, and 44% of offenders in treatment are aged 25-34, compared to 41%.

4.4Profile of alcohol using offenders

4.4.1Alcohol misuse is a significant factor in violent crime and disorder. In 2005/06, 17% of violent crimes were committed in or around pubs and clubs.

4.4.2Newbury-Birch[10] found 69% of men and 53% of women in contact with Probation were classed as having an alcohol misuse disorder.

5.Programmes and interventions currently available

5.1The list below outlines some of the key programmes and interventions that are available to improve the health and well-being of drug and alcohol using offenders in Hertfordshire. These programmes and services provide interventions to drug and alcohol using offenders and, in some cases, to offenders in general. However, offenders are also generally able to access the wider range of services, programmes and interventions that are available to all citizens in the county.

5.2Hertfordshire has a Pooled Treatment Budget (£4,568,032 in 2011/12) which is used to commission three main providers to provide drug and alcohol treatment services. The majority of the budget goes to the statutory National Health Service (NHS) provider with the bulk of the remaining provision delivered by third sector organisations:

• Hertfordshire Partnership Foundation Trust (HPFT) (NHS)

HPFT provides the clinical prescribing aspect of drug and alcohol intervention, including a range of provision to ensure safe prescribing of both community detoxification and maintenance regimes.

• Turning Point

Turning Point (third sector) provides a range of Tier 2 and Tier 3[11] non-prescribing services, including one-to-one and group psycho-social interventions and structured day care in the west of the county, and structured day care and criminal justice interventions countywide. In addition it provides a countywide needle exchange co-ordination service.

• Westminster Drug Project (WDP)

Westminster Drug Project (third sector) provides predominantly Tier 2 services with some Tier 3 services in the east of the county.

5.3In addition, The Living Room, based in Stevenage, is an abstinence based treatment service who receiving some funding from the Joint Commissioning Team. A small number of other organisations also provide treatment services, including DrugLink (Dacorum), and Re-Solve (Welwyn Garden City). Although these are not necessarily commissioned to provide these services, they operate as part of the wider treatment system.

5.4Furthermore, a number of other organisations are commissioned to provide residential detoxification and rehabilitative services for Hertfordshire residents, although the majority of these are based outside of the county.

5.5The Drug Interventions Programme (DIP) is a voluntary programme, funded mainly by the Home Office and has been in Hertfordshire since 2005. The programme works with adult offenders throughout Hertfordshire who have been identified as being problematic Class A drug users and who are in contact with the criminal justice system. DIP provides access to a wide range of medical and non medical interventions designed to address substance misuse and offending behaviour, including access to a dedicated drug worker, care planning and outreach, rapid access to substitute prescribing, a drug work programme and a low threshold group work programme. Clients are also offered support to access benefits, housing and accommodation and education and training.

5.6Traditionally, Hertfordshire has had a dedicated DIP service based in Welwyn Garden City. In 2007, the dedicated clinical team provided by Hertfordshire Partnership NHS Trust was re-located and based in mainstream Community Drug and Alcohol Team (CDAT) services across the county. In 2009, as part of Hertfordshire’s Drugs System Change Pilot, the dedicated criminal justice team in Welwyn Garden City was re-located to mainstream Turning Point services across the county.

5.7The annual budget for the Drug Interventions Programme in 2011/12 is approximately £1.08m. The vast majority of this (£714,000) supports the criminal justice element of Turning Point’s countywide contract, and a further £140,000 is allocated to Hertfordshire Partnership Foundation NHS Trust for the provision of rapid opioid substitute (methadone) prescribing. The remaining budget is spent on staffing to oversee programmes for drug using offenders.

5.8Drug Rehabilitation Requirements (DRR) are one of 12 tailored requirements of a Community Order first introduced in the Criminal Justice Act of 2003, and replaced Drug Treatment and Testing Orders. This requirement is designed for drug using offenders, with three levels ranging from one hour to fifteen hours of treatment contact per week. Interventions include one to one counselling, drug testing, prescribing and group work.

5.9DRR clients were included as part of Hertfordshire’s Drugs System Change Pilot, in order to take the range of interventions available to drug using offenders who engaged ‘voluntarily’ through DIP, and extend these interventions to offenders on DRRs.

5.10The treatment element of DRRs is absorbed into Turning Point’s countywide contract, managed by the Joint Commissioning Team. This element of provision cost £341,693 in 2010/11.

5.11In 2009/10, Hertfordshire Probation Trust commenced 184 community orders with a DRR, against an annual target of 180. Hertfordshire also had a target to complete 75 of its commencements, but achieved 107. In 2010/11, Hertfordshire’s target is 150 commencements and 75 completions. At the end of December 2010, Hertfordshire has had 142 commencements and 71 completions.

6.Drugs System Change Pilot

6.1The Drugs System Change Pilots were established to test new innovative approaches to delivering a more comprehensive service delivery model, and Hertfordshire has been one of seven pilot areas, including Essex, Bradford, Sefton, Lambeth, Leicester, and Hampshire & Southampton. Hertfordshire’s pilot focussed on drug using adult offenders, and the initial stage of the pilot re-configured the existing criminal justice substance misuse service by expanding the DIP to increase the range of interventions available to offenders on community sentences with DRRs.

6.2In addition, the Pilot enabled the Drug and Alcohol Partnership to explore new ways of improving the continuity of care of Hertfordshire offenders between prisons and community services. The Pilot also provided an opportunity to explore innovative ways of improving access to education, training and employment (ETE) opportunities, and also ways by which families and carers of drug using offenders could be supported.

6.3Although not an intervention in itself, Operation Patron plays a key role in assessing the outcomes of interventions provided to adult drug using offenders who are engaged in treatment. As part of the Drugs System Change Pilot, stakeholders were keen to know whether the changes brought about by the Pilot would have a positive impact on outcomes.

6.4134 clients had been included in the analysis to the end of November 2010. 724 offences were committed in the year prior to engagement, reducing to 481 once they had started to engage with treatment services and for up to one year following commencement of engagement. Overall there was a 34% reduction in offending.

6.5Developed as part of the Drugs System Change Pilot, the Through the Gates project was developed to improve continuity of care between prisons and community-based services. Offenders who engage with drug treatment services in prison are matched with one of 35 volunteer mentors from SOVA (Supporting Others through Volunteer Action), who have all been trained and security cleared to work with offenders in prison.

6.6Volunteers support offenders by preparing them for their release, and continuing to support their engagement with community-based services on release. For those offenders most at risk of re-offending and drug use on release, volunteers collect offenders at the prison gates and take them directly to appointments with treatment services, JobCentre Plus and other agencies as necessary.

6.7To the end of January 2011, 213 clients have been referred to the Through the Gates project. 29 are currently active with volunteers whilst in the community, and a further 102 are currently being support by volunteers whilst in prison awaiting release. A further 15 offenders have received support form volunteers and their engagement has concluded. All of those offenders who have worked with volunteers have continued to be engaged in drug treatment in the community.

6.8In 2010/11, the through the Gates project cost £60,000. The project has been deemed to be successful and will be continued into 2011/12, although at a reduced budget of £45,000. It is likely that the model will be expanded to cover a wider range of offenders in custody.

7.Alcohol Treatment Requirements (ATR)