There is a way to get addicts off drugs

How can a humane and effective solution to one of society's most enduring problems be so fiendishly difficult to access?

"How would you feel," the Conservative Party billboard advertisement asks, "if a bloke on early release attacked your daughter?" What a cynical and ignorant piece of scaremongering this is. The implication, of course, is that Labour is "soft on crime", keen to let dangerous sex criminals and psychopaths walk the streets, reluctant to resort to something as simple and straightforward as locking miscreants away from potential victims.

"How would you feel," the Conservative Party billboard advertisement asks, "if a bloke on early release attacked your daughter?" What a cynical and ignorant piece of scaremongering this is. The implication, of course, is that Labour is "soft on crime", keen to let dangerous sex criminals and psychopaths walk the streets, reluctant to resort to something as simple and straightforward as locking miscreants away from potential victims.

The truth though, is quite different. The way Labour is running the criminal justice system is indeed shocking and scandalous. But it is not the reluctance of the Government to promote custodial sentencing that is the problem. Instead, the difficulty is that there are now more people in our creaking prison system than ever - more men, more women, more children. The number of women and children in our prisons, in fact, has not been so high since the Victorian era.

And despite the fact that Labour is theoretically committed to rehabilitating criminals as well as punishing them, the intense overcrowding that nearly all prisons are habitually experiencing means that drug use, self-harm, mental illness and suicide are rife in our jails. Our prisons are crammed with vulnerable people, many of whom shouldn't have been given a custodial sentence in the first place, and many of whom will emerge from their sentence less able to cope with life on the outside than they were before.

"How would you feel," the Conservative Party might more realistically ask, "if your daughter fell in with a bad crowd, did drugs, couldn't get help with her drug problem, got caught shoplifting, got sent to prison, self-harmed, got on to harder drugs, couldn't get the help she needed in prison either, and ended up killing herself?"

This sort of thing happens far more often to young women these days than the scenario threatened by the Conservatives. I know of no case involving a man on early release killing anyone's daughter. But in our prisons last year, 95 inmates committed suicide, 13 of them women. This year is shaping up no better, despite the fact that survey after survey shows that the general population believes that prison sentences are not an appropriate way of dealing with female criminals.

Nevertheless, the female prison population has more than doubled since 1994, with nearly two-thirds of women, typically, on remand. Two-thirds of them also have a drug problem, according to 2001 statistics from the Home Office, with more than half of prisoners reporting that they have committed offences connected to their drug-taking.

Organisations from the Esme Fairbairn Foundation to Drugscope advise that what women need is drug treatment rather than prison, with both of these groups suggesting that the most effective treatment by far is residential treatment. This approach has significant public support along with, when there isn't an election looming, support from all the main political parties. Labour have pledged to open 80 more residential drug treatment centres, doubling the intake of addicts. At the last Tory party conference, David Davis made a more expansive promise. He wanted to see a 10-fold increase in residential beds.

Amazingly, though, according to a recent report, Using Women, only 2 per cent of convicted females are sentences to residential drug treatment. Even more amazingly, there are often empty beds among the 1,470 already available. While the efficacy of residential drug treatment is acknowledged by all, it is treated in reality as a last resort rather than the form of treatment that is most suitable for many people.

John Grady, of Pierpoint Addiction Treatment Centres, was one of those who believed that there was political will to tackle drug use by referring addicts to residential treatment. He was particularly encouraged by such developments as the launching of the Government's BedVacs scheme, a database that collates and updates constantly what residential beds are available and where.

He has been opening treatment centres in the north of England for a decade and a half now. The success rate among addicts treated at his centres is impressive, and Grady felt that the services his group offered would only be enhanced by the establishment of a dedicated women-only facility.

Last year, investing more than £600,000, he opened Craiglands, Britain's sole women-only primary treatment centre. Yet despite the massive need for such a facility and the thousands upon thousands of suitable patients, this modest 16-bed treatment centre has been for the last year only half full. None of its referrals have come through the Government's BedVacs scheme. And Craiglands is not the only centre experiencing this problem. Other long-established facilities are finding that even though they want to take referrals from the NHS or from the criminal justice system, they are still relying on paying customers from the private sector. Worse, at some facilities, beds set aside in block contracts for social use have sometimes remained empty even though they have already been paid for.

So what is going wrong? How can it be that a humane and effective solution to one of our society's most enduring and debilitating problems is so fiendishly difficult to access? The basic problem is that individuals referred to residential treatment need to get funding from their local authority's social services budget. There is no dedicated budget for drug treatment. With such things as care of the elderly and provision of support to special needs children coming out of the same stack of cash, it is easy to see how it is that addicts suddenly emerge as much less of a priority.

Doctors could, in theory, refer patients directly, and pay for treatment from their primary care trust budget. But treatment can last for many months, and any doctor will therefore be minded to steer his patient instead into palliative treatment such as methadone prescription. Likewise, a concerned family getting in touch with a centre directly cannot themselves apply for a grant. They must go to social services and undergo a massively bureaucratic rigmarole involving a local drug action team and needs assessment officers.

Even among drug action teams, there is not always a suitable level of awareness of the efficacy of residential treatment. In the drug treatment community as a whole, alternative prescription, which does not address the underlying psychological difficulties that often prompt drug abuse, is usually preferred. Addicts themselves are often happy enough to be given a legal source of drugs (which they can supplement from the street, or sell); a residential treatment programme is a much tougher option. Often, the people on drug action teams do not themselves understand how crucial it is to push for hard-to-get funding.

What we have is a postcode lottery, where the chances of winning the needed treatment are very remote. For some, it seems that it is only possible to get residential treatment if you are already in the criminal justice system. "How would you feel if your daughter had to commit a crime, simply in order to get funding for residential drug treatment?"

How can it be that a treatment so widely admired is so little supported? Wouldn't it be great if our politicians were asking questions like that, instead of spreading ignorant propaganda designed to frighten the people they claim to want to represent?

d.orr@independent.co.uk