This blog looks at part two of Professor Dame Carol Black’s independent review of drugs, focussed on prevention, treatment, and recovery. It highlights the key issues relevant to voluntary organisations working in the criminal justice system and the people they support.

In February 2019, the then Home Secretary, Sajid Javid, appointed Professor Dame Carol Black to carry out an independent review of drugs. Phase one of Dame Carol’s review sets out a detailed picture of the challenges that drug demand and supply pose to society.

On 8th July 2021, Dame Carol published phase two of her review which focusses on prevention, treatment, and recovery, including pathways into treatment and away from the criminal justice system. The report concludes that “the public provision we currently have for prevention, treatment and recovery is not fit for purpose, and urgently needs repair”.

The report sets out 32 recommendations, including for greatly increased investment into both drug treatment services and employment support. Alongside this greater investment, Dame Carol makes recommendations across a range of different areas. This blog highlights the key issues relevant to voluntary organisations working in the criminal justice system and the people they support.

Diverting people away from the criminal justice system

The report notes the number of referrals from the criminal justice system to drug treatment programmes has “fallen sharply”, and that there has been a decline in community sentences with drug rehabilitation or alcohol treatment requirements. Where the time or expertise is often not available to help arrange these outcomes, sentencers move towards custodial options.

Therefore, to address these challenges, the report recommends that government departments work together to ensure additional funding for treatment services leads to better treatment pathways for people from criminal justice settings. It suggests there should also be a focus on diverting people from the criminal justice system and into treatment services, maximising the use of Community Sentence Treatment Requirements (CSTRs) and rolling them out to all parts of the country. Implementing these recommendations will lead to greater demand for drug treatment services, emphasising the need for greater investment.

Drug use services in prisons

The details of regimes inside prisons fell outside the scope of this report, but the report did note that efforts to reduce drug use in prison were undermined by the availability of drugs to prisoners. The report points to evidence that suggests demand for drugs in prisons is led by a “widespread sense of boredom, hopelessness and lack of purposeful activity in custody”.

Consequently, the report recommends the Ministry of Justice (MoJ), Department of Health and Social Care, and NHS England work together to improve transparency and accountability of the commissioning and delivery of drug use services in prisons. It recommends that there also should be enough staff available to take prisoners to their treatment appointments within the prison.

Continuity of care as people move from prison to the community

Dame Carol highlights the high risk of overdose or reoffending at the point at which someone is released from prison. Data from Public Health England shows that only a third of people referred for further community treatment following their release from prison go on to receive it within three weeks. Access to benefits is also a significant contributor to whether someone will reoffend or relapse. The report also emphasises the problem of people often being released from prison on a Friday afternoon and struggling to access the services they need.

Therefore, Dame Carol recommends the MoJ ensure everyone who leaves prison has ID, a bank account, and, where they cannot claim benefits online, access to the Department for Work and Pensions’ telephony service on the day of release. Moreover, people leaving prison with drug dependencies should be able to access treatment in the community.

Probation services

Dame Carol notes the probation service has an important role in implementing the report’s recommendations. She recommends that the government should ensure ongoing reforms enable people convicted of offences to first access, then continue to engage with, treatment in the community. More also needs to be done on identifying, assessing, and referring people into treatment services from court, and providing advice to the courts about “treatment-sentencing options”. Probation officers should work with treatment providers to agree a joint plan to support people in the criminal justice system who need drug treatment.

The report also welcomes the new health and justice partnership co-ordinator role. This role sits within the probation service and is being tested in five areas to promote understanding and collaboration between local health and justice partners. It recommends the MoJ funds these roles across the probation service so that all probation areas across England are covered, alongside the introduction of the new integrated care systems by the NHS.

What next?

Following the publication of Dame Carol’s report, the government has already announced that it will be setting up a new Joint Combatting Drugs Unit, based on some of the recommendations. This unit will “co-ordinate and drive a genuinely whole-of-Government approach to drug policy”. The government has also committed to publishing an initial response to the findings of the independent review that sets out a “clear cross-government commitment to this agenda”.

Clinks welcomes Dame Carol’s focus on diversion, supporting people in the community, and continuity of care for people leaving prisons. These are issues that Clinks has highlighted previously in our work, including in our briefing, Sentencing in England and Wales, and our recent blogs looking at the funding for substance misuse services and the CSTR programme in action.

Moreover, we support Dame Carol’s desire for a more holistic, joined-up set of services to support people, in recognition that drug misuse can often be related to a set of interconnected issues, such as homelessness and rough sleeping, and poor mental health. This is very much in keeping with the evidence that Clinks submitted to the review as part of the Making Every Adult Matter coalition, of which we are a member, which supports people facing multiple disadvantage.

What is important now are the steps that the government takes in implementing changes within the criminal justice system, and the amount of investment that it brings forward to build and develop effective services to enable people to transform their lives. Clinks will continue to work with, and advocate for, the voluntary sector working in criminal justice, and champion its role in providing substance misuse support.