BREAKING THE CIRCLE

The drug-free wing challenge

by Robin Burgess.

British prisons are rife with drug use, yet we send individuals to them who have proven problems with drugs, in an attempt to free them from the temptation of easily available drugs on the outside. At the same time we seek to punish them for the offences they committed whilst involved in drug use in some way. In this scenario the provision of drug counselling and advice is clearly problematical. It makes it logical to concentrate on the lesser goal of harm-reduction, which of course is impossible whilst Home Office policy prevents needle supply in prisons. As a result a sense of hopelessness about the possibility of constructive work in prisons develops, which advances neither policy, rehabilitation, nor inmate development.

In this context the idea of drug-free wings in prisons is of considerable value. Drug and HIV services have been working increasingly within prison environments for a number of years - offering a range of interventions including counselling, pre-release work, befriending, harm-reduction, education and group work. Though similar to services offered on the outside they are constrained by prison politics and culture and often varying from wing to wing in one prison. Such services also have to contend with the powerful forces of probation, education, medical departments, as well as prison staff.

Treatment agencies are probably the least powerful agents in institutions which are racked by factional struggles and competitiveness

The inmate looking to use their sentence as a time for a serious effort at changing their drug habit has their own set of problems to contend with in prison. These include the rampant dealing of drugs in their environment, the widespread prescribing of drugs by prison medical officers, the acceptance by prison officers of cannabis dealing and use as a sedation measure, the lack of anything approaching an open access counselling and treatment service inside. Though on paper the choice to stop using drugs is theirs the reality is an environment which is stacked against their interests and can hardly offer any incentives. It is an environment which encourages use.

It might be argued that prison is not for the purposes of rehabilitation but, in keeping with Home Secretary Michael Howard's views, more to do with retribution. Similarly, in the anti-rehabilitation branch of criminology, 'drug addiction' is an unwanted label for socially-created 'deviancy' that requires no rehabilitation - and even if it does, rehabilitation does not work in a coercive environment. Both of these negative views can be disregarded. While the retributive capacity of prison can be questioned (particularly if inmates have the opportunity to be stoned most of the time), rehabilitation for drug offenders does not become a reality because of the environmental problems referred to above. We have returned to the circle of hopelessness, and the root cause is the lack of conviction and consensus in what prison is for. It seems to me that one way out of this futile and sterile quandary, at least for drug-related offenders, is the concept of a drug-free environment that allows space for people who are seriously motivated to do something constructive about their habit, practice abstinence and receive the real help they need.

Of course, not all individuals who are users of drugs and are offenders can be classified as requiring, or be forced to undergo treatment - at least not of a drug-free nature. Individuals commit offences and use drugs, and the two are linked in a million different ways. It is simply naive to assume that all offending by drug users can be attributed to their drug use. The one may predate the other, the two may exist side-by-side or the one may have led to the other on some occasions for instance. What we have to do is to start to construct some models of intervention that address the needs of a broad range of individuals. We have to assess accurately how and why drug users become involved in crime, at the same time as we examine their attitudes to their offending and their drug use, and where they are now, before we can deliver the sort of service which will address the problems they say they have.

At the same time we have to ensure that inmates leave prison with a different attitude to drugs and offending than they came in with. This requires a range of responses on site of which the drug-free wing or prison is but one option. For the inmate who does not view their drug use as a problem the drug-free wing, enacted by compulsion, is a mistake of treatment and ethics. For them a mixture of counselling and group work programmes which address both offending and drugs fits their requirement. In this context, the drug-free wing comes at the end of a chain of responses matching inmate need and attitude to resources. At all points along this chain, compulsion of inmates to attend treatment they do not want and may not benefit from is counter-productive.

For the individual who really wants to make a go of abstinence, is motivated, aware and understands the nature of their use, the drug-free wing provides the kind of environment they need. However, there are a number of issues to be considered at the outset. Firstly, transfer to such a unit should not be regarded as a perk, or something earned because of good behaviour; drugs may have been the cause of bad behaviour. Access should be open to anyone who is assessed as having the right kind of motivation. However, it would seem appropriate to offer some kind of reward for inmates successfully working within such programmes. Secondly, such a unit should not be organised by the medical profession - any unit must be truly drug-free, and this mean no benzodiazepines, no codeine, and most of all, no methadone. It is important that the unit is drug-free and not just loosely therapeutic - opening out the concept to include controlled access to drugs is entirely counter-productive.

The individual should be detoxed prior to transfer. Thirdly, urine testing should be applied only to individuals requesting admission to such programmes, or within them. If urine testing only happens in these contexts the argument about it creating prison disorder no longer stands up.

Given these kinds of safeguards the drug-free prison environment offers considerable opportunities not only to inmates but to agencies. Those voluntary service providers quibbling about the human rights basis of urine testing, and still locked into a solely harm-reduction approach, are just handing drug treatment within prisons on a plate to the private sector. We may as well just call the Correctional Minnesota model Corporation of Seattle Inc. straight away. The drug-free wing is coming. We can either step aside and let it be done badly, or we can become involved and do it properly. We have an obligation to do the latter.

Robin Burgess is chief executive of the Council on Addiction for Northamptonshire {CAN).

Drugs and Offending, the multi-media group work pack is available from CAN: tel 01604 27027.

PROPOSED PRISON SERVICE STRATEGY OUTLINED IN GREEN PAPER

[5.18] HM Prison service will introduce compulsory drug testing following the implementation of the Criminal Justice and Public Order Bill.

[5.19] Heads of prison establishments will review their immediate operational arrangements for tackling drugs and the Director-General will report progress to the Home Secretary by the end of June 1995.

[5.20] HM Prison Service will include in its 1995-96 Business Plan an action to reduce the level of drug misuse. This action plan will demonstrate how HM Prison service's national policy and guidelines on drug misuse will be implemented by prison establishments. In particular, local strategies include:

effective supply control measures such as improved perimeter security, use of dogs to check for drugs, searching and supervision of visits;

consistency with the mandatory elements of the Prison Service's national strategy. This is particularly important in respect of control and safety within prisons and the treatment and "throughcare" of prisoners with drug problems. Consistency should still allow the necessary flexibility to meet local circumstances;

training for multi-disciplinary teams of staff on drug-related issues including supply control measures and the treatment of drug misusers;

participation in local multi-agency partnerships to tackle drug misuse in general and, in particular, to discourage young people from using drugs;

a commitment to take account of the equal opportunities implications of tackling drugs in prisons.

The action plan will also take into account the recommendations of the Criminal Justice Working Group of the Advisory Council on the Misuse of Drugs in its review of drug misuse in prisons.