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Full text of presentation:
The debate: 'This house believes that we need more coercive testing and treatment services'
Speech in opposition
by Dr Judith Rumgay, London School of Economics

> Link to additional article: FAITH IN FORCE: CRITICAL REFLECTIONS ON COERCED DRUG TREATMENT


  1. I come from a background in the probation service and my research emphasises offender rehabilitation, rather than drug treatment. My remarks will undoubtedly reflect that background. I am not against coercion in drug treatment per se. Changing the lifestyles of serous and recidivist drug using offenders is a challenging undertaking and there is no doubt that coercion, applied with discrimination in reflective practice, can be a helpful tool in persuading offenders to engage in that process.
  2. What I am objecting to here is the word ‘more’ in this motion. I have four grounds for my objection:-
  3. Firstly, we have already witnessed a steady encroachment of penal priorities into the field of drug treatment over the past decade. This drift carries with it the risk of becoming reliant on coercion, enforcement and punishment as the primary means by which to alter offenders’ behaviour. We can see this growing reliance most clearly in the introduction of Abstinence Orders, in which the provision of treatment to assist the process of withdrawing from a drug using lifestyle is apparently superfluous. Yet, we do not need to experiment with prioritising enforcement over treatment in intensive supervision programmes to know what the result will be. As long ago as the early 1990s, the Americans demonstrated, very clearly, that intensive surveillance and enforcement in supervision does not yield positive results except when these activities are accompanied by high quality treatment provision. Absent this, these methods become a means of clogging the penal system with offenders who are unable to comply with the strict behavioural requirements of supervision, leaving diminished resources for effective control of those whose offending itself presents high risk.
  4. Secondly, the expansion of coerced intensive supervision of offenders in the community during the 1990s up to the present time is not matched by any reduction in the use of imprisonment. Rather, for the past 15 years, there has been a steady decline in the seriousness of the probation community supervision caseload, which can be measured by the numbers of offenders placed on community orders with previous experience of imprisonment and the numbers without previous convictions. Fewer offenders now placed on community supervision have previous convictions and fewer have already served a custodial sentence than 15 years ago. Put simply, increasingly intrusive and coercive forms of supervision are being visited upon a caseload of decreasing seriousness. Thus, the costs of increased technological surveillance and of enforcement of supervision have not been offset by a corresponding decline in the use of imprisonment. For all our innovation, we remain the European Union’s leader in the imprisonment. It is difficult to comprehend how this can be justified as an exercise in enhanced public protection.
  5. Thirdly, all this expansion of coerced treatment, with its accompanying costs, has taken place with little thought as to whether we are making good enough use of the existing mainstream treatment opportunities. An attraction of the coercive approach arose from early American evaluations that found an association between coercion and time spent in treatment. Time spent in treatment is itself associated with successful outcome. It was all too easy to conclude that ‘coercion works’. Wrong – it is engagement with treatment that works. The very high drop out and breach rates of DTTOs and all the effective practice pathfinder programmes demonstrate the damaging naïveté of privileging coercion over engagement,
  6. NTORS, which was notable for its evaluation of common mainstream drug services, rather than of new, experimental and limited innovations, demonstrated that these relatively modest community services can assist in the reduction of offending even though that that is not generally an explicit focus of their treatment strategies. Perhaps we should be seeking ways to encourage offenders to utilise community drug services more effectively, rather than generating more specialised programmes specifically for them. Indeed, the proliferation of specific offender programmes, in the context of general resource scarcity, is potentially discriminatory and divisive in communities overburdened with drug problems.
  7. Finally, the expansion of coerced surveillance and treatment has a marked tendency to operate indiscriminately. We need only re-examine the wording of the motion to realise this potential for indiscriminate entrapment of individuals in criminalising processes. For, although I have limited my response to a discussion of its implications for offenders, the motion does not actually limit itself to any particular target population for the attentions of these new coercive interventions. It merely asks for ‘more’ of them.

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FAITH IN FORCE: CRITICAL REFLECTIONS ON COERCED DRUG TREATMENT

Judith Rumgay, London School of Economics

We have witnessed a steady encroachment of penal priorities into the field of drug treatment over the past decade. Since the Criminal Justice Act 1991, there has been a range of residential and non-residential treatment requirements available for insertion into probation orders. The Crime and Disorder Act 1998 introduced the Drug Treatment and Testing Order (DTTO), modelled on the American Drug Court initiatives, which broke new ground in mandating for compulsory drug testing, with regular court oversight of treatment progress. This drift towards coerced treatment carries with it the risk of becoming reliant on coercion, enforcement and punishment as the primary means by which to alter offenders' behaviour. The DTTO legislation, indeed, explicitly relegated the role of the probation officer to monitoring, enforcing and reporting progress to the court. We can see this growing reliance on coercion most clearly in the introduction of Abstinence Orders, in which the provision of treatment to assist the process of withdrawing from a drug-using lifestyle is apparently deemed superfluous.

Yet, we do not need to experiment with prioritising enforcement over treatment in intensive supervision programmes to know what the result will be. As long ago as the early 1990s, the Americans demonstrated, very clearly, that intensive surveillance and enforcement in supervision does not yield positive results except when these activities are accompanied by high quality treatment provision (Clear and Hardyman 1990; Petersilia and Turner 1990). Absent this, these methods become a means of clogging the penal system with offenders who are unable to comply with the strict behavioural requirements of supervision, leaving diminished resources for effective control of those whose offending itself presents high risk (Petersilia 1999).

Moreover, in the UK, the steady expansion of coerced intensive supervision of offenders in the community during the 1990s up to the present time is not explained by any reduction in the use of imprisonment. Rather, for the past 15 years, there has been a steady decline in the seriousness of the Probation Service's community supervision caseload, which can be measured by the numbers of offenders placed on community orders with previous experience of imprisonment and the numbers without previous convictions. Put simply, increasingly intrusive and coercive forms of supervision are being visited upon a caseload of decreasing seriousness (see Home Office 2004 for statistical evidence on this point). It is difficult to comprehend how this can be justified as an exercise in enhanced public protection.

All of this expansion of coerced treatment, with its accompanying costs, has taken place with little thought as to whether we are making good enough use of the existing mainstream treatment opportunities. An attraction of the coercive approach arose from early American evaluations that found a positive association between coercion and length of time spent in treatment. Time spent in treatment is itself associated with successful outcomes (Gottfredson, Najaka and Kearley 2003). It has been all too easy to conclude from this that 'coercion works'. This superficial interpretation is simply wrong: it is engagement with treatment that works. The very high drop out and breach rates of DTTOs demonstrate the damaging naïveté of privileging coercion over engagement (Turnbull et al 2000).

NTORS, which was notable for its evaluation of mainstream drug services, rather than of new, experimental and limited innovations, demonstrated that these relatively modest community support services can assist in the reduction of offending even though that is not generally an explicit focus of their treatment strategies (Gossop et al 2003). Perhaps we should be seeking ways to encourage offenders to utilise community drug services more effectively, rather than generating more specialised programmes specifically for them. Indeed, the proliferation of specific offender programmes, in the context of general resource scarcity, is potentially discriminatory and divisive in communities overburdened with drug problems (Rumgay 2001).

Changing the lifestyles of serous and recidivist drug-using offenders is a challenging undertaking. Certainly, coercion, when applied with discrimination in the context of holistic and reflective practice, can be a helpful tool in persuading some offenders to engage in that process. However, the ease with which we are seduced into indiscriminate reliance upon coercion as our primary vehicle for enforcing behavioural change testifies to our reluctance to acknowledge the complex social and personal difficulties that characterise the lifestyles of drug-using offenders.


References
Clear, T.R. and Hardyman, P.L. (1990) 'The New Intensive Supervision Movement.' Crime and Delinquency, 36(1): 42-60.
Gossop, M., Marsden, J., Stewart, D. and Kidd, T. (2003) 'The National Treatment Outcome Research Study (NTORS): 4-5 Year Follow-up Results.' Addiction, 98: 291-303.
Gottfredson, D.C., Najaka, S.S. and Kearley, B. (2003) 'Effectiveness of Drug Treatment Courts: Evidence from a Randomized Trial.' Criminology and Public Policy, 2(2): 171-196.
Home Office (2004) Probation Statistics England and Wales 2002. London: Home
Office.
Petersilia, J. (1999) 'Alternative Sanctions: Diverting Nonviolent Prisoners to Intermediate Sanctions: The Impact on Prison Admissions and Corrections Costs.' In E.L. Rubin (ed) Minimizing Harm: A New Crime Policy for Modern America. Boulder, CO: Westview Press. Pp. 115-49.
Petersilia, J. and Turner, S. (1990) 'Comparing Intensive and Regular Supervision for High-Risk Probationers: Early Results from an Experiment in California.' Crime and Delinquency, 36(1): 87-111.
Rumgay, J. (2001) 'Accountability in the Delivery of Community Penalties: To Whom, For What and Why?' In A. Bottoms, L. Gelsthorpe and S. Rex (eds) Community Penalties: Change and Challenges. Cullompton, Willan, pp. 126-45.
Turnbull, P.J., McSweeney, T., Webster, R., Edmunds, M. and Hough, M. (2000) Drug Treatment and Testing Orders: Final Evaluation Report. Home Office Research Study 212. London: Home Office.


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