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A case-study of substitute opiate prescribing for drug-using offenders

This paper presents a case study of a Criminal Justice Intervention Programme (DIP) for drug-using offenders in the UK. Of 180 offenders offered the scheme, 103 (57%) successfully engaged and 59 (32%) stayed six weeks or more. The majority of referrals (94%) were for heroin misuse and 45% also reported crack use. Less than a third (27%) of all referrals reported injecting. Those who engaged initially were more likely to be injectors (70% compared to 30% of those who did not engage), females, polydrug users, and older clients. But those who stayed in treatment for at least six weeks were more likely to be non-injectors (60% stayed in treatment compared to 40% who did not), male and ethnic minority groups. Qualitative analysis of 40 semi-structured interviews with clients emphasized the benefits of fast access and friendly helpful staff. However, clients believed that drug use itself was interlinked with social, economic and psychological problems and identified a need for comprehensive ‘wrap-around services’ and help with housing and employment. The complexity of the relationship between drug use and crime was seen as reflecting the complexity of these underlying problems. The opportunities and limitations of combining individual treatment and public safety objectives are discussed.