Coerced Drug Treatment in England and Wales: An Evaluation of Drug Treatment and Testing Orders in One Locality

Coerced drug treatments were first introduced to the UK in 2000 under the Criminal Justice Act 1998 entitled Drug Treatment and Testing Orders (DTTOs). Since the introduction of DTTOs, drug treatments within the English and Welsh criminal justice system have expanded substantially and DTTOs have since been replaced by Drug Rehabilitation Requirements. As a new initiative DTTOs were under intense scrutiny and subject to much evaluation. One such evaluation forms the basis of the current thesis. Running from 2001 to 2004 the evaluation considered both quantitative and qualitative data relating to all aspects of DTTOs. The findings showed high order revocation rates (57%) though for those who remained engaged with the order there were reductions in drug use and offending. Reductions in drug use whilst on an order were related to length of time on the order, sentencing court and whether the offender was sentenced whilst RIC or in the community. Greater number of previous convictions, positive order outcome and lower overall drug use while in treatment significantly predicted lower reconviction rates. Offenders were positive about the orders liking aspects which worked to increase and maintain motivation. Motivation was a key theme of interviews with both DTTO staff and offenders on the orders. The interviews revealed that the treatment aspect of DTTOs focused on reducing offending rather than drug use, contrary to the expectations of external agencies. Based on the findings from the evaluation and recent changes in drug policy, aspects that coerced drug treatments need to consider include: a shift in focus from reducing offending to treating drug use; use of evidence based psychosocial interventions; the role of motivation and particularly methods of increasing; and a change from focusing on single treatment episodes to instead viewing multiple episodes of treatment in terms of treatment careers.