FIRST ANNUAL REPORT & NATIONAL PLAN

The United Kingdom Anti-Drugs Co-ordinator CABINET OFFICE FIRST ANNUAL REPORT & NATIONAL PLAN Tackling Drugs to Build a Better Britain

TACKLING DRUGS TO BUILD A BETTER BRITAIN United Kingdom Anti-Drugs Co-ordinator s Annual Report 1998/99 United Kingdom Performance Targets for 2008 and 2005 National Plan 1999/2000

CONTENTS Contents Page FOREWORD 1 ANNUAL REPORT 1998/99 3 UK LONG AND MEDIUM TERM TARGETS AND NATIONAL PLAN 1999/2000 14 iii

FOREWORD FOREWORD I knew when I took on the job of being the first UK Anti-Drugs Co-ordinator that a lot of work had to be done. This last year has been enormously challenging. This is my first Annual Report reviewing what we have achieved in the last year and looking ahead to what will come next. In the White Paper Tackling Drugs to Build a Better Britain published in April 1998, we said that making a lasting difference was at least a ten year project. It will take that long to rid our society of the cycle of drugs and crime which blights so many lives. But together we will do it. The Government has fully backed it with 217 million of new money. And for the first time, assets seized from drug dealers will be channelled into helping those whose misery they profit from. The White Paper identified the four main areas we need to tackle to make Britain a much safer place and to ensure all our children grow up in safe communities with every opportunity open to them. They are: helping young people resist drug misuse; protecting communities, enabling those with drug problems to overcome them; stifling availability of drugs. Already things are changing. Over the last year, Government departments, agencies and others working in the field have signed up to common goals to make the strategy happen. Often that meant changing the way they worked, which has not always been easy. But I have been very impressed with the determination and dedication to achieving results shown by all those working in this area. A lot of hard work has gone into getting the systems right and making sure we do share common goals. More still needs to be done which is why we are devoting an extra 6 million to improving research and information gathering. The overall aim of the ten-year strategy is to shift the emphasis away from dealing with the consequences of the problem, to actively preventing it happening in the first place. So a large proportion of the 217 million will be aimed at treatment and education over the next three years. I expect that to make a substantial impact on the amount of drugrelated crime committed and the severe misery that causes. We know that treatment works. It is the only way to break the link between drugs and crime. And much earlier on, we need to explain properly to our children what the risks of drug taking are. Too often, they stray into a life of drugs without properly understanding the consequences. Most schools are now developing polices but still more needs to be done in conjunction with parents, youth workers, children and teachers if we are to make a real impact. Those who do develop drug problems must have early access to good treatment programmes which provide constructive help and allow them to see a way out. Those working in the Prison Service do not need me to tell them how important their treatment programmes are in prison. Putting people through proper programmes, with support in the 1

FOREWORD community, can mean the difference between hope and a future, or the return to a life of crime. We are piloting the new Drug Testing and Treatment Orders to make the prospect of change a reality, and to help break once and for all the link between drugs and crime. And to prevent that cycle continuing we need to stifle the supply of drugs getting on to our streets. The enforcement agencies have been successful in arresting more drug offenders and in seizing more drugs during this last year. But I know the frustration of parents, husbands, wives, brothers and sisters who tell me that there are always people plying their evil drug trade on the streets of our towns and cities. So the agencies are working closely together to make an impact on street availability, particularly heroin and cocaine. In the coming year, I will be looking more closely at the economy of the drugs trade, particularly its production and processing. I will be convening a group of experts to look at what impact we can make on that important level. And I will be holding a number of seminars on the four key aims of the strategy with all those we rely on most those who deliver it on the ground. Together we are building a framework for tackling drugs that will really work. It will reduce the misery caused by drugs both to addicts, their families and those who are victims of drug-related crime. People are impatient, of course they are. So am I. But it will take time to achieve our ultimate target of a healthy and confident society increasingly free from the harm caused by drugs. KEITH HELLAWELL 2

ANNUAL REPORT 1998/99 ANNUAL REPORT 1998/99 I am pleased to be able to report a year of good progress in implementing Tackling Drugs To Build A Better Britain, together with our targets for the future, and a detailed action plan for 1999/2000. During the last year, we have drawn in a wide range of expertise and experience from outside Government. My Deputy, Mike Trace, has established four strategy support groups, which have played an important role in assessing progress on the ground, reporting to my strategic steering group of senior officials from departments and agencies. Departments and agencies have also worked increasingly closely together, and with me and Mike Trace, during the year. The proposed new Drugs Prevention Board should provide an added impetus for an improved co-ordinated approach to drugs prevention and education. An international co-ordinating committee chaired by the Foreign and Commonwealth Office (FCO) has made good progress in co-ordinating a systematic approach to all activity undertaken overseas to stop drugs reaching our shores. HM Customs and Excise (HMC&E) and the National Crime Squad (NCS) have agreed an Operational Protocol. The intelligence agencies have increased their contribution. The responsibility for co-ordinating anti-drugs activity has transferred to the Minister for the Cabinet Office, giving a clear signal that this important, cross cutting issue is a central part of the Modernising Government agenda. Drugs problems will be addressed also through other wider programmes, such as Sure Start, the New Deal for Communities, and the Crime Reduction Programme. Partnership with the private sector was taken forward through Drugs the Business Agenda, a national initiative with Royal and Sun Alliance and Business in the Community which involved a flagship conference in October, an information booklet for business and a series of regional events to draw in business interests. Drug Action Teams (DATs) are the main mechanism for delivery of the strategy on the ground. This year, we provided a common planning tool a template to encourage a systematic approach to local planning. DATs had to assess what was being done in their area under each aim of the strategy, what was being spent and by whom, and whether the action in hand was adequate or effective. The audit of their plans has shown that there is much in hand and considerable local commitment. In a number of areas, all the relevant agencies are working together to plan and deliver an effective programme of activity against drugs which is in line with the national strategy. But this is not yet consistent across the country. 3

ANNUAL REPORT 1998/99 YOUNG PEOPLE Objective: to help young people resist drug misuse in order to achieve their full potential in society Tackling Drugs to Build a Better Britain identified that young people and those responsible for them, need to be prepared both to resist drugs and, as necessary, to handle drug-related problems. Information, skills and support need to be provided in ways which are sensitive to age and circumstances, and particular efforts need to be made to reach and help those groups at high risk of developing very serious problems. There is evidence that effective prevention should start early, with broad life-skills approaches at primary school, and be built on over time with appropriate programmes for young people as they grow older via youth work, peer approaches, training and wider community support. Approaches need to be better integrated nationally and locally. The main responsibility for ensuring that action is taken to meet this objective lies centrally with the Department for Education and Employment (DFEE), the Department of Health (DH), and the Home Office (HO), and locally with the education service, youth and community services and health promotion services, co-ordinated by the DAT. Current evidence suggests that: between 2-3% of 11-12 year old schoolchildren have ever taken an illegal drug; 23% of schoolchildren aged 14-15 have taken an illegal drug in the last year, 13% in the last month; 29% of young people between 16-24 have taken an illegal drug in the last year, 14% in the last month. Illegal drug use peaks among the 16-24 age group, but experimentation starts significantly from 13-14. There is some concern that the age of first use may be getting younger. Cannabis is the most widely used drug. There is some concern that heroin and cocaine use may be increasing. Whilst I believe the most recent advice to schools will help develop drug policies, more will need to be done in conjunction with parents, youth workers, children and teachers themselves, if we are to make a real impact. We need a great deal of goodwill and support by the media if we are to help our children resist drugs. Action during 1998/99: New DfEE guidance on drugs education in schools was issued in November 1998. The Health Education Authority (HEA) issued an advice leaflet to parents. To increase skills, and develop a more integrated approach to Personal, Social and Health Education in schools, a PSHE Advisory Group was established and its report will inform the review of the National Curriculum. The Social Exclusion Unit reported on Truancy and Exclusions. Targets for reducing both have been set and guidance issued. The new Pupil Support Grant will provide 500 million over three years to reduce truancy, unruly classroom behaviour and unnecessary school exclusion. Managing Drug Related Incidents: the right responses, published by SCODA in April 1999, provides 4

ANNUAL REPORT 1998/99 step by step guidance on how to deal with emergencies, identifies the factors to consider and offers realistic responses. Research into new young heroin users by Professor Howard Parker was published in July 1998. A more in-depth study was commissioned and is currently in progress. A national conference on parents and drug prevention was held in Manchester in June 1998. Good practice guidance on many aspects of prevention was produced by the Drugs Prevention Initiative. Local action Drug Action Team draft action plans for 1999/2000 indicate that in many areas localised guidance on drugs education and the management of drug-related incidents has been produced. In all areas, some drug education is taking place in schools and in most, also in other settings. The action plans show a lack of co-ordination in some areas. The better programmes involve drugs education groups or multi-agency drugs education teams to develop a more co-ordinated approach. It is clear that coverage is not yet comprehensive, so that by no means are all young people currently receiving drugs education in line with DfEE guidance, at primary and secondary school. The plans show that some work is in hand to provide support and information to parents, and in some cases parents and carers are involved in the school programmes, but there are gaps. Funding is not consistent, and a surprisingly high proportion of it is being provided by the police service. This should be reviewed very carefully. For their plans the DATs, also had to assess what action was being taken to increase access to information and services for vulnerable groups of young people, including school excludees; truants; looked after children ; young offenders; young homeless; and the children of drug misusing parents. They had also to look specifically at action to reduce exclusions from schools arising from drug-related incidents, and to reduce the number of young people under 25 using heroin. The overall picture is of many potentially valuable projects taking place around the country, but not yet in a consistent or comprehensive way. Good practice in working with vulnerable groups will be developed through new projects in Health Action Zones, and the Drugs Prevention Advisory Service (DPAS). There is a clear case for pulling together better information on effective practice across the country, and for DATs to do more to draw existing provision more closely together, to identify more sustained and long-term funding provision and to co-ordinate new approaches. COMMUNITIES Objective: to protect our communities from drug-related anti-social and criminal behaviour Tackling Drugs to Build a Better Britain identifies that helping drug-misusing offenders to tackle their drug problems and become better integrated into society has a 5

ANNUAL REPORT 1998/99 significant impact on levels of crime. Local partnerships can work successfully to tackle local drug problems, and to improve the quality of life for communities. It is difficult to exaggerate the damage that drugs bring to our communities. Our young people are entrapped or enticed into drug misuse, and some become reliant and addicted to these substances. They are subservient to dealers who demand they steal, deal or prostitute themselves to pay their debts and are subject to violence if they do not. They withdraw from family and school structures to the despair of their loved ones. This affects us all. We must break this cycle of despair. The work during the first year of the strategy has been largely to identify the measures we currently have in place and the way in which positive intervention can make a real difference. It can and it must. There is continuing evidence of the significant links between drug use and crime: around 32% of the proceeds of arrestees offending behaviour from acquisitive crime is geared to the purchase of heroin and/or crack; around half of arrestees who reported using drugs in the last 12 months, believed their drug use and crime were connected; around 30% of arrestees said they were currently dependant upon one or more drugs (11% heroin), and only one in five had received some kind of treatment for drug dependence in the past with the same proportion wishing to receive treatment at the current time; the National Treatment Outcome Research Study (one year follow-up) shows reductions in criminal behaviour after treatment of around one third amongst residential clients and a quarter amongst community methadone clients. The overall reduction in the number of specific offences is around 70%. Action during 1998/99 The new Drug Treatment and Testing Order was introduced, to give offenders with drug problems the opportunity to tackle their drug misuse and reduce offending. Pilots for its implementation were set up in Croydon, Liverpool and Gloucester. The Drugs Prevention Initiative produced updated guidance on managing effective referral schemes. A forthcoming report* on evaluation of their demonstration projects confirms that arrest referral schemes have a positive impact on drug use and offending: 74% of the sample of arrestees referred took up treatment; their drugs use and spending on drugs reduced significantly, with a corresponding impact on criminal activity. In follow-up these gains were still apparent 12 months later. Crime and Disorder partnerships were established by legislation, and required to audit crime in their area and develop strategies to reduce it. Where they and the new Youth Offending Teams are addressing drug related crime, they must act in partnership with DATs. * Bridging the gap: referring offenders to drug treatment services, Edmunds M et al [Home Office forthcoming] 6

ANNUAL REPORT 1998/99 The Public Entertainments Licences (Drug Misuse) Act 1997 was brought into effect in May 1998, introducing tough powers to enable local authorities to shut down clubs immediately where the operators cannot, or will not, deal with a serious problem of drug misuse on the premises. The Home Office issued guidance on how local authorities, the police, local drugs agencies and clubs could work in partnership to reduce drugs problems and increase safety for clubgoers; and a committee, chaired by Home Office minister, George Howarth, has been monitoring the situation since the guidance was issued. A White Paper on regulation of the Private Security industry, including club door staff, was published by the Home Office in March 1999. The AA published a discussion paper Drugs and Driving. Periodic returns from an ongoing survey into the incidence of drugs in road accident fatalities (drivers, passengers, cyclists, pedestrians) which is being run by the Department of the Environment, Transport and the Regions suggests that fatalities showing traces of an illegal substance have increased fivefold to 16%, compared with a similar survey in 1985-87. But there is no measure of accident causation. Furthermore, it is much more difficult to establish the incidence in non-fatal accidents, because there are no readily available, reliable, roadside screening devices. Recent trials have been conducted on the practicability in roadside conditions of prototype drug detection devices, but they require further development before they are ready to go forward for approval for use by the police. Work has gone forward during the year to develop robust techniques for the police service in how to recognise and act on incidences of drug-impaired driving. The Home Secretary introduced a new key performance indicator for policing to increase the number of offenders referred to and entering treatment programmes as a result of arrest referral schemes. Local action In assessing the effectiveness of local action, attention has been paid in particular to whether it is integrated with other related activity, and sufficiently influenced by available evidence of the potential impact of getting drug using offenders into treatment. In the template for local action plans, DATs were asked specifically to assess the baseline of numbers of offenders being referred to and engaged in treatment. The plans reveal a patchy response and some uncertainty of responsibility. Many DATs identify the need for comprehensive coverage of referral schemes, but there are far fewer cases where funding has been set aside. Most DATs identify that there are arrest referral schemes in their area, but only a small proportion so far involve face to face workers, which are the most likely to be effective. There is much lower availability of probation referral schemes, court referral schemes and prison schemes. DATs have in hand a range of activity aimed at energising and involving communities, linked in most cases with Crime and Disorder Partnerships. There are many good examples, particularly around multi-agency initiatives on estates, improving the quality of life for local residents, but very little of the activity has yet been independently evaluated. There is some research evidence available in a Home Office report about ways to tackle local drug markets, but there is little sign in local plans of such evidence having been 7

ANNUAL REPORT 1998/99 operationalised. There seems to be a need for clearer guidance, tighter definitions and targets to be established, and this will be taken forward in 1999/2000. On tackling drugs in clubs and pubs, the plans suggest that Home Office guidance is being followed widely with many good local schemes. Some DATs have work in hand also to develop workplace policies and road safety initiatives, experience of which may be helpful for the development of national action in due course. TREATMENT Objective: to enable people with drug problems to overcome them and live healthy and crime-free lives Tackling Drugs to Build a Better Britain identifies that there is growing evidence that treatment works, but that the supply of effective treatment services is failing to match demand. Many of this country s drug services, particularly those that serve some of our large cities, are impressive. They are striving to provide integration between specialist medical and community provision. Staff are well motivated and keen to help a difficult client group. However, the scope, accessibility and sometimes the effectiveness of available treatments are inconsistent and generally insufficient. The information available on the use of these services is no longer appropriate for the needs of the strategy. The Regional Drug Misuse Databases currently collect information only on presentation for treatment, not participation in treatment. This is being reviewed. At March 1998, those presenting for treatment for the first time or after a break of six months was around 24,000 for England and 30,000 for the United Kingdom. The number of drug misusers with serious problems has been estimated to be between 100,000 and 200,000, many of whom do not seek or cannot get access to effective services.* I can understand why some treatment agencies have been protective of their programmes and concerned when asked to account for their outcomes, as historically they have been under-funded. However, more money is being devoted to treatment largely through the criminal justice system in the next three years due to the major damage those people are causing to themselves and society. This money must be spent on facilities which are available to the community as a whole, and that is why I have a continuing dialogue with the Probation and Prison Service to ensure that they do not become protective of the money allocated to them. There is evidence, however, that over recent years we have actually been losing residential treatment places in part due to lack of funding. That is why I am exploring the notion of some way of funding these programmes in the short term through the use of seized assets and business contributions. In terms of access to the prescribing services, one of the barriers to meeting demand has been the limited engagement of drug misusers through primary care, although there are examples all over the country where general practitioners and the primary care teams * Arrest Referral Emerging Lessons from Research, Edmunds. M, et al (1998) 8

ANNUAL REPORT 1998/99 are offering excellent support to drug misusers. We must use the experience of these practices to encourage the others. Whilst some doctors have an ethical objection, many feel that they lack the knowledge to be effective. The issue of new clinical guidelines should reassure them, together with related seminars, and will hopefully encourage more doctors into this field of treatment. Too many distraught parents have expressed to me their disappointment in the lack of response they have received from their GPs and frustration at the lack of available advice and guidance. I hope that the above provision and the information contained in the guidance issued by the Health Education Authority will help meet the public demand. There is public misconception that the Prison Service does not care or is ambivalent about the use of drugs in prisons. I have found this not to be the case. All the prisons I have visited during the year are committed to adopting the new prison strategy and are proud to report substantial reductions in their prisoners who test positive for drugs, together with increases in those who are punished for possession of drugs either within prisons or attempting to bring them into prisons. A big issue which is arising from successful treatment within any agency is the support that an individual needs when he or she leaves a programme. Some treatment agencies have set up after-care and support mechanisms within a community, but if a person returns to the same problems and the environment that he came from, the likelihood of reverting to his previous drug use is high. This is why social services and community support is an essential part of tackling the drugs problem. The New Deal is the Government s commitment to this agenda. The inclusion of the Director of Housing on the DAT is another positive measure, but local authorities and businesses will need to look more favourably on reformed drug addicts if we are not to waste their time in treatment. The strategy contains a firm commitment to improve provision of drug treatment across the country, so that all problem drug misusers, irrespective of age, gender or race have proper access to support from appropriate services, including primary care, when needed. Action in 1998/99 Drugs services were identified for the first time in NHS Priorities and Planning Guidance. Health authorities were required to include anti-drugs measures in their Health Improvement Programme. A working group developed guidance on Clinical Practice, published on 12 April 1999. Mike Trace oversaw a cross-cutting crisis intervention initiative to address the shortfall in funding for treatment services in London. SCODA and the Social Services Inspectorate issued guidance on services for young people and for the children of drug-misusing parents. DH ran a Specific Grant programme to develop dual diagnosis services for people with both drugs and mental health problems. 9

ANNUAL REPORT 1998/99 The new Prison Service Drug Strategy was published, giving a commitment among other things to the setting up of a drug treatment service framework, CARATS*, and the development of rehabilitation programmes. The Advisory Council on the Misuse of Drugs (ACMD) took forward an inquiry into preventing drug-related deaths. The Health Care National Training Organisation established a joint forum on drugsrelated training. Local Action Information gathered by DATs for their action plans for 1999/2000 very much confirms the need for this strategy to address both treatment capacity and the local mechanisms for purchasing it. In many cases, DATs have found it difficult to identify which activities are being provided, at what cost. There is no evidence of any significant expansion of services during 1998/99. The funding for services continues to be complicated and based on historic practice rather than any process of collective strategic assessment of need. Without a cohesive service framework it is difficult for funding to be redirected to meet the changing needs of the population, or to meet newly identified strategic objectives. There is little evidence overall of consistent objective setting and output measurement. Most DATs confirm that women, ethnic minorities, young people and stimulant misusers are under-represented in existing treatment services, but only a few have clear plans for redressing this. Some good examples of specific initiatives include liaison work with Obstetrics and Maternity Departments, targeted outreach work, or adaptations to existing services to meet diverse needs. In some cases DATs have indicated that they have had to make a conscious decision not to increase access, because agencies were working at full capacity and long waiting lists were in place. In my view, people with drug problems should not have to wait longer than four weeks from the point of referral to enter treatment. It remains a cause for concern that too many drug misusers with serious problems do not seek help before experiencing many years of chaotic use. This is confirmed by studies of those in the criminal justice system. DATs identify a good spread of advice and information services, although there are some problems of access in rural areas, and of services becoming congested because of the difficulty of referring all clients on to treatment programmes. Similarly, a good spread of health promotion, education and needle exchange services across the country have been effective in keeping the incidence of injecting-related HIV low. Hepatitis C is identified as a serious problem which needs to be addressed urgently. More continues to need to be done also to reduce the proportion of drug users who inject and share; to reach users with the most severe problems; and to ensure the safe disposal of needles and minimise anti-social behaviour near needle exchanges. The picture in relation to the kind of residential rehabilitation, structured day care and prescribing programmes which have been shown to be capable of having a major impact on drug use, health, offending and social integration gives some cause for concern. Access to such programmes is limited, with extensive waiting lists and funding delays. The position * Counselling, Assessment, Referral, Advice and Throughcare Service 10

ANNUAL REPORT 1998/99 did not improve in 1998/99: indeed there has been some closure of residential places during the year. We will be seeking to arrest and reverse this trend over the next 3 years as part of work to improve access to all treatment modalities. DATs indicate that in many cases their financial information is inevitably incomplete or unreliable. Nonetheless it is striking that, assessed against population data, there seems to be considerable variation in the funding allocated between regions. This has implications for the capacity of services to respond to local needs. It is vital that all health and local authorities, in partnership with agencies through DATs, allocate sufficient resources to tackle these serious problems. AVAILABILITY Objective: to stifle the availability of illegal drugs on our streets Tackling Drugs to Build a Better Britain identified the drugs trade as an international multi-billion pound industry, estimated in 1997* as having a turnover amounting to about 8% of total international trade. Considerable resources also are deployed world-wide to combat this trade, by reducing drug production, processing and trafficking. Enforcement activity would seem to be successful, in that between 1987 and 1997 there has been a tenfold increase in the amount of drugs seized, number of seizures and numbers of offenders dealt with. But there have been no signs of a commensurate reduction in street level availability. It is notoriously difficult to assess the impact on availability of the various forms of activity against supply, but effective law enforcement remains a vital part of the strategy for tackling drugs and we must identify better means of so doing. That is why all the agencies are working closely together to make an impact on street availability, particularly those drugs which cause the major harm. The frustration of local dealers, when the police disrupt their market places, may reduce the number of arrests for minor drug offences, but these actions will deter all but the committed dealer and addict and give much reassurance to the public who at the moment believe, wrongly, that the police are doing nothing about drugs. This is just one of the new measures we are introducing to stifle the availability of drugs on our streets. There is a strong strategic commitment to develop future action in line with the best available evidence of what really has an effect on the availability of drugs to young people. Action in 1998/99 The United Nations General Assembly Special Session on drugs agreed in June 1998 to develop strategies with a view to eliminate or significantly reduce the illicit cultivation of the coca bush, the cannabis plant and the opium poppy by 2008. The National Crime Squad was launched on 1 April 1998. * by the UN Drug Control Programme 11

ANNUAL REPORT 1998/99 On the same date, the National Criminal Intelligence Service was put on a statutory footing. HMC&E significantly revised its drugs enforcement policies and priorities to match the emphasis of the strategy, and drugs resources were refocused to maximise impact on Class A drugs. An international co-ordination committee set in hand a comprehensive assessment of all action overseas aimed at cutting off supplies of drugs to the United Kingdom. The Department for International Development published a strategy paper, Illicit Drugs and The Development Assistance Programme, which highlights how the Government s commitment to poverty reduction can make a valuable contribution to combating illicit drugs. The National Crime Squad and HMC&E National Intelligence Service agreed an Operational Protocol A Working Group on Confiscation reported proposals for enhancing measures to confiscate illegal drugs assets and a study was launched in March 1999 to report this summer on the merits of a confiscation agency. In January 1999, the Home Secretary announced a new initiative to clamp down on visitors and prisoners involved in smuggling drugs into prisons, including new powers to ban visitors caught or suspected of smuggling drugs. The revised arrangements provide a firmer and more consistent approach to the problem. Local Action DAT reports confirm that not all DATs have yet developed a strategic approach to stifling the availability of drugs to young people across all relevant agencies at local level. There is wide acknowledgement that DATs need to engage more effectively in this area and ensure that all local activity is properly monitored and, where appropriate, evaluated to help them determine the impact of measures in place. Many DATs identified the need for better data collection mechanisms and information systems to improve their understanding of where best to focus attention and more effectively target the availability of drugs through improved multi-agency working. The local crime audits will help to contribute to this process. Better systems for measuring effectiveness are being developed nationally. ACTION IN SCOTLAND, WALES AND NORTHERN IRELAND Scotland s enhanced drugs strategy, Tackling Drugs in Scotland: Action in Partnership was published in March 1999. The document sets out Scotland s drugs strategy against the background of the UK Drugs White Paper. Tackling Drugs in Scotland builds on the Ministerial Drugs Task Force report of 1994, and the steps taken since 1997 to strengthen the framework for action against drug misuse in Scotland. The document reflects the four strategic aims of the UK White Paper and the corresponding corporate objectives. These are supported by specific objectives appropriate for Scotland, with a matching action programme. Other elements in the enhanced strategy are strengthened co-ordination, a focus on DATs for local action, an annual planning cycle, wide ranging partnership arrangements, accountability for action, and performance management at the centre and locally. 12

ANNUAL REPORT 1998/99 Following a review, Forward Together, Wales current strategy to combat drug and alcohol misuse will be refocused to reflect many of the key elements of Tackling Drugs to Build a Better Britain, including its strategic aims and main objectives. The refocused strategy for Wales will retain the wider substance misuse remit and build on the achievements of Forward Together. It will also emphasise the importance of partnership work at a local level and the need to tackle the social causes of substance misuse by linking with the wider social inclusion agenda. As with the White Paper, performance management will be a key component of the refocused strategy to enable regular assessment of progress in Wales. In 1999-2000, 1.5 million is being made available, as part of the package of measures in a Social Inclusion Fund, to support drug and alcohol treatment services, improving access to treatment particularly for vulnerable younger people. The Central Co-ordination Group for Action Against Drugs in Northern Ireland set up a Review Team in March 1998. The team undertook a major consultation exercise, including meetings with key people, focus groups and a survey of over 500 people. Their recommendations are reflected in a new strategy for addressing drug misuse problems in Northern Ireland, built round the same four main aims as Tackling Drugs to Build a Better Britain, but with specific objectives which relate to the situation in Northern Ireland. The new strategy is currently the subject of final consultation, and it is anticipated that it will be launched during the summer. 13

UK TARGETS FOR 2008 AND 2005 AND THE NATIONAL PLAN FOR 1999/2000 UK TARGETS FOR 2008 AND 2005 AND THE NATIONAL PLAN FOR 1999/2000 The aim is to create a healthy and confident society, increasingly free from the harm caused by the misuse of drugs. We will reduce the use of all drugs substantially, and aim to break the link between drugs and crime. Programmes should consistently address the needs of the whole community, regardless of gender, race, age or drug taking behaviour. Government activity against illegal drugs is co-ordinated by the Minister for the Cabinet Office, as advised by the UK Anti-Drugs Co-ordinator, and delivered principally by the Home Secretary, the Secretary of State for Health, the Secretary of State for Education and Employment, the Financial Secretary to the Treasury, the Foreign Secretary, and the Secretary of State for International Development. The Secretary of State for the Environment, Transport and the Regions, the Secretary of State for Defence and the Secretary of State for Culture, Media and Sport also have significant influence. For the first time, national and local agencies and departments are being brought together to achieve corporate performance targets. These targets are ambitious, but will help focus our joint effort and spur us all on to better performance. These targets include a new emphasis on ridding our society of the link between drugs and crime which blights so many lives and even whole communities. We have set a target for reducing the use of all drugs substantially. But we know that the most dangerous drugs, such as heroin and crack cocaine, have an enormous impact on crime. The illegal income needed to feed the habit of a heroin or crack user can amount to 10-20,000 a year, and as a result, such users are responsible for a substantial proportion of all crime particularly theft and burglary. So we are setting tough targets for reducing the use of these drugs by young people under 25: by 25% within 5 years, and by 50% within 10 years. An additional 217 million has been allocated to Government departments over the next three years, for which Ministers are bound by a Public Service Agreement to deliver additional outputs against drugs. Modernising Government emphasises our commitment to ensuring that public bodies are clearly focused on the results that matter to people, that they monitor and report their progress in achieving these results and that they do not allow bureaucratic boundaries to get in the way of sensible cooperation. For action against drugs, local agencies must take this agenda forward locally through DATs. Additional support is being provided for this: a total of 5 million in 1999/2000 in central funding; the new Drugs Prevention Advisory Service; centrally-provided guidance and assistance; as well as the resources identified above. This investment must be conditional on achieving improved results through modernisation and reform. From 1999/2000, assets seized from drug traffickers in this country will be channelled back into anti-drugs activity, through a new Confiscated Assets Fund. The Fund will also allow for seized assets to be shared with other governments where the successful case has 14

UK TARGETS FOR 2008 AND 2005 AND THE NATIONAL PLAN FOR 1999/2000 involved international cooperation. The activities to be funded will be identified by the UK Anti-Drugs Co-ordinator based on his assessment of the strategic priorities which are not otherwise being supported through the Comprehensive Spending Review allocation. For 1999/2000 the Fund will total 3 million; rising to 5 million in 2000/01. In 2001/02, the amount in the Fund will be set according to receipts in 1999/2000. It is essential that we focus in the long term on outcomes, but first we need to develop the necessary information-gathering mechanisms and baselines. There is a marked shortage of reliable information in this area. A major new research programme, costing 6 million over 3 years, will start in 1999/2000. Better and shared information systems will be put in place to show more definitively what the drug problems are, and what works best against them. In 1999/2000 we shall: establish robust baseline figures by means of a new national schools-based survey of young people s drug-taking behaviour; set up a large-scale programme of urinalysis and interviewing of arrestees, NEW- ADAM, and run it in eight sites in England and Wales; complete a review of the Regional Drug Misuse Databases and establish a baseline for the medium and long term treatment targets; improve our understanding of the movement and distribution of Class A drugs both to and within the United Kingdom. All parts of the United Kingdom will work closely together to develop broadly compatible and comparable research and information systems. YOUNG PEOPLE Objective: to help young people resist drug misuse in order to achieve their full potential in society Under the Comprehensive Spending Review 57 million of Departmental funding has been allocated over three years to support more sustained and better drug education and prevention work in schools and the community by means of: the DfEE Standards Fund: 21 million to schools to support training of teachers and delivery of effective drugs education programmes; 18 million DH prevention expenditure; 18 million for the Home Office Drugs Prevention Advisory Service (DPAS), 9 new regional teams providing support and assistance to all DATs across the country. Our Key Performance Target is to reduce the proportion of people under 25 reporting use of illegal drugs in the last month and previous year substantially, and to reduce 15

UK TARGETS FOR 2008 AND 2005 AND THE NATIONAL PLAN FOR 1999/2000 the proportion of young people using the drugs which cause the greatest harm heroin and cocaine by 50% by 2008, and by 25% by 2005. By 2002, our targets are to: require all DATs to have in place integrated, sustained and comprehensive programmes involving lifeskills approaches in all schools, the youth service, further education, the community, and with parents, based on evidence of good practice; delay the age of first use of class A drugs by 6 months; Reduce exclusions from schools arising from drugs-related incidents by reducing the number of such incidents, as part of the Government s overall strategy to reduce all exclusions from schools by one third; reduce by 20% the numbers of 11-16 year olds who use Class A drugs. During 1999/2000, we will: strongly encourage all schools to have policies on drug education in line with DfEE guidance; [DfEE] assess DAT prevention programmes and set in hand a plan of action to improve them; [HO] improve co-ordination of activity by the creation of a new Drugs Prevention Board to take forward joint national commissioning of effective prevention and education; [DH, HO, DfEE] develop an improved programme of action to reduce misuse of Class A drugs particularly heroin and cocaine among young people. [Drugs Prevention Board] COMMUNITIES Objective: to protect our communities from drug-related anti-social and criminal behaviour Significant additional resources have been allocated under the Comprehensive Spending Review to increase the number of offenders referred to and engaged with treatment services. This includes 60 million for implementation of the Drug Treatment and Testing Order and around 60 million for treatment in prison (also referred to under treatment). A start has been made in reallocation of police service resources to drug related partnerships, such as arrest referral schemes. In the Home Secretary s Policing Priorities for 1999/2000, a benchmark of 1% of their budget has been suggested for the purpose. Additional funding should also be made available as necessary from additional sources, such as the 3 million to be available in 1999/2000 from the assets seized from drug traffickers. Our Key Performance Target is to reduce levels of repeat offending amongst drug misusing offenders by 50% by 2008 and 25% by 2005. By 2002 we will ensure that: 16

UK TARGETS FOR 2008 AND 2005 AND THE NATIONAL PLAN FOR 1999/2000 all police services operate face-to-face arrest referral schemes covering all custody suites; there will be a significant expansion of Probation and Court referral schemes in line with emerging evidence from the Drug Testing and Treatment Order pilots and other studies; the proportion of arrestees testing positive for Class A drugs is reduced from 18% (1998/9 baseline) to 15%; we establish a baseline measure for drug-related absenteeism/accidents at work. During 1999/2000 we will: double the number of face-to-face arrest referral schemes and the number of arrestees referred to and entering treatment programmes; [HO] evaluate Probation and Court referral schemes; [HO] support police trials for Drug Recognition Training and Field Impairment Testing in respect of drug driving. [DETR/HO] TREATMENT Objective: to enable people with drug problems to overcome them and live healthy and crime-free lives Under the Comprehensive Spending Review, significant additional resources have been allocated for drug services: 20.5 million for Personal Social Services and 50 million for health authorities over the next three years. In broad terms this could increase treatment provision by about one-third, but there will need to be a matching increase in capacity: recruitment, training and buildings. It is crucial to the delivery of the ten-year strategy that this capacity building is funded, steered and monitored in the short to medium term. The additional resources available for the full range of treatment services to fund referrals from the Criminal Justice System should result in a steady rise in the numbers of problem drug misusers entering treatment. Our Key Performance Target is to increase the participation of problem drug misusers, including prisoners, in drug treatment programmes which have a positive impact on health and crime by 100% by 2008; and by 66% by 2005. By 2002 we will: require all DATs to have established a maximum waiting time for admission into a drug treatment service and to be monitoring agencies performance; ensure that the CARATS annual caseload reaches 20,000; that there are 30 new prison-based rehabilitation programmes; and that 5,000 prisoners a year go through treatment programmes; 17

UK TARGETS FOR 2008 AND 2005 AND THE NATIONAL PLAN FOR 1999/2000 have in place National Occupational Standards for specialist drug and alcohol workers; reduce the numbers of those in treatment who report injecting and the numbers of those injecting who report sharing; have in hand a plan of action to reduce drug-related deaths, from a baseline established in 2000/01; ensure that all treatment programmes accord with a nationally accepted quality standard. By the end of 1999/2000 we will: develop firm audit mechanisms for health and local authority treatment commissioning; [DH] as part of DAT action plans require each health authority working with local providers to introduce protocols to increase uptake of Hepatitis B vaccination; [DH] require each health authority to carry out an assessment of the substance misuse treatment needs of young people in their area, and produce a plan through the DAT in conjunction with Youth Offending Teams, to meet these needs; [DH] require each health authority, through the DAT, to assess the need for and commission training in the treatment of drug misusers for general practitioners and primary care teams and develop plans for the introduction of supervised consumption of controlled drugs by pharmacists [DH] require each DAT to produce an action plan to meet the local demand for detoxification and substitute prescribing services and for community-based structured therapeutic programmes [DH] have established CARATS: the basic treatment framework to improve the assessment, advice, throughcare and support of prisoners; and put in place more and better quality treatment programmes; [Prison Service] implement as appropriate the forthcoming findings of the ACMD review on reducing drug-related deaths. [DH] AVAILABILITY Objective: to stifle the availability of illegal drugs on our streets The planned new survey of young people s drug misuse, together with a surveillance system made up of an integrated programme of local surveys and monitoring mechanisms, should provide a more robust baseline by 1 April 2000 of perceptions and experience of the availability of drugs. Additional work will develop better measures of effectiveness of supply and demand measure on availability, both at international and domestic levels, and a better handle on the scope and nature of the illicit market. There will be improved security procedures in prisons to detect drug smuggling. 18

UK TARGETS FOR 2008 AND 2005 AND THE NATIONAL PLAN FOR 1999/2000 Our Key Performance Target is to reduce access to all drugs amongst young people (under 25) significantly, and to reduce access to the drugs which cause the greatest harm, particularly heroin and cocaine, by 50% by 2008 and 25% by 2005. By 2002 we will: have developed and implemented drug distribution models, on which flow estimates from source to Europe and the United Kingdom can be more accurately calculated; increase the percentage of heroin and cocaine seized, which was destined for Europe and the UK, as proportion of overall availability; increase by one third the amount of assets identified from drug traffickers and secured; have developed and implemented a model to assess the levels and routes of supply drugs within prisons; reduce the rate of positive results from random drug tests from 20% in 1998/99 to 16%. In 1999/2000 we will: develop and implement a comprehensive and dynamic threat assessment mechanism, to focus the United Kingdom s diplomatic and operational efforts, and the effective use of resources geared to assessed risk and opportunity; [International Co-ordination Committee] increase Class A drugs prevented and seized by 10%; [applies jointly to all the enforcement agencies]; increase by 5% the number of trafficking groups disrupted or dismantled primarily involved in Class A drugs; [joint measure applies to FCO, intelligence agencies, HM C&E, NCIS, NCS]; increase by 10% the number of offenders dealt with for supply offences in respect of Class A drugs; [applies to all enforcement agencies] increase by 10% the amount of assets identified from drug traffickers and secured. in prisons, put in place more dogs trained to detect drugs; and more CCTV in prison visits areas; obtain better information about supply routes and availability of drugs to prisoners; discourage families from smuggling drugs. [Prison Service]. 19