KEY POINTS:
People with drug problems pack our prisons. Figures show more than half the people who commit crimes are using at least one drug at the time of their arrest. And 90 per cent of prisoners suffer from a substance abuse disorder at some time in their lives.
A tougher stance on crime since the 1999 criminal justice system referendum, when 92 per cent of us voted for harsher sentences, has meant we are now cramming offenders through the prison gates faster than ever.
We will need around 10,000 prison beds by 2011 if nothing is done to reduce jail rates.
The number of prison treatment places will soon rise from 160 to 500, but when most prisoners (8076 at last count) need that treatment, resources are obviously stretched dangerously thin. Most prisoners with drug problems simply go untreated.
In the long run, this makes society less safe. Drug-addicted prisoners do not somehow magically rehabilitate themselves without treatment, and when they are released, they are likely to quickly re-offend.
The Drug Foundation has just released its policy position on tackling problems around alcohol and drugs in our criminal justice system. We have done extensive research into local and overseas initiatives that could reduce offending and address the serious health needs of many prisoners.
Here are what we think are some of the "best buys" for the Government.
Services across the criminal justice system. We need to identify offenders with drug problems at the outset and ensure treatment is part of their sentencing from the word go, whether they're locked up or put on home detention. Drug treatment interventions need to happen at police cell, court, and remand centre levels, as well as in prisons. And programmes need to be co-ordinated across these agencies.
Treatment works. In the United States, the National Institute on Drug Abuse has evaluated diversion to treatment and prison-based treatment and found that comprehensive drug treatment reduces drug use, criminal behaviour and recidivism.
The institute estimates that every dollar invested in prison addiction treatment yields a return of $4 to $7 in reduced crime. In diversion to out-of-prison treatment programmes, savings were as high as $12.
Perhaps we should consider compulsory treatment. US offenders sentenced into treatment had drug use and crime reductions similar to, and sometimes better than, those of voluntary patients.
Get the treatment right. International research indicates not all treatment programmes are equal. "Boot-camp" style approaches do not reduce use or recidivism. Counselling has some effectiveness in reducing recidivism but little in reducing drug use.
Residential therapeutic community approaches work best, and we need to build on what we are already doing with this. Corrections Department research has found that people who complete these programmes are 13 per cent less likely to re-offend.
Meet treatment needs in full. Estimates are that fewer than a quarter of people needing treatment receive it. And prisoners can only access treatment if they are in prison long enough to attend a programme, and have already stopped using. This excludes most prisoners on short sentences, many of whom are women. Treatment programmes which begin in prisons and continue after release could eliminate such gaps.
Minimise harm. The reality is that drug use is common in prison, and many addicts say that is where their drug problem began. Fortunately, New Zealand recognises the value of harm minimisation, meaning Corrections supports services to reduce harm to prisoners who do manage to access drugs.
All prisoners on methadone therapies before entering prison can continue their treatment. But existing prisoners cannot access this therapy, and this must change. We need to look seriously at introducing needle exchange programmes too, which could greatly reduce the spread of Hepatitis C.
Aftercare. International evidence indicates well-planned, long-term support for people released from prison, including community-based treatment, housing and employment support, helps maintain reduced usage and recidivism. Sure it costs, but relapsing offenders on a continuous crime and prison cycle cost more.
Using these "best buys" suggestions, there is no reason we cannot replicate many of the successes seen overseas. But it's going to take a bit of a re-think by our decision-makers. That will be a challenge as we head to an election, when the short-sighted scramble for votes can win out over long-term policy. Any party daring to be progressive on this issue may find itself accused of being soft on drugs and crime, especially in a debate dominated by those in the "lock 'em up and throw away the key" camp.
The rising level of imprisonment resulting from a decade of tough stances has been a disaster. Hope lies in learning from what has worked elsewhere, and building something similar here. This is not being soft on drugs and crime - it's being smart on drugs and crime.
* Ross Bell is executive director of the NZ Drug Foundation
