Balance Between Disciplinary and Therapeutic Strategies in Dealing With Drugs - Essay Example

?UK prison system has successfully attained the balance between disciplinary and therapeutic strategies in dealing with drugs : Tutor: Date: Introduction The United Kingdom has three legal systems each with a separate prison system. One is for Wales and English, the second is for Northern Ireland and the third is for Scotland. England and Wales account for the highest number of offenders incarcerated with the total prison population reaching almost 90,000 inmates (Home Office 2001). Scotland has a total of 15 prisons that are run by Scottish Prison Service and the prison population is less than 10,000 inmates. Northern Ireland has the least number of inmates at less than 2,000 and only few prisons. Drug abuse in the UK is governed by Misuse of Drugs Act and several other laws that prohibit organised crimes related to illicit drugs. It is estimated that over 300,000 individuals in UK consume illegal drugs and one third of the drug addicts engage in routine crimes. About 75,000 drug users enter the prison system annually with about 16 percent of the drug addicts abusing drugs regularly while in prison (Robinson & Crow 2009). On average, 55 percent of prisoners have drug related problems while about one third of suicide deaths and self-harm crimes are committed within the first week of imprisonment (Robinson & Crow 2009). The UK prison system has successfully attained a balance between the disciplinary role of the prison strategies and therapeutic strategies in dealing with drug abuse problem (Tonry 2004). Historically, any prison system was used to discipline the offenders through harsh punishments and long imprisonment terms. However, due to the high number of repeat offenders, many prison systems including the United Kingdom have implemented new measures of rehabilitating the offenders and controlling repeat offences (Robinson & Crow 2009). Some of the rehabilitation initiatives that have been implemented include counseling, drug therapies and skills training (Robinson & Crow (2009). Criminologists have consistently pointed that unemployment, anti-social behaviours such as drug abuse and poor social environment contribute to the level of crime in the society. Rehabilitative functions such as education programs for drug abusers, medical therapies and counseling may be costly, but help in minimizing the drug abuse problem in the society (Keene1997). The prison system has contained the offenders in a humane manner thus allowing the offenders to successfully integrate in the society after their imprisonment term (Gravett 2000). Substance abuse is a critical problem among the prison population. Therapeutic treatments for the offenders benefit both the individual and wider society. Some therapeutic strategies include detoxification in order to manage the withdrawal symptoms and prevent the long run relapse in to substance abuse (Mathiesen 2006). The UK prison system has also implemented community based therapeutic services within the prisons that enable health workers to attend to drug offenders. The National Probation Service ensures that the prison staffs continually improve the access to therapeutic care and implement strategies that minimize supply of drugs in the prison system (Tonry 2004). Some of the challenges experienced in the therapeutic strategies include illicit access of drugs in the prisons, increased harm to prisoners due to overdose and integration of the CARAT services in to a multi-agency therapeutic team. The prison system provides methadone or buprenorphine that is made to limit withdrawal symptoms. The prison population has increased and role of drug enforcement must be emphasized. Significant populations of the drug offenders are seeking minimal punishments under the Misuse of Drugs Act. Drug law enforcement is responsible for about one third of the imprisoned offenders in the UK prison system. Illegal drug users over the age of 18 years are considered serious criminals while high drug dependency among the low-income individuals is likely to engage in other serious crimes such as felonies (Keene1997). Disciplinary strategies In an attempt to control drug abuse among the UK population, the government has implemented strict policies that depend on incarceration due to the desire to incapacitate the offenders (Garland 2001). Serving long imprisonment terms for drug related crimes is meant to discourage potential drug abusers from abusing drugs or participating in other related crimes. Imprisonment as a punishment strategy plays an important role in law enforcement since it reduces the consumption of illegal drugs in the society (Foucault 1977). Due to the risk of arrest and subsequent imprisonment, this strategies aim at making the availability of illegal drugs scarce and also increasing the market prices of the illegal drugs (Foucault 1977). Imprisoned drug offenders do not contribute to the drug market outside the prison thus leading to scarcity of illegal drugs in the society (Lee 2007). Disciplinary is not the only solution of controlling drug abuse system in UK prison system. The prison system has implemented several drug treatment and prevention mechanisms that aim at reducing the dependency on drugs. The number of offenders with drug related problems has increased tremendously over the past decades thus the prison system has been forced to use therapeutic measures in treating the offenders of drug dependency. The drug harm minimizing strategies aim at providing incentives for the prisoners in order to reduce drug abuse (Home Office. 2006a). Therapeutic strategies The main aim of the therapeutic strategies are to break the criminal link between the criminal behaviour of the drug abusers and the drugs and then grant an opportunity for the ex-offenders to take care of their livelihoods and desist from re-offending. The Integrated Drug Treatment System (IDTS) ensures that incarcerated drug abusers receive same therapeutic attention as their counterparts in the communities. Effective drug therapy will liberate the prisoners, their families and entire society from drugs-related crimes. The prison systems have implemented strict security controls that limit the supply of drugs in the prisons such searching of the visitors. In addition, the prison system encourages voluntary drug testing. The drug response strategies aim at reducing the supply of drugs in the prisons, reducing the demand and also minimizing the harm associated with drug abuse. The UK prison system has ensured prisoners have access to high health care services in order to minimize the exposure to drugs while in prison. The drug treatment initiatives aim at ensuring the psychological and mental wellbeing of the drug-addicted prisoners since some criminal behaviour such as violent robbery and rape are associated with drug abuse. The prison staff is also well trained in supporting or treating the prisoners of drug dependency and all prisoners are involved in their own care and treatment process. The Irish prison service (IPS) has been hiring nurses in the prison system since 1999 with the aim of providing adequate medical attention to the drug addicts. Illicit drug abuse in the UK prisons was responsible for the outbreak of HIV/AIDS in HM prison in Glasgow in the year 1993. The particular outbreak demonstrated how sharing of drug injection equipments inside the prison facilities could lead to broader health risks for the prisoners, their immediate spouses and local communities (Mackey and levan 2012). The annual costs of maintaining a prisoner in the detention facilities has escalated thus it would be unfair not to provide rehabilitation services. The economic benefits of therapeutic strategies exceed the total costs of the traditional and disciplinary based prison system since rehabilitation decongests the prisons by reducing repeat offences. The prison system has implemented behavioural approaches such as social skills training, self-monitoring techniques and community reinforcement that enables drug addicts attain self-efficacy. Another useful behavioural therapeutic strategy is cognitive-behavioural training that helps the drug offenders cope with depression and mood swings thus minimising the drug withdrawal effects. More than 40 UK probation facilities use the cognitive-behavioural technique in providing behavioural training to the drug addicts (Waller and Rumball 2004). In addition to behavioural training, the UK prison system uses educational programmes that aim at changing the attitudes of the drug users. This programmes also target teenagers who are at risk of abusing drugs due to peer pressure and unsupportive social background. More than 10,000 probation offenders graduate from the drug and alcohol abuse education courses yearly. In addition, drug offenders are also trained on cigarette smoking cessation thus reducing the prevalence of tobacco related diseases among the prison population. Group therapy is also a key part of the educational programmes since it helps minimising the perceptions of social isolation among the imprisoned drug offenders. Mackey and levan (2012) asserts that the UK prison system has successfully embraced pharmacological treatment through the use of methadone hydrochloride as a substitute for the heroine. The UK government has allocated enough funds for the detoxification within the prison facilities. Prisoners are provided with a decreasingly dose of oral methadone for seven days in order to minimise the discomforts associated with heroine withdrawal (Dolan &Wodak p 85). Another detoxification drug that is administered is Lindholme that treats the withdrawal effects of heroine and opium abuse. According to policy makers, there is high reduction of drug abuse among the ex-offenders who had received detoxification treatment. In addition, offenders who receive methadone detoxification are less likely to engage in risk taking behaviours such as syringe sharing (Dolan &Wodak, 1996: 86). Methadone detoxification may not be problematic in treating the drug abusers of addiction, but the major concern lies with prevention of relapse in to drug abuse after the prisoners are released. In this case, the UK prison system has initiated relapse prevention training activities that aim at making the ex-prisoners aware of activities that may lead to relapse in to drugs. This therapeutic technique prolongs the interval before a relapse and also minimizes the severity of relapses once they occur. This method is mainly employed immediately before the prisoners are released in to the society and usually occurs within the prison setting. Another therapeutic strategy that has been implemented is counseling. Counseling, Assessment, Referral Advice and Throughcare (CARAT) strategy entails outside social workers providing therapeutic care to the drug offenders and addicts within the prison system. This is a multi-agency approach that aims at providing support to drug offenders even after their release. The main aims of CARAT are to identify substance users and provide an ongoing counseling and support through their imprisonment term. CARAT also works with both internal and external stakeholders in ensuring that appropriate drug problem intervention efforts are implemented in tackling the drug abuse problem within the prison system (HMPS 2005a). CARAT promotes the liaison between the community agencies and prison establishments in order to ensure drug addicted prisoners receive adequate therapeutic care. The prison will agreed with the community workers on the treatment plan and regular assessments are carried out to the prisoners up to six weeks after the end of the imprisonment term (HMPS 2005a). According to statistics released in 2011, less than 10 percent of the prisoners tested positive for drug abuse compared to a rate of 30 percent at the inception of the CARAT services in 1999. In addition, more than 50,000 prisoners voluntarily accept the voluntary drug testing exercises due to the quality of therapeutic care provided by the prison system in England and Wales. The Department of Health Care in the UK started drug harm minimizing measures to the prison community since 1993 in order to shift the prison health care services from normal treatment model to a safe lifestyle and health-promotion model. The health Advisory committee of the UK prison system ensures prisoners change their behaviour by providing education and training on the health risks posed by drug abuse (HMPS 2005a). The UK prison system has created democratic therapeutic communities within the prison service and all democratic therapeutic communities must be registered with the Community of communities which is a network of therapeutic communities (Lord President of the Council 1998). The democratic therapeutic communities mainly aim at providing residential and long term care and intervention to offending behaviours of the prisoners. This includes both psychological and emotional support since the prisoners convicted of drug related crimes are expected to spend at least 18 months in the communities in order to learn new skills through regular practice (Lord President of the Council 1998). The therapy is provided in either in a small group setting or communities setting since residents within the therapeutic community are expected to attend the education. Some communities include Dovegate, Grendon and Aylesbury. The communities consist of multi-disciplinary teams that include psychotherapists, probation officers and prison officers. However, retention problems in therapeutic communities often arise due to differing therapist style and inefficiencies of the community therapy providers. In many instances, community therapeutic care entails aftercare component that is continued to a substantial period after the offender parole. The initial stage for the comprehensive treatment may occur in the prison setting which the second stage that will be therapeutic community may happen immediately after the offender is released from the prison. The last stage of the community therapy will entail group therapies, skills training and counseling services in order to enable the ex-offender to successfully integrate back to the society. Community therapeutic care is efficient in reducing the drug abuse problem, but the costs may deter some offenders from completing their therapeutic programme. Through privatization of the prison building and management services, the UK prison system has resulted to more cost effectiveness and better therapeutic care for the prisoners. Premier Custodial Group which is a private prison operator provides excellent correctional facilities that include counseling services and spiritual growth programs. UK Detention services (UKDS) and Group 4 Securicor are some of the several companies that operate local prisons and correctional facilities in Wales. The UK prison system has catered for the long term medical conditions that are common among the drug offender population. Numerous frameworks have been implemented to cater or coronary heart disease, renal conditions and chronic obstructive pulmonary disease. Behavioural habit like smoking, past illegal drug abuse, and excessive drinking increases the risks of risky diseases such as HIV and communicable diseases. In addition, the prison medical staffs are tasked with advocating for healthier lifestyles, smoking cessation and healthy diet in order to minimize the negative effects of drug abuse (Lord President of the Council 1998). Drug abuse among prisoners is responsible for increase in suicides, psychosis and depression. The prison system allows care Programme Approach (CPA) to support mental health treatment while the Offender Mental Health care Pathway provides the guidelines for dealing with drug related mental complications among the prisoners (Pates and Rile, D.M. 2012). According to Prison and Probation Ombudsmen report of 2008, the prisoners with substance abuse history are identified and treated within 72 hours after their admission in the prison facilities. The custody nurses are expected to collect the blood sample of the prisoners and analyse the health status of the prisoners who may be under the influence of substance abuse (Pates and Rile, D.M. 2012). Due to the demographic shifts in the prison population in UK, the high aging number of prisoners has forced the prison authorities to increase the social and health care support services for the older prisoners. Prisoners aged 60 years and above must be assessed for any health care problems and accorded with better accommodation facilities, assistance with medication management and personal hygiene. The Scottish prison service has refurbished the prisons in order to meet the disability requirements and ageing population needs of the prisoners. The prison system also caters for the needs of women and children. For instance, together women is a initiative that provides advice in family issues, education and training on substance misuse. Since the number of children sentenced to custody has tremendously increased, the UK prison system has a Youth justice board that monitors the children services such as families and schools (Pates and Rile, D.M. 2012). According to therapeutic outcomes studies, these therapeutic strategies lead to less risk-taking behaviours, low suicide levels in prisons, reduction in drug dependency and improvement in both the physical and psychological wellbeing of the prisoners (Pates and Rile, D.M. 2012). Conclusion The UK prison system has succeeded in balancing disciplinary strategies and therapeutic strategies when dealing with drugs. The Integrated Drug Treatment System (IDTS) has been implemented in all adult prisons and aim at integrating clinical with psychological treatment through referrel, counseling and methadone detoxification. The system caters for the risks of drug overdose, suicides and self-harm while in the prison facilities. Drug abuse poses great health risk to prisoners and high likelihood of development of lifestyle diseases or even committing suicide. The prison authorities have developed strategies of curbing drug abuse in the prisons and eliminating the dependency on drugs in order to minimize repeat offences. Some programmes include enhanced security and screening in the prison facilities in order to ensure drug-free environment, mandatory drug testing and counseling services. The therapeutic strategies aim at reducing the demand for drugs through investments in drug treatment medical personnel and facilities. The prison system has ensured multi-agency collaboration with social workers and therapeutic communities in order to improve the wellbeing of the drug addicts. The drug abuse services range from education, relapse prevention training, pharmacological treatments, and cognitive-behavioural methods to collaboration with therapeutic communities. The aftercare provided by the CARAT ensures that the drug offenders successfully integrate in to the society after their release thus minimizing repeat offences and relapse to substance abuse. More than 1,000 drug offenders are referred to Drug intervention programmes and evidence shows a decline in offending after completion of the therapeutic programme. Therapeutic drugs management strategies such as intensive cognitive-behavioural training, social support, opium detoxification, and multi-agency collaborations with social workers have reduced the drug-related crimes in UK. References: Dolan, K &Wodak, A. 1996. “An international review of methadone provision in prisons”. Addiction research. Vol 4(1): pp 85-87. Foucault, M. 1977. Discipline and punish: the birth of prison, London: Penguin. Garland, D. 2001. The culture of control: crime and social order in contemporary society, Oxford: Oxford University Press. Gravett, S. 2000. Drugs in Prison: a practitioner’s guide. 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