1. Alternatives to what? Drug treatment sentences as an alternative to prison overcrowding and expansion Alex Stevens

2. Alternatives to what? ISSDP Lisbon 2008 A new alliance for alternative sentencing? Social progressives  Reduce the infliction of pain. Fiscal conservatives  Reduce the cost of the criminal justice system "the continuation of an increasingly costly social control policy which, in terms of effectiveness, possesses few advantages over an apparently much cheaper alternative becomes ever more difficult to justify" (Scull, 1977: 139)

3. Alternatives to what? ISSDP Lisbon 2008 The argument presented here The problem:  Prison expansion and overcrowding The proposed solution  Sentencing drug-related offenders to treatment alternatives instead of prison But:  The alternatives vary widely in context, targeting, treatment content and approach to non-compliance  Net-widening – the use of imprisonment is not reduced, penal supervision intensifies and expands. So, court-ordered treatment as an alternative to what?  The most effective treatment options?  More effective ways of reducing the use of imprisonment?

4. Alternatives to what? ISSDP Lisbon 2008 Prison overcrowding (2005 data) Source: Council of Europe Penal Statistics (SPACE I), * US Bureau of Justice Statistics

5. Alternatives to what? ISSDP Lisbon 2008 Prison expansion

6. Alternatives to what? ISSDP Lisbon 2008 The proposed solution Alternatives to imprisonment  Council of Europe Recommendation R(99)2  “In providing for community sanctions and measures which could be used instead of deprivation of liberty, consideration should be given to the following… treatment orders / contract treatment for specific categories of offenders”  United Nations Standard Minimum Rules for Non- custodial Measures (The Tokyo Rules)  “Member States shall develop non-custodial measures within their legal systems to provide other options, thus reducing the use of imprisonment”

7. Alternatives to what? ISSDP Lisbon 2008 Alternatives within alternatives Context  USA, compared to UK, compared to continental Europe Targeting  Exclusion for drug sellers, violent offenders and those with previous treatment history? Urban Institute survey of 600 drug courts in 2005: –88% excluded offenders with any history of violent offending –49% excluded people with prior treatment history Focus on drug possession offences. –E.g. exclusion of drug dealers from California and other drug courts.

8. Alternatives to what? ISSDP Lisbon 2008 QCT Europe - Crimes leading to QCT sentence

9. Alternatives to what? ISSDP Lisbon 2008 Alternatives within alternatives (continued) Treatment content  12 step Minnesota Model?  Opiate substitution?  Long-term residential, therapeutic community?  Who chooses? Approach to non-compliance  Definition: Any drug taking, non-attendance, or new offending?  Response: Limited to review and resentencing, or graduated sanctions (including imprisonment)? In Baltimore Drug Court, use of imprisonment as a sanction virtually eliminated the difference in the use of imprisonment between the drug court sample and the traditionally sentenced control group (Harrell, 2003).

10. Alternatives to what? ISSDP Lisbon 2008 Net-widening? The idea, taken from Cohen (1985), that creating alternatives does not reduce the ‘size of the catch’ of the penal net, but merely leads to more intensive supervision of a larger number of people. Can be tested with individual programmes (e.g. Harrell, 2003) or at the aggregate level, using data on sentencing and crime patterns for appropriate areas (e.g. countries, states, counties).

11. Alternatives to what? ISSDP Lisbon 2008 Net-widening? England & Wales

12. Alternatives to what? ISSDP Lisbon 2008 Net-widening? England & Wales

13. Alternatives to what? ISSDP Lisbon 2008 Net-widening? England & Wales

14. Alternatives to what? ISSDP Lisbon 2008 Net-widening? USA Nevada New Hampshire Ohio New York

15. Alternatives to what? ISSDP Lisbon 2008 Side effects of alternatives Blocking treatment entry to ‘voluntary clients’.  E.g. reductions in numbers of ‘voluntary’ clients in California after introduction of Proposition 36 (Hser et al 2007). Diversion of cash from ‘voluntary’ treatment  E.g. Federal drug control budget FY2009 – Increase of $27.9 million for drug courts, decrease of $112 million for “other treatment capacity”. Diverts intellectual and political attention from more genuine alternatives.  Reducing time spent in prison  Decriminalisation

16. Alternatives to what? ISSDP Lisbon 2008 The effect of decriminalisation on prison population?

17. Alternatives to what? ISSDP Lisbon 2008 Questions The United Nations has already stated that  “The use of non-custodial measures should be part of the movement towards depenalization and decriminalization instead of interfering with or delaying efforts in that direction” (1990, Tokyo Rules) Are treatment alternatives - in practice - alternatives to more meaningful attempts to reduce the use of imprisonment? What would other data sources suggest on this question? Answers, please, to: a.w.stevens@kent.ac.uk

18. Alternatives to what? ISSDP Lisbon 2008 References Cohen, S. (1985). Visions of Social Control Cambridge: Polity Press Harrell, A. (2003). Judging Drug Courts: Balancing the Evidence. Criminology & Public Policy, 2(2), 207-212. Hser, Y.I., Teruya, C., Brown, A.H., Huang, D., Evans, E., & Anglin, M.D. (2007). Impact of California's Proposition 36 on the drug treatment system: Treatment capacity and displacement. American Journal of Public Health, 97(1), 104-109. Scull, A.T. (1977). Decarceration. Community Treatment and the Deviant: A Radical View Englewood Cliffs, NJ: Prentice-Hall Singh Bhati, A., Roman, J., & Chalfin, A. (2007). Going to Scale in the Treatment of Drug Involved Criminal Offenders Washington DC: The Urban Institute Justice Policy Center

19. The effectiveness of quasi- compulsory treatment in Europe Appendix

20. Alternatives to what? ISSDP Lisbon 2008 QCT alternatives to prison Quasi-compulsory treatment:  Treatment of drug dependent offenders that is motivated or encouraged by the criminal justice system and takes place outside regular prisons. It is quasi-compulsory because offenders can choose not to accept treatment (and so to face the usual punishments for their crimes)

21. Alternatives to what? ISSDP Lisbon 2008 Questions on QCT Does it get more offenders into treatment?  People who are younger than other drug treatment clients?  People who are more prolific offenders than other clients? Is it less effective than ‘voluntary’ treatment?  It does not work because offenders are not motivated to get treatment? Does it damage treatment for volunteers? Does it reduce crime?  for individuals?  for society? Is QCT more cost-effective than imprisonment? Is it an effective alternative to imprisonment?

22. Alternatives to what? ISSDP Lisbon 2008 The QCT Europe study Quantitative interviews at intake and then 6, 12 and 18 month follow-ups  Comparing people who go through QCT (n=428) with others who enter comparable treatment ‘voluntarily’ (n=417) Qualitative interviews with a smaller sample of clients, staff, probation officers, lawyers and judges. Funded by 5 th Framework Research & Development programme

23. Alternatives to what? ISSDP Lisbon 2008 QCT Europe Sample (n=845) UK – 157 Austria – 150 Germany – 153 Switzerland – 85 Italy – 300

24. Alternatives to what? ISSDP Lisbon 2008 At entry to treatment Mean age – 31  QCT does not appear to get younger people into treatment than the people who ‘volunteer’ Offending ( average reported days of offending in previous six months)  69 days for QCT clients.  35 days for ‘volunteers’. Motivation  QCT clients were not less motivated to change than ‘volunteers’

25. Alternatives to what? ISSDP Lisbon 2008 Does QCT get more offenders into treatment? Most (85.3%) QCT clients had previously been in treatment. Some reported that they would not have entered treatment this time without the “push” of QCT. Differences between countries in the type of offender who gets this ‘alternative’ to imprisonment.

26. Alternatives to what? ISSDP Lisbon 2008 Is QCT less effective than ‘voluntary’ treatment?

27. Alternatives to what? ISSDP Lisbon 2008 Does QCT damage treatment for volunteers? Some concern over effects of having reluctant clients in treatment groups.  May damage process of recovery for more motivated clients. Some evidence of increase in QCT provision leading to barriers to treatment entry for other people. But these concerns can be dealt with by improving process:  Carefully planning the induction of QCT clients into treatment.  Increasing capacity of treatment system.

28. Alternatives to what? ISSDP Lisbon 2008 Does QCT reduce crime (for individuals)?

29. Alternatives to what? ISSDP Lisbon 2008 Does QCT reduce crime for societies? These individual level reductions in crime are valuable, but unlikely to lead to major reductions in overall levels of crime.  Small proportions of criminals are caught and convicted.  Peak age for offending is in the teenage years (before the age that people enter QCT).

30. Alternatives to what? ISSDP Lisbon 2008 Cost benefit of QCT UK figures (approximate)  Year in prison = €54,000  QCT treatment (DTTO) = €9,500 Even if QCT is no more effective than prison, it is still more cost-effective Australian drug court more cost-effective than prison (Shanahan et al 2004) ‘Voluntary’ treatment  Consistent findings of cost-effectiveness (Belenko et al 2005)  NTORS cost:benefit ratio of 1:9 (Godfrey et al 2004)

31. Alternatives to what? ISSDP Lisbon 2008 Limitations Sample sizes are relatively small in each country. The sample did not compare QCT clients to prisoners (it was not possible to randomise sentencing). There were large differences between treatment centres in the quality and outcomes of treatment.

32. Alternatives to what? ISSDP Lisbon 2008 QCT as an alternative to imprisonment Our results suggest: 1.QCT does get some people into treatment who would otherwise not be there. 2.These people are not necessarily less motivated to change. 3.QCT is no less (or more) effective in reducing drug use and crime than voluntary treatment.

33. Alternatives to what? ISSDP Lisbon 2008 QCT as an alternative to imprisonment 4.QCT is likely to be less expensive than prison and to save costs of future crimes avoided. 5.More research is needed (including randomised and qualitative studies). 6.QCT can be an effective alternative to prison. When it is a real alternative to prison. When the quality of treatment is high. When coordination between treatment and justice systems is well managed.