title: Sentenced to treatment: early experience of drug treatment and testing orders in England.
abstract: Drug Treatment and Testing Orders (DTTOs) were introduced in the 1998 Crime and Disorder Bill and were piloted in three areas in England over the subsequent 18 months. The orders, funded by the Home Office, allow drug using offenders to be coerced into attending for treatment, to have regular urine tests and to be reviewed by the courts. In Croydon an equal partnership was set up between probation, a local statutory provider of drug services and a voluntary sector agency. Treatment plans were individualised and included a variety of treatment options. Forty-eight orders were imposed mainly for persistent shoplifting. Sixty-three percent of individuals had used heroin and 54% crack cocaine in the 30 days before the order was imposed. Ethical issues raised in coerced treatment were important for the individuals providing treatment although the clients all had to consent to treatment. The pilot programme raised issues about the nature of treatment, clinical responsibility, the selection of clients for orders and the objectives of treatment. Frequent urine testing was problematic but in the vast majority of cases clients were not breached just because of positive tests. The provision of DTTOs in an area created unacceptable inequalities in access to treatment. The paper concludes that partnership working and clear objectives are vital for treatment programmes to operate effectively. More research is needed to explore the most optimum way to deliver treatment in the context of a DTTO.
authors.affiliation: National Addiction Centre and South London and Maudsley NHS Trust, London, UK. e.finch@iop.kcl.ac.uk
authors.forename: Emily
authors.initials: E
authors.lastname: Finch
authors.forename: Janet
authors.initials: J
authors.lastname: Brotchie
authors.forename: Karen
authors.initials: K
authors.lastname: Williams
authors.forename: Sue
authors.initials: S
authors.lastname: Ruben
authors.forename: Lorna
authors.initials: L
authors.lastname: Felix
authors.forename: John
authors.initials: J
authors.lastname: Strang
mesh_terms: D000293:Adolescent; D003068:Coercion; D003416:Criminal Law / Q000331:legislation & jurisprudence*; D005260:Female; D006801:Humans; D008297:Male; D008605:Mental Health Services / Q000331:legislation & jurisprudence*; D008875:Middle Aged; D010865:Pilot Projects; D012189:Retrospective Studies; D015813:Substance Abuse Detection / Q000331:legislation & jurisprudence* / Q000379:methods*; D019966:Substance-Related Disorders / Q000175:diagnosis* / Q000628:therapy* / Q000652:urine; D006113:United Kingdom