Karen Duke - Drugs, Prisons and Policy-Making (2004)

Drugs, Prisons and
Policy-Making
Karen Duke
Drugs, Prisons and Policy-Making
For my father
and
in memory of my mother
Drugs, Prisons and
Policy-Making
Karen Duke
Senior Lecturer in Criminology
Middlesex University
© Karen Duke 2003
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Duke, Karen.
Drugs, prisons and policy-making / Karen Duke.
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Includes bibliographical references and index.
ISBN 0–333–98203–7
1. Prisoners–Drug use–Government policy–Great Britain.
2. Prisoners–Drug use–Great Britain–Prevention. 3. Prison
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Contents
Preface vii
List of Abbreviations xi
1 Analysing Prison Drugs Policy: Problems, Networks

and Contexts 1
Introduction 1
Towards a framework for analysing prison drugs policy 7
Research design and methodology 24
2 1980–6: Prelude to Policy Development 31

Introduction 31
Drugs policy context: the heroin ‘epidemic’ and shifting
political and policy landscapes 32
Penal policy context: containing and managing the ‘crisis’ 39
Nature and extent of the drugs ‘problem’ in prisons 42
Dealing with drug users in prisons 46
Conclusion 54
3 1986–93: The HIV/AIDS Crisis and Fears of

Contamination 56
Introduction 56
Drugs policy context: the discourses of ‘harm
minimisation’, ‘public health’ and ‘partnership’ 57
Penal policy context: key attempts at reform 1986–93 63
The end of the denial: reconceptualising the drugs
‘problem’ in prisons 67
The response to the drugs ‘problem’ in prisons 75
Conclusion 87
4 1993–7: Coming Clean and Taking Control? 89

Introduction 89
Drugs policy context: Tackling Drugs Together 90
Penal policy context: the post-Woolf era 95
A threat to order, control and discipline: reconceptualising
the drugs ‘problem’ in prisons 98
Response to the ‘problem’: the 1995 prison drugs strategy 103
The role of the policy network 110
v
vi Contents
The question of ‘balance’ in the 1995 prison drugs

strategy 118
Conclusion 122
5 1997– : Eradication to Realism? 124

Introduction 124
Drugs policy context: ‘breaking the vicious circle’ 126
Penal policy context: ‘tough on crime, tough on the
causes of crime’? 130
Review of the 1995 prison drugs strategy 134
Response to the ‘problem’: the 1998 prison drugs strategy 137
Impact and influence of prison drugs policy 146
Conclusion 149
6 Conclusions: Shifting Agendas and Policy Networks 151

Activating and resisting agendas 151
Future agendas and policy networks 163
Appendix 168
References 172
Index 194
Preface
In her analysis of imprisonment around the world, the prominent

penal reformer, Vivien Stern, has argued, ‘it is impossible to talk about
crime, prisons and prisoners without coming to the question of drugs’
(Stern, 1998: 121). In Britain, the current government has become
obsessed with what they perceive to be a direct link between drugs and
crime. Millions of pounds have been committed to its fight against
drug-related offending. The aim is to provide interventions at each
stage of the criminal justice process – arrest, bail, sentencing, imprison-
ment, and community supervision (see Home Office, 2001). However,
this emphasis on the interconnections between drugs, crime and pun-
ishment has not always been so pronounced, particularly in terms of
the discourses and policies around drugs and prisons. This book traces
the history of the development of prisons drugs policy in England
since 1980 and exposes the processes by which the drugs ‘problem’
shifted from being a concealed and relatively invisible issue to one
which occupies an important and significant place on the penal policy
agenda.
When I first became interested in the interface between drugs and
prisons in the mid-1990s what struck me was the paucity of research in
this area and also the lack of attention paid to policy development and
the key actors involved in these processes. Drugs and prisons are polit-
ically sensitive research areas, and for many years access to conduct
research on these topics was virtually denied (Pearson, 1990). As the
drug ‘problem’ in prisons was acknowledged and more explicit policies
began to develop, the focus of much research was on the prevalence of
drug taking before, during and after imprisonment; the extent and
nature of HIV risk behaviour; the results of mandatory drug testing and
the monitoring and evaluation of various strands of policy. Within this
context, there was clearly a need for the research gaze to capture those
who are in the powerful positions of ‘making’ and influencing policy
in order to understand the conflicts, contradictions, uncertainties and
politics inherent in the policy process. This study was therefore based
on semi-structured interviews with key policy actors, including civil
servants and representatives from drug agencies, penal reform groups,
and professional associations, and an analysis of documentary materi-
als. In particular, it examines the activities of policy networks around
vii
viii Preface
drug issues in prisons and their involvement in agenda setting, lobby-

ing and influencing the policy process within the wider political, eco-
nomic and social contexts.
The book is based on the construction of a series of four case studies
which correspond to the key phases in prison drugs policy develop-
ment since 1980: 1980–6; 1986–93; 1993–7; and 1997 onwards. It
explores the policies around drug treatment and throughcare,
HIV/AIDS, supply reduction activities, and security and control mea-
sures. The development of policy has hinged upon complex patterns of
conflict, contradiction and convergence between treatment and pun-
ishment. Throughout the phases, particular policy networks have
evolved around drug-related issues within the penal system, expanding
and becoming more complex in their structure and operation over
time. They have attempted to contain, balance and negotiate the con-
tradictions and tensions within policies. The book seeks to explore the
different forms this ‘balancing act’ or ‘containment’ has taken and
examine how it has been shaped by the following processes or forces:
the way in which the drug problem has been framed and defined; the
role of research, evidence and knowledge; and the impact of wider
social, political, policy and institutional contexts.
Chapter 1 begins by exploring the statistical indicators of drugs use
and offending within the prison population. It outlines the intercon-
nected themes which will run through the book, including the role of
the policy network, the shifting conceptualisations of the drugs
‘problem’, the role of research and evidence, and the impact of wider
contexts. The chapter also explains the research design and method-
ological framework employed in the study.
Drawing on documentary and interview data, Chapters 2 to 5 form
the core of the analysis. Chapter 2 considers the period from 1980 to
1986 and examines the initial collusion around drugs within prisons. It
explores how a small policy network began to emerge which lobbied
for changes in the way prisoners with drug problems were treated.
Given the constraints of the prison context during this period, it is
argued that the policy network adopted a pragmatic approach by press-
ing for service provision on release, rather than tackling the problem
internally from within the prison environment. This phase laid the
foundations for later policy developments. Chapter 3 focuses on the
period 1986–93 and explores the impact of HIV on the development of
a more explicit drug policy within the prison system. However, it
argues that the policies which emerged were inadequate and failed to
fully embrace the concept of ‘harm minimisation’ and the public
Preface ix
health agenda which were successfully operating in the community.

Such initiatives were constrained by the unwillingness of the Prison
Service to consider radical policies, the inherent conflict between treat-
ment and punishment, and the pressure to adopt a hard-line,
abstinence-based approach. Chapter 4 considers the period from 1993
to 1997 and explores how the populist punitive rhetoric around drugs
and prisons and the new managerialism impacted upon policy devel-
opment. It demonstrates how the drugs issue in prison was increas-
ingly framed as a problem of order and control. The response in both
political and policy terms was to ‘get tough’ and take control of the
problem by implementing a defined prison drugs strategy in 1995
which emphasised mandatory drug testing and security measures. As
the contradictions and tensions between treatment and punishment
intensified, the chapter explores how a policy network began to form
which attempted to re-balance the strategy towards treatment and care.
The focus of Chapter 5 is on the revised 1998 prison drugs strategy and
the key changes which have occurred since New Labour’s victory in the
1997 general election. Although these reforms mark an attempt to
rebalance the strategy towards care and treatment for prisoners, it is
argued that the basic punitive framework for delivering the strategy
has remained intact and the emphasis on the discourses of ‘security’,
‘control’ and ‘punishment’ has endured. Moreover, in the process of
attempting to rebalance the new strategy towards treatment, the policy
network around prison drug issues has been reshaped with drug agen-
cies entering into more formalised, contractual partnerships with the
Prison Service.
The book concludes in Chapter 6 by reconsidering and summarising
the developments within prison drugs policy from 1980 in relation to
the key research questions, themes and debates outlined in Chapter 1.
It then discusses the significance of the research findings for the future
development of prison drugs policy and the activities of policy net-
works. In particular, it focuses on the growing incorporation of a core
part of the policy networks, namely the drug agencies, and questions
whether these processes are inevitable.
****
I am indebted to many people for their guidance and assistance with

this book. I would like to thank all of the people who were interviewed
x Preface
during this research. They must remain nameless as I promised to

protect their anonymity, but I would like to express my gratitude to
them for being so generous with their time and sharing their experi-
ences, knowledge and contacts with me.
My colleagues and students at Middlesex University have been sup-
portive and helpful in developing ideas. I have benefited considerably
from the constructive comments, guidance and inspiration of Susanne
MacGregor. I am very grateful to Sarah Neal for reading the various
versions of the chapters and for her valuable suggestions, support and
friendship throughout the research and writing process. Thanks also to
Nigel South, Betsy Thom and Tony Cutler for their comments and
encouragement to publish. I am grateful to Heather Gibson, Briar
Towers and Jennifer Nelson of Palgrave for their editorial support.
Thanks are also reserved for the library staff at Middlesex University
Library (Enfield), Senate House, University of London Library, the
Home Office Library, and the Institute for the Study of Drug
Dependence (now Drugscope) for their expertise and help in locating
and ordering references. I am grateful to the Prison Service, the Home
Office and the UK Anti-Drugs Co-ordination Unit for responding to my
requests for documents and other information. The Tables which
appear in the Appendix are reproduced with the kind permission of the
Home Office.
Finally, this book would not have been attempted or completed
without the ongoing support and encouragement from my parents,
Donna and Claude Duke, and my brother, Scott Duke. I am also grate-
ful to my friend, Lorna Klose for all her supportive emails and sharing
her experiences of writing with me. My greatest thanks go to Hugh
Giles, who lived through the process with patience and understanding,
commented on the various drafts and provided useful advice at each
stage. Very special thanks are reserved for Scott Duke-Giles, who
appeared during the writing phase and provided a wonderful distrac-
tion. Without them, the project would never have been undertaken or
finished.
Karen Duke
Middlesex University
November 2002
List of Abbreviations
ACMD Advisory Council on the Misuse of Drugs

ACPO Association of Chief Officers of Police
ACOP Association of Chief Officers of Probation
ADFAM The national charity for the families and friends of drug
users
ADSS Association of Directors of Social Services
AIDS Acquired Immune Deficiency Syndrome
CARAT(s) Counselling, Assessment, Referral, Advice, and
Throughcare Service
CCTV Closed circuit television
CDCU Central Drugs Co-ordination Unit
CDPU Central Drugs Prevention Unit
CFI Central Funding Initiative
DARI Drug Addiction Research Initiative
DAT Drug Action Team
DDAC District Drug Advisory Committee
DHA District Health Authority
DH Department of Health
DPAS Drugs Prevention and Advisory Service
DPI Drugs Prevention Initiative
DRG Drug Reference Group
DTTO Drug Treatment and Testing Order
EMCDDA European Monitoring Centre for Drugs and Drug
Addiction
GP General Practitioner
HIV Human Immunodeficiency Virus
HMP HM Prison
ISDD Institute for the Study of Drug Dependence
KPI Key performance indicator
LGDF Local Government Drugs Forum
LDPF London Drug Policy Forum
MDT Mandatory drug testing
NACRO National Association for the Care and Resettlement of
Offenders
NAPO National Association of Probation Officers
NHS National Health Service
xi
xii List of Abbreviations
PGA Prison Governors’ Association

POA Prison Officers’ Association
PRS Parole Release Scheme
PRT Prison Reform Trust
RAP Radical Alternatives to Prison
RAPt Rehabilitation for Addicted Prisoners Trust
SCODA Standing Conference on Drug Abuse
TDT Tackling Drugs Together
UKADCU UK Anti-Drugs Co-ordination Unit
VIR Viral Infectivity Restrictions
VTU Voluntary Testing Unit
WHO World Health Organisation
WIP Women in Prison
1
Analysing Prison Drugs Policy:
Problems, Networks and Contexts
Introduction
The drug issue in prisons is a global phenomenon and has become a

policy concern in many countries. There are several groups which can
be identified in relation to drugs within the prison population: those
who are imprisoned for drug offences and who may also be drug users;
those who are imprisoned for non-drug offences, but who are drug
users; and those who begin using drugs during their prison sentences.
The proportion of prisoners serving sentences for drug offences has
increased dramatically over the last two decades. Reflecting the ‘war on
drugs’ and introduction of mandatory minimum sentences for minor
drug offences, the percentage of the federal prison population in the
United States serving sentences for drug offences has more than
doubled over the last 20 years from 25 per cent in 1980 to 55 per cent
in 2001 (Federal Bureau of Prisons, 2002). In England and Wales, the
percentage of male prisoners serving sentences for drug offences
increased from 2 per cent in 1980 to 15 per cent in 2000. The percent-
age of women prisoners serving sentences for drug offences has
increased even more sharply from 5 per cent in 1980 to almost two-
fifths (37 per cent) in 2000 (Home Office Prison Statistics, 2001). One
factor which helps to explain this rise is the increasing number of
foreign national women convicted of drug-trafficking offences (see
Green, 1996).
In comparison with the general population, there are high rates of
drug use and drug dependence amongst prisoners both prior to impris-
onment and during their sentences. In the US, over half of all prisoners
(56 per cent) were found to have a diagnosable drug use disorder
(Robins and Reiger, 1991). In the European Union, problem drug users
1
2 Drugs, Prisons and Policy-Making
and/or injecting drug users represent up to 50 per cent of the prison

population in some countries (European Monitoring Centre for Drugs
and Drug Addiction, 2001). In England and Wales, over half of male
(51 per cent) and female (54 per cent) remand prisoners were assessed
as drug dependent. Although cannabis is the most frequently used
drug both inside and outside prisons in England and Wales, one-fifth
of male sentenced prisoners (19 per cent) and female sentenced prison-
ers (20 per cent) had used heroin in prisons, with women being more
likely to report opiate dependence than men (Singleton et al., 1999).
More than one-third (36 per cent) of male sentenced prisoners and
one-fifth (18 per cent) of female sentenced prisoners who had used
heroin reported their first use of the drug in prison (Singleton et al.,
1999).
Patterns of drug use vary between the different groups within the
prison system, but a typical profile of a drug user in a European prison
would include the following characteristics: very socially deprived;
poly-drug use; previous prison sentences; several treatment attempts;
high incidence of relapse; and severe health damage (including irre-
versible infectious diseases) (see EMCDDA, 2001). Due to the secrecy
surrounding drug use within prisons and the reluctance of prison
authorities to fully embrace harm reduction principles, prisons are also
the setting for high-risk behaviours such as unsafe injecting practices
(Strang et al., 1998). Drugs are in great demand within the prison envi-
ronment due to the number of existing drug users and also because
they provide a means of escaping from the deprivations of prison life.
In Britain, official interest in drug issues within the penal system is
relatively recent, with formal policy only beginning to develop from
the mid-1990s. The prison system was included in national drugs
policy for the first time in 1995. The increasing interface between drugs
and penal policy has prompted interest in this area from various per-
spectives including the Prison Service in its strategies to combat drugs
in prisons (HM Prison Service 1995a; 1998b), the former Conservative
and current Labour governments in their national drugs strategies (HM
Government, 1995; 1998a); the Department of Health in their review
of services for drug users (Department of Health, 1996); the Home
Affairs Select Committee (1999) and the Advisory Council on the
Misuse of Drugs (1996) in their reports on drugs and prisons; various
voluntary agencies working with prisoners and drug users; and the
media. Increasing amounts of government expenditure have also been
directed at the prison drugs ‘problem’. For example, during 1996–7,
£4.2 million was made available to cover the costs of implementing
Analysing Prison Drugs Policy 3
mandatory drug testing. For the three years commencing 1999/2000,

the Prison Service received an additional £76 million to fund a new
framework for drug treatment within the prison system (DPAS, 1999).
Despite the increasing interest in the relationship between drugs and
prisons, this area has attracted very little research attention. This
neglect is related to the difficulties around gaining access to conduct
research on this sensitive topic within prisons. Until the early 1990s,
politicians, government officials and prison governors were reluctant
to publicly acknowledge that there was a drugs ‘problem’ or even that
drugs were being used within the prison system. The research which
was eventually conducted in this area was focused mainly on the
nature and extent of drug use amongst prison populations (see Maden
et al., 1990; 1991; 1992) and their patterns of drug use and HIV risk
behaviour (see Dolan et al., 1990; Dye and Issacs, 1991; Turnbull et al.,
1991; 1994; Bird et al., 1992; 1993; Strang et al., 1998). These studies
have highlighted the extent of drug use prior to and during imprison-
ment, the problems and risks associated with continued use and the
lack of treatment services within the prison system.
With the implementation of the 1995 and 1998 prison drug strate-
gies in England and Wales and the more open acknowledgement of a
drug ‘problem’ within prisons, there now appears to be greater willing-
ness to allow researchers to undertake research and evaluations in this
area. The Prison Service commissioned its own evaluation research to
examine the effectiveness of the strategies (see Edgar and O’Donnell,
1998; Farrell et al., 1998; PDM Consulting Ltd, 1998). Other studies
exploring the impact of particular aspects of the policy in individual
prisons (see Seddon, 1996; Gore et al., 1996; Keene, 1997a; Bird et al.,
1997; Hughes, 2000) and the experiences of women drug users in
prisons have been conducted (Malloch, 2000). Although some of the
studies have been policy related and provided some critique of the
evolving strategy, they have not focused on the dynamics of the policy
process itself. This lack of research highlighted the need to trace the
contemporary origins of the ‘problem’ of drugs in prison and to
explore the processes involved in the development of policy.
Policies and initiatives must be viewed as not just a reaction to the
current situation, but as historically and culturally framed. One impor-
tant theme emerging from both analyses of drugs policy and penal
policy is the complex relationship between medical and penal forms of
control. There has been a long history of debate regarding the locus of
responsibility for the social control of drugs. British scholars have gen-
erally concluded that policy has been shaped by an accommodation
between medical and criminal justice concerns (see Berridge, 1978;

Smart, 1984; Stimson and Oppenheimer, 1982; Pearson, 1991; Dorn
and South, 1994). As Smart (1984: 31) has argued, ‘the drug user is in
the unique, although unenviable position of occupying the locus of
attention of several different modes of regulation; legal, moral and
medical. Whilst these analytically distinct modes overlap in their con-
centration on the drug user, they are also frequently in conflict’. The
conflicts between these forms of control manifest themselves within
the values and ideologies of practitioners and professionals, in the deci-
sions regarding policy options and also at a structural or institutional
level where there has been historical tension between the key govern-
ment departments (i.e. the Home Office and Department of Health).
Analyses of drugs policy indicate a balancing act between medical and
penal forms of control or between treatment and punishment. This
balance has changed over time and is influenced by the nature of
addiction or the drugs ‘problem’ as well as the social, political and
institutional contexts. Within policy there is an enduring tension
between ‘whether the addict is to be termed sick and a fit subject for
medicine, or bad, and a subject for penal control’ (Berridge, 1996b:
302).
Similarly, the competing paradigms or discourses of ‘rehabilitation’
and ‘welfare’ versus ‘punishment’ and ‘justice’ are important compo-
nents of penal policy development. Several analyses have illuminated
these tensions and the problems of containing and managing these
contradictions (see Garland, 1985; 2001; Cohen, 1985; Adler and
Longhurst, 1994). However, other observers of contemporary policy
argue that a ‘new penology’ has emerged which involves a shift away
from the individual towards the aggregate (Feeley and Simon, 1992;
1994). Its goals are managerial rather than transformative. The new
penology is not concerned with rehabilitation, treatment, interven-
tions or even punishment for the individual offender, rather it empha-
sises managerial processes and ‘techniques to identify, classify and
manage groupings sorted by dangerousness’ (Feeley and Simon, 1992:
452). Interestingly, Feeley and Simon (1992) argue that drug use has
become a major feature of the contemporary penal landscape and the
new penology. Drug use is treated as a risk indicator for re-offending
and employed as a criterion to classify offenders. The new initiatives
around drugs are often represented in the language of the old penology
with its focus on individuals, reform and rehabilitation; however, in
practice greater emphasis is placed upon drug testing than drug treat-
ment. In effect, testing fills the gap left by the decline of other treat-
ments, interventions and programmes. As Feeley and Simon (1992:

462) argue, ‘by marking the distribution of risk within the offender
population under surveillance, testing makes possible greater coordina-
tion of scarce penal resources.’
The tensions and contradictions between medical and penal forms of
control manifest themselves in their most acute form where drugs and
prisons interface or within the development of prison drugs policy. For
example, Berridge (1999: 274) notes that the prison doctors who gave evi-
dence to the Rolleston Committee in the 1920s adopted a much harsher
approach to dealing with drug addicts in prisons compared to their col-
leagues in the community by subjecting their patients to abrupt with-
drawal rather than maintenance prescribing. At the end of the 1980s,
MacGregor (1989b: 199) points to the lack of attention paid to the prison
system in drugs policy and service development, arguing that ‘this
neglect is the real hidden scandal of the 1980s’. By the mid-1990s, the
prison system was becoming much more of a focus in drugs policy discus-
sions. For example, in relation to the 1995 prison drugs strategy, Berridge
(1996b: 304) highlights the growing convergence between medical and
penal responses: ‘the penal aspect of the health response as well as the
health aspects of the penal approach are once more on the agenda.’
This book presents a case study of the development of prison drugs
policy in England from 1980, involving documentary analysis and
interviews with key policy players including civil servants, directors of
drug agencies and penal reform groups, and spokespersons from pro-
fessional associations. It explores policy development through the
prism of the ‘policy network’. The policy network approach has
become one of the dominant approaches to studying policy-making
(Dowding, 1995), but has rarely been applied in analyses of drugs and
penal policy. In relation to prison drugs policy, important questions
which needed to be addressed were: why did policy begin to develop,
why did it develop in a particular way, who was involved in this devel-
opment, and how did they shape policy outcomes?
Since the early 1990s, drug issues in prison have become increasingly
important in drugs and penal policy debates leading to the develop-
ment of very explicit policies in 1995. Since 1980, prison drugs policy
can be divided into four main phases of development: 1980–6;
1986–93; 1993–7; and 1997 onwards. A central contention of this book
is that this policy development has hinged upon the complex patterns
of conflict, contradiction and convergence between treatment and
punishment. Throughout the phases, particular ‘policy networks’ have
evolved around drug issues within the prison system, becoming more
complex in their structure and operation over time. It will be argued

that these networks have played key roles in containing, balancing and
managing the contradiction between treatment and punishment and
that their activities have been influenced by (a) how the drug problem
in prison has been framed and defined; (b) research, evidence and
knowledge; and (c) wider contextual features. This research therefore
aims to address the following questions which are interlinked:
How influential have the policy networks around drug issues in prison
been in the development of policy? When have they been most
influential and why?
How have these networks attempted to contain the contradiction
between treatment and punishment in policy development?
How has this ‘containment’ been shaped by changes in the way in
which the drug problem has been framed and defined, new research,
evidence and forms of knowledge, and the impact of wider political,
policy, social and institutional contexts?
I am using the term ‘treatment’ to cover a wide range of therapeutic

activities which involve ‘caring’ for drug users such as detoxification,
maintenance prescribing, harm reduction measures, drug-free wings,
drugs counselling, throughcare and aftercare services, and practical
help and advice. The term ‘punishment’ refers to those activities which
involve ‘punishing’ or ‘controlling’ drug users such as mandatory drug
testing and the associated sanctions, and security measures including
cell and body searches, CCTVs, use of sniffer dogs, intelligence gather-
ing, and targeting visitors. However, it is important to note that
‘caring’ and ‘controlling’ measures often converge. Control and pun-
ishment can also be viewed as methods of ‘caring’ for prisoners. For
example, creating a drug-free prison environment can be viewed as
caring for prisoners. Similarly, care and treatment measures can be
viewed as methods of ‘controlling’ and ‘punishing’ prisoners. Examples
include the practices of abrupt withdrawal, coerced treatment, and
withdrawing privileges for positive drug tests.
The next sections will outline the main features which will underpin
the analysis which follows in Chapters 2, 3, 4 and 5. A number of
themes and concepts will be explored: dimensions of policy and policy
analysis; the role of the policy network and the institutional context of
policy development; the framing of the drug issue in prison; the rela-
tionship between research and policy; and the impact of shifts in wider
contexts and related policy subsystems.
Towards a framework for analysing prison drugs policy
Key dimensions of policy

There is a lack of consensus as to what constitutes ‘policy’ and how the
term should be defined. Hill and Bramley (1986) suggest that policy
should not be treated as a self-evident, concrete or constant phenome-
non. They argue that any attempt to define policy will be artificial in
that what we are trying to define is contested. Similarly, Gordon et al.
(1993: 8) suggest it is misleading to view policy analysis as the study of
‘identifiable things called policies which are produced, or crystallise, at
a particular stage in the decision process’. Thus, policy should be con-
ceived of in more fluid and dynamic terms. It is helpful nevertheless to
place at least some loose parameters around the term and outline some
of its key dimensions. Jenkins (1978: 15) offers one of the most useful
working definitions of public policy:
A set of interrelated decisions taken by a political actor or group of

actors concerning the selection of goals and the means of achieving
them within a specified situation where these decisions should, in
principle, be within the power of these actors to achieve.
This definition has a number of strengths encapsulating several key

dimensions of policy (Hill and Bramley, 1986). It emphasises that
policy is more than a single decision, but involves a series or pattern of
decisions extending over time. So, rather than focusing on one particu-
lar shift in prison drugs policy, I have adopted a more longitudinal
approach by exploring a series of policy decisions extending over a
period of nearly two decades. The term ‘political actors’ could be
expanded to include officials, politicians and other policy influencers.
This is important in the analysis of prison drugs policy because several
groups have been engaged in decision-making. The definition stresses
that both means and ends are involved in policy. The means by which
the drugs policy was pursued were, arguably, of equal significance to
the end result of the policy. The definition emphasises that policies are
contingent in that they refer to or depend on a specified situation.
Prison drugs policy has been shaped by a wider political, social, institu-
tional and policy context. Policy is restricted to that which can be
achieved or those ‘matters over which the state has authority, and to
actions/results which are practically feasible’ (Hill and Bramley, 1986:
3). Decisions taken in relation to the development of prison drugs
policy have been restricted to what can be feasibly or practically
achieved within the authority of the state. However, in the arena of

penal policy the exercise of state power is often pushed to its limit. An
indication of this is the number of successful challenges that there
have been to various aspects of prisons policy before the European
Court of Human Rights.
Another important feature of the definition is that it also allows for
the possibility for inaction or the decision not to move (Jenkins, 1978).
Policies can therefore refer to what is not being done (Heclo, 1972).
The absence of policy is also defined as a ‘policy’. In a similar vein,
policies can serve symbolic purposes. They are often created only to
give the impression that action is being taken by government in order
to maintain political support, but leaving the particular problem
untackled (see Edelman, 1964; 1971; 1988). In many cases there can be
barriers to some policy issues or problems becoming public. Therefore,
political activity may be mainly concerned with maintaining the status
quo and resisting challenges to the existing circumstances (Ham and
Hill, 1993). As we will see in later chapters, this was the case with the
drug issue in prisons for many years. There was no official admission
that drugs were a ‘problem’ in the penal setting which meant that the
issue was not being addressed by formal policy. A public acknowledge-
ment that drugs were problematic would have been a tacit admission
of the failure or non-existence of policy.
Policy analysis
Wildavsky (1979: 15) emphasises the ‘art’ and ‘craft’ of policy analysis
which involves imagination, thought and creativity. A range of activi-
ties are involved in analysing policy. Hogwood and Gunn (1984) iden-
tify several approaches to policy analysis including studies of policy
content, policy process, policy outputs, evaluation studies, information
for policy-making, process advocacy, and policy advocacy. My analysis
best fits into their category of studies of the policy process which are
concerned with exploring the various influences on the development
of a policy issue and how this development unfolds over time.
However, it can also be classified as a study of policy content in that I
seek to describe and explain the origins, changes and developments
within prison drugs policy.
It is difficult to locate policy analysis within existing disciplinary cat-
egories. It is a field which is composed of various models, theories and
disciplines. Analysts of public policy often find it useful to adopt an
open and multidisciplinary approach to their subject which draws on
several different disciplines. For example, Ham and Hill (1993: 11)
argue that policy analysis must be a multidisciplinary pursuit and its

purpose is ‘to draw on ideas from a range of disciplines in order to
interpret the causes and consequences of government action, in partic-
ular by focusing on the processes of policy formulation’. Similarly,
Hogwood and Gunn (1984: 30) stress that policy analysis must develop
‘an integrated, or interdisciplinary approach, which will combine in a
synergistic manner elements from many disciplines’. It became clear
during the course of my research that an analysis of drugs policy devel-
opment in prisons failed to fit neatly into any one disciplinary cate-
gory. The ‘problem’ of drugs in prison has several dimensions. It can be
viewed as a drug issue, penal issue, legal issue, public health issue,
medical issue, community issue, crime issue, political issue, economic
issue and so on. It follows that the subject of prison drugs policy can
be viewed through a variety of different disciplinary lenses including
criminology, sociology, law, political science, public administration,
history, medicine, and so on. In my analysis, I have therefore found it
useful to adopt a multidisciplinary approach which draws on the ideas,
theories, concepts and research from a variety of social science disci-
plines including social policy, criminology, sociology, political science
and public administration. The literature from the area of ‘policy
studies’ or ‘policy sciences’ provides a useful overarching theoretical
and conceptual framework for this study.
Policy networks
Analysing policy networks has become one of the dominant
approaches to studying policy-making in the UK, Europe and North
America (Dowding, 1995). Various case studies have demonstrated the
relevance and utility of the ‘policy network’ concept in describing the
policy process in different sectors (see Marsh and Rhodes, 1992; Wilks
and Wright, 1987; Smith, 1993; Berridge, 1996a; 1997; Thom, 1999;
Ryan et al., 2001). Policy network approaches emphasise the interac-
tion and patterns of association between various actors in particular
policy areas. The type of relationships that form between civil servants,
politicians, group representatives and others are seen to shape policy
outcomes and explain policy change. Rhodes and Marsh (1992a) char-
acterise policy networks as meso level concepts which provide the link
between the micro level of analysis dealing with the role of interests
and the macro level of analysis dealing with the distribution of power
within society. Policy networks both influence the policy process and
reflect the relative status and power of the various interests in particu-
lar areas of policy (Rhodes and Marsh, 1992a).
Policy networks have been conceptualised in a variety of ways (see

Rhodes and Marsh, 1992b; Sabatier, 1988; Hajer, 1993; Wilks, 1995).
Wilks and Wright (1987) offer a model which stresses the need to dis-
aggregate to subsectoral networks and places emphasis on interper-
sonal relationships. They draw distinctions between ‘policy universe’,
‘policy community’ and ‘policy network’. The policy universe refers to
the large population of actors or potential actors who share a direct or
indirect interest in policy and may contribute to the policy process on
a regular basis. Under their typology, policy communities are more disag-
gregated systems of actors drawn from the policy universe who share a
common interest in a particular policy area and interact with one
another to shape policy. The policy network is the linking process or the
outcome of the interaction within a policy community or between a
number of policy communities over particular policy issues, problems
or functions (e.g. budgeting, auditing, or planning). In effect, policy
issues, problems and functions provide the occasion for a policy
network.
Wilks and Wright (1987) argue that their model, which treats the
concepts of ‘community’ and ‘network’ as separate, has several advan-
tages. First, policy subsystems always generate policy communities but
these do not always generate networks. Second, it recognises that the
members of a policy network can be brought in from different policy
communities within the same or different policy areas. Third, it
enables researchers to identify those members of a policy community
who are excluded from a policy network. Finally, their model also
stresses that all policy issues in a subsector are not necessarily dealt
with by one network, thus allowing comparison of membership, func-
tion, and characteristics of networks whose membership is drawn from
the same policy community (Wilks and Wright, 1987; Wright, 1996).
Policy networks at the sectoral level often play a role in shaping the
membership, values and outcomes of subsectoral policy networks
(Cavanagh et al., 1995). In relation to drugs policy during the 1980s
and 1990s, Berridge (1996a; 1997) identifies a drugs policy community
consisting of revisionist doctors, researchers, drug agencies and civil
servants. Similarly, Wilson (2001) examines the activities of key players
in the penal reform community. Drawing on the model offered by
Wilks and Wright (1987) emphasising the subsectoral level, I am con-
cerned with intersection between drugs and penal policy and their
respective policy communities, the emergence of policy networks
around prison drug issues and how these have changed and evolved
over the various phases of policy development from 1980. Over time,
policy networks have interacted over several different issues such as

release and throughcare, drug treatment and detoxification, HIV/AIDS
and harm reduction, security and control issues, and mandatory drug
testing (see Table 1.1).
Although the network approach has been widely applied, it has been
subject to various critiques (see Atkinson and Coleman, 1992; Kassim,
1994; Dowding, 1995; Blom-Hansen, 1997). In particular, the network
approach fails to provide an account of why relationships form and
change between the various actors and how power is exercised. It also
fails to provide an adequate account of the role of the state and institu-
tions and the impact of political discourse, ideology and cognitive
frameworks of network members (Atkinson and Coleman, 1992;
Kassim, 1994). There is often no clear indication of boundaries delin-
eating where networks begin and end or who is excluded and included
(Kassim, 1994). Most analyses of networks have tended to focus on
whole policy sectors, thus neglecting the subsectoral level of policy.
Moreover, issues tend to overlap with other issues and interact with
policy solutions. They tend not to remain within one policy network,
but often intersect with the interests and concerns of other networks.
Because policy networks change over time, Wilks (1995) has outlined
the need to provide more dynamic, longitudinal analyses, rather than
snapshot analyses of one particular period.
Atkinson and Coleman (1992) argue that two key questions should
be asked in relation to policy networks, namely, who participates and
who wields power? My analysis is concerned with the changing mem-
bership of policy networks around drug issues in prison. During the
course of policy development, key roles have been played by drug
Table 1.1: Policy communities and policy networks (the Wilks and
Wright (1987) typology adapted to prison drugs policy)
Policy level Policy actors
Policy area Health,Criminal Justice Policy universe

Policy sector Drugs, Prisons Policy communities
Policy subsector Prison drugs policy
(focus)
Policy issue e.g. Throughcare Policy networks
Treatment
HIV/AIDS
Security/control
Mandatory drug testing
agencies, penal reform groups, professional associations, the Prison

Medical Service, researchers and government departments. The
Advisory Council on the Misuse of Drugs (ACMD) has produced two
reports dealing with the prison system (ACMD, 1980; 1996). It has
been influential in shaping policy outcomes, but also in the develop-
ment of services and practice. Policy network analyses indicate that
some members or organisations will be located at the ‘core’ of the
policy system while others will occupy a position on the margins or
‘periphery’ (see Coleman and Skogstad, 1990; Marsh and Rhodes, 1992;
Smith, 1993). The analysis will therefore focus on which organisations
and individuals are included or excluded in the networks, which
members gain access to the ‘core’ or remain on the ‘periphery’, who
has the power to influence and shape policy and practice and how
these positions have altered over time.
Network approaches offer only a partial explanation of policy shifts
and variation. There is a need to explore how interests, ideas, dis-
courses, institutions and social, economic and political contexts inter-
act and influence how networks operate over time. Several scholars
have attempted to bridge some of the gap between network approaches
and institutional arguments (see Skocpol, 1985; 1992; Smith, 1993;
Pierson, 1994; Blom-Hansen, 1997) and this work provides a starting
point in addressing some of the criticisms of the network approach dis-
cussed above. For example, Smith (1993: 2) argues that the impact of
groups depends on the interests of state actors and the types of rela-
tionships between groups and the state – policy networks – which exist
in specific policy areas. Similarly, the ‘new institutionalists’ assert that
institutions and patterns of governance matter by setting the parame-
ters for action and establishing the rules of the game, by shaping group
identities, goals, and choices and by enhancing the bargaining power
of some groups while devaluing others (Skocpol, 1992; Pierson, 1994).
Skocpol (1992) has cogently argued that politicians and civil servants
are actors in their own right who are enabled and constrained by polit-
ical organisations and possess the ability to make independent contri-
butions to policy development. This capacity of the state to act
autonomously is dependent on the fiscal, judicial, and administrative
capacities (Weir and Skocpol, 1985). However, it is often the case that
governments need groups to develop and implement policy so they
‘exchange access to the policy process for co-operation and thus estab-
lish a policy network’ (Smith, 1993: 59). Policy networks are therefore a
means of increasing state autonomy. Smith (1993: 6) describes the rec-
iprocal relationship between the state and groups in the following
terms: ‘group power depends on state recognition and state power

depends on the support of groups’.
Drawing on the work of the ‘new institutionalists’, this research is
concerned with the impact of institutions, structures and state actors
in the development of policy networks and prison drugs policy. The
key state agencies or institutions involved in this area have changed or
been reorganised over time and include the Prison Service, the Home
Office, the Central Drugs Co-ordination Unit (1995–8), the UK Anti-
Drugs Co-ordination Unit (1998–2001) and the Home Office Drugs
Strategy Directorate (from 2001). The degree of state autonomy will
also be explored by examining the discourses, interests, activities and
influence of state actors – politicians and civil servants – over time.
However, this is not to suggest that the state has a set of unified inter-
ests: policy may be the outcome of conflict between state agencies
(Smith, 1993). The institutional contexts of other groups participating
in the policy networks such as drug agencies, penal reform groups and
professional associations are also significant in my analysis. The ideo-
logical foundations of these groups are important as these are brought
to the policy network fora by their representatives. Their ideas and dis-
courses play a central role in how the drug issue in prison becomes
defined, how policy alternatives are framed and placed on the agenda,
and how policy is implemented (see Duke, 2000).
The particular focus of this book is to assess the role, influence and
power of policy networks in prison drugs policy and to explore their
role in containing the central contradiction in policy development
between treatment and punishment. This containment has been
shaped by several processes such as how the drug issue in prison has
been framed and defined; the relationship between research and
policy; and the impact of shifts in the wider social, political and insti-
tutional context and related policy subsystems. These processes appear
more or less dominant in the different phases of policy development.
Each of these processes will be discussed and elaborated upon below.
Framing the drug ‘problem’ in prisons

The way in which the drug ‘problem’ has been perceived, defined and
redefined over time is an important influence on policy development.
Analyses have shown that who the drug addict or user is becomes
significant in how the problem is defined and understood (see
Berridge, 1999; Harding, 1988; Lart, 1998; South, 1999). In particular,
race, gender and class are important factors influencing the construc-
tion of drugs ‘problems’ and the types of policy adopted. Equally
important however are the data on the real extent and nature of the
social phenomenon which include indicators such as the size of the
drug problem, its social and physical location, and the characteristics
of the drug users (MacGregor, 1999a).
The way in which the drug issue in prison has been defined and
framed has shifted over the various phases of policy development and
influenced policy outcomes. Defining social problems and framing
policy agendas continues throughout the policy process. In order to
understand a social problem, we must explore the process by which it
came to be identified and defined as a problem (Becker, 1966). From a
social constructionist standpoint, ‘problems’ are created by society and
viewed as the outcome of a political process where certain groups are
labelled by the powerful as ‘problematic’ or ‘deviant’. In relation to
drugs policy in prison, a key role has been played by policy networks
in defining policy issues and problems. However, as Jock Young
(1997a) has argued, the social constructionist perspective attempts the
impossible in that it tries to explain the reaction against deviance sepa-
rately from the deviance itself or the formation of social problems sep-
arately from the problems themselves. Thus, the reaction against drug
use in prison cannot be bracketed off from the phenomenon itself. In
left realism, the two sides of the dyad – action and reaction, the
signified and the signifier, rule-making and rule-breaking – interact and
shape each other (Young, 1997a). In my analysis, I will integrate these
two processes by examining the reaction, framing and definition of the
drug problem in prison as well as the nature and extent of the problem
itself.
Rein and Schon (1993) offer a useful framework for analysing policy
discourse which integrates facts, values, theories and interests. In their
view, policy participants construct and make sense of problematic
policy issues through a process of ‘framing’ which is defined as ‘a way
of selecting, organising, interpreting, and making sense of a complex
reality to provide guideposts for knowing, analyzing, persuading, and
acting’ (Rein and Schon, 1993: 146). Policy issues are often framed in
terms of severity, incidence, novelty, proximity and crisis (Rochefort
and Cobb, 1993). These dimensions influence whether they will be
placed on the policy agenda. Severity refers to how serious a problem
and its consequences are perceived to be. It often helps if an issue
affects a large number of people or has a devastating impact on a few
people. Incidence refers to the number of people affected or at risk of
the problem and whether the problem is perceived to be growing,
stable or declining. Novel, unprecedented or trailblazing issues have
the capacity to win attention quickly. Proximity refers to whether the

problem is perceived to be personally relevant or of general social
concern. Problems which have reached ‘crisis’ or emergency propor-
tions are also given priority on policy agendas. However, the distinc-
tion between ‘problem’ and ‘crisis’ is not always clear. Advocates often
use the rhetoric of crisis to stress the urgency of an issue. This is partic-
ularly the case in relation to the areas of prisons and drugs. References
to the ‘penal crisis’ and the ‘drugs crisis’ have become enduring fea-
tures within these policy lexicons.
The populations affected by the problem are also defined. In particu-
lar, distinctions are drawn between populations who are perceived to
be deserving versus undeserving, legitimate versus illegitimate, worthy
versus unworthy, familiar versus strange, and sympathetic versus
threatening (Rochefort and Cobb, 1993). Characteristics such as race,
gender, class and age are also considered. Often, ‘deviants’ and other
excluded groups do not receive equivalent considerations. In
definitional terms, it could be argued that drug using prisoners are
labelled as doubly ‘deviant’ in that they are viewed both as criminals
and drug misusers, and therefore defined as undeserving, illegitimate,
unworthy, strange and threatening. Moreover, the discourse of ‘less eli-
gibility’ has always influenced the development of penal policy and
ensured that the conditions and services available to prisoners are not
superior to those available to the working classes or they will not be
deterred from committing crime (Melossi and Pavarini, 1981). The way
in which drug users in prison are perceived by policy-makers and the
public are therefore crucial in terms of determining the balance
between treatment and punishment in policy design.
Policy issues and problems are malleable and open to competing
interpretations, definitions and solutions. Each framing of a particular
policy terrain is likely to select and name different features of the prob-
lematic situation which may lead to conflicting frames. Rein and
Schon (1993) argue that the ‘institutional embedding’ or the structural
location of the different policy actors will affect the way in which a
policy issue is framed. Each professional group within the penal system
have their ‘own jurisdiction, career structure, interests and ideologies’
(Garland, 1990: 182). In relation to prison drugs policy, the ‘institu-
tional embedding’ of the various participants will influence their
framing of drug issues, the nature of their discourses and the types of
policies and courses of action advocated. Framing could highlight
issues around treatment, harm reduction, release and throughcare,
security, control, punishment or drugs testing.
It is important to examine the naming and framing of policy issues

over time in order to identify ‘frame shifts’ (Rein and Schon, 1993). It
will be clear from the analysis which follows that four frame shifts can
be identified over the phases of prison drugs policy development. In
broad terms, as the extent and nature of drug use in prison became
officially acknowledged by civil servants, politicians and prison gover-
nors, the framing of the issue shifted from being defined primarily as a
medical issue and a problem of treatment for individual prisoners to a
control, order and enforcement issue and a problem for the institution.
Role of research, evidence and knowledge

Research can play an important role in sensitising policy networks to
new issues and turn what were regarded as ‘non-problems’ into ‘prob-
lems’ (Weiss, 1977b: 16). This book is therefore concerned with the
role of evidence, research and knowledge in the recognition, definition
and framing of drug issues in prison and in the development of policy,
implementation and change (see also Duke, 2001). Carol Weiss (1986)
argues the term ‘research utilisation’ is associated with a variety of dif-
ferent meanings and interpretations. She identifies seven different
models of the research–policy relationship: knowledge-driven,
problem-solving, interactive, political, tactical, enlightenment and
research as part of the intellectual enterprise of society.
The knowledge-driven model is derived from the natural sciences and
assumes a linear application of research findings. Here, basic research
highlights an opportunity, applied research is conducted to define and
test these findings, appropriate technologies are then formulated, and
finally application occurs. It assumes that the existence of knowledge
will drive it towards development and use. Few examples of the knowl-
edge-driven model can be found in the social sciences (Weiss, 1986).
The problem-solving model also offers a linear account of research utilis-
ation. Here, research directly influences policy choices and decisions by
providing evidence, information and knowledge which help to solve
and illuminate a particular policy problem. This can be achieved by
drawing on existing research, data and information or by commission-
ing new research to fill gaps in knowledge. Although this model is the
most common perception of research utilisation, it is rare to find
examples of research having such a direct effect on policy decisions
(Weiss, 1986).
Within the interactive model, information is sought not only from
researchers, but from a range of actors in the policy process including
politicians, civil servants, journalists, interest groups, practitioners,
planners, and clients. There is no linear relationship from research to

policy decision, instead the process consists of a ‘disorderly set of inter-
connections and back-and-forthness that defies neat diagrams’ (Weiss,
1986: 35). Members of policy networks pool their knowledge, intelli-
gence and perspectives in order to define and make sense of the
problem. Research is but one element of a process which involves
political insight, experience, pressure, technology and judgement
(Weiss, 1986). In this model, researchers can play an important role in
promoting and acting as partisans for their research (see Donnison,
1978; Booth, 1988; Bartley, 1996). Tizard (1990: 438) argues that
researchers need to ensure that their findings and ideas progress
through crucial ‘gateways’ if they are to come to the attention of
policy-makers and influence the policy process. It is therefore impor-
tant to recognise the ‘micro-political activism undertaken by many
scientists, regardless of their policy orientations at the macro
level’ (Bartley, 1996: 23).
In many cases, various interests and ideologies coalesce to pre-
determine the positions of policy-makers on particular issues or problems.
Under the political model of research utilisation, new research and
evidence is therefore unlikely to influence or change these positions. It
therefore plays a legitimisation or justification function for particular
policy decisions. Research which confirms the existing arguments is used
by advocates as ‘ammunition’ to attempt to neutralise opponents and
persuade those who doubt their position (Weiss, 1986). The political
model often masquerades as the problem-solving model (Tizard, 1990).
For example, in analysing the clinical trials of heroin and methadone
prescribing in the 1970s, Berridge and Thom (1996) argue that this
research did not determine policy, but provided justification and
legitimation for policy changes which were already underway. They
conclude that the research–policy relationship is influenced by policy
networks, civil servants, the historical context and the local traditions in
particular policy areas. Another example within penal policy is the
research which indicated that ‘nothing works’ in terms of treatment and
rehabilitation in prisons in the 1970s (see Martinson, 1974). This
provided further justification for the decline of the rehabilitative ideal
and the shift in policy towards the justice model.
A variant of the political model is the tactical model. Here, the
findings of research are unimportant, rather it is mere existence of
research or the notion of ‘research in progress’ which is considered
paramount. When faced with demands for action on particular issues,
governments are able to delay responses by playing the ‘research card’
(i.e. they are awaiting the results of research). Social researchers and
the research they produce can also be used to deflect criticism away
from government in relation to unsuccessful policies (Weiss, 1986). As
Tizard (1990) argues, employing research as a tactic results in many
research reports remaining unread and collecting dust on the shelves
of government departments.
Research can also enter the arena of policy through a process of
‘enlightenment’ or ‘indirect diffusion’ (Weiss, 1986). Within the
enlightenment model, single pieces of research or even a body of related
studies do not directly impact upon policy, rather it is the effect of
cumulative research and information over time which sensitises policy-
makers to new issues and shapes the way in which problems are
defined and framed. However, the role of research through the process
of enlightenment can have a dramatic impact and can help to redefine
the policy agenda. Although the enlightenment model often corre-
sponds most closely to the way in which research informs policy deci-
sions (see Weiss, 1980), it does have several limitations. For example,
there is no filtering process by which inadequate or invalid research is
screened out. Many research findings will also fail to penetrate the
policy arena, while others take such long periods that they are out of
date or irrelevant by the time they are considered. Finally, the more
research conducted on a particular issue, the more complex the impli-
cations become for policy decisions. The direction for policy therefore
becomes less clear.
Research can also be viewed as part of the intellectual enterprise of
society. Here, research is not viewed as an independent variable affect-
ing the policy process, but rather as a dependent variable. As Weiss
(1986: 39) argues, ‘social science and policy interact, influencing each
other and being influenced by the larger fashions of social thought’.
Policy interest often sets the parameters of research, influencing which
social issues or problems are studied. One of the barriers to exploring
the relationship between research and policy is that they are often
treated as separate and self-contained activities. Smith (1992) also
emphasises the reflexive relationship between policy and research and
argues that research and policy are processes which constantly interact
and shape one another.
It is important to acknowledge that different types of research corre-
spond to different types of models (Tizard, 1990). In my analysis, I aim
to draw on the various models discussed above to explore ‘research
utilisation’ within the phases of prison drugs policy development. The
penetration of evidence into the policy-making arena is not automatic
and depends on various factors. These factors have been discussed by

various commentators and include the nature, type and quality of the
research, the characteristics and institutional location of the researcher,
the characteristics of the policy-making apparatus, the extent of the
gap between the worlds of the researcher and policy-maker, and
whether research is discovered and publicised (see Bulmer, 1978; 1982;
Finch, 1986; Booth, 1988; Tizard, 1990; Petersilia, 1991). The political,
economic and social context of research utilisation is also important.
During the period under review, research in all areas of public
policy was influenced by the 1971 Rothschild report which estab-
lished the distinction between the roles of client and research
provider and a reorientation towards planning, efficiency and rele-
vance. By the 1980s and 1990s, reflecting the market values imposed
by the Conservative government, research had become a commodity
and there was growing pressure for more accountability and tighter
project management. This has had serious consequences for the pro-
duction of independent research and new knowledge (see Samson
and South, 1996; Shove, 1996; Walker, 1989). Due to changes in
research funding and the way research is now commissioned and
conducted, researchers are under pressure to ask particular questions
and produce research which intersects with a particular research pro-
gramme or agenda (Bartley, 1996). Much research has become atheo-
retical and preoccupied with existing policies, rather than concerned
with discovering and theorising about new problems. Although there
were increased opportunities for criminological research in the 1980s,
the attempt to integrate research with wider theoretical frameworks
declined, leading to the rise of what Young (1986) has characterised
as ‘administrative criminology’.
The impact of related policy subsystems and the wider context

The way in which the drug issue in prison is framed, debated and
the setting out of policy options is influenced by wider forces. Rein
and Schon (1993: 154) emphasise that the framing of a policy issue
always occurs within a ‘nested context’. In this view, policy issues
emerge in connection with governmental programmes, which exist
within a wider policy environment, which is part of a broader politi-
cal, social and economic setting, which is situated within a historical
era. Features of this context shift and impact on each other, often
resulting in the reframing of a policy issue. Rein and Schon (1993)
distinguish between four nested contexts: internal, proximate,
macro and global.
The internal context refers to the policy program itself and changes in
its own personnel, sponsors or clients. In this analysis, changes within
the internal structure and organisation of prison drugs policy and the
membership of policy networks will be explored. The proximate context
refers to the changes in the policy environment in which the particular
program operates (Rein and Schon, 1993). Prisons drugs policy can be
viewed as the outcome of interaction between three main public policy
subsystems or sectors: penal policy, drugs policy and social policy. The
distinction and separation between these areas of policy is artificial as
they overlap in both practice and theory. Traditionally, penal policy
and the criminal justice system have not been included in the realm of
social policy, but have been placed in a separate and distinct category
of public policy (Hudson, 1993). Similarly, drug issues have tended to
be the province of the medical-scientific community and have there-
fore occupied a marginal position within social policy (MacGregor,
1998b).
There are aspects of the penal system which are concerned with the
general welfare needs of prisoners, such as probation, specialist services
delivering drug treatment and counselling, as well as other agencies
providing services in prison and on release. Hudson (1993) has illus-
trated the cleavage and continuity between social and penal policy and
argues that the same ideological and material forces affect the develop-
ment of both sets of policies and that they deal with the same ‘client’
groups – the poor, the disturbed, and the addicted. Similarly,
MacGregor (1998b) shows how the development of drugs policy in
Britain, once the domain of the medical community, has also begun to
converge and intersect with other areas of policy. As drugs have
become ‘normalised’ within communities, policy responses have
become more congruent to the way in which other ‘social problem’
groups are dealt with. Thus, the concept of ‘policy spillovers’ is useful
to explain the process where new principles, ideas or policies are trans-
ferred or spill over to adjacent policy areas (Kingdon, 1995). Although
my analysis concentrates mainly on the impact of developments and
changing discourses within penal and drugs policy, the growing
overlap between these areas with wider social policies is also impor-
tant. It is also concerned with the reverse process or the extent to
which developments in prison drugs policy have impacted upon or
been transferred to adjacent policy areas.
The internal and proximate contexts can also be shaped by ‘policy
transfers’ or policy convergences between countries. Garland (2001)
argues that the languages and practices in crime control between the
USA and UK are converging due to the fundamental structural and cul-
tural changes occurring in late modernity. However, Jones and
Newburn (2002) argue that both the role of structural factors and
human agency are important in understanding the nature of policy
convergences and divergences within and between nation states. For
example, in his analysis of programme development at the Home
Office, Rock (1994) notes how civil servants who had previously held
posts in North America began to channel North American models,
policies and practices into the Home Office. In the case of prison drugs
policy, policy initiatives from the United States, such as drugs testing,
certain types of treatment programmes and drugs courts, have played
important roles in influencing policy development. However, these
transfers have not been direct, but mediated through key actors and
organisations involved in the policy networks around drug issues in
prisons.
The macro context refers to wider changes in the overall direction of
policy and social, economic, political and institutional change, while
the global context refers to those at the broadest level such as changes in
the historical eras in which reframing may occur (Rein and Schon,
1993). From 1979 to 1997, significant changes took place in prison
drugs policy under the Conservative governments of Thatcher and
Major. This development has occurred within a broader context of tur-
bulent political, historical, economic and social change heavily
influenced by the ideologies of the New Right. Thatcherism was under-
pinned by a combination of neo-liberalism emphasising the free
market, freedom, choice, liberty, limited state, and the primacy of the
individual, and neo-conservatism emphasising authority, order, stabil-
ity, tradition, the family and morality. The ideologies of the New Right
informed Conservative policy, but often in inconsistent and contradic-
tory ways (see Brown and Sparks, 1989; Atkinson and Savage, 1994).
For example, in some policy areas such as welfare provision, controls
on public spending and minimal state intervention were advocated,
while in other areas such as law and order, resources and state inter-
vention increased.
Since 1979, developments in public policy have challenged the tradi-
tional ‘public administration model’ of welfare delivery based on a
bureaucratic structure, professional domination, accountability to the
public, equity of treatment, and self-sufficiency (Butcher, 1995). Under
the Conservative governments, there was increasing emphasis on a
more managerialist and consumerist orientation to public sector organ-
isation. The ‘new public management’ which emerged emphasised
value for money, a performance-based culture, the disaggregation of

large bureaucratic organisations, promotion of greater competition
through the use of market-type mechanisms, and customer orientation
(Butcher, 1998: 25). Cutler and Waine (1997: 6) outline the key dimen-
sions of public sector managerialism which include an hierarchical
approach where targets are set and monitoring is controlled from the
top; an assumption that the structure is universally valid and can be
applied to both the private and public sectors; the need for perfor-
mance monitoring and the assumption that it is possible to develop
valid management information; and tension within professional prac-
tice as a result of the hierarchical approach.
Initially, the criminal justice system was believed to be safe from
these managerialist tendencies. It was not subjected to the large-scale
reforms of health and education. This was related to the increase in
expenditure on law and order during the 1980s, the opposition and
power of key professional groups such as the judiciary and chief con-
stables, the dispersal and lack of co-ordination between the various
agencies in the criminal justice system, the lack of alternative providers
in the market, and the absence of ‘consumers’ (i.e. there was no
prospect of reconceptualising offenders as ‘consumers’) (James and
Raine, 1998; McLaughlin and Muncie, 1994). However, the managerial-
ist agenda was soon applied to the problems of crime and punishment
in the form of financial controls, performance monitoring, and organi-
sational design. For example, several prisons were contracted out, con-
tracts were awarded for prison escort duties, the operation of prisons
and the administration of the Crown and County Courts were hived
off into Next Steps agencies, partnership and multi-agency structures
were established, aggregate monitoring systems were introduced, and
management by objectives or performance indicators were introduced
across the whole criminal justice system. A common theme emerging
from the literature is the notion that managerialism is not concerned
with the individual or the overall purpose of the criminal justice
system, but with the management of crime, punishment and criminals
(see Feeley and Simon, 1992; Garland, 1996; James and Raine, 1998).
The principles of partnership, crime prevention and involving the
community in drugs and crime control are also prominent themes in
policy. For example, Drug Action Teams consisting of senior represen-
tatives from various local agencies were established in each health
authority district in 1995. A distinctive feature of these partnership
structures is the closer alliance between the criminal justice system and
other agencies. Other policy subsystems and the ‘community’ have
therefore been drawn into the management of the contemporary drug

problem. As Garland (1996) argues, the managerialist trends intersect
neatly with the partnership principle, multi-agency approaches, and
the rise of the community where the state seeks to activate action on
the part of non-state agencies and organisations to take responsibility
for controlling crime.
It is within this context that prison drugs policy began to be devel-
oped and formulated in a more explicit way, taking on the attributes of
managerialism. Shifts within these nested contexts will be an impor-
tant feature in the framing and reframing of drug issues in prison.
However, Rein and Schon (1993: 155) also argue that the ‘reframing of
issues can shape the contexts on which that reframing is dependent’.
This links into the arguments of the new institutionalists which
emphasise the role of ‘policy feedbacks’ or the ways in which previ-
ously established policies or inherited policy structures shape subse-
quent political processes (Skocpol, 1992; Pierson, 1994). In this view,
policy is treated as both an independent and dependent variable.
Skocpol (1992: 58) argues that policies have feedback in two major
ways. First, policies transform and expand the capacities of the state or
alter the administrative possibilities for future initiatives. Second, new
policies affect the social identities, goals and capabilities of the groups
involved in politics. In some cases, groups will have a stake in the
expansion and continuation of particular policies while in others,
groups may seek to repeal or reorient policies (Skocpol, 1992).
Themes in contemporary drug policy have powerful historical
antecedents (Berridge, 1989). For example, Stimson and Lart (1994)
argue that the discourses of harm minimisation, risk reduction and
public health during the late 1980s were not so unusual and have a
long history within past drugs policy. Pearson (1991: 169) concludes
‘there is a persistent thread of continuity through which the ‘British
system’ retains the possibilities of a flexible and adaptable approach to
drugs problems’. Similarly, prior to the 1990s, several commentators
recall a sense of continuity and pragmatism within penal policy devel-
opment (see Rock, 1995; Garland, 1996; Faulkner, 1996). Policy pro-
posals contained a history and links with existing policies and
programmes. However, the penal populism and policies advocated by
the Home Secretary, Michael Howard, in 1993 indicated a very sudden
and radical change in penal policy leading to a ‘remarkably volatile
and ambivalent pattern of policy development’ (Garland, 1996: 449).
Since the election of the New Labour government in 1997, a sense of
stability has been restored with the continuities and similarities
between Conservative and Labour penal policy (see Brownlee, 1998;

Morgan, 1999). The policy feedback dynamic underlines the impor-
tance of taking an historical approach in order to explore how prison
drugs policy has unfolded over time.
These interconnecting themes will run through my analysis: the role
and influence of policy networks in containing and managing the con-
tradictions between treatment and punishment and the way in which
this process of containment has been shaped by the framing of the
drug issue in prison; research, evidence and knowledge; and wider con-
textual features. The framework employed to develop these themes and
concepts draws upon the policy sciences literature. Although this liter-
ature has been used extensively in other areas of public policy, it has
rarely been applied to the areas of drugs, penal and criminal justice
policy. The next section will elaborate on the research design and
methodological framework which were employed to investigate the
role of policy networks in the development of prison drugs policy.
Research design and methodology
Existing research on drug issues and prisons has tended to focus on the
prisoners themselves, emphasising prevalence issues, risk behaviour and
their ‘performance’ in relation to the new rules, tests and regulations of
the most recent prison drugs strategies. Although criminologists are
beginning to examine the activities and cultures of the professionals
working within the criminal justice system (see Rock, 1986; 1990;
1994; 1995; Reiner, 1991 and Ryan et al., 2001), the tradition within
criminological research has been to concentrate on offenders and
‘deviant’ populations. Similarly, drugs research has been dominated
mainly by studies of drug users (see for example Becker, 1963; Young,
1971; Rosenbaum, 1981; Pearson, 1987a; Parker et al., 1998). With the
exception of several analyses of drug markets and law enforcement (see
Dorn et al., 1992; Collison, 1995), the focus of research has rarely been
on those in positions of power such as the police, Crown Prosecution
Service, Customs and Excise, and the probation and prison services or
those involved in the formulation of the policies drug users are subject
to. The focus has tended to be on the ‘objects’ of policy, rather than on
the policies themselves or the policy-makers and professionals working
within this area.
In the case of drugs and prisons research, there was therefore a need
to impose scrutiny on those who were in positions of power in relation
to the processes of policy-making. In order to explore how policy
developed over time, which factors influenced this development and

the role and influence of policy networks in this process, a qualitative
case study was viewed as the most appropriate design. The main
methods employed in the case study were semi-structured interviews
with key actors in the policy process and an analysis of policy and
other documents.
Documentary analysis
Documentary records have great significance in contemporary social
settings, particularly within the policy arena. Here, many of the key
actors are involved in the production and consumption of written
records and other types of documents (Atkinson and Coffey, 1997).
However, documents represent artificial or partial accounts which
cannot be taken at face value and require critical assessment.
Documentary materials should be approached for what they are and
what they are used to accomplish through an examination of their role
in organisations, their type and form, and the cultural values attached
to them. It is therefore important to attempt to get below the surface of
documents by probing and analysing their construction, production
and consumption. In relation to drugs policy, Spear (1995: 13) argued
for a fundamental rethink and the need to progress beyond the ‘glossy
government publications’ and their associated political rhetoric.
Within a context of increasing managerialism, Morgan (1997a) also
notes how prison policy documents have become briefer and glossier
over time, containing less meaningful information. Such documents
tend to reduce the complexity of policy issues to very simplistic and
crude levels.
In the area of prison drugs policy, there are several related types of
documents which can provide a source of data at the national level.
These are mainly ‘official’ documents which have been either written
or influenced by those involved in the policy networks around prison
drug issues. Under the typology of documents created by Scott (1990)
which focuses on dimensions of authorship and access, ‘open pub-
lished documents of State origin’ were the key ones employed in my
analysis. The main documents selected were those relating to prison
drugs policy, penal and criminal justice policy, national drugs policy,
and ACMD reports. Where available, I also collected and analysed
annual reports and other relevant documentation produced by penal
reform groups and drug agencies to explore the role of prison drug
issues in their work. Statistics relating to the prison population, drug
addict notifications and drug offenders also formed part of this analysis
in order to explore the extent and nature of the ‘problem’ of drugs in

prisons over time through the use of ‘official’ indicators. Although
these statistics have a number of limitations, they are used by policy-
makers as one of the indicators of the extent of the drug ‘problem’
(Mott, 1994).
In order to understand the system of production, exchange and con-
sumption of documentary materials, one needs to consider authorship
and readership. When using official government documents, it is often
impossible to determine the identity of those responsible for their pro-
duction or the authors (Scott, 1990; Atkinson and Coffey, 1997). This
anonymity is part of their ‘facticity’ and the official production of
documentary reality. Although there may be an implied ownership of a
document within a particular government department or agency,
official documents do not usually have visible human agencies who
express feelings, opinions and beliefs. As Atkinson and Coffey (1997:
59) argue, ‘the absence of an implied personal author is one rhetorical
device that is available for the construction of ‘authoritative’, ‘official’,
or ‘factual’ accounts. It implies a reality that exists independently of
any individual observer, interpreter or writer.’ Within my analysis, I
was interested in exploring the contribution of policy networks in the
construction and production of the key documents relating to prison
drugs policy.
In analysing the content meaning, the focus is upon the relation-
ships within the text or its parts to each other, the relationship of the
text to other texts, and the relationship of the text to those who partic-
ipated in its construction (Ericson et al., 1991: 48). It is therefore
important to look beyond separate texts and analyse how they are
related. Atkinson and Coffey (1997) refer to these relationships
between texts as ‘intertextuality’, a term derived from the field of liter-
ary criticism. Within my analysis, I was interested in examining the
temporal dimensions of documents, the relationships between the
various key documents and in exploring any shifts in the discourses
around penal and drugs policy over time. In particular, I was interested
in exploring how the ‘problem’ of drugs in prisons had been framed
and defined within documents over time; the variations and changes
in the conceptualisation and operationalisation of the concepts of
treatment and punishment over time and between documents; how
the tensions between these concepts were managed within the docu-
ments and if this had changed over time; the role of research in pro-
posals for policy changes and the influence of the social, political and
wider policy context. By analysing documents at the broader sectoral
level (i.e. documents relating to drugs, penal and criminal justice

policy), I was also able to explore the influence of and interface
between developments in wider policy subsystems and those in prison
drugs policy.
The consultation lists of government departments are often used in
research on policy networks as the key data source to explore member-
ship and influence. As Cavanagh et al. (1995) argue, this method is
problematic and reveals little about the frequency and quality of the
consultations. In order to operationalise policy networks and assess
their influence, it is therefore necessary to interview both civil servants
and interest groups. In this research design, semi-structured interviews
were also conducted with key actors in the policy process, some of
whom had been involved in the construction of policy documents.
Documents can be used alongside other forms of data so that the biases
of each can be understood and compared. For certain research ques-
tions, the public record and documentation is insufficient (Useem,
1995). Entering the worlds of those involved in the policy networks
and engaging them in discussion was the only way to generate rich
and detailed data on their perceptions and experiences of the
‘problem’, the policies and the processes involved in their develop-
ment. In the interviews, respondents did refer and speak either explic-
itly or implicitly about the documents which were included in this
analysis. The methods were therefore interconnected with the docu-
mentary analysis informing the direction and focus of the interviews
and providing historical and contextual dimensions to the interview
data, while the interviews influenced further analyses and explorations
of the documents.
Semi-structured interviews
The fieldwork involved a total of 37 interviews with a wide range of
policy actors including fifteen civil servants working in government
departments involved in the formulation and implementation of the
1995 prison drugs strategy; 12 representatives of drug agencies devel-
oping and providing treatment services within the prison system; 6
directors of penal reform groups lobbying for reform within the prison
system; and 4 spokespersons for professional associations. Although
policy is shaped and influenced by others including government minis-
ters, members of both houses of parliament, journalists and the prison-
ers themselves, these groups were not interviewed. Those selected for
interviews were considered to belong to a central core of influence in
the policy process. This group can be defined by their knowledge of
prisons and drugs, their role as mediators within policy development

and their regular interaction with one another over time. The rationale
for interviewing civil servants is that they play a central role in the for-
mulation, implementation and management of the policies; liaise
between Permanent Secretaries and their Ministers and other outside
interests; and play a key role in steering between conflicting models of
development. Drug agencies were considered important as they deal
with the day-to-day realities of delivering care and treatment to drug
users within the prison environment. Penal reform groups provided a
perspective on the control of drug users within a wider penal reform
agenda. Professional associations represent the interests of those
involved with the day-to-day implementation and delivery of policy.
The principles of snowball sampling were used. Each respondent was
asked to identify others they felt should be interviewed. This helped to
identify members of the policy network and those who were consid-
ered to be ‘key’ players. The network of individuals involved in prison
drug issues is extremely small. For this reason, it is necessary to with-
hold specific details about the organisation, agency, or department of
each respondent in order to ensure that information is non-attribut-
able. A striking characteristic of those interviewed was their varied
backgrounds and experience in both the drug and penal fields. Many
had been involved with different jobs and responsibilities over time
relating to the areas of prisons and drugs. The main criterion for select-
ing the respondents was seniority. They needed to be in a position
within their organisation to influence policy formulation, implementa-
tion and development. Of the 37 interviewed, 27 were men and 10
were women. In terms of ethnicity, all respondents were white. For a
more detailed methodological and reflexive discussion of the key
dilemmas of researching those in positions of power in policy net-
works, see Duke (2002).
The main focus of the interviews was to explore how the respondents
viewed the development of policy in this area and the processes and
factors influencing its development; how they defined the ‘problem’ of
drug issues in prison, the methods used to manage it, why these
methods were used, the appropriateness and effectiveness of these
methods, and what they believed could work more effectively. The
interviews were retrospective in that they included discussions of the
origins of prison drugs policy. It was difficult to access individuals who
had been involved in policy-making in the very early stages as some of
them had retired, changed jobs or died. In the final sample, over half
(i.e. 21 respondents) could be described as having long-standing
involvement in some aspect of the area under study. Most of this group
had experience and knowledge dating back to the early 1980s which
enabled them to reflect on the development of policy.
Interviews were conducted between September 1997 and March
1998. This period was marked by a number of political and policy
changes which affected the research. After Labour won the general
election in May 1997, a series of new policies were in the process of
being formulated and implemented. For example, an anti-drugs coordi-
nator was appointed in October 1997 whose mandate was to guide and
coordinate the new national drugs strategy which was launched in
April 1998. The prison drugs strategy was also in the process of being
revised and was launched in May 1998. The timing of the fieldwork
was important as prison drugs policy was on the cusp of change and
entering a new phase. Respondents were therefore positioned to both
reflect back on the previous strategy and comment on the proposals for
the new strategy. Other significant developments during this period
included calls for a Royal Commission to explore the possibilities
around drugs legalisation, the campaign in the Independent on
Sunday newspaper for the legalisation of cannabis and the Home
Secretary’s son found dealing cannabis. These issues and events perme-
ated the interviews through informal discussion and provided further
insights into the politics and dynamics of the policy process.
Sabatier (1988; 1991) argues that longer term studies of the policy
process covering a time perspective of at least a decade are needed for
three main reasons. First, this usually allows for policy to complete at
least one formulation/implementation/ reformulation cycle so that the
success or failure of a policy can be assessed. Second, the ‘enlighten-
ment function’ of research stresses that the cumulative effect of
research findings impacts upon the policy process gradually (Weiss,
1977a), thus requiring a longer time period to assess its influence.
Third, in order to understand the significance of particular innovations
in policy, policy-oriented learning, and the importance of changing
socio-economic factors, policy analysis should be conducted over
longer time periods. In order to assess the influence of various forces
influencing the development of prison drugs policy, this research has
therefore adopted a time perspective of approximately eighteen years
from 1980 to 1998. The study begins in 1980 because this year marked
the first formal documented interest in drug issues in prison with the
publication of the first ACMD report on drug dependants within the
penal system (ACMD, 1980). The main focus of the research revolves
around the 1995 prison drugs strategy which involved fundamental
shifts and changes in the way that drugs were dealt with in prisons.
One of the key difficulties in researching the contemporary policy
process is that it is continually developing and expanding. This causes
problems for researchers in terms of choosing a cut-off point for their
analyses. Moreover, as policies evolve and time passes, interpretations
and analyses often develop and change (Berridge, 1994). My analysis
ends in 1998 which marked the reformulation of the 1995 strategy.
Through my interpretations of the main policy documents and inter-
views with key policy actors, it became clear that the development of
prison drugs policy could be divided into four main phases: 1980–6;
1986–93; 1993–7 and 1997 onwards. At the time of writing, the last
phase continues to evolve and develop.
Chapters 2, 3, 4 and 5 deal with the phases of prison drugs policy
development chronologically. Each of these chapters broadly conforms
to the same pattern. They begin by introducing the particular phase of
policy development and highlighting the main features of the period.
This is followed by a brief discussion of the drugs and penal policy con-
texts during the particular phase. The chapters then explore how the
‘problem’ of drugs in prison was defined and framed. This is followed
by an analysis of the policy response to the drugs ‘problem’ in prisons
during the period under review. The chapters draw upon the key policy
documents, reports and relevant research, as well as data generated
through the interviews conducted with key actors in the policy
process. Chapter 6 reflects on the analysis of developments in the
various phases by re-visiting the questions, concepts and theories out-
lined above. This final chapter concludes by exploring the significance
of my findings for the future development of prison drugs policy.
2
1980–6: Prelude to Policy
Development
Introduction
The period from 1980 to 1986 marked the beginning of external

interest in drug issues within the penal setting. In 1980, the Advisory
Council on the Misuse of Drugs (ACMD) published its report, Drug
Dependants within the Prison System in England and Wales. This was the
first document which dealt with drug issues in the prison system.
During the early 1980s, there was no public document which outlined
the Prison Department’s policies for dealing with drugs and drug users
in prisons. This is in marked contrast to later phases of policy develop-
ment where there was an explicit prison drugs strategy document
which specified clear aims and objectives for tackling the drug
‘problem’. However, this does not mean that there was not a ‘policy’
on drugs during the early 1980s. As discussed in Chapter 1, the absence
of policy can be defined as a ‘policy’. Moreover, drug users in the
prison system were treated in a particular way and this practice can be
defined as ‘policy’. Policy was therefore implicit rather than explicit,
unstated rather than stated, informal rather than formal, and private
rather than public. During this period, there was increasing pressure
from various sources for a more explicit and defined prison drugs
policy. This phase could be viewed as a ‘transitional’ period or a
‘prelude’ to more formal policy development. The drugs ‘problem’ in
both the community and the prison was changing, the type of person
using drugs was changing, definitions of drug takers were changing,
the location of drug use was changing, and the groups and profession-
als involved in dealing with drug users were changing and expanding.
Furthermore, the election of the Conservative party under the
leadership of Margaret Thatcher in 1979, along with the ascendancy of
31
New Right ideas, altered the political and public policy landscape
dramatically.
The Thatcher government embarked on a strategy which involved
radically restructuring the British economy, dismantling the welfare
state, breaking the power of trade unions, reducing public expenditure
and minimising state intervention. Thatcher had placed ‘law and
order’ issues at the centre of her election campaign and committed the
government to additional resources for the criminal justice system. The
Conservative party focused almost exclusively on crimes which caused
public anxiety such as public order and street crimes, particularly
mugging (Hall et al., 1978). The existence of certain populations who
were perceived to be dangerous, including black youth, ‘welfare
scroungers’, drug addicts, and football hooligans, were used to justify
and legitimise increased surveillance, regulation and punitive sentenc-
ing (Brake and Hale, 1989). In the areas of criminal justice and penal
policy, the discourses of punishment and just deserts tended to prevail
over those of welfare, help and treatment. Welfare agencies contracted,
while penal agencies expanded (Hudson, 1993). However, the
Conservative package of social and criminal justice policy reforms
implemented in the early 1980s failed: crime rates continued to soar;
poverty, homelessness, unemployment and ill health increased; indus-
trial disputes continued (notably the miners’ strike in 1984), and a
number of riots occurred in various inner-city areas including Brixton
(south London), Toxteth (Liverpool), Handsworth (Birmingham) and
the Broadwater Farm Estate (Tottenham, north London) (Reiner and
Cross, 1991).
This macro context provides the background, framework and setting
for changes within drugs, prisons and ultimately prison drugs policy
during 1980–6. The chapter begins by exploring the drugs and penal
policy contexts during the period under review and then examines the
drugs ‘problem’ in prison and the responses to it.
Drugs policy context: the heroin ‘epidemic’ and shifting

political and policy landscapes
By the late 1970s, the drug dependency units established during the
1960s had become less central in the treatment of drug use (Stimson,
1990a). The heroin problem had stabilised and the proportion of newly
notified addicts under the age of 21 had begun to decrease (Home
Office Statistical Bulletin, 1984). The clinics were treating only a small
proportion of drug users, mainly heroin addicts, while the voluntary
1980–6: Prelude to Policy Development 33
sector and general practitioners were beginning to play increasingly

important roles in helping polydrug users, particularly those who were
using barbiturates, tranquillisers, amphetamines and opiates (Jamieson
et al., 1984). In 1971, a national co-ordinating and representative body
for drug services called the Standing Conference on Drug Abuse
(SCODA) was established which provided a voice for the growing
voluntary sector in drugs policy development. Many of the key
assumptions underlying drug treatment were being challenged in the
late 1970s and early 1980s. For example, therapy and rehabilitative
techniques such as therapeutic communities and counselling were
becoming increasingly important; the appropriateness of maintenance
prescribing was being questioned; the limitations of ‘physical’ treat-
ment were recognised and a wider social approach was advocated
which took into account housing, employment and training, and child
care; and significantly a distinction was beginning to be made between
the drug ‘addict’ and other patterns of drug use (MacGregor and
Ettorre, 1987). The ACMD (1982) recommended that the terms ‘drug
addict’ and ‘drug dependant’ should be replaced with the label
‘problem drug taker’ who would be defined in the following terms:
any person who experiences social, psychological, physical or

legal problems related to intoxication and/or regular excessive
consumption and/or dependence as a consequence of his own use
of drugs or other chemical substances (excluding alcohol or
tobacco). (ACMD, 1982: 34)
This definition encapsulated a wider range of drug takers and took the
view that drug problems are wide ranging, extend beyond the clinical
discourses of dependence and addiction, and require more than just a
medical response. The ACMD (1982) viewed the dichotomy of treatment
within the clinic and rehabilitation in non-statutory agencies as unhelp-
ful and advocated a broader social approach. Similarly, the House of
Commons Social Services Committee (1985: ix) argued that ‘overcoming
dependency demands more of a social than a clinical approach’. Thus, a
more comprehensive and integrated treatment and rehabilitation policy
was advocated which stressed liaison, collaboration, co-ordination and
co-operation between statutory and non-statutory agencies. Drug advi-
sory committees (DDACs) were established in health authority districts
to develop and plan local service provision. They included representa-
tives from the health service, local authority, police, probation and other
statutory and non-statutory agencies. It is important to note, however,
that prisons were not expected to provide membership to these new

structures.
By the 1980s, the era of the specialist in drug treatment was over and
generalists in the community were encouraged to get more involved
(Stimson, 1990a; Strang and Gossop, 1994). Within this new multidis-
ciplinary framework, new voluntary and non-specialist services in the
community were established and there was a new role for the general
practitioner in treating drug use. The 1982 ACMD report was
influential in establishing new and broader forms of working with drug
users around social models of care (Berridge, 1997). There was therefore
a shift in balance as the prominence of the specialised medical
discourse began to decline (Stimson and Lart, 1994).
Just as some of these new ideas and concepts began to penetrate the
official world of policy-making, there was a dramatic increase in heroin
use. In the first half of the 1980s, official indicators point to a heroin
‘epidemic’ with a peak in 1985 and a subsequent levelling off in the
latter half of the 1980s (Power, 1994). For example, between the years
1980 to 1986, the number of new drug addicts notified to the Home
Office had increased dramatically from 1, 600 in 1980 to 6, 409 in
1985 and then decreased to 5, 325 in 1986 (see Table A.3, Appendix).
Moreover, the percentage of new drug addicts addicted to heroin
increased by 20 per cent over this period. The number of drug offences
had also increased from 17, 158 in 1980 to 23, 905 in 1986 (see Table
A.2, Appendix). Although the great majority of these offences were for
unlawful possession and involved cannabis, the proportion of offences
associated with heroin increased from 4 per cent in 1980 to 12 per cent
in 1985 (Home Office Statistical Bulletin, 1987). Research studies
conducted in various British cities and towns also indicated a sharp
increase in heroin use (see Ditton and Speirets, 1981; Lewis et al., 1985;
Pearson, 1987a; Parker et al., 1988). This was linked to the arrival of
cheap, high purity heroin in abundant supply from South-West Asia.
Furthermore, heroin from this source could be smoked which was per-
ceived as a clean and safe way to use the drug. The stigma of injecting
was therefore removed and more people were willing to experiment
(Power, 1994; Griffiths et al., 1994).
The response to this ‘epidemic’ was to focus on heroin almost exclu-
sively and fall back on the old ideas and discourses around disease,
addiction and drug addicts. The professional consensus which had
been attained around the notion of ‘problem drug taking’ and the need
for multidisciplinary approaches was ignored by policy-makers
(MacGregor and Ettorre, 1987). The drug problem had become a highly
politicised issue and the prevailing discourse was one of panic, danger
and fear. Drugs had become defined as an ‘alarming issue, a crisis, an
epidemic, even as a plague’ (MacGregor, 1989a: 3). There was much
concern within political circles that the UK would ‘inherit the
American nightmare’ where drug taking and crime would become a
way of life for the ‘underclass’ in society (MacGregor and Ettorre,
1987). In effect, a ‘moral panic’ had been created around drugs, drug
use and drug addicts (Cohen, 1972). This was neatly characterised by a
speech given by the Home Secretary, Leon Brittan, to the London
Diplomatic Association in 1983 in which he professed a strategy of
eradication:
Drug abuse is a disease from which no country and no section of

modern society is immune … Stamping it out will be slow and
painful … The rewards are great if we succeed – and the price of
ultimate failure unthinkable (quoted in Home Office, 1985: 3)
The heroin ‘epidemic’ was associated with a younger group of ‘new

heroin users’ who tended to be concentrated in areas with high levels
of unemployment, social deprivation (Pearson, 1987a) and established
irregular economies for drug distribution (Auld et al., 1986). Heroin use
was therefore not a ‘national problem’, but better understood as a
highly localised and scattered phenomenon with patterns of use also
subject to local and regional variation (Pearson and Gilman, 1994). For
young people who had been deprived of achieving status through
employment, heroin provided a ‘lifestyle’ and a new mode to enhance
status and prestige (Pearson, 1987b). There was however the perception
amongst the public and politicians that the drug problem was spread-
ing, spinning out of control, and corrupting other social groups. The
discourse and debate in the 1980s focused on the integration of certain
groups in society and fears of contamination and leakage into the
general population (MacGregor, 1989a).
1985 national drugs strategy

The reaction to the drug problem in the 1980s was ‘designed to
preserve the existing social order’ (MacGregor, 1989a: 11). Bi-partisan
agreement between parliamentary right and left and the low level of
politicisation regarding the problem led to a lack of informed political
debate (Dorn and South, 1987). Rather than leaving policy decisions to
informed members of the drugs policy community, politicians and
central government began to play more active roles in drug issues and
policy development. In 1984, a Ministerial Group on the Misuse of

Drugs was established with representatives from all government
departments who had an interest in drug issues. This represented a
‘new division of labour’ or ‘diffusion of responsibility’ for drug issues
between government departments (Lart, 1996: 73). The role of the
group was to develop and oversee the implementation of the 1985
national drugs strategy which involved activity in five main areas:
reducing supplies from abroad; tightening controls on drugs produced
and prescribed; making policing more effective; strengthening deter-
rence; and improving prevention, treatment and rehabilitation (Home
Office, 1985: 7). This marked an important shift in emphasis as
enforcement measures were given much more prominence in the new
strategy with three of the five aims having penal implications.
The expenditure on treatment and enforcement-related activities
provides some indication of the balance between these two strands of
drugs policy. For example, the total health and welfare drugs-related
expenditure was estimated at £25–45 million per annum in the mid to
late 1980s, compared to an estimate of £100 million for drugs-related
enforcement activities (Dorn, 1990). Although the 1985 strategy
stressed enforcement and the relationship between drugs and crime, a
government funded survey of drugs research uncovered very little
British criminological research in these areas and recommended that
future research should be conducted on drug networks at a local level,
the question of effectiveness in customs and law enforcement, the
relationship between drugs and crime, the effects of sentencing on
subsequent drug use, alternative strategies and law enforcement, and
drug use in prison (Pearson, 1990).
Treatment and rehabilitation measures within the strategy centred
on the Central Funding Initiative (CFI) which was developed to
improve services for drug users. Funding over a period of three years
was offered on a pump priming basis to statutory and voluntary organ-
isations which provided new services or developed existing ones. Most
of the services which were subsequently funded by the CFI were multi-
disciplinary, community-based and accessible. The initiative was suc-
cessful in targeting areas which had the most serious drug problems
and required drug service development (MacGregor et al., 1991). The
thrust behind policy development during this period was ‘to attempt
to access other resources and bend them to meeting the increased need
for services propelled by the increased misuse of drugs’ (MacGregor,
1998a: 140). However, the moves to involve ‘generalists’ such as GPs,
social workers, CPNs and others in the provision of services was not
wholly successful and the main outcome of the initiative was a new
layer of drug agencies and specialists (MacGregor, 1998a).
Prevention activities under the government’s new strategy were in the
form of high-profile mass media anti-heroin campaigns beginning in
1985. These initiatives were viewed with suspicion by the drugs policy
community which warned the government against a national campaign
based on fear tactics as this could backfire by stimulating interest in
drugs and leading to increased experimentation (ACMD, 1984). As Power
(1989) has argued, even a perfunctory review of the literature on
campaigns confirms such views and reservations. Despite the warnings,
the government went ahead with their plans. Both quantitative and
qualitative evaluations of the campaigns were undertaken and confirmed
that young people’s attitudes against heroin had been reinforced
(Research Bureau Ltd, 1986; Andrew Irving Associates, 1986). However,
these evaluations have been criticised on methodological grounds due to
the sampling design and size (see Marsh, 1986). Moreover, as Dorn
(1986) argues, the researcher’s conclusions were based on the incorrect
assumption that strong anti-drug attitudes will prevent drug use or that a
change in attitude will produce a change in behaviour.
Enforcement efforts took the form of new structures of drug enforce-
ment, penalties, surveillance and intelligence. Drug traffickers and
dealers were the targets of these efforts and the aim was to ensure that
they were ‘punished severely and should not profit from their illegal
activities’ (Home Office, 1985: 14). The National Drugs Intelligence
Unit (NDIU) was created under the command of a newly established
post of National Drugs Intelligence Officer and regional crime squad
drug wings were established to bring a greater degree of co-ordination
into the policing of drugs. Following the recommendations of the 1985
Home Affairs Committee, the Drug Trafficking Offences Act of 1986
introduced wide powers for the confiscation of assets of drug dealers.
The 1985 Controlled Drugs (Penalties) Act increased the sentencing
tariff for trafficking in class A drugs from 14 years to life imprisonment.
Greater attention was also paid to international co-operation with
regard to drug trafficking through the ratification by the UK of the
United Nations Convention Against Illicit Traffic in Narcotic Drugs
and Psychotropic Substances of 1988 and by a series of bilateral Mutual
Legal Assistance Treaties agreed between the UK and a number of
countries. The assumption was that activity on the supply front and
the disruption of low level markets would impact upon the demand for
drugs by reducing availability and making them more expensive (Dorn
and Murji, 1992).
As South (1998: 91) argues, these developments ‘placed the police,

customs, courts and prisons at the forefront of official rhetoric about
responses in policy and practice’. These punitive measures were aimed
at the traffickers or the ‘corruptors’ of drugs, rather than the drug users
or the ‘corrupted’ (Young, 1973). In practice however, Pearson (1991)
argues that these enforcement activities coexisted along with harm and
demand reduction strategies. Although abstinence was being stressed at
the political level, the ACMD (1984) was advocating risk reduction and
harm minimisation as the two basic criteria for drugs prevention.
There was therefore a clear gap between the ‘political’ and ‘policy com-
munity’ views of drugs (Berridge, 1991). Similar to previous phases of
drugs policy development, a bifurcated policy of control was pursued
which now involved life sentences and confiscation of assets for drugs
traffickers and improved services, diversion and prevention initiatives
for users and potential users (Dorn, 1990). However, enforcement type
activity has much more political and populist appeal compared with
health-based initiatives which can appear ‘too soft’. Politicians and
policy-makers were therefore able to stress that tough action was being
taken against drug traffickers and other drug ‘villains’, while drug
workers and other professionals were working behind the scenes
dealing with ‘problem drug takers’ or drug ‘victims’ within a treatment
and rehabilitation based framework.
Although medicine remained a central force in drugs policy-making,
Berridge (1997) argues that the medical hegemony of drugs policy was
becoming diluted. During the 1980s, the policy community around
drugs broadened to include a wider professional spectrum as new
alliances were developed (Edwards, 1990). For example, the ACMD
membership began to change from a mainly medical one, to one
which included social workers, teachers, police and probation officers,
psychologists, sociologists as well as the traditional psychiatrists and
pharmacologists (Edwards, 1990; Berridge, 1997).
Although the 1985 drug strategy was generally viewed as a penal
response to the drug problem, the irony was that there was no
reference to the Prison Service, the treatment needs of drug using pris-
oners or to the ACMD report on drug dependants in the prison system
published in 1980. Within the prison environment, much of the new
thinking regarding drugs and drug treatment failed to penetrate policy
and practice immediately. Indeed, for many years, what was occurring
outside the prison walls had not impacted on how prisoners with drug
problems were treated. There were different discourses around drug
issues operating inside and outside the prison walls. The next section
will outline the context and main developments within penal policy
during the period 1980–6.
Penal policy context: containing and managing the ‘crisis’
By the 1970s, the penal system was described by a number of commen-

tators from various perspectives as being in a ‘state of crisis’ (see Evans,
1980; Hall, 1980; Bottoms, 1980; Fitzgerald and Sim, 1982; Woolf,
1991). Fitzgerald and Sim (1982) argue that the prison crisis is best
understood as a series of interwoven crises: the crises of ‘visibility’,
‘authority’, ‘containment’, ‘conditions’ and ‘legitimacy’. The key
explanatory factor is the ‘crisis of legitimacy’ or engaging with the
question ‘what are our prisons for?’. Since the collapse of the rehabilita-
tive ideal in the early 1970s, which placed emphasis on the treatment,
training and reform of offenders (Allen, 1981), policy-makers and
politicians have not engaged effectively with this ‘crisis of legitimacy’.
Instead, they have tinkered with sentencing and parole policy, hoping
to have an impact on prison numbers and, when given the choice, they
have placed security concerns at the centre of the policy agenda. With
the election of the Thatcher government, the rhetoric of ‘law and order’,
‘just deserts’ and ‘punishment’ emerged as the legitimising ideologies of
penal and criminal justice policy (Hall, 1980).
In Britain, the emphasis on treatment, training and rehabilitation
began to shift following the ‘crisis of containment’ in the 1960s
(Fitzgerald and Sim, 1982). During this period, there was a significant
increase in prison escapes, including a number of high-profile crimi-
nals, which prompted the government to call for an inquiry. Lord
Mountbatten was asked to examine the reasons for the escapes and
make recommendations for improved security. The Mountbatten
report left an important legacy on the prison system and introduced a
new era characterised by an intensification and proliferation of
security, surveillance and control across the entire prison estate (Sim
1991; Downes and Morgan, 1997).
By the late 1970s, the prison population had increased dramatically
from an average population of 37, 820 in 1975 to 42, 264 in 1980 (see
Table A.4, Appendix).This increase led to severe overcrowding with two
and three prisoners being held in a cell built for one, degrading condi-
tions and inadequate sanitation (Fitzgerald and Sim, 1982). The 1970s
were also characterised by concerns about security, control and con-
tainment. For example, the prisoners’ rights movement began in 1972
through the National Prisoners Movement (PROP), a series of serious
riots took place, and prison officers engaged in an increasingly militant

campaign of industrial action over pay and conditions. As Fitzgerald
and Sim (1982: 2) note, ‘what everyone did agree about was that at the
end of 1978 the prison system was in crisis’.
In November 1978, the government responded by establishing a
committee under the leadership of Mr Justice May to inquire into the
state of the prison service. The May Committee recommended a
massive prison building and refurbishment programme to end the
practices of slopping out and sharing cells. They also made recommen-
dations in relation to the objectives of the penal system conceding that
the ‘rhetoric of ‘treatment and training’ had had its day and should be
replaced’ (Home Office, 1979: para. 4.27). After much debate, the
concept of ‘positive custody’ was proposed with the hope of develop-
ing regimes with a real purpose and objectives. Under this framework,
prison authorities and staff were responsible for creating an environ-
ment whereby prisoners could respond and contribute to society
positively, preserving and promoting their self respect, minimising the
harmful effects of prison life, and preparing and assisting them for
discharge (Home Office, 1979: para. 4.26). However, the implementa-
tion of the May Report became the responsibility of the new Thatcher
government and the notion of ‘positive custody’ was never officially
adopted.
Morris (1989: 189) argues that the Thatcher government would
never have considered setting up a structure like the May Committee,
preferring instead to employ ‘high powered individuals from the
world of commerce to conduct managerial-style reviews’. During the
1980s, Royal Commissions and standing advisory bodies, such as the
Advisory Council on the Penal System, tended to be replaced with
official inquiries which were ad hoc, highly specific, short-term, man-
ageable, and internal (Downes and Morgan, 1997). By the 1980s, links
between the Home Office and pressure groups were strengthened
forming a policy community which interacted over various issues.
Although the government often ignored protest from the pressure
groups, it also recognised their use in identifying problems, assessing
the feasibility of reforms and increasing the legitimacy of the policy
process (Downes and Morgan, 1997: 115). New pressure groups
emerged on the scene including Inquest which was founded in 1981,
the Prison Reform Trust (PRT) in 1982 and Women in Prison (WIP) in
1983. During the 1980s, the penal reform lobby and academic com-
mentators began to press for the recognition of prisoners’ rights and
timetables for the introduction of minimum standards and conditions
(Morgan, 1997), while the new government began devising strategies

for ‘managing’ the prison system.
The problems of an increasing population, overcrowding, riots,
and industrial action by prison officers endured throughout the
1980s. The response by the Conservative government was one of
‘penal pragmatism’ with no consideration of long-term or overarch-
ing goals (Bottoms, 1980: 4) and a contradictory mix of policies. In
1982, the most extensive prison building programme since the nine-
teenth century was initiated. While the prisons were being built, two
techniques were employed to reduce the prison population and
overcrowding which simultaneously appeased both the ‘law and
order’ lobby and liberal critics. These included increasing the
numbers of short-term offenders eligible for parole and introducing
a range of community penalties to divert offenders from custody,
while simultaneously increasing parole restrictions for those who
had committed more serious and violent offences. Both techniques
were part of a bifurcated policy or twin-track approach which distin-
guished the most serious and dangerous offenders from the less
serious and dangerous, ensuring the former received tough prison
sentences with restricted prospects for parole and the latter received
more lenient measures in the community (Bottoms, 1977; 1980).
Such a strategy had great political appeal because it allowed the
government to remain tough to appease the law and order lobby and
populist opinion, whilst simultaneously appearing soft to liberal
critics (Edelman, 1984).
In 1984, the Home Secretary, Leon Brittan, reduced the minimum
qualifying period for parole from twelve to six months. This led to an
increase in the numbers of grants of parole to short-term prisoners who
had committed less serious offences. At the same time, parole restric-
tions were imposed on those who had committed more violent and
serious offences. For example, prisoners serving life sentences for
certain types of murder would normally remain in prison for a
minimum of 20 years before becoming eligible for parole, unless there
were exceptional circumstances. Similarly, prisoners serving more than
5 years for violent offences or drug trafficking were unlikely to be
granted parole until just before the ends of their sentences or in excep-
tional circumstances. The parole policy had two main effects. First, it
led to a dramatic increase in the long-term prison population. Second,
it removed all incentives amongst long-term prisoners towards positive
behaviour and led to much hostility and unrest (Cavadino and
Dignan, 1997).
The loss of faith in rehabilitation as the primary purpose of impris-

onment and the rising prison population also led to a proliferation of
‘alternatives to custody’ which reflected a growing disillusionment
with the efficacy of prison for reforming offenders and the costs of
mass imprisonment. In the early 1980s, such alternatives included
community service orders and intermediate treatment for juvenile
offenders. The new alternatives to custody were thought to be both
more humane and effective. However, the criticism of deinstitutionali-
sation that developed in the 1970s and continued in the 1980s
suggested that these forms of punishment were neither humane nor
effective in terms of cost or reducing offending compared with impris-
onment (Greenberg, 1975). In fact, it was argued that these forms of
decarceration actually widened the net of social control and extended
the segregative principle from the institution to the community
(Cohen, 1985). The mode of penality had been dispersed throughout
society to more locations, agencies and personnel. Throughout this era,
the prison persisted and community corrections supplemented, aug-
mented, and replicated the prison rather than replacing it.
By the mid-1980s, the institutional context of policy-making began
to shift as increasing emphasis was placed on the financial manage-
ment of the public sector and drives toward the 3 E’s: Economy,
Effectiveness and Efficiency. Managerialism began to creep into all
areas of public policy and the problems of crime and punishment were
no exception. Rather than engaging with the question of legitimacy or
‘what are prisons for’, the Prison Service became obsessed with the
technical and legal requirements of keeping prisoners in custody
(Morgan, 1997). The penal strategies of the early 1980s cannot be
deemed successful in their practical aims. The prison population con-
tinued to rise, overcrowding was still a problem, inadequate conditions
prevailed and riots and disturbances were regular occurrences. During
the period 1980 to 1986, the average prison population rose from 42,
264 in 1980 to 46, 770 in 1986 (see Table A.4, Appendix). The crisis of
legitimacy remained untackled, with no long-term strategy, penal
philosophy or overarching goals identified for the prison system. It was
within this penal setting and policy context that the issue of drug users
in the prison system began to be debated.
Nature and extent of the drugs ‘problem’ in prisons
It was not until the late 1970s that the issue of drug users within the
prison system began to be recognised and debated. Historically, drug
users in the criminal justice system, and particularly prisoners, had not
been given prominence in discussions of drugs policy. As one com-
mentator argued, ‘in the 1970s prisons were regarded as a footnote,
albeit a perplexing one, in the treatment and rehabilitation debate’
(Runciman, 1996: 4). Similarly, the problem of drugs using prisoners
had not been a priority within penal policy. At this time, there was vir-
tually no research or evidence on the extent or nature of the drug
problem in prisons and very little external scrutiny (Berridge, 1990;
Pearson, 1990). Although there was no official, formal documented
policy or strategy which was publicly accessible, drug using prisoners
were dealt with by the Prison Medical Service (PMS). There was
growing criticism of the practices of the PMS from drugs experts and
other professionals in the community. The interest in the issue there-
fore emanated from external sources, rather than from internal sources
within the prison system. In the 1980s, three investigations were con-
ducted which began to examine the treatment of drug users in prison,
highlight and define the problem, and question existing strategies.
These included the 1980 ACMD report on drug dependants within the
prison system, the 1985 House of Commons Social Services Committee
Report on the Misuse of Hard Drugs, and the 1986 House of Commons
Social Services Committee Report on the Prison Medical Service.
By the late 1970s, the drugs policy community began to show inter-
est in the drug issue in prisons. In June 1977, the ACMD working
group on Treatment and Rehabilitation appointed three of its members
to examine and report on the treatment of drug dependants within the
prison system. Statistical evidence collated by the enquiry indicated a
growing number of drug dependants entering the prison system. A
sample of male addicts, followed up for five years after their first
notification, showed over half (56 per cent) had some experience of
custody (Mott, 1977). The report also provided evidence that the
majority of prisoners who were considered to be addicts had not been
receiving treatment during the year in which they were imprisoned.
Prior to the 1970s, prisoners with drug problems tended to be viewed
by both prisoners and prison staff as particularly ‘deviant’ and on the
margins of the mainstream population and culture within prisons.
Many prisoners were forced to keep their addiction hidden to avoid
mistreatment, bullying and harassment from other prisoners and
prison staff. Very few would actively seek treatment and help. During
the late 1970s and early 1980s, there was a perceived shift in the prison
population in relation to the characteristics of drug users or drug
involved offenders. A director of a drug agency who had been involved
in drug treatment in prisons during this period suggested there was a

shift or crossover emerging between mainstream criminality and drug
importation and dealing:
People who were coming in with drug problems were considered second
class citizens for a long time and were almost in the same category as
child molesters. They were seen apart from the criminal population and
they didn’t really mix very much … It used to be the case in the 1970s
that criminal gangs down in South London wouldn’t touch drugs. It was
mainly the hippies, degenerates and down and outs. Then what started to
happen is that mainstream criminals started to get into drug importation.
The whole division started to get more blurred. (Interview (03) with
director of drug agency)
Mirroring what was occurring in the community during the period

1980–6, increases in drug use and drug offences were also represented
in the prison population in terms of official indicators. For example,
the number of new drug addicts notified to the Home Office by prison
medical officers increased from 320 in 1981 to 1, 102 in 1986 with the
proportion of all notifications increasing from 14 to 21 per cent during
this period (see Table A.1, Appendix). In addition, drug offenders
sentenced to custody had increased in number from 1, 676 in 1980 to
3, 928 in 1986, with the proportion rising from 10 to 16 per cent over
this period (see Table A.2, Appendix).
Illegal and legal drugs: issues of control and collusion

During the late 1970s and early 1980s, there was increasing concern
that prescription drugs, such as tranquillisers, were being used as
mechanisms of control and discipline by the Prison Medical Service,
particularly in women’s prisons (Ryan, 1983; House of Commons
Social Services Committee, 1985 and 1986; Sim 1990). In November
1977, the Medical Committee Against the Abuse of Prisoners by
Drugging was formed through the National Prisoner’s Movement. It
consisted of representatives from the National Prisoners’ Movement,
the National Council for Civil Liberties, the National Association for
Mental Health, SCODA, Radical Alternatives to Prison and Release, as
well as a number of consultant psychiatrists. The Committee moni-
tored the allegations of drugging and campaigned for a prison health
service administered by the NHS (Sim, 1990). By 1986, contradictory
evidence was submitted to the Social Services Committee regarding the
levels of prescribing. Some submissions pointed to excessive levels and
coercive practices, while other evidence indicated that prescribing

policy had undergone a radical change with prisoners being subjected
to abrupt and inhumane withdrawal (House of Commons Social
Services Committee, 1986: xli–xlii).
The use of prescription drugs in controlling prisoners was related to
the collusion amongst prison staff around the use of illegal drugs.
Evidence submitted to the 1985 Social Services Committee suggested
that illegal drugs were available and being used in the prison system.
For example, the Association of Police Surgeons reported:
When the addict goes to prison he will be able to, in most circum-
stances, continue with drug abuse. While we appreciate the
difficulties for the prison authorities with the present state of over-
crowding especially in local prisons, it is common knowledge
among addicts that drugs are available. (House of Commons Social
Services Committee, 1985: xxxiii)
Similarly, the Prison Medical Association argued it was ‘difficult to ini-

tiate treatment and rehabilitation in long-term prisons where uncon-
trolled drink and drugs are so readily available’ (House of Commons
Social Services Committee, 1985: xxxiv). There was also evidence,
albeit limited, of the availability of drugs within prisons in the annual
reports of the Prison Service. For example, since the 1970s, deaths
associated with drug overdoses and misuse had been recorded (Home
Office, 1975, 1977, 1978, 1983) and dogs were increasingly being
trained to detect drugs (Home Office, 1985b).
Despite these rumours and evidence, the Prison Service was reluctant
to publicly acknowledge an ‘illegal’ drug problem in prisons. This collu-
sion was a powerful force which masked the nature and extent of the
problem and also had a detrimental effect on initiating research in this
area. In a summary of research on drugs, law enforcement and crimi-
nology in 1986, Pearson (1990: 142) described the problems of negoti-
ating access on drug issues in prison as ‘insurmountable’. A public
admission or evidence on the nature and extent of the problem might
have forced the prison authorities to initiate some form of action to
deal with it. Such a tacit admission would have indicated the failure or
non-existence of a drugs policy. Drugs, particularly cannabis, were
viewed as functional in that they kept the prison and prisoners quiet
and under control, making the job of prison staff easier. As the
National Association of Probation Officers (NAPO) argued in their evi-
dence to the 1985 Social Services Committee, ‘uniformed prison staff
collude with the use of cannabis unless it becomes so virulent that a

‘purge’ is necessary for credibility to be retained’ (House of Commons
Social Services Committee, 1985: 48). Those who had been involved in
prison drug treatment during this period suggested that the collusion
and complacency around drugs use was related to control issues:
What you had was a Prison Service – a monolithic organisation – which

had a stance that if we don’t talk about it, we don’t have to do anything
about it. (Interview (10) with director of drug agency)
What appeared to be occurring was a form of ‘institutionalised’

collusion:
There was a complacent attitude – a collusive attitude – by prison person-

nel. Because with a compliant, stoned population, they were much easier
to manage. It was an institutionalised collusion … It was a lot of turning
a blind eye. (Interview (15) with director of drug agency)
Thus, both illegal and prescribed drugs were used as mechanisms of

control within a prison system which was operating in a context of an
increasing population, overcrowding, inadequate conditions and
unrest. Illegal drugs were condoned and legal drugs were prescribed to
minimise disruption and to contain and manage a potentially volatile
population which was increasingly made up of prisoners serving long-
term sentences with little hope of parole. This collusion prevented the
growing illegal drug problem from becoming public and therefore
policy in this area was private, in-house and internal. As Heclo (1972)
reminds us, policies can consist of what is not being done.
Dealing with drug users in prisons
Paradoxically, it was within the non-treatment, non-rehabilitative

and ‘just deserts’ penal framework which had emerged during the late
1970s and early 1980s and the collusive environment around drugs,
that the ACMD (1980: 1) rather naively suggested that a prison sen-
tence should be regarded as an ‘opportunity’ for drug treatment and
rehabilitation. In 1985, this point was reiterated in the Social Services
Committee report (1985: xxxiii) on the misuse of hard drugs: ‘our
greatest concern is that the time so many addicts spend in custody
represents a wasted opportunity for tackling the problem of their
addiction’.
The role of the Prison Medical Service

During the period 1980–6, the Prison Service had its own system of
health care, the Prison Medical Service (PMS), which was separate from
the National Health Service (NHS). Prison doctors and medical staff are
employed by the Prison Service and are not accountable to health
authorities in the outside community. Medical staff within prisons
have always experienced an acute conflict between their contradictory
roles of caring for the health of prisoners and maintaining control and
discipline (Sim, 1990; Ralli, 1994). For example, under the Prison Rules,
medical officers have the dual responsibility of providing medical care
and ensuring that prisoners are fit for certain punishments, such as
solitary confinement and physical restraints. Sim (1990: x) cogently
argues that control and discipline have been more central to their roles
than health care: ‘prison medical workers, rather than operating from a
perspective bereft of ideology and politics, have been intimately
involved in reinforcing the discipline of penality’. Similarly, in
evidence to the 1986 Social Services Committee enquiry into the
Prison Medical Service, the Royal College of Psychiatrists urged a
review of the prison medical officer’s role outside the provision of
health care (House of Commons Social Services Committee, 1986: 62).
The Prison Medical Service was central to how drug users were dealt
with in the prison system during the 1980s. Drug addiction was
defined by the Prison Service primarily as a medical problem and dealt
with internally. Drug treatment, particularly withdrawal programmes,
were firmly located in the hands of Prison Medical Officers and subject
to their clinical judgement. Drugs policy was therefore related to the
internal practices of prison medical officers. All prisoners, both those
beginning their sentences and on remand, were medically examined
by a prison medical officer on admission to prison, providing the main
opportunity to identify drug users. The initial assessments, however,
were noted to be very brief and often ‘perfunctory to the point of use-
lessness’ (House of Commons Social Services Committee, 1986: xi).
This was mainly due to the large numbers of new prisoners who had to
be processed in a very limited period of time, as well as the prison
medical officers’ lack of experience and training in working with drug
users (ACMD, 1988). As a result, many drug users escaped detection
and some actively tried to conceal their drug use due to fear of being
sent to a more secure prison, increased chance of cell searches, and a
reduced chance of early release (Tippell, 1989). Women prisoners, in
particular, are often reluctant to disclose a drug problem, as they fear
their children may be taken into care (Nichols and Henderson, 1990).
If prisoners were identified as drug users on reception, they could be

offered a short-term withdrawal programme depending on the profes-
sional judgement of the prison medical officer.
Historically, the discourse of less-eligibility has underpinned penal
policy whereby prisoners should not be seen to be in receipt of services
or living in conditions which are superior to those living in the
community (Sim, 1990; Sparks, 1996). When this discourse is trans-
lated into penal practice however, it has often meant that prisoners
receive a standard of service provision well below that offered in the
community. The discourse of less eligibility also applies to the treat-
ment prisoners receive for drug addiction and has a long history. For
example, the Rolleston report of 1926 defined addiction as a disease
requiring medical treatment and legitimised maintenance prescribing.
However, the approach derived from the Rolleston report was class
based and had been developed for the middle-class addict who was per-
ceived to be ‘deserving’ and ‘respectable’ (Berridge, 1989; 1999;
Stimson and Lart, 1994). In contrast, the Rolleston consensus was not
extended to drug addicted prisoners who were treated by methods of
abrupt withdrawal. Berridge’s analysis (1999: 274) illustrates how, ‘the
prison doctors formed a distinct group who always favoured harsher
methods, in particular the abrupt withdrawal method of treatment;
their addict clientele was distinctively different’.
These distinctions between treatment in the community and prison
have continued. For example, the ACMD (1980) argued that treatment
in prisons was not congruent to what was being offered in the commu-
nity and that much of the existing provision was inadequate and
dated. Treatment provision in prisons had not kept pace with the new
thinking and theories around addiction. The professional consensus
which had been achieved in the community around ‘problem drug
taking’, social models of care, and integrated treatment and rehabilita-
tion had not penetrated the prison environment. Within the penal
setting, the dichotomy between medical treatment and rehabilitation
persisted. The Social Services Committee (1986: xxxix) argued that
drug addiction in prisons should be defined as a social service problem,
rather than a medical problem.
The ACMD (1980) also criticised the withdrawal programmes in prisons
as inadequate, particularly in relation to remand prisoners. Three recom-
mendations were made to improve withdrawal procedures emphasising
that they should take full advantage of the techniques developed by spe-
cialised units in the NHS; maintenance regimes should be instituted for
drug dependant remand prisoners; and the widest possible use should be
made by the courts of drug treatment centres, for remanding notified

drug dependants on bail for the purpose of obtaining medical reports
(ACMD, 1980). However, it was clear the legacy of the practices adopted
by the prison doctors of the Rolleston era had endured. In their response
to the ACMD report, the Home Office advocated an abstinence-only
approach and considered maintenance regimes inappropriate within the
prison system (Home Office, 1980). Five years later, in the 1985 Social
Services Committee report, submissions indicated that withdrawal pro-
grammes in prisons remained inadequate. Although provision varied
between establishments, many prisoners taken into custody in police
cells, remand centres and prisons were only given one option – abrupt
withdrawal. In evidence to the Committee, Dr Akhter of the Royal
College of Psychiatrists provided this graphic description of the inhu-
mane treatment drug addicted prisoners received: ‘the only treatment
that drug addicts get in prison is ‘cold turkey’. Nothing is prescribed and
they are just given a mattress on the floor’(House of Commons Social
Services Committee, 1985: xxxiii).
There were clear contradictions between the public and private dis-
courses operating within the prison system. The public discourse was
pushing forward the punitive, anti-drug, abstinence-based approach,
while the private discourse was quietly condoning and permitting drug
use. The private discourse involved turning a ‘blind eye’ and collusion
to maintain control of an increasingly unstable system.
Drug treatment provision

With the exception of pioneering projects like the Community Drugs
Project in London which undertook drugs work with prisoners (see
Dorn and South, 1985), drug treatment and counselling programmes
were scarce in prisons in the 1980s. The Social Services Committee
(1985: xxxv) concluded: ‘we cannot but condemn the absence of even
rudimentary services for prisoners with a history of drug use, both
while in custody and after release’. Despite the growth and diversity in
services in the community, there were very few outside agencies under-
taking drug work in prisons (Hamer, 1998). Most provision was inter-
nal, medically driven and provided on an ad hoc and individual basis.
A civil servant suggested that the lack of service provision was related
to the failure to acknowledge the problem of drug users within the
prison system and the lack of a clear drugs policy at this time:
Prior to the 1990s, there was very little clear action on drugs in prison and
individual cases were tackled through the medical model. The Prison
Service wasn’t really out there acknowledging that it had a large number
of drug misusing prisoners or in fact didn’t know whether it had or not in
any structured way. (Interview (19) with civil servant)
The ACMD (1980) suggested that the reasons for this paucity in
treatment facilities included the shortage of psychiatrists in the Prison
Service; failure of the Joint Consultant Programme between the Prison
Medical Service and the NHS; opposition to treatment in prisons by
some psychiatrists; unwillingness of prisoners to seek treatment; low
concentrations of drug users in a single prison to make treatment
viable; the range of sentences served by prisoners made it difficult to
maintain intensive therapeutic regimes; many therapies were based on
a single theory of addiction and were unacceptable to many drug users;
prisoners often changed their minds about treatment between remand
and return for sentence; and overcrowding and budget cuts made it
difficult to initiate and sustain programmes.
In the late 1970s and early 1980s, the few formalised attempts at
drug treatment in prisons involved some form of therapeutic commu-
nity based on a democratic, collaborative, self-help ethos (ACMD,
1980). In such units, no psychotropic medication was available, con-
sultants from the NHS were brought in and prison officers were trained
to work within these regimes. The ACMD (1980) described the efforts
to provide therapeutic regimes in five prisons: the Holloway
Therapeutic Unit, the Annexe at Wormwood Scrubs, Grendon
Psychiatric Prison, Pentonville and Feltham. The ACMD recommended
that more therapeutic units for drug dependants be established on the
model of those operating at Holloway and Wormwood Scrubs and that
follow-up studies be undertaken of drug dependants who had received
treatment in custody. In response, the Home Office argued that
resources were not available for any further units (Home Office, 1980).
In 1985, the Social Services Committee was similarly impressed by
what they witnessed during their visit to the Annexe at Wormwood
Scrubs and reiterated the ACMD recommendation regarding the provi-
sion of further similar units.
Overall, the ACMD report received very little attention and did not
have a huge impact on the prison system or prison drugs policy
(Tippell, 1989; Runciman, 1996; Hamer, 1998). With reference to the
1980 ACMD report, the Social Services Committee (1985: xxxiii) noted
that, ‘the sad truth is that none of these recommendations have been
carried out: this report would seem to have been swept under the
carpet.’ In order for the report to be taken seriously, the Prison
Department would have had to at least acknowledge a drugs ‘problem’

and that existing provision was inadequate. It can be argued, however,
that the ACMD had some success in highlighting the importance of
one of their recommendations – to establish a service to co-ordinate
and improve the aftercare provision available to ex-drug dependant
prisoners on release.
Release and throughcare: the development of services

Much of the ACMD report focused on the release and throughcare
arrangements for drug dependant prisoners which were viewed as both
‘the most important and the weakest element in providing this “com-
prehensive service”’ (ACMD, 1980: 7). Drug dependant prisoners have
similar problems to other prisoners during the resettlement process,
such as housing and employment, as well some specific problems
related to their drug dependant status. For example, there was growing
evidence that a high proportion of prisoners die from an overdose on
release from prison because they cannot tolerate the same levels as
they could prior to custody. A study of addict deaths in London
between 1970 and 1974 indicated that 10 per cent died within a few
days of release from prison (Stevens, 1977 quoted in ACMD, 1980).
Prisoners with a history of drug problems were often denied parole
because the Local Review Committee was concerned that insufficient
support was available in the community (Parole Release Scheme,
1983).The ACMD (1980) highlighted the importance of liaison and
communication between drug agencies and prisons so that follow-up
arrangements could be made on release. They found evidence that vol-
untary agencies were experiencing difficulties gaining access to prisons
to establish contact with future clients and to undertake throughcare
work. The Prison Service often resisted allowing access to these agen-
cies because many drug workers were ex-addicts or ex-prisoners them-
selves and because the staff turnover rates were high. On the other
hand, there was also evidence to suggest that drug agencies and drug
treatment centres were reluctant to become involved within the crimi-
nal justice system, particularly prisons. In many cases, they may have
refused prisoners due to time and financial constraints (Tippell, 1989),
but their reluctance also reflected an underlying resistance to become
involved in treatment and therapy within a coercive environment.
As a result of the findings and recommendations of the ACMD,
SCODA co-ordinated a small working group to plan a service for
problem drug users in prison who were eligible for parole (Parole
Release Scheme, 1985). The group consisted of representatives from
SCODA, NACRO, non-residential and residential drug services, Inner

London Probation Service, and the Prison Service. The impetus for this
initiative emerged primarily from the voluntary sector, although the
prison and probation services supported it. It was originally envisaged
that the service would perform a co-ordinating role between prison
and services in the community, but the Home Office advised that
funding would not be available for non-residential service (Parole
Release Scheme, 1985). As a result, the working group developed plans
for a residential facility which would be attached to the service. After
several years of planning and negotiation, the Parole Release Scheme
(PRS) was established in 1983. The development of the PRS is charac-
teristic of the move away from ‘specialists’ and towards involving
‘generalists’ in the work with drug users which occurred during the
1980s. It represented the first dedicated service for drug using prison-
ers. Adopting a pragmatic and modest approach to its work with ex-
prisoners, the scheme began as a small pilot project with three main
functions: to link prisoners who were eligible for parole and had a drug
history with suitable post-release services; to offer a residential service
through its own hostel; and to monitor its work and learn more about
drug users in prison (Parole Release Scheme, 1984). In terms of
resources, the PRS had four staff, one hostel and an agreement to work
with seven prisons in London and the south-east chosen by the Prison
Department.
It was originally envisaged that the PRS would work with approxi-
mately thirty parolees per year. In reality, however, this was a huge
underestimate (Tippell, 1989). As discussed in the previous section on
penal policy, changes were announced to the parole system to alleviate
the growing prison population in 1984. The length of sentence during
which a prisoner would be eligible for parole was reduced. This meant
that more prisoners were placed into the parole process and thus more
imprisoned drug users were eligible for referral to the PRS (Tippell,
1989). In the first year of operation, the PRS received 124 requests for
referral instead of the thirty originally envisaged. By 1986, the PRS had
received 404 requests for referral and was receiving 1, 000 enquiries per
year from probation officers in relation to drugs and drug services (PRS,
1986).
An emerging policy network

Over the course of the phase 1980–6, it is clear the work of the ACMD
and the Social Services Committees on the misuse of hard drugs and
the Prison Medical Service began to generate discussion and debate
regarding the treatment of drug users in prisons. The drugs and penal
policy communities began to recognise that there were important
issues which needed to be addressed within prisons regarding drugs. A
policy network began to emerge around drug issues in prison which
operated at the subsectoral level or at the interface between penal and
drugs policy. The main concern for this policy network was the treat-
ment provision for drug using prisoners, particularly on release.
Although the Home Office and Prison Medical Service remained at the
core of this network, an increasing number of groups and organisations
became involved at the periphery including the probation service,
SCODA, NACRO, and drug agencies. The drug issue within prisons was
gradually becoming exposed and subject to greater external scrutiny
and challenges.
This policy network recognised the constraints within the prison
system during this period, including the difficult penal conditions and
context, the lack of a formalised drugs policy, the collusion around drug
issues, the professional power of the Prison Medical Service, the lack of
financial resources, and the decline of the rehabilitative ideal. Rather
than attempting to tackle the problem on the inside, they pursued a
much more realistic and pragmatic approach by developing measures to
deal with the problem on the outside through throughcare and release
measures. Working within these parameters meant that they would not
have to confront the problems, conflicts and constraints internal to the
system. The Parole Release Scheme marked the beginning of drug
service development in prisons. It revealed a glaring gap in provision
and highlighted the lack of understanding around this aspect of the
drug problem (Tippell, 1989). In the following chapters, it will become
clear that service development preceded policy development in this
area. Following the work of the PRS, other drug agencies began to work
within prisons and internal interest in the drug issue within the prison
system began to increase. It gradually became more acceptable for drug
agencies to become involved in the criminal justice system:
the prisons started to develop an interest in drugs and drawing in outside

agencies. It wasn’t really so much through drugs as much as through some
of the throughcare issues and pre-release groups. They started to see the
value of outsiders. The drug agencies were freaking because you know we
were ‘right on’ and we were a little bit on the edge when it came to crimi-
nal justice issues and legality. Many drug agencies shied away [from]
working in prison … gradually they began to see that they could do it.
(Interview (26a) with director of drug agency)
Conclusion
Although very little substantive research or evidence existed in relation

to the drugs ‘problem’ in prisons during the period from 1980 to 1986,
statistics on notifications and drugs offences showed increases and
several official reports pointed to a growing ‘problem’. There were,
however, powerful forces masking this increasing ‘problem’. Drugs,
particularly cannabis, played an important control function within the
prison system and prison staff were reluctant to admit that drugs were
being used. A form of ‘institutionalised collusion’ emerged which kept
the problem hidden from outside scrutiny. During this period, drugs
were seen primarily as an ‘individual’ problem rather than a problem
for the ‘institution’. Prisoners who had been identified as having drug
problems were dealt with individually mainly through the medical
model. However, the treatment they received was inadequate and
often inhumane in comparison with community provision, particu-
larly in relation to withdrawal programmes. Various recommendations
had been made to improve treatment programmes in prison, yet the
government had failed to seriously consider or implement any of
them.
During this period, prisons were operating on the periphery of the
drugs policy debates, similarly drugs were not central to the penal
policy debates. Many of the new ideas in relation to drug users and
drug treatment in the community had not penetrated the walls of the
prison. Although the tradition of treatment and rehabilitation contin-
ued in the community by the caring professions, the discourses of ‘law
and order’ and ‘just deserts’ were particularly acute within the prison
environment.The objectives of drug treatment were clearly in conflict
with the aims of penal policy. Moreover, treatment objectives would
also be hindered in a system under crisis with its increasing popula-
tion, inadequate conditions, unrest and overcrowding. The idea that
prison should be regarded as an opportunity for drug treatment also
conflicted with the fact that drugs, both illegal and legal, were used as
mechanisms of control in the prison environment. Those lobbying for
change recognised the power of this punitive framework, but rather
than tackling the problems on the inside, chose to tackle it in the com-
munity on release.
A key figure in prison drugs policy described the early 1980s as a
period of ‘modest ambitions’ in relation to developments in both
policy and service provision. Although no concrete prison drugs
policy or strategy emerged during the period from 1980 to 1986, it
was an important phase in that it laid the foundations for later

policy developments. External interest in drugs and drug users in
prison was growing and a small policy network was beginning to
form around the issue. The Prison Medical Service had always had a
monopoly over the control of drug treatment in prisons, but this
began to change as more external drug agencies became involved in
treatment provision in prisons from the mid-1980s. By 1986–7,
drugs policy was increasingly shaped by the HIV/AIDS crisis. The
next chapter will explore the impact of HIV/AIDS within the prison
system and on policy development.
3
1986–93: The HIV/AIDS Crisis and
Fears of Contamination
Introduction
This chapter focuses on the period 1986 to 1993, which signalled the
beginning of more explicit policy development in relation to drug
issues in prisons. As in the previous phase, the issues of throughcare
and treatment continued to be emphasised, resulting in a more formal
policy document on throughcare in 1987 (HM Prison Service, 1987)
and a manual dealing with guidelines on how drug users should be
cared for within the prison system in 1991 (HM Prison Service, 1991).
The HIV/AIDS crisis was the key factor precipitating this move towards
a more defined prison drugs policy. In 1986, HIV/AIDS first began to be
debated in relation to drugs policy in the community (Stimson and
Lart, 1991; Berridge, 1996a). In contrast to the earlier phase, the
‘denial’ and ‘collusion’ which existed around drug issues in prison were
no longer sustainable in light of HIV and the evidence and research
base which was beginning to emerge on the nature and extent of the
problem. The concern around HIV and injecting drug use within the
prison environment resulted in a policy network forming around this
issue which began to pressure the Prison Service to acknowledge and
respond to the problem.
During the period 1986 to 1993, the macro public policy context
continued to be shaped by the reforms and restructuring initiated by
the Conservative government. The discourses of managerialism, value
for money, privatisation, devolvement, voluntarism, partnership and
community were becoming dominant features of the public policy and
political landscape. These were evident in the reforms to the NHS,
education and local government as well as criminal justice policy. The
main thrust behind the reforms and restructuring was to shift the state
56
1986–93: The HIV/AIDS Crisis 57
towards the role of facilitator rather than provider (Atkinson and

Savage, 1994). However, as Reiner and Cross (1991: 7) argue, two
contradictory trends can be identified: the devolvement of responsibil-
ity from official agencies to the community and the enhancement of
power and control within central government. These themes and
trends influenced the development of drugs and penal policy during
1986 to 1993.
The chapter begins with a brief outline of the major developments in
drugs and penal policy which provide the context for the emerging
policy on drugs in prisons. It then explores the nature and extent of
the drugs ‘problem’ in prison and how it was reconceptualised by key
actors during this phase. The final section of the chapter examines the
policies developed around drugs and HIV/AIDS in prisons during this
phase. It will emerge that these policies were inadequate, failing to
fully embrace the concepts of ‘risk reduction’ and ‘harm minimisation’
and the public health agenda which were successfully operating in the
community. In effect, it appears that they were designed to appease
critics and give the impression that action was being taken (Edelman,
1971).
Drugs policy context: the discourses of ‘harm

minimisation’, ‘public health’ and ‘partnership’
During the period 1986 to 1993, official indicators showed that the
drug problem continued to grow. With the exception of a decrease
between the years 1986 and 1987, the number of new drug addicts
notified to the Home Office increased steadily from 5, 325 in 1986 to
11, 561 in 1993 (see Table A.3, Appendix). The heroin ‘epidemic’ of the
early 1980s, however, appeared to be levelling off, as the percentage of
newly notified heroin addicts fell from 91 per cent in 1986 to 78 per
cent in 1993. During this period, the number of drug offences
increased threefold from 23, 905 in 1986 to 68, 480 in 1993 (see Table
A.2, Appendix). As a result of the crack cocaine ‘crisis’ in the United
States during the latter half of the 1980s, there was growing political
and media concern regarding increasing use of cocaine in the UK.
However, the addict statistics failed to show a significant problem, with
the proportion addicted to cocaine accounting for less than 10 per cent
throughout the period 1986–93 (Home Office Statistical Bulletins,
1987–94; see also Power, 1994 and Bean, 1993).
By the end of 1985, HIV infection was already established within
drug injecting populations in England, Wales and Scotland. For
example, 55 cases of HIV infection among injecting drug users were

reported in England and Wales and 356 cases in Scotland (Robertson,
1994). Local studies conducted in Edinburgh pointed to a rapidly
spreading HIV epidemic amongst the drug injecting population, with
sero-positive levels of around 50 per cent (Robertson et al., 1986). This
epidemic was associated with a shortage of clean syringes and ‘shoot-
ing galleries’ where as many as 30 drug users would gather to share a
single syringe. The way in which the drug problem was framed and
defined changed in light of the HIV/AIDS crisis. Injecting drug users
were expected to be one of the key groups in terms of heterosexual
transmission and therefore seen as a threat to public health. Drugs
policy became shaped and reinforced by the advent of HIV/AIDS. The
main response was to re-examine harm minimisation policies and to
continue the emphasis upon collaboration, co-ordination and
partnership between agencies and services.
HIV/AIDS and harm minimisation

The interest and concern regarding the relationship between HIV and
injecting drug use were minimal initially. During the early period of
the virus, key players in the drugs world were slow to come forward
and many lacked expertise in relation to HIV/AIDS. Berridge (1996a:
93) argues that although a liberal consensus had been achieved in
mainstream AIDS policy by 1986–7, this was initially difficult to extend
to the area of drugs due to problems with political and public approval
around harm minimisation techniques such as syringe exchanges, the
isolation of drugs policy psychiatrists from public health and clinical
medicine, and the traditions of local drugs policy-making. Conflicts
and divisions were also rife within professional groups in terms of the
choice between abstinence and harm minimisation approaches.
However, the epidemic amongst drug injectors in Scotland and the
subsequent McClellend Report advocating harm minimisation helped
to shape future policy (Berridge, 1996a).
In 1987, the UK government initially implemented three measures to
tackle the spread of HIV through injecting drug use including a publicity
campaign, provision of extra resources to drug services, and the intro-
duction of 15 pilot needle exchange schemes (ACMD, 1988). The ACMD
established a working group to discuss and consider the implications of
HIV/AIDS for drug services and to make recommendations on how the
problem should be tackled. The group produced three influential reports
on the topic (ACMD, 1988; 1989; 1993). They concluded in their first
report that ‘HIV is a greater threat to public and individual health than
drug misuse’ (ACMD, 1988: 1). Thus, the containment of the virus was
viewed as more important than drugs prevention (Stimson, 1990b;
Berridge, 1991). The drugs policy community increasingly recognised
that many drug users may not wish to stop injecting and that risk reduc-
tion and harm minimisation strategies must be developed to work with
this group. Research evidence from the pilot syringe exchanges also
indicated that they had been successful in attracting clients and chang-
ing risk behaviour, but less successful in retaining clients and attracting
women and young people (Stimson et al., 1988).
Policy-makers were eventually persuaded that harm minimisation
strategies must be adopted to contain the virus and the threat of
leakage into the general population. As Berridge (1996a: 95) argues, the
gap between the ‘political’ and ‘policy community’ views on drugs
policy narrowed and an alliance or consensus developed which was
based on harm minimisation rather than eradication or cure. Drugs
had become a problem of public health rather than individual pathol-
ogy (Berridge, 1996b). Harm minimisation was officially adopted as a
policy goal and involved the extension of syringe exchange schemes,
free distribution of condoms, education around injecting and sexual
practices, and increased use of methadone prescribing. The new
language of risk reduction, harm minimisation, accessibility, and user
friendliness became the ‘official’ discourses in relation to HIV/AIDS
and drugs (Stimson and Lart, 1991).
The HIV/AIDS epidemic and the shift towards greater harm minimi-
sation also brought new players into the field including infectious
disease specialists, public health professionals, GPs and a re-shaped vol-
untary sector (MacGregor, 1998a). Although at one level the response
to HIV/AIDS indicated a partial re-medicalisation of drugs policy, the
emphasis on involving generalists such as community workers, out-
reach workers, and ex-addicts in drugs interventions continued
(Stimson, 1990b). More funds were made available for drug services.
The Central Funding Initiative in the mid-1980s had produced a wide
range of new drug agencies which were in place and ready to adapt and
respond to the HIV/AIDS crisis. In 1988–9 an extra 3 million pounds
and in 1989–90 an extra 5 million pounds were made available for
drug services to increase their role in halting the spread of HIV (Home
Office, 1990b). Such funding enabled many of these services to survive.
However, in order to meet the requirements of HIV funding, many ser-
vices were bent towards responding to HIV and injecting drug use, to
the exclusion of other drugs and other drug users (MacGregor, 1998a).
HIV had a profound effect on the way in which drug services operated.
Accessible services which operated outreach, open-door and user

friendly policies were developed and big targets such as abstinence
were replaced with smaller targets and a hierarchy of goals (Stimson,
1990b). Moreover, their traditional autonomy was increasingly eroded,
they were asked to collaborate with other agencies, become part of a
wider planning process and accountable for large sums of earmarked
finance (Cranfield et al., 1994).
As argued in the previous chapter, drugs policy during the mid-1980s
was set within an increasingly penal framework and more focused on
enforcement issues than previously. The HIV/AIDS epidemic was seen
to have the effect of overturning that policy. However, as Berridge
(1996a) argues, the reality was much more complex. HIV/AIDS did not
overturn the penal response nor did it introduce brand new concepts
into the drugs policy debate. During the period 1986–93, the 1985
national drugs strategy was not revised in any significant way in
response to the HIV/AIDS crisis and its five main action points
remained unchanged. The bifurcated policy of control endured with
punitive enforcement measures targeted towards drug dealers and
traffickers and harm and demand reduction measures for drug users.
During the late 1980s, policy-makers, politicians and the media
became increasingly concerned and preoccupied with the notion that
crack would threaten the stability of British communities. They feared
that the crack ‘epidemic’ amongst black people in some inner cities in
America would reproduce itself in Britain, particularly in areas where
there was a significant black population (Bean, 1993). The panic
around crack ensured that the ‘war on drugs’ continued and provided
legitimacy for the existing penal framework.
Two very contradictory discourses – enforcement/punishment and
harm minimisation/public health – continued to operate simultane-
ously and were articulated publicly at the political level. As Edelman
(1984) argues much political mileage can be gained by putting forward
soft and hard approaches simultaneously. Such a strategy appeases
both liberal critics and hard-line law and order advocates. It is possible
to draw a discursive distinction between the legitimate, deserving
victims and the illegitimate, undeserving villains of drugs, whereby the
victims receive treatment and harm reduction and the villains receive
punishment and custody (Collison, 1993; 1994). However, as Collison
(1993: 383) cogently argues, in practice this distinction is simplistic
and the two sides of the ‘British System’ are frequently dealing with
the same groups of people (i.e. low level dealers drawn into the crimi-
nal justice system who are also problem drug users).
During 1986–93, there were also indications that drug issues in the
criminal justice system, particularly in relation to prisons, were moving
into mainstream drugs policy debates. Since their report on prisons in
1980, the ACMD showed a renewed interest in the criminal justice
system. In the series of reports on AIDS and drugs (ACMD, 1988, 1989;
1993), the special problems around the link between HIV and drug use
in prisons were specifically highlighted. In 1990, the Criminal Justice
Working Group of the ACMD was appointed. It explored the various
aspects of the criminal justice system in relation to drug users in three
major reports dealing with probation, police, and prison (ACMD, 1991;
1994; 1996). Policy networks began to form around each of these
issues. The membership of the Criminal Justice Working Group varied
according to the subject area, but many of the representatives had con-
tinuous membership, including Ruth Runciman who chaired each
group. The membership was generally comprised of officials from the
Home Office, Department of Health, Crown Prosecution Service, and
the Scottish Office, psychiatrists, social researchers, and representatives
from probation, police, social services, magistrates and drug agencies.
Although the response to HIV/AIDS was perceived to be radical, this
was only possible because of powerful historical antecedents (Berridge,
1991). Harm minimisation was not a new or unusual discourse, but
one which had a long history and strong tradition in Britain dating
back to the Rolleston era. The response was therefore based on what
had gone on before. As Berridge (1996a: 95) suggests, the AIDS
epidemic re-emphasised and gave political legitimacy to issues in drugs
policy which were already on the agenda within the drugs policy
community. Alongside the penal response, drug services had been
expanding through the CFI and becoming integrated with general
health provision, harm minimisation was advocated, and partnership,
prevention and ‘community’ were being re-emphasised.
The drive towards partnership, community and prevention

During the period 1986–93, there were further calls for improved part-
nership and collaboration between services and agencies around drug
issues, a renewed stress on drugs prevention and moves to involve the
community in tackling the drug problem. In 1989, the Home Office
Drugs Prevention Initiative was established which involved setting up
20 local drug prevention teams throughout England, Scotland and
Wales. The aim of these new structures was to involve all sectors of the
community in tackling drugs and assist in the development of commu-
nity initiatives (Home Office CDPU, 1993). Collaboration between
agencies and services at local level also continued to be stressed

through the DDAC structures. The interface between criminal justice
agencies and other agencies in DDACs was becoming more apparent.
For example, it was increasingly recognised that DDACs would have to
engage with prisons particularly around HIV/AIDS issues because pris-
oners were seen to be a key population in relation to the transmission
of the disease. The Department of Health (1988) suggested that a
framework was required to enable local collaboration with prisons built
either around the ‘adoption’ of prisons by local health agencies for
health care services or with prison education services. Similarly, the
ACMD (1991) made recommendations that the Probation Service
should collaborate with health and local authorities regarding the
treatment of drug using offenders and play a role in the preparation of
and consultation on community-care plans.
Despite these numerous recommendations and moves towards joint
working, the system of collaboration was not working effectively
(Baker and Runicles, 1991; Dorn and South, 1994; Howard et al., 1994).
Several problems associated with joint working were identified in a
report by the London Research Centre and the National Local
Authority Forum on Drug Misuse: some areas did not have functioning
DDACs; membership was dominated by the health service; irregular
attendance was common; support structures were weak; terms of refer-
ence were vague; there was little involvement in resource allocation
decisions; difficulties arose over non-coterminous boundaries; seniority
levels amongst members varied; there were difficulties in ensuring
commitments to joint working; social services were not aware of drug
issues; and DDACs had not been incorporated into the formal plan-
ning machinery (Baker and Runicles, 1991). In 1992, the Department
of Health commissioned Roger Howard, an independent consultant at
the time (now Chief Executive of Drugscope), to identify good practice
and make recommendations for new collaborative arrangements to
tackle drugs use. Howard et al. (1994: 9) proposed new partnership
structures to replace the existing DDACs and predicted that the role of
the criminal justice system would feature prominently in any future
collaborative arrangements:
The criminal justice system remains a key area of change for tack-
ling drugs misuse, which statutory and voluntary agencies will need
to address together. The boundaries of what constitutes enforce-
ment and what constitutes prevention, treatment and care are being
redrawn
Penal policy context: key attempts at reform 1986–93
During the latter half of the 1980s, the penal crisis continued, culmi-
nating in serious riots at Strangeways and other prisons in 1990. This
was described by Sparks et al. (1996: 15) as the ‘most drastic and public
notorious event in the modern history of the prisons of England and
Wales’. During the late 1980s and early 1990s, several attempts were
made to manage and contain the crisis in British prisons. The emphasis
on economy, effectiveness and efficiency continued and the discourses
of managerialism and privatisation began to manifest themselves in
more concrete and visible ways. For example, in 1987, the Fresh Start
initiative was introduced which involved a fundamental overhaul of
working arrangements for prison officers and management structures.
By the late 1980s, the issue of prison privatisation was also gradually
creeping onto the political agenda. In 1989, two remand prisons were
handed over to the private sector to manage on an experimental basis.
In 1992, Wolds remand prison on Humberside was contracted out.
However, before it could be evaluated, an amendment to the 1991
Criminal Justice Act allowed for the extension of privatisation to the
mainstream prison population (Ryan and Sim, 1998).
As discussed in the previous chapter, with the decline of the rehabil-
itative ideal, the ‘just deserts’ approach to sentencing moved to the
forefront of penal policy (von Hirsch, 1985). Penal policy during the
late 1980s and early 1990s was in the direction of making punishment
proportionate to the gravity of the offence, making ‘fair’ punishment
the main penal aim rather than the reform or rehabilitation of offend-
ers, reserving imprisonment for serious offences, and substituting com-
munity penalties for short prison sentences for non-violent crimes
(Hudson, 1993). During the period 1986–93, two central themes were
operating within the discourse on justice: ‘just deserts’ and ‘punish-
ment in the community’ (Collison, 1993). These themes and trends
underpinned the Green Paper, Punishment, Custody and the Community,
and the White Paper, Crime, Justice and Protecting the Public, culminat-
ing in the 1991 Criminal Justice Act which marked a significant shift in
penal policy and a pragmatic response to the prison population crisis.
The Act can be viewed as the outcome of careful deliberation and
refinement of the relevant issues by civil servants who had consulted
widely and engaged key interest groups in the debates (Faulkner, 1996;
Downes and Morgan, 1997). By the late 1980s, the penal lobby was
growing increasingly sophisticated in its structure and organisation
and could not be ignored by policy-makers. For example, the Penal
Affairs Consortium (PAC) was formed in 1989 and consists of an

alliance of diverse organisations including penal reform groups such as
the Prison Reform Trust (PRT), NACRO, Howard League and Women in
Prison as well as professional associations including the Prison Officer’s
Association (POA), the Prison Governor’s Association, and the National
Association of Probation Officers (NAPO). As Downes and Morgan
(1997: 114) comment, such a combination of interests was ‘previously
unthinkable’.
1991 Criminal Justice Act

The 1991 Criminal Justice Act put forward a new sentencing frame-
work which placed emphasis on proportionality, just deserts, retribu-
tion, incapacitation, and protecting the public. Prison would be
reserved only for the most serious offenders, as it was considered inef-
fective in reforming the majority of prisoners and an ‘expensive way of
making bad people worse’(Home Office, 1990a: 6). The overall aim of
the 1991 Criminal Justice Act was to reduce the use of custody, rather
than tackling the ‘crisis of legitimacy’ which had been plaguing the
penal system. As Hudson (1994: 294) argues, the 1991 Act prioritised
‘acts’ over individuals and legal facts over social facts as rehabilitation
professionals lost power and sentencers moved to the forefront of the
penal response.
With regard to drug offenders, the Act pursued a bifurcated approach
allowing for harsh punishments for drugs traffickers and treatment and
diversion from custody for less serious offenders with drug problems.
Sentencers were enabled under the Act to attach an additional require-
ment to probation orders – that the offender should undergo treatment
for drug or alcohol dependency. In theory this meant that more drug
users would be brought into contact with the treatment services, thus
locating this group of less serious drug using offenders outside the
general framework of ‘punishment in the community’ and ‘just
deserts’, by prioritising drug problems over crime problems (Collison,
1993).The Act also put forth new arrangements for local funding and
partnership whereby local probation services were expected to develop
agreements with the independent sector and other agencies on best
practice in dealing with offenders in the community. Funding of vol-
untary organisations, some of which deal with drug issues, would be
passed from the Home Office to local probation services. As a result,
probation services would have more of a role in commissioning.
However, research conducted by Lee (1994) suggests that within the
first six months after commencement of the 1991 Act, very few
conditions of drug treatment were made and it was debatable whether

those which were imposed were actually being used as alternatives to
custody. Various factors could have contributed to their low take-up
rates including their lack of credibility amongst sentencers as a
sentencing package for more serious offenders and the competition
between the various types of community punishments; the financial
constraints of both probation services and drug agencies; the problems
around assessment and disclosure of drug problems amongst offenders
and questions regarding the motivation of offenders towards treatment
(Collison, 1993; Lee, 1994). In practice, the welfarism and treatment
orientation of the 1991 Act was abandoned for increasing repression,
punishment and criminalisation of addicted offenders and drug-related
crime (Collison, 1993; Henham, 1994). Women, particularly foreign
nationals working as drug ‘mules’, have become the victims of such
policies as more and more are sentenced for drug-trafficking offences
(see Green, 1991; 1996).
The Woolf inquiry

After the riots at Strangeways and other prisons in 1990, Lord Justice
Woolf and Judge Stephen Tumin were called upon to conduct an
inquiry into their causes. Although Woolf concluded that there was
‘no single cause of riots and no simple solution or action which will
prevent rioting’ (Woolf, 1991: para. 9.23), he identified three require-
ments that must be met and balanced if the prison system was to
remain stable: security, control and justice. The programme of change
involved 12 main recommendations including improvements to prison
management, new standards relating to overcrowding and sanitation,
emphasis on prisoners maintaining links with their families and com-
munities and improved standards of justice in prison. The report was
greeted favourably across the political spectrum resulting in a consen-
sus amongst politicians, civil servants, the media, most academics and
penal reform groups. The report had ‘transcended the divisions’
between these groups and united them on the ‘ideological terrain of
penal reform’ (Sim, 1994: 42). Others argued that Woolf’s analysis was
consistent with contemporary penal practice and discourse and did not
offer any radical analysis of the prison system (see Hudson, 1993; Sim,
1994). In particular, Woolf failed to address the problems in women’s
prisons and the racism inherent within the system (Carlen and
Tchaikovsky; 1996; Hudson, 1993). In addition, he failed to address the
purposes of imprisonment in any comprehensive or detailed way.
However, Woolf had placed the notion of ‘justice’ at the centre of his
conceptual framework in an attempt to resolve the crisis of legitimacy

within the prison system (Sparks, 1994: Sparks and Bottoms, 1995).
In terms of implementation, Woolf made it clear that his recommen-
dations had to be taken together as one package. The Home Secretary,
Kenneth Baker, announced some immediate reforms to letters, tele-
phone calls, visits, home leave, and sanitation on receipt of the report
in February 1991. The official response to the Woolf Report was con-
tained in the White Paper, Custody, Care and Justice (Home Office,
1991c) which claimed the government had accepted all of Woolf ‘s
proposals with the exception of parliamentary control on overcrowd-
ing which would be dealt with after the 1991 Criminal Justice Act was
fully operational. However, the timetable for implementation was
vague in relation to the main recommendations. In the summer of
1991, Baker announced that Woolf’s agenda would take approximately
20 to 25 years to implement and made it clear that no extra resources
would be devoted to implementing his recommendations. It is evident
the government responded to the proposals in a ‘pick and mix’ fashion
rather than comprehensively as Woolf had intended. Cavadino and
Dignan (1992) identify their response as a two-speed approach with
security measures, such as x-ray machines and metal detectors, in the
fast lane and reforms such as improved regimes, the end of overcrowd-
ing and the adoption of enforceable standards in the slow lane.
Changes to the Prison Medical Service

As we saw in the previous chapter, the Prison Medical Service (PMS)
had been long criticised as inadequate and often inhumane in its
medical treatment of prisoners. It had been the subject of several
official reports which called for urgent reform (Home Office, 1964;
1990c; 1990d; 1990e; House of Commons Social Services Committee,
1986; Woolf, 1991). In particular, medical treatment in prisons was not
considered to be of a comparable standard to that provided in the
community.
In April 1992, the Prison Medical Service was renamed the Health
Care Service for Prisoners. The aims of the new service were to provide
a total system of care dealing with the whole person and to promote
general health rather than being solely focused on ill health (HM
Prison Service, 1992). The new health service for prisoners was to be
delivered through a multidisciplinary approach and to encompass
physical and mental health, treatment and cure, training and educa-
tion, conditions and regimes. This shift towards a more ‘health’ based
service and the greater emphasis on multidisciplinary approaches
provided the framework and context for the way in which drugs and
HIV/AIDS were dealt with in the prison system. The opening up of the
prison to outside agencies in the community had the potential to
challenge the monopoly prison medical officers had over the care and
treatment of prisoners with drug problems. Before exploring some of
these issues, the next section will first examine the nature and extent
of the ‘problem’ of drug use in prisons and how it was reconceptualised
during the period 1986–93.
The end of the denial: reconceptualising the drugs

‘problem’ in prison
During the late 1980s and early 1990s, the drug problem in prison was
reconceptualised and framed in new ways. The problem had progressed
to the stage where it could no longer be denied nor ignored. The
collusion around drugs became increasingly untenable due to a
number of interlinked factors – changes in the drug problem in terms
of incidence and severity, the HIV/AIDS crisis and fears of leakage into
the general population, an emerging policy network around HIV and
drug issues in prisons, and the growing research and evidence base.
The drug problem in prisons was finally acknowledged reluctantly by
the Prison Service. This process was referred to as the ‘end of the
denial’ by informed members of the policy network around drug issues
in prisons. As a director of a drug agency argued:
There was always an absolute denial that there was any drugs in prison
… Drugs are illegal therefore they don’t exist. That went on right up until
the early 1990s … when there was an acknowledgement that there was a
drug problem in the prison setting. Before, there was always a complete
and total and utter denial, partly because no one really knew what to do
about it. So if we pretend it is not there, it will just go away. But it didn’t,
it got bigger and bigger. (Interview 04)
In terms of official indicators, the number of drug addicts and drug

offenders in prison decreased in the latter half of the 1980s, but began
to increase again by the 1990s. For example, the number of new
addicts notified to the Home Office by prison medical officers fluctu-
ated, decreasing from 1,102 in 1986 to 624 in 1989, but then
increased steadily each year until 1993 when the number reached
1,941 (see Table A.1, Appendix). Similarly, the number of drug offend-
ers sentenced to custody had decreased from 3,928 in 1986 to 3,268 in
1991, but then increased again to 4,835 in 1993 (see Table A.2,
Appendix). Reflecting the greater use of cautioning for drug offenders,
particularly for unlawful possession, the proportion of drug offenders
sentenced to custody decreased progressively from 16 per cent in 1986
to 7 per cent in 1993 (Home Office Statistical Bulletin, 1994b). With
the ‘end of the denial’ and the growing public acknowledgement of
the drug problem, a director of a drug agency suggested that this
caused the issue of drugs in prison to grow and perhaps take on its
own momentum:
One of the consequences of public acknowledgement of things is that they

increase in their incidence. Yet the objective of public acknowledgement is
to try and start to control them. There’s a symbiotic relationship between
opening issues out and acknowledging them at a national level and the
issue growing as an issue … that’s happened in prisons. (Interview 08)
The increase in the extent of the drug problem in prisons was associ-
ated with heightened awareness of the issue and concern amongst
drugs experts, civil servants and other professionals that the problem
was becoming more serious with an increasing number of prisoners
using drugs other than cannabis. Perceptions regarding the drugs
‘problem’ in prisons had shifted in terms of incidence and severity. As
a civil servant commented:
In the late 1980s, there was an acknowledgement that drugs were in

prison, but the perception was that it was all cannabis … Although the
Service didn’t admit it, the general philosophy was that this contributes to
a quiet jail and wasn’t causing a very great problem. I remember at that
time an obsessive belief that somehow as a matter of choice prisoners were
not trying to smuggle anything else into the prison other than cannabis.
That was the major change … a realism with which we now view this.
(Interview 14b)
Those working within prisons suggested that heroin use had become
accepted as a part of prison life. In a sense, it had become ‘normalised’.
The increased use of drugs, particularly class A drugs, was beginning to
pose a threat to the prison environment in terms of order and control
problems. Drugs were seen to be the source of more violence, bullying
and intimidation within prisons (HM Chief Inspector of Prisons, 1992).
A penal reformer recalled that as drug use became ‘routine’ in prisons,
it became a problem of control and order:
You can’t authoritatively measure it, but the use of drugs in prisons – the
routine use of drugs – grew massively in the late 1980s, early 1990s. The
interest in what to do about it was to a significant extent a reflection of
what was happening. Drug use was becoming routine in prisons … it
offended against common sense ideas of ‘law and order’ and it was
associated with intimidation and violence … it presented control
problems. It certainly was a control issue. (Interview 24)
As discussed in the previous chapter, both illegal and legal drugs

were viewed as functional and used as control mechanisms within the
prison system during the early 1980s. During 1986–93, drugs were
perceived to be more problematic as they became a major part of the
informal prison economy. Sparks et al. (1996: 122) define the ‘informal
economy’ as an endemic control problem which consists of the follow-
ing activities: gambling, money lending, the trading of goods, importa-
tion of drugs, manufacture of alcohol and other ‘sub rosa’ trading. Staff
and prisoners consider these activities to be a part of prison life, not
always a matter for serious concern and may contribute to the smooth
running of an institution. Major threats to prison order result from
indebtedness and extortion, rather than from the activities themselves.
Staff must therefore strike a delicate balance when tackling these
activities as they risk destabilising the prison environment or losing
legitimacy (Sparks et al., 1996: 122). However, the link between
HIV/AIDS and needle sharing within prisons highlighted the problem
with ‘turning a blind eye’, the collusion and the failure to tackle the
problem of injecting drug use which was seen not only as a threat to
the prison population, but also to the outside community.
HIV/AIDS crisis
Another factor, perhaps the most important, which was linked to
greater awareness and the reconceptualisation of the drug problem in
prison was the HIV/AIDS crisis. The first prisoners in England and
Wales known to be HIV positive or to have an AIDS diagnosis were
received into the prison system during the period 1984–6. The number
of known reported HIV positive prisoners remained fairly stable and
averaged between 40 to 70 per month from 1986–91. During 1992–3,
this figure dropped to an average of 30 to 35 cases. By April 1995, a
total of 449 known HIV positive prisoners had been reported since
1985, 30 prisoners with an AIDS diagnosis were notified, and 12 pris-
oners with an AIDS-related illness had died during their sentences (HM
Prison Service, 1995c: 7).
The monotony of the prison regime produces tensions which can

lead to particular forms of ‘escapism’ such as homosexual sex amongst
heterosexual men and drug use (Thomas, 1990). There are special con-
ditions operating within the prison environment which have implica-
tions for the risk of HIV transmission both inside prisons and on
release in the community. If a syringe is smuggled into a prison, then it
is likely to be widely shared amongst prisoners (Dolan et al., 1990;
Stimson et al., 1988; Turnbull et al., 1991; Covell et al., 1992).
Homosexual activity does occur between prisoners, some of whom lead
heterosexual lives on the outside (ACMD, 1988; Harding, 1990).
Tattooing, another high-risk activity in relation to HIV, also occurs in
prisons. Moreover self-injury and suicide attempts carry HIV risks and
are frequent occurrences in prison (Liebling and Krarup, 1993). By its
nature the prison population also contains a disproportionate number
of people who are likely to be at greater risk of HIV infection: young,
sexually active, drug users, drug injectors, prostitutes and violent
offenders (Dolan et al., 1990; Harding, 1990; HM Prison Service,
1995c). The HIV/AIDS crisis provided further disincentives for drug
users to seek help because of fear that they might be coerced into
taking an HIV test, segregated from the rest of the population, and
subject to stricter security, searching procedures and hostile treatment
from other prisoners and prison staff (Thomas, 1994).
As we saw in the earlier section on drugs policy, drug injecting
prisoners were considered to be a key population in terms of
HIV/AIDS prevention, education and intervention (ACMD, 1988;
1989). The main concern was the threat of transmission to the
general population. Just as HIV funding allowed for a number of
developments in the drugs field, such as the move away from
abstinence-based approaches and the opening up of a wider range of
drug treatment options, it also enabled drug agencies to expand
their work in prisons and provided the thrust for the interest in the
area (Exeter Drugs Project, 1990; Parole Release Scheme, 1991;
Hamer, 1998). Although drug agencies had been working with
prisoners for several years, the prison authorities showed little inter-
est in the nature of the work they were doing as this would imply
that they should be recognising the problems, developing effective
strategies and providing resources to deal with the problem. There
was still an underlying resistance by the Prison Service to fully
acknowledge the problem of drugs and high-risk behaviour in
prisons and implications for policy and practice. A director of a drug
agency described the situation in these terms:
We always had this sort of ‘Cinderella’ existence really. We went in,

people knew we did things, but people didn’t want to know what we did,
because if they did know what we did, then they’d have to do something
about what we did. There was this whole sort of charade that was played
out. (Interview 10)
On the other hand, many groups had a vested interest in highlighting

or ‘talking up’ the HIV issue in prisons as it provided new opportuni-
ties for funding and an expansion of their remit into the prison
system:
There are flavours of the year. There was HIV/AIDS when it was the
flavour of the year. This meant it attracted grants. We used to call it
‘positively funded’ … Drugs – the war on drugs – became a hot public
issue. Groups see the opportunities for funding and so it was in their
interest to talk it up. (Interview 29 with penal reformer)
The advent of HIV/AIDS eventually widened the interest around

drug issues in prison. A policy network began to form around the issue
which lobbied for acknowledgement of the problem and a response
from the Prison Service. The key groups involved in this policy
network around HIV and drugs included members of the ACMD
(1988; 1989; 1991), drug treatment agencies (Trace, 1990), medical
professionals (Farrell and Strang, 1991), penal reform groups (Prison
Reform Trust, 1988; 1991), probation officers (Fletcher, 1990),
HIV/AIDS organisations, health authorities, and social researchers who
had been attempting to conduct research on the problem. The issue
had also been flagged up during the Woolf Inquiry (Woolf, 1991) and
by Judge Tumin in his role as Chief Inspector of Prisons (HM Chief
Inspector of Prisons, 1992). There was also interest in AIDS in prison at
the international level. For example, the Council of Europe sponsored
a study of policy and practice in 17 European countries (Council of
Europe, 1987; Harding, 1987) and the World Health Organisation also
convened a consultation on the prevention and control of AIDS in
prison in 1987 (WHO, 1987). It was mainly external interest, rather
than internal interest in the issue which initially was driving forward
policy development. As a spokesperson from a professional association
argued:
All drug policies were driven by concern about HIV and AIDS then and
prison was seen as being a major route of transmission back into the
mainstream population. That’s what made the medics interested. That’s

what made the drugs world interested. That meant that health authorities
and treatment services wanted to get involved in prisons … The drive
came from that direction rather than from within prisons. (Interview 21)
However, there is also evidence that civil servants working in the

Directorate of Prison Medical Services at Prison Service Headquarters
were pressuring for more systematic information on aspects of
HIV/AIDS in prisons and for a more strategic approach. In particular,
Len Curran, a principal psychologist, had written a number of key
reports advocating change (see Curran and Morrissey, 1989; Curran
1991a; 1991b; 1991c; 1991d; 1992).
The growing research/evidence base

No official, systematic research on the extent and nature of high-risk
behaviours in prisons, particularly on homosexuality or drug use, had
been undertaken during this period. Reflecting the collusion around
drugs and the reluctance to admit that drugs were being used in prison,
as well as the general problems of gaining access to conduct research in
prisons, researchers had been repeatedly denied access to prisons to
conduct such research throughout the 1980s (Thomas, 1990; Pearson,
1990). Although there had been pressure for systematic information on
HIV/AIDS issues, Ministers argued that the problem was small, under
control, and research in this area would be fraught with methodologi-
cal difficulties associated with sampling, ethics, self-report and the
veracity of inmates’ accounts (Curran, 1991a). Rumours that research
on high-risk behaviours in prisons had been conducted, but suppressed
were circulated within the policy network (see also Berridge, 1996a:
225). Illicit drug taking and, arguably, homosexual sex in prisons con-
stituted disciplinary offences for which any prisoner who took part in
these activities was liable to be punished. There was therefore no
official recognition from the government that drugs or homosexual sex
were significant ‘problems’ within prisons. As Thomas (1990: 2) argues,
the lack of evidence and the formal, legalistic reaction allowed for an
‘official’ discourse to emerge which suggested that the incidence of
homosexual activity, drug use and drug injecting were minimal and
therefore the threat of HIV was not a major problem and did not
require radical action.
By the early 1990s, another set of data and an ‘unofficial’ discourse
were also beginning to emerge which questioned and challenged the
‘official’ discourse. Researchers eventually managed to gain limited
access to prisons and to samples of ex-prisoners which enabled them to

begin to construct a picture of the problem. Research began to show
that a substantial proportion of prisoners had been dependent on
drugs prior to imprisonment (Maden et al., 1990; 1991); illegal drugs
were available in prisons (HM Chief Inspector of Prisons, 1992;
Turnbull et al., 1994); drug use in custody was fairly widespread
(Turnbull et al., 1991), injecting and sharing needles were occurring
within prisons (Stimson et al., 1988; Donoghoe et al., 1989; Dolan et
al., 1990; Dye and Issacs, 1991; Carvell and Hart, 1990; Kennedy et al.,
1991; Turnbull et al., 1991; Bird et al., 1992; 1993; Power et al., 1992;
and Covell et al., 1993); the number of needles and syringes found in
prisons had increased consistently between the years 1985 and 1989
(Turnbull et al., 1991); and the first reported outbreak of HIV infection
in a prison in Britain was reported at Glenochil prison in Scotland in
1993 (Christie, 1993). In terms of homosexual activity, there was still a
lack of evidence. However, based on reports from prison staff and ex-
prisoners, Curran and Morrissey (1989) estimated that between ten and
fifty per cent of the long-term male prison population may engage in
homosexual activity at some time during sentence. In relation to tat-
tooing, Dolan et al. (1991) found that seven per cent of a total of 98
drug injectors reported sharing tattooing equipment when they were
in prison.
Much of the existing research and evidence quoted above has focused
on male prisoners. There has been a real lack of attention paid to needs
and circumstances of female prisoners. Another limitation of the research
is that much of it has been based on small sample sizes and samples of
ex-prisoners. Despite its methodological flaws, this research played an
important role in raising awareness of the problems in prison and placing
these issues on the policy agenda. Curran (1991a: 18), a civil servant in
the Directorate of Prison Medical Services, conceded:
The department has been nervous of research into HIV seropreva-

lence and into risk behaviour in prison. In retrospect such an
approach has merely served to attract criticism from a number of
influential and vocal sources. The research has proceeded outside
and has suffered from sampling problems and small sample sizes.
This has not deterred wide dissemination of the results and has
heightened rather than decreased speculation on risk behaviours.
The media also played a role in constructing both HIV/AIDS and

drug use as problems in prisons by heightening interest and making
these issues more visible. In 1989, the BBC produced a Panorama pro-
gramme entitled The Killer Inside, which focused on drug use in
prisons, needle sharing and HIV/AIDS. The reporter, Robin Denselow,
interviewed prisoners and staff in Wandsworth, Saughton, and Stafford
prisons. The interviews revealed that drug injectors were sharing
needles in prisons. One prisoner claimed they had two sets of ‘works’
between 30 prisoners, while another prisoner who was HIV positive
was sharing a needle with 20 other prisoners who were aware he was
infected with the virus. In many ways, this programme amplified the
issues of drugs and HIV/AIDS (Cohen, 1972), but it also helped to high-
light the plight and treatment of HIV positive prisoners and the lack of
policy response. Members of the policy network recalled that this was a
particularly powerful programme at the time and had much impact in
terms of raising awareness around the issues and placing them on the
policy agenda.
This growing research and evidence base corresponds to the ‘enlight-
enment’ model of research utilisation (Weiss, 1986), whereby a body of
evidence accumulates over time eventually sensitising policy-makers to
new issues and shaping the framing and conceptualisation of prob-
lems. It also corresponds to the ‘interactive’ model where research,
information, and data are pooled by a diverse range of actors such as
civil servants, journalists, interest groups, practitioners and profession-
als in order to make sense of the problem. The research was used by
the policy network to pressure for a different response in relation to
the problems of drugs and HIV transmission in prisons (Berridge,
1996a) and to force a public acknowledgement that drugs were being
used in prisons. Once this information was published and in the public
sphere, it meant that the problem could no longer be denied and
ignored by the Prison Service or the government. As a spokesperson
from a professional association argued, it was no longer politically
possible to deny the existence of a problem:
once the thing becomes public, once you say there are people using
drugs in prison, you then get a political dynamic happening. The pro-
fessionals are quite happy for people to be using drugs in prison as long
as it’s cannabis, as long as they’re not injecting. But politically it
becomes untenable for the government to allow prisoners to engage in
illegal activity while they’re supposedly serving a sentence. That is
unacceptable to Daily Mail-driven public opinion. It then becomes
unacceptable for politicians. That ratchets the awareness up that much
more. (Interview 21)
The interest around the drug problem in prison reflected the preoc-
cupation with drugs in the outside community. Problems such as drugs
and HIV/AIDS, however, appear to be subject to time lags or delays
before they manifest themselves within the prison environment. This
is linked to the initial denial of the problems and the speed at which
the Prison Service deals with issues. Once the Prison Service acknowl-
edged the drug problem, they were forced to ‘catch up’ in their
response to it. A director of a drug agency recalled that this was a slow
process:
There was sort of a ‘catch-up’ phase where prisons themselves hadn’t

recognised that they had an issue around drugs and they had a very
steep learning curve to navigate … It wasn’t a problem they wanted to
believe they had. How they might respond to it and what the resource
implications of responding to it might be – that was a slow process.
(Interview 28)
The response to the drugs ‘problem’ in prisons
The period from the late 1980s to 1993 was described by one key
policy actor as a time when a ‘mood was developing’ in terms of
responding to the drug problem in prisons. More formal and explicit
policy development began with the statement of policy on the
throughcare of drug users in prison in 1987 which carried through
some of the issues highlighted by the policy network which had
formed around treatment and throughcare issues during the earlier
phase. This was followed by a more comprehensive manual of policy
guidelines entitled Caring for Drug Users in 1991. The HIV/AIDS crisis
also resulted in policy development which intersected with prisons
drugs policy. The next sections will explore the policy response to
drugs and then examine the response to HIV/AIDS.
Treatment and throughcare policy: Policy statement on the

throughcare of drug users in prisons 1987
Following the interest generated by the ACMD and the policy network
around throughcare issues during the early 1980s, a statement of
policy and associated guidelines on the throughcare of drug users in
prison was issued by the Director of Prison Medical Services to all man-
aging medical officers in 1987 (HM Prison Service, 1987). Although
there was recognition that all prison staff could play a role in the
throughcare, a more co-ordinated approach was advocated particularly
between prison medical officers and seconded prison probation

officers. The content of the statement did not focus on specific goals of
the Prison Service in relation to throughcare, but was mainly con-
cerned with loose guidelines regarding practice and specifying the
responsibilities of the key actors involved. Prison governors were given
overall responsibility for ensuring that a coherent system was estab-
lished to deal with drug users. Medical officers were responsible for
identifying and assessing drug users on reception to custody; arranging
withdrawal programmes in accordance with their own clinical judge-
ment; maintaining medical oversight throughout the prisoner’s sen-
tence; and advising on further drug treatment support through outside
agencies or self-help groups. Prison probation officers were responsible
for continuing care and support throughout prisoners’ sentences,
overall throughcare, and follow-up treatment and support on release.
The medical officer and probation officer were to develop an effective
working relationship and endeavour to communicate and liaise effec-
tively over the care and support of drug using prisoners (HM Prison
Service, 1987).
In practice, however, these throughcare guidelines were not fully
implemented across the prison system. In a study conducted by
National Association of Probation Officers (NAPO), probation officers
indicated that the guidelines had not been acted upon and the inertia
came from prison governors (Fletcher, 1990). The ACMD (1988: 63)
found that the use of methadone and other drugs to alleviate with-
drawal symptoms varied between prisons. Since the 1980 ACMD
report, there was no evidence of any improvements in relation to drugs
advice and counselling or the expansion of therapeutic programmes in
prisons. Furthermore, voluntary agencies were still experiencing
difficulties gaining access to undertake drug work in some prisons.
Although the guidelines on throughcare placed great emphasis on the
work of the probation service, there was evidence of seconded prison
probation officers having very limited resources, experience and
training to deal with drug users (ACMD, 1988: 63).
Policy on treatment: Caring for Drug Users 1991

In 1991, a manual entitled Caring for Drug Users was prepared by the
Advisory Group for Drug Education, a multidisciplinary group of
experts from the Prison Service and external drug agencies and organi-
sations. There was growing recognition of the variations in service pro-
vision throughout the prison system and that any effective drug work
was ‘locally inspired and led’ (HM Prison Service, 1991a: 2). The aim of
policy was to build upon these efforts across the Prison Service and to
make the most of ‘the opportunity presented by imprisonment to help
drug users break or modify their habit’ (HM Prison Service, 1991a: 2).
The manual included guidelines for assessment and identification of
drug users, detoxification, treatment and counselling, general health
care and lifestyles, harm minimisation, throughcare, and liaison with
community agencies. A multidisciplinary response was advocated
which involved all prison staff including prison medical officers,
probation officers, prison officers, psychologists, education officers,
governors as well as specialist groups and agencies in the community.
The aim was to create a positive climate in which drug users would
reveal their drug problems and seek help.
Under these new guidelines, it was clear however that the quality
and type of care for drug using prisoners was not congruent with what
they would have received in the community. The legacy of the
Rolleston report and the discourse of less eligibility in relation to the
treatment of drug users in the prison system endured. Ross et al. (1994)
argued that the 1991 guidelines for dealing with drug users in custody
breached normal standards of professional ethical care. For example,
drug addicts in prison were much less likely to be receiving treatment
with a notifiable drug (i.e. methadone) than their counterparts in the
community. In many cases, prisoners receiving methadone treatment
on the outside were not given the opportunity to continue their treat-
ment within prisons. Where methadone was offered in prison, it was
provided on an accelerated seven day regimen (HM Prison Service,
1991a, sec. 2: 4). The accelerated withdrawal programme does not
replicate the physiological rate of withdrawal and can cause with-
drawal symptoms and stress to patients (Ross et al., 1994). Moreover,
strip cells were often used for prisoners who were addicted to opiates.
Such short regimens and harsh treatment may lead prisoners to use
illegal drugs in prisons. Ross et al. (1994: 1094) argued that the monop-
oly which the PMS had over medical provision in prisons, the non-
standard treatment regimens and the abuse of the concept of clinical
judgement left ‘the prisoners disenfranchised to the point of suffering
serious avoidable morbidity’.
At the same time as the manual was published, revised throughcare
guidelines were also issued (HM Prison Service, 1991b). Re-emphasising
the key roles of the probation service and prison medical officers, these
were similar to those issued in 1987, but they placed much more
emphasis on utilising a multidisciplinary approach involving all prison
staff. As discussed in the earlier section on partnerships in drugs policy,
prisons were also encouraged to become involved in wider drug part-

nerships in the community. Prisons were expected to be represented
on DDACs where appropriate so that prisons could access local multi-
disciplinary staff training provision and develop contacts with the
providers of services (HM Prison Service, 1991a, Appendix 2).
Despite the key roles allocated to prison probation officers and
prison medical officers, the HM Inspectorate of Probation found that
prison probation officers were offering very little and prison medical
officers were playing only a marginal role in the provision of drug ser-
vices (Home Office, 1993a). In prisons where drug work was occurring,
outside drug agencies were playing the leading role in responding to
the needs of prisoners. A director from a drug agency suggested that by
the early 1990s, a UK model of prison drug work had emerged. This
referred to the work being done by the Exeter Drugs Project in the
south-west, the Parole Release Scheme in the south-east, and the York
Drugs Resource Scheme in Yorkshire (see Parole Release Scheme, 1989;
Tamlyn and Billings, 1995; Hamer, 1998). The model was described by
a director of a drug agency as follows:
Each of these programmes developed independently, but when we did

come together and talked about it, we realised we were doing the same
thing. We were putting a large amount of emphasis on pre-release work
with particular concerns regarding tolerance and overdose … We then got
caught up in the HIV/AIDS scare … There was a fair amount of group-
work. The model for counselling was very much around brief interventions
… There was an underlying consensus that prison wasn’t the best place to
deal with your underlying problems which may have precipitated drug use,
but it may be the place where you start that journey and recognise how
long the journey is and where you can go to complete that. The model
used by all those agencies was about very high turnover and fairly brief
work, trying to reach as many people as possible. (Interview 26a)
This model of drug work, however, was not universally applied

throughout the prison system. It existed only in a few areas in the
country and depended on the innovative work of particular drug agen-
cies, rather than any centrally driven policy. As Roger Ralli, the Deputy
Chair of the Advisory Group for Drug Education, conceded, in order
for the 1991 guidelines to be put into practice across the prison system,
there was a need for extensive staff training and support and commit-
ment from prison governors (Ralli, 1994). In prisons where this guid-
ance was implemented, the quality of services to drug users improved.
However, the ACMD (1996) found that implementation was patchy

and not all prison staff were aware of the existence of the manual.
There was no centrally co-ordinated activity or provision. Similarly, the
HM Inspectorate of Probation found that drug service provision was
very ad hoc, piecemeal, and disorganised and there was a lack of an
overall drugs strategy in prisons (Home Office, 1993a: 75).
It is interesting to note that at this point in time security measures
to tackle drug smuggling, drug trafficking and drug use in prisons
were dealt with separately under security policies. There was no
overall policy or strategy which connected drug control measures
with treatment and throughcare measures. The focus was solely on
the treatment and ‘caring’ aspects of dealing with drugs. This was to
change significantly in later prison drugs policy development from
1994 onwards. In effect, the response during this phase was
essentially about the Prison Service reluctantly acknowledging the
problem of drug use in prisons, but not initiating any action which
would embarrass them or lead to public disapproval. It was an
attempt to address some of the problems highlighted by the policy
network around treatment and throughcare. However, it was not an
integrated strategy which would address the drug ‘problem’ in
prisons holistically.
Managing and containing the HIV/AIDS crisis in prisons

The majority of prison staff and prisoners reacted with fear, panic and
antagonism towards the first group of known HIV positive prisoners
(HM Prison Service, 1995c). The panic around the disease was
magnified within the prison environment. The problem of HIV shifted
from being primarily a medical issue to a management problem for the
Prison Service. A civil servant recalled this shift:
It was the reaction of the staff to them that made it quite clear that this
was something that had to be dealt with. Up to that point, people
assumed that it could be dealt with in a reasonable way as a medical
concern. It was only when staff reaction became so vivid, that in fact, it
was realised that it wasn’t just a medical problem, but that it was a
management problem. (Interview 31)
In 1986, the prison chaplain at Chelmsford died of an AIDS-

related illness and his death sparked off industrial action by prison
staff. As discussed in the previous section on penal policy, industrial
relations between the Prison Officers’ Association (POA) and prison
management continued to be fraught with difficulty during this

period due to the introduction of Fresh Start in 1987. It was within
this context that at the AGM of the POA in 1987, a resolution was
passed which called for the compulsory screening of all prisoners for
HIV. It was argued that this would enable prison officers to protect
themselves from the virus if they knew which prisoners were HIV
positive. However, the then Director of the Prison Medical Service,
Dr John Kilgour, decided against compulsory screening and main-
tained that any HIV testing should be voluntary, carried out only
with the prisoner’s consent, and with the provision of pre- and post-
test counselling. Because many of the management decisions had
been devolved to local level, there was evidence and rumour that
screening was nevertheless taking place in some prisons (Berridge,
1996a). Similarly, Turnbull et al. (1991) found that some ‘high-risk’
groups, including drug users, were being segregated until they agreed
to be tested and could prove they were negative.
Viral Infectivity Restrictions (VIR)

One of the methods of dealing with HIV positive prisoners was to
subject them to Viral Infectivity Restrictions (VIR). These guidelines
were originally developed in 1985 for prisoners with Hepatitis B to
protect others within the institution from this highly contagious
disease. The type of restrictions placed on infected prisoners was left to
the discretion of the medical staff, but they could be segregated in a
separate unit or isolated cells. Moreover, their regimes could also be
restricted in terms of association with other prisoners and participation
in work and recreation activities (HM Prison Service, 1995c: 7). In May
1986, the Prison Service produced a confidentiality code for prisoners
subject to VIR. In theory, this meant that prison staff with an opera-
tional ‘need to know’ were informed of a prisoner’s VIR status, while
the actual diagnosis (i.e. HIV or Hepatitis B) remained confidential.
However, the definition of ‘need to know’ remained vague and in prac-
tice, confidentiality was not preserved (Padel, 1990). In some cases, VIR
status was stamped on prisoner’s files and the code was also extended
to those outside the prison including court staff, police and others
involved in the criminal justice system (Prison Reform Trust, 1988).
Due to the fear and panic amongst prison staff and other prisoners,
VIR status became synonymous with HIV (Bright, 1995).The effect of
VIR and the lack of confidentiality meant that prisoners feared reveal-
ing that they belonged to a high-risk group (i.e. drug users, prostitutes,
homosexuals or haemophiliacs) due to the treatment they might
receive. A drug worker recalled the difficulties in providing drug

services in prisons at this time:
We had horrendous difficulties if we had an HIV person and it became

widespread public knowledge in the late 1980s … There was a lot of
ignorance around – a lot of fear … There was pressure at that time to
disclose if someone had revealed an HIV status or even if they revealed
they were [in] a high-risk group … The way they identified HIV inmates
was to put yellow and red tape around their files … And of course, that
would be in the landing office and many people got badly hurt when their
status became known amongst the other inmates. (Interview 06)
There had been several calls to end the use of VIR by various experts
and organisations (WHO, 1987; ACMD, 1988; 1989; Farrell and Strang,
1991; Woolf, 1991). By 1991, the Prison Service recommended that
HIV positive prisoners who were otherwise healthy should not be seg-
regated, but kept on normal landings. However, medical officers and
prison management retained the power to segregate HIV positive pris-
oners ‘for reasons of good order, discipline, health or safety’ (Home
Office, 1991a, annex A, para. 18). The application of this policy was
strongly localised (Berridge, 1996a). For example, on the K1 wing of
Wandsworth prison, VIR and segregation still operated and prisoners
were kept in a basement with little time out of their cells, whereas
Bristol prison had rejected VIR, ensured full confidentiality to HIV pos-
itive prisoners and integrated them on normal landings. The practices
at Wandsworth prison had been condemned in 1991 by the Woolf
Inquiry as a ‘travesty of justice’ (Woolf, 1991: para. 360). Although
there had been many calls for reform in relation to VIR, one third of
prisons in England and Wales were still segregating HIV positive
prisoners (ACMD, 1993). The manner in which HIV positive prisoners
were dealt with in the prison system illustrates the Prison Service’s
preoccupation in dealing with high-risk groups rather than tackling
high-risk behaviour.
By 1986, the Prison Service had established an AIDS Advisory
Committee to advise the Director of Health Care on all matters relating
to HIV in prison. Its membership included outside agencies, indepen-
dent experts on HIV and prison staff. The Committee developed a
strategy which aimed to: prevent people from becoming infected;
prevent onward transmission of the virus; minimise the social stigma
of HIV and provide proper medical treatment, support and care to
those with HIV (HM Prison Service, 1995c: 10).
Training and education

Prisoners were excluded from the general public education effort on
HIV which took place in the community, leaving them with little
factual information about the virus. When the leaflets, entitled ‘AIDS –
Don’t Die of Ignorance’, were distributed to every household in the
country, prisons and hospitals were not included in the initial distribu-
tion. Parliamentary questions were tabled regarding this matter and
eventually the leaflets were made available (Prison Reform Trust, 1988).
However, this information did not address the specific concerns of pris-
oners. In August 1987, a leaflet was specifically designed for prisoners,
entitled ‘AIDS: Information for People in Prison’. Because drug inject-
ing and homosexual sex contravene prison rules, these issues were not
addressed adequately in the leaflets and distribution to all prisons and
prisoners did not occur (ACMD, 1988; Prison Reform Trust, 1988).
Prison was still being regarded as an ‘opportunity’ to make contact
with drug users, draw them into treatment and educate them towards
safer practices (ACMD, 1988). Education and training were regarded as
the cornerstones of the Prison Service’s response to the HIV/AIDS
problem in prisons (HM Prison Service, 1995c: 21). In 1987, the AIDS
Advisory Committee developed ‘AIDS Inside’, a training package for
prison staff consisting of a video, leaflet and training manual. In 1989,
a similar package, entitled ‘AIDS: Inside and Out’, was developed for
prisoners. These training and educational efforts had limited impact,
however (Turnbull et al., 1994; Berridge, 1996a); and targets for the
education of operational staff and inmates had not been achieved in
many institutions (Curran, 1991b). Trace (1990) argued that few staff
were interested in HIV training sessions and for those who were inter-
ested, it was difficult for them to watch the videos due to other duties.
The video for prisoners explored what was defined as ‘risky behaviour’,
but failed to acknowledge that these activities actually occurred in
prisons. In a section on how to protect yourself after release, the leaflet
provided advice on safer sex and injecting practices (Trace, 1990).
Thus, the focus was on activities on release, rather than those within
prison. The ACMD (1988) recommended that private and confidential
counselling should be provided on risk reduction covering activities
both whilst in prison and on release. The ACMD felt it most appropri-
ate that outside agencies undertake this work rather than prison
medical officers. The educational package also failed to address the
needs of women, young people, those without English as their first lan-
guage and those with learning difficulties. The Prison Service, however,
did not view this as a matter for concern and recommended that these
particular groups could be dealt with at a local level (HM Prison

Service, 1995c: 27).
In 1991, the Prison Service issued a circular instruction indicating that
all prisons should set up multidisciplinary working arrangements to deal
with HIV/AIDS (Home Office, 1991a). This was linked to a training
manual, HIV and AIDS: A Multidisciplinary Approach in the Prison
Environment, and three specialist training courses. These training courses
included an HIV update for medical officers, an HIV counselling course
for prison staff, and a multidisciplinary course for prison managers. The
multidisciplinary approach was to involve medical officers, psycholo-
gists, probation officers, health care staff, prison officers, educationalists,
and the prison chaplaincy. Curran (1991b: 17) suggests that there were
several factors which mitigated against such an approach and the
implementation of the strategy: HIV was often viewed as a medical
problem by operational managers and staff; there were several
competing priorities within the prison system and a large number of
new initiatives (i.e. Fresh Start, Prison Service re-organisation, suicide
prevention, and sex offender programmes); there was a lack of good
information regarding prevalence of HIV and risk behaviour; and the
numbers of prisoners known to be HIV positive was low.
Harm minimisation
As discussed earlier, the advent of HIV/AIDS in the community was
eventually followed by an expansion of services for drug users, the
adoption of the principles of harm minimisation, and a broad-based
community approach involving doctors, pharmacists, police, social
workers, and probation officers. However, prisons were excluded from
these changes in practice and the liberal consensus which had been
achieved (Farrell and Strang, 1991; Berridge 1996a). The incorporation
of harm minimisation as a drug treatment philosophy had been met
with difficulties within the prison environment resulting in inadequate
choice and standards of care in relation to HIV positive prisoners com-
pared to similar patients in the community (Young and McHale, 1992).
One of the main factors in the adoption of the ‘abstinence’ based
approach was the resistance to publicly acknowledging that either drug
taking or homosexual sex is taking place in prisons. To adopt a harm
minimisation and risk reduction philosophy would mean condoning
two illegal activities in the prison environment. This was seen by the
Conservative government, in particular, to be politically unacceptable.
The Home Office’s reliance on ‘legal formalism’ placed prisoners at
greater risk from HIV/AIDS than the general public (Thomas, 1990: 90).
In the area of prison drugs policy, it is evident that the ‘conflict

between principle and pragmatism is most acute.’ (MacGregor, 1998a:
149). Traditionally, the criminal justice system has viewed drugs as a
cause of criminality and a crime in itself, not as an individual health or
public health concern. This criminal justice perspective towards the
control and criminalisation of drug users has constrained prison gover-
nors and others from incorporating harm minimisation into drug
policies (Hayes, 1991). The definition of harm minimisation in prisons
was described by a civil servant as being different to that in the
community:
We probably still encounter a little lack of clarity by what we mean by

harm minimisation. Because on the streets, [it] means needle exchanges
and things like that. Now we know we’re not going in the foreseeable
future down the route of needle exchange. (Interview 19)
Within the prison environment, the definition of harm minimisa-

tion could be extended to include more than just safe injecting prac-
tices, safe sex and methadone prescribing. Similar to Pearson’s
arguments that the principles of harm reduction should have wider
application, (Pearson, 1992b), a civil servant argued that in practice the
term needed to be associated with providing a safe environment for
prisoners in terms of the violence and bullying around the drugs trade:
Harm reduction is also about going back to the violence thing [and] is
linked to helping prisoners, particularly young offenders, get through their
sentence safely … Many governors [who] are aware will not say, ‘don’t
take drugs because they’ll harm you’, because they realise that’s not going
to have impact on recreational users. What they will probably say is, ‘For
goodness sakes, don’t borrow money to buy drugs. That’s the real danger.’
(Interview 14b)
In the community, policies have vigorously promoted safe sex prac-

tices and the use of condoms in the prevention of HIV. The Prison
Service, however, initially resisted the introduction of condoms mainly
on legal grounds. Under the Sexual Offences Act 1956 (as amended in
1967 and 1994), homosexual sex is considered legal only if it occurs in
a private place between two consenting men aged 18 or over. It is
legally unclear whether a prison cell constitutes a private place as
required by the Act. If a cell is not private then homosexual activity is
unlawful. This issue has been the focus of much debate between the
Prison Service and its legal advisers. The Prison Service has argued that
the provision of condoms would mean that illegal acts were being con-
doned. However, the ACMD (1988: 65) pointed out that it was difficult
‘to see how allowing access to condoms in prison could be regarded as
condoning unlawful acts when placed in the context of the public
health considerations involved.’ Other arguments were also made by
the Prison Service that condoms do not provide adequate protection in
anal sex; condoms would increase the incidence of homosexual activ-
ity; there was a lack of evidence that high-risk behaviour occurs; staff
would object; and condoms could be used for other purposes such as
drug smuggling (Curran, 1991c).
In other European prison systems, including France, Denmark,
Germany and the Netherlands, condoms have been made available
to prisoners (British Medical Journal, 1995). There have been various
calls from outside bodies and organisations for the provision of
condoms in prison (WHO, 1987; ACMD, 1988; 1989; Trace, 1990;
Prison Reform Trust, 1991). Curran and Morrissey (1989) also found
that the majority of prisoners and staff at Wormwood Scrubs wished
to see condoms provided. Based on the House of Lords judgment in
Gillick v. West Norfolk, if prison medical officers were providing the
means of protection, they could not be held responsible for encour-
aging an illegal act. In effect, the provision of condoms in prisons
was seen to be a medical matter. Therefore during the period
1986–93, the prison policy on condoms was that they could be
provided subject to the clinical judgement of the prison medical
officer. In practice, however, condoms were not freely available.
Many prison medical officers refused to view them as a prescription
and prisoners were reluctant to request them.
Similar to the issue of condoms, the provision of needle exchanges
in prison has not been seen as appropriate by the Prison Service (HM
Prison Service, 1995c) or by the ACMD (ACMD, 1988). Needle
exchanges could be seen as encouraging drugs use and contradictory to
the duties of prison staff to detect the smuggling of drugs into prisons
and prevent drug use in custody. It was felt that ‘the conflict between
encouraging prisoners to use an exchange scheme and detecting illicit
drug use would have no easy resolution’ (HM Prison Service, 1995c:
30). Arguments have also been put forward that needles could be used
as weapons within the prison environment (Trace, 1990; British
Medical Journal, 1995). However, stopping syringes and drugs getting
into prisons means that there will be more sharing of existing ones and
thus, a greater threat of HIV transmission.
Because the Prison Service adopted an abstinence-based approach to

drugs, this set the scene for conflict between the prison administration
and the drug agencies who may be working within a harm minimisa-
tion framework. There are clear conflicts and contradictions within
drugs work in the prison environment which are contained and
managed by the drug agencies involved. A civil servant indicated the
difficulties from their perspective:
It’s a hard one for us in working with the agencies who quite properly
would talk about harm minimisation approaches. It’s hard for us to
say that means that some of our prisoners are taking drugs some of the
time because it’s an illegal activity that we have some difficulty in
countenancing. It’s a rubbing point between work agencies can do and
our approaches to it. Sometimes those things don’t come together very
neatly. (Interview 14a)
However, drug workers have been forced to find ways of delivering

realistic strategies within the prison environment:
We can actually work with harm reduction providing we’re working

towards providing an abstinence-based regime. You can get away with it
… The people on the ground are realists. They know that they need
something being done. (Interview 10)
Obviously we were worried about needle sharing in prisons and addressing

that through harm reduction techniques … There was a tacit condoning
by the Prison Service that they intentionally would not be in the room
when we were talking about harm reduction. (Interview 26a)
These contradictions between policy and practice have allowed the

Prison Service to publicly advocate a tough, abstinence-based policy
towards drugs, while drug agencies are working behind the scenes in
the privacy of the prison ensuring harm minimisation is taking place
without the support of the institution, adequate resources or an
‘official’ policy framework. The Prison Service has been reviewing its
policies on risk reduction and harm minimisation for many years.
Issues such as the availability of sterilising tablets and condoms have
been debated frequently, but some of the decisions or compromises
which have been reached have not been satisfactory and have placed
prisoners at greater risk of infection. The Prison Service AIDS Advisory
Committee undertook a policy review of HIV/AIDS in prison which
began in 1992. It was not until 1995 that the Committee published its
review and its recommendations. These will be discussed in the next
chapter.
It is evident that many of the ideas and discourses which were
prominent in drugs policy during the 1986–93 period failed to pene-
trate the development of drugs and HIV/AIDS policies in prisons. The
policies which did emerge, including the 1987 throughcare guidelines,
1991 treatment manual, and HIV policies on VIR and education and
training, were hindered by implementation which was strongly
localised. The Prison Service limits its role to setting a policy frame-
work and standards and then local management applies these to mirror
local circumstances. Although the Prison Service can highlight the
importance of the policy guidelines and their recommendations for
good practice, they have no power to ensure that these are imple-
mented locally. This allows for much discretion and choice, particu-
larly for prison governors, in implementing central policy decisions
often leading to wide variation and lack of consistency across the
system.
Conclusion
During the phase 1986–93, the HIV/AIDS crisis became the driving
force behind the development of a more explicit prison drugs policy.
By 1986, the HIV/AIDS issue had become linked to injecting drug use
and fears of transmission into the heterosexual population became a
reality. In the community, HIV/AIDS had become a ‘national emer-
gency’ in policy terms provoking a ‘wartime response’ (Berridge,
1996a). Prisons were no longer immune from external scrutiny and
could not deny the existence of the drug problem in prison. The
‘official’ discourses around drugs in prison which were evident in the
early 1980s could no longer be sustained. The ‘end of the denial’ was
linked mainly to the HIV/AIDS issue, but also to a growing evidence
base which began to challenge the view that a drug problem did not
exist in prisons. Furthermore, a policy network was growing around
the drugs and HIV issue in prison which began to lobby the Prison
Service for a humane and pragmatic response.
Although a liberal response to the issue of HIV/AIDS and drug use
had eventually been achieved in the community through policies of
harm minimisation and risk reduction, this was extremely difficult to
extend to the prison environment (Berridge, 1996a). Such policies were
constrained by the institutional context of the prison system and the
unwillingness of the Prison Service to consider radical policies. The

inherent conflict between care and control and concern about the
public imagery of adopting anything other than a hard-line,
abstinence-based approach was important during this period and
became enduring features of subsequent policy development. The
focus of the next chapter is the period 1993–7 in which fundamental
changes occurred within drugs and penal policy and most importantly,
prison drugs policy.
4
1993–7: Coming Clean and Taking
Control?
Introduction
During the period 1993 to 1997, significant developments took place

in prison drugs policy. This phase begins in 1993 because this year
marked a dramatic U-turn in penal policy which greatly influenced the
development of drugs policy in prisons. By 1995, the first prison drugs
strategy was formulated involving an explicit and comprehensive plan
to tackle and measure the drug ‘problem’ in prisons. In contrast to the
earlier phases of policy development, the new strategy incorporated
both supply and demand reduction measures. It introduced new
powers to test prisoners for drugs, increased security measures and
emphasised drug treatment and rehabilitation. For the first time,
prison issues were incorporated into national drugs policy and the
Prison Service was expected to play a key role in national and local
drugs policies and partnerships.
In order to contextualise the changes which took place in prison
drugs policy during this period, the key developments in drugs and
penal policy are discussed in the first part of the chapter. These
changes were occurring against the backdrop of the Major government
(1990–7), which continued and intensified Thatcher’s key reforms. A
new ‘Back to Basics’ campaign was introduced which reaffirmed tradi-
tional Conservative themes such as the nuclear family, law and order,
discipline, and educational standards. By the mid-1990s, the
Conservative government had implemented a range of legislation
which increased the state’s power to intervene in the lives of those on
the political and economic margins or the so-called ‘problematic’
groups such as single parents, young people, the homeless, drug takers,
illegal immigrants, and the unemployed (Ryan and Sim, 1995). With
89
regard to offenders, Major argued that ‘we should understand less and
condemn more’ (quoted in Downes and Morgan, 1997: 130). During
this phase, both penal and drugs policy were affected by the populist
punitive rhetoric and by the new managerialism which had effectively
penetrated both policy areas.
The latter part of the chapter explores the way in which the drugs
‘problem’ was framed by key players and the policy response. During
this phase, the drug issue in prisons was officially acknowledged and
politicians in a sense had ‘come clean’ regarding the ‘problem’. Drugs
were increasingly framed as a ‘problem’ of order and control for the
institution. The response in both political and policy terms was to ‘get
tough’ and take control of the problem by implementing a defined
strategy which emphasised mandatory drug testing and security mea-
sures. As prison drugs policy became more explicit, the contradiction
between treatment and punishment intensified. A number of compet-
ing objectives required balancing: safety, security, control, punish-
ment, treatment, and care. However, the policy framework failed to
address how the ‘balancing act’ could be achieved (Seddon, 1996).
Within a framework which included a punitive political context, an
increasing emphasis on managerialism and the influence of US policies
and ideas, this chapter will show that the penal aims of the strategy
had clearly taken precedence over those of health and treatment. In
response, a policy network began to form which criticised the intro-
duction of mandatory drug testing and the over-emphasis on control
and punishment. It lobbied for increased resources and more focus for
treatment and care. Although this network had some success in rebal-
ancing the strategy, the focus on punishment, control and security
continued to be predominant.
Drugs policy context: Tackling Drugs Together
During the period 1993 to 1997, official statistics indicated that the
drugs ‘problem’ in the community was continuing to grow. For
example, the number of new drug addicts notified to the Home Office
increased steadily from 11,561 in 1993 to 18,281 in 1996, and the pro-
portion addicted to heroin increased by 6 per cent during this period
(see Table A.3, Appendix). The number of persons found guilty, cau-
tioned or dealt with by compounding for drugs offences also increased
dramatically from 68,480 in 1993 to 113,154 in 1997 (see Table A.2,
Appendix). By the early 1990s, the drug problem in Britain had
changed. Research began to show that poly-drug use including
1993–7: Coming Clean and Taking Control? 91
cannabis, amphetamines, LSD, and Ecstasy was increasing amongst

young people (see Denham-Wright and Pearl, 1995; Miller and Plant,
1996; Parker et al., 1998).
In May 1995, a new drugs strategy, Tackling Drugs Together, was
launched, outlining the government’s plans for tackling drugs for the
period 1995–8. This represented the first attempt to provide a national
drug ‘strategy’ as previous frameworks tended to be more descriptive of
current policy (i.e. the 1990 document UK Action on Drug Misuse),
rather than strategic (Dorn and Seddon, 1995). The strategy focused on
three main areas: crime, young people and public health. It was under-
pinned by the following common Statement of Purpose:
To take effective action by vigorous law enforcement, accessible

treatment and a new emphasis on education and prevention to:
increase the safety of communities from drug-related crime; reduce
the acceptability and availability of drugs to young people; and
reduce the health risks and other damage related to drug misuse.
(HM Government, 1995: 1)
As was the case in other policy areas, the strategy also introduced per-
formance indicators to monitor and evaluate progress, indicating a
more ‘managerial’ approach towards the problem of drugs. The new
strategy represented a new conception of what constituted ‘policy’. It
was much more strategic, concrete and specific in relation to key aims
and objectives than previous policy frameworks.
The strategy, however, focused almost exclusively on drugs and the
drug problem and failed to make links between drugs and other social
issues such as housing, employment and economic regeneration. The
three strands of the Statement of Purpose were to be interdependent
and given equal importance. Although it was stressed that the
Statement was not listed in priority order, the order has been assumed
by informed observers to reflect the priorities of the strategy. In
response to the strategy, many groups, associations and individuals
argued that a careful balancing act would have to be achieved to
ensure that crime, enforcement and control objectives would not over-
ride public health, treatment and prevention objectives (see ACOP,
1995; ACPO, 1995; ADSS, 1995; All Party Drugs Misuse Group, 1995;
Baroness Jay of Paddington, 1995; LDPF, 1995; LGDF, 1995; Phoenix
House, 1995; Release, 1995; SCODA, 1995; Turning Point, 1995). The
strategy also represented a retreat from the harm minimisation princi-
ples which had been pursued during the previous phase of drugs policy
from 1986 to 1993 (Ashton, 1995). Abstinence had now become the
goal of intervention with harm minimisation as a means to that end,
rather than an end in itself (HM Government, 1995). During this phase
of policy development, it appeared that concern around HIV/AIDS was
superseded by the relationship between drugs and crime. The ‘drugs-
crime link’ had become the driving force behind policy development.
Further research on the links between drugs and crime was to be com-
missioned by the Home Office (HM Government, 1994). Moreover, the
criminal justice system was increasingly being seen as a location or
opportunity for drug treatment intervention. Findings from the
National Treatment Outcome Research Study (NTORS) showed that the
1,110 drug misusers in the NTORS cohort had committed over 70,000
separate crimes in the three months before entry into treatment. In the
two years prior to treatment, the cost to the criminal justice system in
dealing with their offences was estimated at £4 million and the cost to
their victims was estimated at £34 million (Department of Health,
1996: 11)
The emphasis on enforcement-related activities was also reflected in
the amount of resources spent on each activity. The funds spent on
enforcement, deterrence and controls greatly outweighed those spent
on treatment, rehabilitation, prevention and education. For example,
for the year 1993–4, the government spent an estimated total of £526
million on tackling drugs across the UK, with £209 million being spent
on police/customs enforcement, £137 million on deterrence and con-
trols, £104 million on prevention and education, £61 million on treat-
ment and rehabilitation and £15 million on international action (HM
Government, 1995, annex B). The new strategy did not attempt to
overhaul radically or redistribute drug spending. Very few new
resources were made available. Informed members of the drugs policy
community suggested that the national drugs strategy was imbalanced
and focused too much on enforcement issues. They thought the claim
that the three strands of the Statement of Purpose (i.e. crime, young
people, and public health) were to be given equal importance was
meaningless rhetoric. The only way to rectify the imbalance in practice
would be to radically overhaul drugs spending.
The bifurcation in drugs policy described in previous chapters con-
tinued to operate during this later phase of policy development. The
emphasis was on prevention and education for young people and treat-
ment for the ‘deserving’ victims of drugs, with increased enforcement
and policing for the hardened user who might also be offending.
Under the aim ‘to increase the safety of communities from drug-related
crime’, one of the main objectives was ‘to reduce the level of drug
misuse in prisons’. This was the first time that penal drugs policy
objectives had been systematically incorporated at the national level.
Due to the growing interest in drug issues in prison within policy net-
works throughout the 1980s and early 1990s (as well as the fact that
law enforcement was one of the main planks of the strategy), the drugs
policy community saw the inclusion of prisons in national policy
development as imperative. However, some alluded to the fact that the
Prison Service was reluctant to be incorporated into the new drugs
strategy. This resistance reflected the insularity of the Prison Service
and their tendency to work on their own with little outside input. As a
drug agency director recalled:
My memory basically is that the Prison Service were trying to stay out of
that. They were trying to plough a single furrow on their own. They felt
that they had a problem and it was a ‘prison’ problem and they could
deal with their ‘prison’ problem. It was with quite considerable reluctance
and a great deal of political pressure that they became part of the targets
within TDT. That demonstrates things which are evident in other organi-
sational structures as well – structures that are very self-contained which
see themselves to some degree as being afflicted and criticised. They felt at
the point that they could produce some sort of solution which was just
their solution which didn’t go beyond their own walls. My sense at that
time was that the Prison Service nationally came on board reluctantly.
(Interview 08)
National and local co-ordination

The 1995 strategy stressed that in order to achieve progress towards the
aims and objectives, multi-agency co-ordination needed improvement
at both national and local levels. At the national level, co-ordination at
Ministerial level remained with the Ministerial Sub-Committee on the
Misuse of Drugs, chaired by the Lord President of the Council. At
official level, the Central Drugs Co-ordination Unit (CDCU) was estab-
lished in 1994 to support the Lord President in co-ordinating the
implementation of the drugs strategy and to ensure the policies and
practice of the lead departments involved in tackling drugs were coher-
ent. CDCU performed a liaison role, with the various departments each
retaining control of their particular policies, operations and resources
(HM Government, 1995). CDCU was part of the Privy Council Office
and physically located in the Cabinet Office, rather than in any partic-
ular government department with an interest in drug issues. In many
ways, this new structure at the heart of government represented a new

‘neutrality’ in drugs policy. The location also ensured that drug issues
assumed a very high-profile position within the hierarchy of govern-
ment. The CDCU had the potential to resolve some of the historical
tension between the Home Office and the Department of Health over
drug issues.
At the local level, 105 Drug Action Teams (DATs) were established to
deliver the strategy on the ground. As in other areas of social policy, there
was a rediscovered emphasis on area-based policies to recognise diversity
at a local level and allow for variation in response (MacGregor, 1998c).
DDACs were replaced by the new DAT structures which were to be com-
prised of senior representatives from the police, probation and prison ser-
vices, local authorities, including education and social services, and
health authorities. Co-option of voluntary sector representation was also
encouraged. Each Drug Action Team was expected to establish at least
one Drug Reference Group (DRG) made up of individuals or groups in the
community who had local knowledge, expertise, or experience in drugs.
The role of the Teams was to make progress in terms of the overall aims
and objectives of the national drugs strategy and adapt action to local cir-
cumstances. The starting point for the boundaries of the teams was the
district health authority.
Prison representation on DATs and DRGs was considered to be very
important, but as the ACMD (1996) warned, there were several practi-
cal barriers to making this a reality. First, prisons are situated in loca-
tions which do not match any neat structural map or set of
boundaries. For example, some health authorities have more than one
prison within their geographical boundary, while others have none.
Second, the allocation of offenders to prisons is based on a number of
factors with geography being only one. Therefore, health authority
concern for prisoners from their district and interest in any prison
within its area would often involve different populations. Third, some
prisons serve an area covered by several DATs. Attendance at each
might be unrealistically demanding on a particular prison and might
seem of little relevance to any particular DAT if prisoners from that dis-
trict were housed not only in the local prison, but in others around the
country (ACMD, 1996: 34–5). In addition to these practical barriers and
perhaps more fundamentally, prison involvement on DATs could be
hindered by the insularity of prisons. Fitzgerald and Sim (1982)
describe this as the ‘crisis of visibility’, a term which refers to the noto-
rious secrecy that surrounds prisons and what takes place inside them.
The ‘crisis of visibility’ has an impact on the relations prisons have
with the outside community and agencies, and how those agencies
and the community relate to prisons.
Penal policy context: the post-Woolf era
U-turn in penal policy: ‘prison makes bad people worse’ to ‘prison

works’
During the period 1993–7, the prison population increased steadily from
44,552 in 1993 to 61,114 in 1997 (see Table A.4, Appendix). Despite
signs of a decreasing prison population in the early period after the
implementation of the 1991 Criminal Justice Act, a speedy retreat from
the principles on which that Act was founded was undertaken by
Kenneth Clarke (Home Secretary 1992–3) and continued by Michael
Howard (Home Secretary 1993–7). As Downes (1997: 9) argues, this
sudden shift in the direction of policy was undertaken for party-political
reasons. Over the period 1989–92, the crime rate had increased by over
40 per cent, the recession had deepened, and the Conservative govern-
ment’s standing on law and order had declined compared to the Labour
party. The government refused to acknowledge the link between crime
and economic factors and thus resorted to ‘one golf club strategy [or]
more punitive policies’ (Downes, 1997: 9).
This phase of penal policy development was imbued with manageri-
alism and what Bottoms (1995) has termed ‘populist punitiveness’. A
populist punitive approach appeals to politicians because they believe
it will reduce the crime rate through general deterrence and incapacita-
tion; it may help to strengthen the moral consensus against certain
forms of activity such as drugs offences; and it will satisfy a particular
part of the electorate (Bottoms, 1995: 39). The new politics of populism
led to departures from conventional forms of policy-making. Under
this framework, Rock (1995) argues government ministers act with
great speed and on impulse, consulting and liaising less with policy
communities of experts, professionals, practitioners, civil servants, and
researchers regarding policy decisions. During this period, shifts in
penal policy were more influenced and determined by forces external
to the prison system such as the Home Secretary, the general public,
the media, and Sir John Woodcock and General Sir John Learmont
who were commissioned by the government to conduct inquiries on
prison security issues (Clark, 1997).
Thus, research conducted by Roger Tarling, the then Head of the
Home Office Research and Planning Unit, which showed that crime
levels would not be greatly reduced through incapacitative strategies
was ignored (Tarling, 1993). In October 1993, Michael Howard advo-

cated the idea that ‘prison works’ on deterrent and incapacitative
grounds at the Conservative party conference. He reasserted the
Thatcherite ‘law and order’ rhetoric of the early 1980s by announcing a
new ‘law and order’ package of 27 proposals which included the intro-
duction of mandatory drug testing (MDT) in prisons, the building of 6
new private prisons, restrictions on bail and cautioning, and more
punitive community service orders.
’Just deserts’ as the sentencing rationale was thus diluted by a renewed
faith in the deterrent and incapacitative qualities of the prison. These
ideas came to final fruition in the 1996 White Paper, Protecting the Public,
which outlined the government’s proposals for ‘honesty in sentencing’,
automatic life sentences for serious violent and sex offenders, mandatory
minimum prison sentences for drug dealers and burglars, and a new
prison building and refurbishment programme (Home Office, 1996). Any
debate regarding the aims of imprisonment, improvements to the regime,
or implementing Woolf’s proposals were clearly absent from the policy
agenda. In fact, Howard announced a package of ‘new austerity measures’
in 1994 which included the earning of privileges through a new incen-
tives and privileges scheme and restrictions on home leave, temporary
release and access to telephones.
During this period, the prison system was undergoing further crises
of ‘containment’ and ‘control’ which fuelled and legitimised the more
punitive, austere, security and control focused agenda. There were dis-
turbances at Wymott prison in 1993 and at Everthorpe prison in 1994.
In September 1994, six high security prisoners attempted to escape and
Semtex was discovered at Whitemoor prison.This was followed by
another escape of three prisoners at Parkhurst prison in January 1995.
These escapes led to the Woodcock and Learmont inquiries into prison
security. The Learmont Report represented a departure from the
general consensus emanating from the Woolf Report that the require-
ments of security, control and justice must be met and balanced if the
prison system is to remain stable. As Morgan (1997b) argues, Learmont
effectively dispensed with the notion of ‘balance’ by suggesting that
the primary purpose of imprisonment is ‘custody’ and that everything
else is subordinated to this basic requirement (see Learmont, 1995:
para. 3.39–3.40).Thus, Learmont did not conceptualise security and
care as complementary, but as being in opposition to one another. The
recommendations of the Learmont Inquiry therefore focused almost
exclusively on security issues by advocating greater use of CCTVs, ded-
icated search teams, restrictions on visits and prisoners’ property and
improved physical security (see Learmont, 1995: para. 7.1–7.120).
With Michael Howard’s pronouncement that ‘prison works’, his

emphasis on austere regimes, and his adherence to law and order
rhetoric, prisoners deriving pleasure from drugs use could no longer be
ignored or tolerated. During a period of overcrowding, crises in secu-
rity, and reduced prisons budgets, it is interesting that the drug issue
assumed such a high priority within the penal system. By 1994, the
Prison Service and the politicians had ‘come clean’ and publicly admit-
ted that there was a drug problem in British prisons. This area became
a political challenge to Michael Howard. He responded vigorously
within his new plans for penal policy. As Carlen (1998: 99) argues the
prison system had been opened up to the ‘war on drugs’. Members of
the policy networks, particularly those from penal reform groups and
drug agencies, saw a clear relationship between Howard’s discourses on
the efficacy and austerity of prisons and the way in which prison drugs
policy subsequently developed:
You can see certain things – MDT being the obvious one – as part of the
crackdown which follows the brief period of liberalisation [after] the
Woolf report … There was a period of what you could call the ‘Prague
Spring’ for the prison system … It doesn’t last very long. The tanks roll
back in and this takes many different forms – the introduction of the
incentive scheme is an example, MDT another … so it’s part of the
change of mood music of the period from about 1993 onwards.
(Interview 24 with penal reformer)
Agency status
A key trend in public sector reform during the late 1980s and early
1990s was the development of ‘agencies’. Under agency status, quasi-
autonomous bodies are established which are responsible for the devel-
opment of operational policies within a policy and resource framework
set by central government (Home Office, 1988b). The agencies are
responsible for delivering the services within these resource limits. On
1 April 1993, the Prison Service was detached from the Home Office,
hived off from direct government control and established as an execu-
tive agency. A Director General, Derek Lewis, was recruited from the
private sector to facilitate these changes. Under the new decentralised
arrangements, more responsibility, control and authority for budgets,
contracts, staffing and regimes was devolved from Prison Service head-
quarters to individual prison governors.
In 1993, six principal goals were set for the Prison Service: to keep
prisoners in custody; to maintain order, control, and discipline in a
safe environment; to provide decent conditions for prisoners and meet
their needs; to provide positive regimes which would help prisoners to

address their offending behaviour and allow them as full and responsi-
ble a life as possible; to help prisoners prepare for their return to the
community; and to deliver prison services using the resources provided
by parliament with maximum efficiency (HM Prison Service, 1993).
Key performance indicators (KPIs) and targets were developed to
measure progress towards these goals. The Corporate Plan outlined the
strategies for achieving the goals over a three-year period and the
Business Plan set targets for the immediate financial year.
This new approach to public sector management had a profound
effect on the way in which the prison system was managed and
operated. It came to be dominated by ‘institutionally-defined man-
agerial goals’ (Garland, 1990: 184), prioritising measures of perfor-
mance and short-term goals rather than articulating a common
purpose, moral mission or set of values. There was also a shift to
focusing on the ‘aggregate’ level, rather than the individual offender
or prison. For example, data on the key performance indicators are
reported as national aggregates making it difficult to ascertain what
is occurring in individual prisons. The emphasis on the ‘aggregate’
also leads to a clash in terms of philosophy for professionals within
the system who may come from social work or probation back-
grounds which focus on the individual (Bottoms, 1995). Various
scholars have argued that the system has become preoccupied with
internal goals, rather than social goals, ‘outputs’ rather than ‘out-
comes’, the aggregate level rather than the individual; and on inter-
nal system processes rather than external objectives (see Feeley and
Simon, 1992; Bottoms, 1995; Garland, 1996).
The drug issue in prison was first given serious attention under these
new arrangements and structures. For example, in the 1996–7 year, a
new KPI was introduced which was to ensure that the rate of positive
random drug testing would be lower in the fourth quarter of 1996–7
than in the first quarter of that year (HM Prison Service, 1996a). In the
next sections, the ways in which the drug problem in prisons was
reconceptualised and the policy response will be explored.
A threat to order, control and discipline: reconceptualising

the drugs ‘problem’ in prisons
During the mid-1990s, the drugs ‘problem’ in prisons began to be

framed in new ways. The concern around HIV and public health
issues during the previous phase began to diminish and there was an
increasing focus on drugs as a problem of order, control and disci-

pline. This shift in emphasis was linked to the punitive political
context discussed above and to a growing awareness of drugs in
prison as a problem of culture and currency with links extending
into the wider community. During 1993–7, official statistics indi-
cated that the drugs ‘problem’ in prisons was increasing. The
numbers of drug addicts notified to the Home Office by prison
medical officers almost doubled from 1,941 in 1993 to 3,665 in
1996, and their proportion out of all notifications increased by 3 per
cent over this period (see Table A.1, Appendix). The number of drug
offenders sentenced to custody also increased dramatically from
4,835 in 1993 to 10,422 in 1997 (see Table A.2, Appendix).
During this phase, informed members of the policy network sug-
gested that there had been not just one drug problem, but a multi-
faceted phenomenon. They saw a variety of different problems
experienced by different people with different drugs in different con-
texts. They disagreed, however, as to whether drugs was primarily a
problem for the ‘individual’ or for the ‘institution’; whether it was a
health problem or an enforcement problem; and whether it was an
‘internal’ problem within prisons or an ‘external’ problem extending
beyond them. But on the whole, with some important exceptions,
these influential groups tended to frame drugs as a problem for the
institution, rather than for the individual; as an enforcement rather
than a health problem; and as an internal rather than an external
problem.
Drugs were particularly problematic when they became a dominant
part of the prison culture. A ‘culture’ had built up around drugs within
prisons during the mid-1990s. They had become an important cur-
rency which generated certain types of behaviours and problems for
individuals and for the institution, including drug dealing, intimida-
tion, threats, extortion, bullying, the accumulation of debts, and vio-
lence (ACMD, 1996). The fear of intimidation and violence was
believed to have led to suicides, prisoners opting to be transferred to
Rule 43 for protection, prostitution, bartering possessions, and failure
to return from home leave due to failing to obtain drugs for others (see
Leech, 1997; Turnbull et al., 1994). A civil servant described drugs as a
‘penetrating problem’ within the institution:
It is an evil that permeates every layer and area of a prison. It is a

penetrating problem … There is nothing that it doesn’t touch or impact
upon. (Interview 20)
Drugs had become one of the most potent, expensive and powerful
currencies within the prison system. The type of currency within prisons
determines how the system will operate. Currencies, such as tobacco, tele-
phone cards and chocolate, have always existed. The problem was not so
much that drugs had become a currency, but that in some prisons they
had become very expensive leading to huge debts and violence. Sparks et
al. (1996) found that in prisons where cash economies operated, the price
of drugs was high and a lot of money was generated through them. The
illegality of drugs was also a key problem. For the first time, the currency
being used not only breached prison disciplinary rules, but was also
against the law. The Conservative administration was particularly con-
cerned with the illegality issue and the public imagery of failing to take
tough action on such activities. The use of alcohol is also against prison
rules and creates problems around violence and control. However,
alcohol was not viewed as problematic and no overall strategy existed for
alcohol during this period. This suggests that the concern around drugs
was set within a political rather than a practical agenda (Hewitt, 1996).
When drugs became a currency, it led to loss of control by the
authorities over the prison environment. For example, the Learmont
inquiry found that prior to the escapes at Parkhurst, drug use and
dealing were pervasive within the prison and had led to an increase in
assaults and violence between prisoners. An internal enquiry con-
cluded that the prison ‘had a serious drug problem [which was] greater
than initially envisaged. The supply of drugs is spiralling out of the
control’ (quoted in Learmont, 1995: para. 2.247). The notion that the
problem was out of control was seen to be the key to the drug problem
among those most concerned with developing prison drugs policies.
Drugs were no longer seen as ‘functional’ in keeping the system under
control (as they had been in the 1980s), but as a disruptive, destabilis-
ing, threatening and dangerous factor:
The consequences of [drugs] affected the whole life of the prison in terms
of potential violence, but also in terms of destabilising the whole system.
It’s by no means only about drug use in itself … It is the overall sense that
it leads to a more unpleasant and unmanageable environment.
(Interview 02 with civil servant)
Imprisoning more drug traffickers and offenders does not ensure that
all drug-related crime will be controlled as the advocates of the 1991
Criminal Justice Act and subsequent legislation had hoped. Research

indicates that many criminals continue to commit crime in the prison
environment just as they had in the community (see Bottoms et al., 1990;
Grapendaal, 1990; King, 1991) and drug traffickers continue to operate
easily within the prison setting (see Early, 1991; Ruggiero, 1995). Drugs
and drug dealing provides a source of status and ‘employment’ for some
prisoners which continues on the outside on release (Ruggiero and South,
1995). As Ruggiero (1995: 66) observes, ‘drugs cause some prisoners to
become desperate and ill while others become rich and powerful’.
Although drug users in prison were seen to be difficult to engage in
the regime and regular work programmes, it is important to emphasise
that drugs are used as a means of coping with the pains of deprivation
of prison life (Sykes, 1966; Irwin, 1980). For inmates who are locked up
for 23 hours a day, drugs (particularly cannabis) provide a method of
relieving the stress and boredom of being in prison, a way to pass their
‘time’ and an aid to sleep (Turnbull et al., 1994; Cope, 1999; Matthews,
1999). Some policy actors argued that the increase in drug use in
prison could be viewed as a reaction to the decline in the quality of
prison regimes due to increasing overcrowding, cuts in prison pro-
grammes, and Howard’s austerity measures introduced during the mid-
1990s. Drug smuggling, trafficking, dealing and use within prisons had
provided a way to pass time in prisons and could be compared to a
‘game’ which occupied a large proportion of prisoners:
If the regime quality was fundamentally different, then we’d have a very
different story in terms of drugs. I principally see it as a quality of regime
issue which means the stultifyingly boring life is tempered by using drugs,
mainly cannabis and in its wake, it becomes a control issue of bullying,
violence, and trade … Therefore what you get is the collusion of princi-
pally families [and] friends breaking through that cordon sanitaire, plus
the occasional prison officer deviates. And the whole thing becomes a
great game. (Interview 05 with director of drug agency)
During this phase, there was also growing recognition amongst the
policy network that the drug problem in prison extended beyond the
prison walls in terms of links with crime and criminals on release,
debts, trafficking, and problems for prisoners’ families and friends. It
was difficult for prisoners to break free of drug networks within prisons
on release. The drug supply networks in prisons were inextricably
linked to those operating in the community. Prisoners’ families and
friends were being pressurised to smuggle drugs into prisons, forced to
assume responsibility for paying debts accumulated by their partners

within prisons, and threatened and hassled by drug dealers operating
within the community who had links with those inside prisons.
Reflecting their orientation towards treating and caring for individ-
ual drug users, it was mainly those from drug agencies who expressed
the problem of drugs in prison in ‘individual’ and health-related terms.
For them, individual problems included people beginning their drug
career in prison, links between drug use and offending behaviour,
unsafe practices within prisons, problems around drug addiction and
other health issues. Drug using prisoners often lacked knowledge about
drugs and experience of drug services and treatment in the commu-
nity. This group tends to be excluded from service provision and from
society in general. The OPCS survey of prisoners showed that less than
one-third (31 per cent) of drug users had sought some sort of treatment
prior to imprisonment. (Bridgwood and Malbon, 1995). Similarly, in
Maden et al.’s study of women prisoners, one third of the women
defined as dependent reported no contact with treatment services
before entering prison (Maden et al., 1990), but over half of the female
and male prisoner samples indicated they would accept treatment if it
was offered to them (Maden et al., 1990; 1991).
In conclusion, it is clear that different drugs cause different problems
for different individuals within different prisons (Turnbull et al., 1994;
ACMD, 1996). In order to address the problems associated with drugs
in prison effectively, this needed to be acknowledged by those
involved in the formulation of policies and strategies. As a spokesper-
son from a professional association cogently argued:
The cannabis problem is a problem of gangsterism and intimidation.

Problems about use of heroin are essentially around health concerns.
Those two might be linked because it might be the same supplier. It might
be the same user, but putting watered down bleach on landings doesn’t do
anything to solve the problem around the violence and intimidation asso-
ciated with cannabis and vice a versa. So you’ve got to sort out what is
‘the problem’. Is it violence and intimidation we’re talking about? …
There’s not one problem. There’s a range of problems and you’ve got to be
clear which one we’re tackling. The odds are that as you deal with [one],
you impinge on others. (Interview 21)
The next section will explore the response to the drug problem in
prison during this phase which took the form of the 1995 prison drugs
strategy.
Response to the ‘problem’: the 1995 prison drugs strategy
In 1995, the Prison Service published a document entitled Drug Misuse in

Prison: Policy and Strategy. This represented the first comprehensive drugs
‘strategy’ within the prison system with clearly defined actions, priori-
ties, objectives and targets. Reducing the level of drug use became one of
the seven strategic priorities in the Prison Service’s Corporate Plan and
would be monitored by a new performance indicator based on the
number of positive results from random drug tests. The reduction of
drug use in prisons was to be achieved through local drug strategies
which focused on three areas: reducing the supply of drugs; reducing the
demand for drugs and rehabilitating drug users; and measures to reduce
the potential for damage to health of prisoners, staff and the wider com-
munity, arising from the use of drugs (HM Prison Service, 1995a: 2).
Prison governors were responsible for developing and implementing
local strategies which were to be agreed with area managers. The ACMD
(1996: 32) welcomed this approach in the hope that it would help to
close the wide gap that historically existed between national policy and
local practice. The 1995 prison drugs strategy was presented essentially
as a two-pronged approach with measures to reduce the drugs supply
and measures to reduce demand for drugs (see Prison Service, 1995a:
14–15). This was the first time that supply and demand reduction activi-
ties were combined within prison drugs policy. It was therefore an
attempt to manage the issues which arise from the contradiction
between asserting that the Prison Service will not condone drug use and
achieving public health objectives to help drug users change their
behaviour (Keene, 1997a). Within the policy discourse, there was a
duality as it simultaneously contained both elements of help and pun-
ishment, providing it with much political appeal (Edelman, 1984).
Concern was expressed by various sources that the new strategy might
over-emphasise supply reduction and concentrate resources on security
measures at the expense of demand and harm reduction (see ACMD,
1996; Penal Affairs Consortium, 1996; HM Chief Inspector of Prisons,
1996). These concerns were well-founded. In practice, the elements of
security, punishment and control took precedence over help and treat-
ment. The next sections will examine the main strands of the 1995
prison drugs strategy and the balance which emerged between them.
Mandatory drug testing

The most controversial element of the 1995 prison drugs strategy was
the introduction of mandatory drug testing (MDT). During a visit to
the United States in Spring 1993, the Director General of the Prison
Service, Derek Lewis, was impressed with American drug testing pro-
grammes and believed they could be effective in reducing drug use in
British prisons (Lewis, 1997). Under the MDT protocols in 1995, ten
per cent of the population of each prison was selected at random by
computer. Selected prisoners were required, without warning, to
provide a urine sample. The mandatory testing powers could also be
used on reception; on suspicion; prior to risk-related activities such as
temporary release and for persistent offenders. MDT is undertaken by
specially trained prison officers, rather than health care staff who are
bound by professional and ethical codes which prevent them from par-
ticipating in activities without the consent of their patients. The MDT
programme was resource and labour intensive and the cost for the pro-
gramme was borne partly from the existing budgets of individual
prisons and by diverting resources from other Prison Service areas.
Although prisoners could not be forced to provide a sample for
testing, those who refused could be disciplined for refusing to obey a
lawful order. Prisoners who tested positive were liable to the usual
range of disciplinary action on adjudication including additional days,
loss of privileges and earnings, and administrative measures such as
closed visits and removal of home leave. However, it was estimated
that 90 per cent of the adjudication outcomes involve awarding addi-
tional days (ACMD, 1996). The Home Office estimated that MDT
would increase the prison population by 300 (Home Office Statistical
Bulletin, 1996) and the annual cost for holding an extra 300 prisoners
in custody would be over £7 million (Penal Affairs Consortium, 1996).
The Prison Service outlined several purposes of MDT including deter-
rence, identification for treatment programmes, helping prisoners to
overcome peer pressure, provision of data on the scale and pattern of
drugs use in prison, and information for a performance indicator of
drug use (HM Prison Service, 1995b). But many key policy players
argued that the link between MDT and treatment was not as sophisti-
cated as it was presented in the strategy. MDT was primarily seen, par-
ticularly by those from penal reform groups and drug agencies, as a
means of control and a method for inflicting more punishment, partic-
ularly for cannabis use:
MDT is essentially a solution to a perceived cannabis problem. It’s all about

order and control. They try and put a gloss on it saying it helps to bring
people forward for treatment programmes … That’s not what it’s all about.
(Interview 21 with spokesperson from professional association)
In February 1995, MDT was piloted initially in eight prisons. By

Spring 1996, it was in place across the entire prison system. The
great speed with which the MDT system was implemented reflected
the priority that drugs had assumed on both the political and policy
agendas. It was implemented in many prisons before the broader
drug strategy was established. In particular, treatment provision was
not in place prior to MDT. Because it was a mandatory requirement
across the prison system operating within a legal framework, MDT
was focused upon at the expense of other parts of the strategy.
Another crucial factor was that the MDT results were the only drug-
related key performance indicator (KPI) which was reported at a cor-
porate level. As a result, MDT was often used as an indicator of the
effectiveness of the overall drugs strategy. All of this was com-
pounded by the political pressure to appear ‘tough’ on the drug issue
in prisons. This legacy of emphasis and primacy on MDT persisted
within the 1995 prison drugs strategy. This was recognised by the
civil servants:
Undoubtedly, MDT has taken too much focus for us … There was
significant political pressure to introduce MDT and get it in quickly,
which meant that we had a rather cockeyed approach in the sense that
some prisons had MDT before they had a broader strategy in place. That
legacy is still with us about needing to look at the balance. (Interview
14a)
There’s no doubt in the first roll out, because MDT was obligatory by a
certain date in every prison, the emphasis has been on the control aspects.
(Interview 19)
Supply reduction
Supply reduction measures also featured prominently within the 1995
prisons drugs strategy. These included improved perimeter security (i.e.
patrolling, searching near perimeter fences, use of dogs and CCTV);
searching (i.e. unpredictable, random searches by specially trained staff
and dog teams); supervision of visits (i.e. CCTV, use of dogs, fixed fur-
niture, searching visitors, and using closed visits for prisoners found
guilty of drugs offences); intelligence gathering and use of informants;
and control of prescribed medication. These drug security measures
were tied into the recommendations from the Woodcock and
Learmont reports. As discussed above, the outcome of these two
inquiries was a greater emphasis and more resources for security
measures which Carlen (1998: 7) has aptly described as representing a

‘fetishism of prison security’. The inquiries had a knock-on effect with
regard to the drugs strategy which ensured that the supply reduction
measures had a very high profile, were taken seriously and
implemented across the prison system.
New powers were given to Dedicated Search Teams which were
specially trained in searching both cells and prisoners for drugs. Media
reports began to emerge that the new strip-searching powers given to
these teams in Holloway Prison led to much intimidation and degrada-
tion amongst women prisoners. It was argued that this type of work
attracted certain types of prison officers or the ‘heavy mob’, who wore
a uniform of PVC leggings, Doc Marten boots and baseball caps (The
Observer, 24 Nov. 1996, quoted in Carlen, 1998: 7–8). Similarly, the
security teams undertaking the searching and testing at Stoke Heath
YOI wore special SAS-style jumpsuits and heavy black boots (Howard
League for Penal Reform, 1996). Such symbolic distinctions between
staff carrying out security and control functions and those undertaking
health and treatment activities ensured that punishment and control
aspects would remain visible and paramount. In 1996, there were 8,036
drug finds in prisons and one-third of these emerged from cell searches
(HM Prison Service, 1997a).
Because visits were seen to be the major route by which drugs enter
the prison, the greatest impact of increased security was felt amongst
visitors to prisons. Those working within prisons argued that the
increased searching, use of sniffer dogs, and CCTVs have made visiting
prisons an intimidating and frightening experience for many visitors.
Police in the community began to work more closely with the prisons
in terms of intelligence gathering, leading to raids on visitor centres
connected to some prisons. These centres are supposed to be safe
places where visitors can have refreshments, wait for their visiting
time, use the washroom facilities, and obtain advice from centre staff.
The raids were conducted insensitively. For example, some visitors
were strip-searched in front of their children. This has become a gen-
dered issue as the majority of visitors to all prisons are women (includ-
ing women’s prisons) who often become coerced and pressurised into
bringing drugs into the prisons (ACMD, 1996: 44). Various prisons
posted up photocopies of news reports giving details of people being
arrested for bringing drugs into prisons in the hope that it would deter
other visitors. However, it is unlikely that these measures will act as a
deterrent because the pressure to smuggle drugs in is too great. Many
visitors fear that their partners and friends inside prisons will be
attacked, bullied or even killed if they fail to bring drugs. As a civil

servant admitted:
We’ve got some victims of drugs in prisons – usually women – who are
under immense pressure to bring things in. As we’ve said to Ministers, it’s
very easy to say that these measures will deter … but, if my son was in
prison and he said to me, ‘Look, someone’s going to knife me, if I don’t get
something in’, you can imagine you might try to get something in.
(Interview 14b)
In 1995, 1,463 visitors were arrested for possession of drugs – an

increase of over 50 per cent compared to 1994. There was a slight
reduction in 1996 with 1,314 visitors arrested (HM Prison Service,
1997a). Visitor centres began to adopt a drug prevention role, for
example, by putting up posters for visitors to advertise help and advice
if they are pressurised into bringing in drugs. In May 1996, ADFAM
National, the charity for the families and friends of drug users, devel-
oped a project which is dedicated to working with prisoners’ families
and visitors to prisons around drug issues.
Treatment provision
Within the 1995 prison drugs strategy document, there was very little in
terms of new proposals and resources for drug treatment initiatives. With
regard to treatment, counselling, and support services, it was stated that
‘it is not possible to advocate a particular programme or programmes
which will meet the immediate needs of the prison, the longer term
needs of the criminal justice system, and the needs of the individual
inmates’ (HM Prison Service, 1995a: 18). It was recognised that different
programmes such as short educational programmes, self-help groups,
individual advice and counselling, and therapeutic communities would
be needed to match varying levels and types of drug use. However, it was
not specified where these programmes were to be provided, who would
be delivering them, or how they would be resourced.
Drug agencies working in the prison setting have always faced the
dilemma as to where they position themselves within the system
(i.e. as independent professionals or as part of the penal establish-
ment). The introduction of MDT altered the political environment
of prison-based drug work and raised complex issues for agencies
(Stokes, 1996). The premise that MDT would identify drug using
prisoners for treatment placed tremendous pressure on drug agencies
as there was insufficient treatment provision for MDT to work as a
referral mechanism. Moreover, some drug agencies refused to work

with MDT positives unless they were paid for working with this
group. A clear separation between treatment and MDT would have
ensured that the voluntary nature of treatment was maintained and
that drug services were not swamped with cannabis referrals (Stokes,
1996). If agencies accepted referrals from MDT, this would change
their position within the prison as they would become part of the
MDT machinery, rather than independent.
There are similar debates about whether or not prison officers should
be involved in drug treatment programmes. As we saw in the previous
chapters, drugs tended to be an area solely for ‘experts’ within prisons,
such as medical staff and external drug agencies. Under the 1995 strategy,
there was an emphasis on a multi-professional and multidisciplinary
approach. All prison staff were to undergo basic training to increase their
understanding of drugs, their effects, and the problems experienced by
drug users to ensure that the strategy was successful and not undermined.
Cultural clashes between prison staff and service providers often occur.
Prison staff tend to work within a very punitive institutional framework
with their work centring around the needs of the institution, whereas
service providers tend to adopt a more caring, client-centred approach
with their work centring around the needs of individuals. The security
and control functions of prison officers raise difficult issues around
confidentiality, particularly in relation to the other parts of the drugs
strategy such as MDT and supply reduction. Because prison officers’
primary responsibilities and skills are around security issues, these will
always take priority and often conflict with treatment programmes. There
is also a perception amongst some prison officers and governors that secu-
rity and supply reduction activities constitute high status work compared
with treatment, rehabilitative and welfare-oriented work. As a spokesper-
son from a professional association argued:
Some prison service staff are more interested in sexy operations like dog
searches and CCTV, than they are in things like … working with individ-
uals to deal with their drug use problems … Most people would regard the
second half of that as being sexier propositions than high walls, dogs and
CCTVs, but the Prison Service don’t, because that’s where their minds are
at. (Interview 21)
Harm minimisation
Similar to the national drugs strategy, HIV and harm minimisation
issues received little attention within the 1995 prison drugs strategy
document. It may be that this was seen to be covered by the Prison

Service AIDS Advisory Committee in their review of HIV/AIDS which
was undertaken in 1992 and published in 1995 (HM Prison Service,
1995c). However, there is no mention of the work of the Committee
or any link made between it and the prison drugs strategy. Local
drugs strategies were expected to include education and information
for all inmates on the risks and harms of drug use; options for
coming off drugs; methods of reducing risk of cross infection; and
the help available for HIV, other bloodborne infection diseases and
drugs (HM Prison Service, 1995a). In their criticism of the strategy,
the ACMD (1996: 38) suggested that in order for it to be more bal-
anced and comprehensive, harm minimisation should be accorded a
more important role and should involve three strands: reducing
drug-related harm to individual prisoners, the prison regime, and
the wider community.
Despite the lack of emphasis on harm minimisation within the
strategy, important policy reforms were occurring quietly within the
penal system. These included more liberal approaches to methadone
maintenance, the provision of sterilising tablets to clean syringes
and general provision of condoms. These reforms can be seen as the
result of the pressure which had been building up over the previous
phases of policy development from various committees and policy
networks lobbying for greater congruence between community and
penal provision. Guidelines on the use of methadone treatment were
reviewed in 1995. Although abstinence was the overall aim of the
drugs strategy, methadone treatment within prisons was to reflect
more closely its use in community drug treatment programmes to
ensure continuity for those prisoners receiving treatment before
custody and on release (HM Prison Service, 1995a).The new guide-
lines for the clinical management of drug users are found in Health
Care Standard 8. The ACMD (1996) warned that a gap would remain
between policy and practice unless steps were taken to ensure the
implementation and rigorous monitoring of the standards. These
were merely ‘guidelines’, meaning that prisons had not been man-
dated to implement them. Drug agencies were sceptical about the
probability of their implementation:
We get rainforests of paper sent out from Cleland House which are termed
‘guidelines’. Why are they guidelines? Why not instructions? So for
example, the Health Care Standards are guidelines … they are a waste of
paper. (Interview 26a with director of drug agency)
The AIDS Advisory Committee made a total of 39 recommendations

including the provision of sterilising tablets; easy access to condoms
and lubricants; and that education concerning HIV should directly
address sexual behaviour and safer sex practices. In 1993, following the
outbreak of HIV infection at Glenochil prison, the Scottish Prison
Service made sterilising tablets available to clean syringes. The AIDS
Advisory Committee also recommended that sterilising tablets be
issued to all prisoners in England and Wales as part of a health and
safety pack (HM Prison Service, 1995c).
Although it appeared from the drugs strategy document that interest
in harm minimisation had diminished, policy reform was slowly occur-
ring and the lessons from the HIV experience in prisons were being
applied to other communicable diseases, such as hepatitis C. Therefore,
harm minimisation and risk reduction measures were seen to be still
on the agenda and pressures for reform of existing policy were still
occurring, but were perhaps not articulated at the political level as
prominently as some of the security and control measures in the 1995
prison drugs strategy. It is clear from the 1995 prison drugs strategy
document that the control and security elements were presented much
more explicitly, with greater definition and detail compared to the
treatment and harm minimisation elements which were much less
explicit, detailed and concrete. Mandatory drug testing and the secu-
rity initiatives were universal requirements across the prison system
which were backed up by central funding and clear deadlines for
implementation, while treatment and harm minimisation initiatives
were to be established through guidelines, which would be subject to
local decisions, resources and timetables. As prison drugs policy
became more pronounced, defined and strategic, the contradiction
between treatment and punishment grew much more acute. In an
attempt to rebalance the strategy towards treatment and care, a policy
network began to form and lobby for more emphasis and resources for
treatment provision. The next section will examine their role in con-
taining the increasing tensions between treatment and punishment.
The role of the policy network
In response to the new prison drugs strategy, interest in drug issues in

prisons had increased and new players had been drawn into policy net-
works. For example, the ACMD (1996) published their report, entitled
Drug Misusers and the Prison System: An Integrated Approach, which pro-
vided an important critique of the evolving strategy. Various groups
produced discussion papers on different aspects of the strategy, such as

the Penal Affairs Consortium (1996) and the Howard League for Penal
Reform (1996). Drug issues in prisons were included in various official
reports (see Department of Health, 1996; HM Chief Inspector of
Prisons, 1996; 1997b; British Medical Association, 1997) and were the
subject of various articles by practitioners and professionals attempting
to influence the direction of policy (see Flynn, 1994; Tchaikovsky,
1994; Trace, 1995; Brazil, 1996; Stokes, 1996; Hewitt, 1996; Heyes and
King, 1996; Rice, 1997). The new strategy also prompted research inter-
est in this area (see Seddon, 1996; Gore et al., 1996; MacDonald, 1997;
Keene, 1997a; Bird et al., 1997).
During this phase, the role of the policy network shifted from a posi-
tion of setting the policy agenda, to one where they were responding
to an agenda set from above. In many respects, they lost some of their
power and influence, particularly during the early stages of the policy
process. On the whole, there had not been open consultation with
many of the key policy players over the details of the strategy, particu-
larly those outside government. They had been sidelined. Prior to the
implementation of the MDT policy, various members of the policy
network attempted to lobby against its introduction. Their attempts
proved futile, but they learned to adapt and deal with the new situa-
tion. In order to realign the strategy, they shifted their focus to extend-
ing treatment provision and the details of policy implementation and
practice.
The battle against MDT and security measures

Before the implementation of the prison drugs strategy, there was
much criticism and concern expressed by penal reform groups, drug
agencies, civil liberties groups and other commentators regarding MDT
and the associated security measures. The main objections were that
MDT would: constitute an invasion of the right to privacy; cause
switching to class A drugs which are less easily detectable compared to
cannabis; lead to riots and disorder; discourage drug using prisoners
from presenting for treatment; divert scare resources away from drug
treatment and prevention; lead to drug-free urine becoming a cur-
rency; result in drugs, urine and injecting equipment being carried
internally, thus increasing the risks of HIV; increase tension between
staff and prisoners with decreased use of cannabis; lead judges and
magistrates to send offenders with drug problems to prison more often;
have a detrimental effect on prisoners’ relationships with family
members and friends; not be backed up by effective treatment
provision; and finally, drugs would become more scarce and therefore
more expensive leading to more violence, debts, intimidation and bul-
lying (see Flynn, 1994; Tchaikovsky, 1994; Trace, 1995; Riley, 1996;
Berger, 1995; Hewitt, 1996; Heyes and King, 1996; Brazil, 1996; Gore et
al., 1996; Howard League for Penal Reform, 1996; ACMD, 1996;
Wayne, 1996; Penal Affairs Consortium, 1996; Rice, 1997).
Issues of race and gender were invisible within the strategy. Local
drugs strategies were to include ‘an assessment of local needs and prior-
ities which takes into account the equal opportunities implications of
tackling drugs in prisons’ (HM Prison Service, 1995a: 3). However,
there was no specification as to what these implications might be and
how prisons should deal with them. The ACMD (1996) stressed that
the needs of women, minority ethnic prisoners, and young offenders
needed to be more carefully considered in the development of the
strategy. Concern was expressed that MDT would lead to new degrada-
tions and indignities in women’s prisons (HM Chief Inspector of
Prisons, 1997a; 1997b). Carlen (1998) illustrates how the construction
of the MDT policy failed to consider and anticipate the differences in
terms of implementation in women’s prisons. There were also concerns
that MDT would be applied in a discriminatory manner, in particular,
there were arguments that the procedures should be ethnically moni-
tored (Runciman, 1996; ACMD, 1996).
The overriding criticism of MDT was that it would cause prisoners
to switch from using cannabis to class A drugs, such as heroin,
which are less easily detectable. Data from the pilot study indicated
that the proportion of prisoners testing positive for opiates or benzo-
diazepines rose from 4.1 to 7.4 per cent, while the proportion testing
positive for cannabis decreased from 33.2 to 29.1 per cent between
the first and second phases of random testing, indicating the possi-
bility of switching from cannabis to opiates and other drugs because
of lower detection rates (Gore et al., 1996). This conversion to class
A drugs was also noted in the canton of Zurich, Switzerland when
random mandatory drug testing was introduced. Their response was
to cease testing for cannabis (Gore et al., 1996). In response to these
initial findings, the Prison Service did not alter the implementation
of MDT policy or procedures. Later, as part of its review of the prison
drugs strategy, both quantitative and qualitative research on MDT
was commissioned by the Prison Service to explore some of these
issues. The fact that they were awaiting the results of this research
was used by the Prison Service as a ‘tactic’ to deflect criticism away
from the evolving strategy.
The various objections, warnings and preliminary research findings

made little impact on the implementation of the policy. A spokesper-
son from a professional association who had been part of the lobby
against the introduction of MDT recalled how he had been impressed
with the planning by the Prison Service in this area:
We could think up 15 good reasons why MDT could never possibly work.
Then we had a briefing from the people from the Prison Service who
thought up 25 reasons why MDT couldn’t work and sorted out 24 of
them. It was a very impressive piece of work – the way they had looked at
every aspect of it … In planning terms, they did an excellent job.
(Interview 21)
Given the statutory powers surrounding the MDT procedures, there

was relatively little that could be achieved through lobbying to stop
implementation. As Dowding (1995: 144) argues, ‘the material power
and legitimacy of the elected government can ride roughshod over any
policy community.’ The service providers recognised this and turned
this into an ‘opportunity’ to argue that more treatment services were
needed if drug users were to be identified through MDT. In their view,
MDT had to be accepted, used as an indicator of drug use and a lobby-
ing tool for expanding treatment provision:
We couldn’t just stand there and stamp our feet and say, ‘this is a terrible
thing’, because you’d just be sidelined. What we did say is that the best
thing it could do is give an indicative baseline of drug use in prison.
(Interview 10 with director of drug agency)
Furthermore, the Prison Service could no longer ignore or deny the

problem of drug use in prisons because of the ‘official’ evidence base
being produced through MDT procedures. For example, the key perfor-
mance indicator for positive random drug testing indicated an increase
from 24 per cent in the first quarter of 1996–7 to 24.2 per cent in the
fourth quarter (HM Prison Service, 1997b). For the drug agencies, the
MDT results helped to raise awareness of the amount of drug use
taking place in prison and therefore provided a starting point for dis-
cussion about what could be done in terms of drug treatment.
Civil servants within the Prison Service also voiced their concerns
around the problems of implementing a solely punitive measure. In
1994, Phillipa Drew, then the Director of Custody, and Tony Pearson,
then the Director of Inmate Programmes, warned that MDT could
cause disorder and staff collusion with prisoners, if it was not intro-
duced with incentives to remain drug-free and within a broader treat-
ment strategy (The Guardian, 28 Oct. 1994, quoted in King and
McDermott, 1995: 195). The Chief Inspector of Prisons (1996) also
argued that testing needed to be followed by either reward or treat-
ment, and that financial provision needed to be made for these ele-
ments. Similarly, the British Medical Association recommended that
MDT should only be used with the provision of a full range of treat-
ment services (BMA, 1997). A policy network comprised of drug service
providers, penal reformers, civil servants and others began to lobby for
centrally funded drug treatment initiatives to back up the MDT mecha-
nism. Given their vested interests in this area, drug service providers
played key roles in this policy network.
Pilot drug treatment programmes

In a limited sense, this policy network had been successful in their lob-
bying for treatment provision. By 1996, the Prison Service had intro-
duced various types of pilot drug treatment programmes within
particular prisons across the country. These programmes were centrally
funded by the Prison Service Directorate of Health Care and indepen-
dently evaluated by PDM Consulting Ltd. In 1995–6, £3.5 million was
made available for the pilots, and £5.1 million in 1996–7 (Penal Affairs
Consortium, 1996). Initially, only 21 prisons were involved in the pilot
programmes. Those prisons without pilot drug treatment programmes
were encouraged to develop and fund their own arrangements involv-
ing external drug agencies. The pilots and evaluation were to be used
as a basis to decide which facilities should be introduced across the
entire prison system. The long-term aim was to provide a range of dif-
ferent drug treatment programmes within clusters of prisons, so that
prisoners within each cluster would have access to treatment which
corresponded to their assessed needs. The treatment programmes could
be seen as almost an afterthought in policy development to rectify an
overly punitive policy and in response to liberal sectors within the
Prison Service and the Home Office, as well as criticism from lobbyists.
However, there was also a growing evidence base indicating that ‘treat-
ment works’ and that the criminal justice system, particularly prisons,
should be regarded as an opportunity for drugs intervention, which
could not be ignored (Department of Health, 1996).
In general, the type of approach adopted by the Prison Service for
the pilot drug treatment programmes was abstinence-based. Politically,
this was a much more expedient and clear strategy to present in the
context of a ‘tough’ policy on drugs, than one based upon harm min-
imisation. There were rumours that Michael Howard had been drawn
in by Phoenix House USA and attracted to the idea of a hard-line,
abstinence-based approach. There was also very little evaluative
research on the various types of prison-based programmes in the UK
and EU to make an informed choice (Turnbull and Webster, 1998). The
12-step, abstinence-based programme at Downview prison run by
Rehabilitation for Addicted Prisoners Trust (RAPt) had also been her-
alded as a success throughout the prison system, won the Guardian
Jerwood Award for charity work, and had also been independently
evaluated (see Player and Martin, 1996; Bond, 1998). Services which
had an abstinence-based, rather than a harm minimisation perspective
were seen to be favoured when it came to letting the contracts for the
pilot drug treatment programmes and when prison governors, who
were pursuing goals of drug-free prisons, decided on treatment provi-
sion for their establishments.
The Prison Service failed to undertake sufficient consultation when
developing the treatment strand of the strategy. The service providers
argued much could have been learnt by examining the development of
services in the community:
Some of the commissioning decisions that they have taken look like they
have not paid sufficient regard to the development of services in the com-
munity. This hell-for-leather search for abstinence – they thought that
they could eradicate the drug problem within prisons by running a few
programmes and detox units … the first tranche of service development
was very much based around that. (Interview 28 with director of drug
agency)
Similarly, the Prison Service could have learnt from those who had
experience of delivering programmes within UK prisons. Many of the
pilot programmes were very expensive, high profile, and could reach
only a minority of prisoners. What was missing were the low cost, low-
profile services which could reach a much broader group. As discussed
in the previous chapter, such services had been developing in the UK
from the late 1980s to early 1990s and had become a model for prison
drug work:
I’ve always seen it as regrettable that in formulating that policy, they

seemed to get very caught up in concerns about contract letting. They did
their own thing rather than building upon what had evolved over a
number of years in the UK. I very much saw a UK model of prisons drug
work which had evolved in response to the need. All of the sudden that
was run roughshod through by the Prison Service letting out some very
large contracts which brought in new players who had not been previously
interested in prisons work. So that we had very high profile TCS, 12 step
programmes, but what we had very little of is the counselling, information
and advice services. The services which are low cost, low profile, but
which reach huge numbers of inmates … The Prison Service really did not
speak to the established providers about what was going on … What they
did do was to bring over people from the US – Phoenix US. (Interview 26a
with director of a drug agency)
The pressure of politics and time led to a policy response which was
not ‘rational’ in any sense. To a certain extent, expertise within the UK
was ignored. The policy and many of the programmes were not based
on UK experience, but US experience and raised the issue of whether
such policy and programme transfers would be effective:
Michael Howard was committed to all things American … The evolving

drug strategy team … didn’t know which way to go. The simple thing
would have been to go and talk to the CDCU, the ACMD and look at the
various documentation and things around and take a very slow approach
to it and construct a strategy which was based upon the experiences of
people working in the community. The pressure of time was one thing and
influence was another … A lot of the things that we experience originate
in someone having a quiet word in someone’s ear somewhere. (Interview
28 with director of drug agency)
It is not surprising that existing service providers in prisons resented

the adoption of American-based programmes and practice. They had
been liaising and sharing knowledge, experience and good practice
between themselves and with their counterparts in other European
countries. By 1994, seminars to improve the provision of drug services
to prisoners had been organised by a group of British Prison Drug
Services and the European Network of Drug and HIV/AIDS Services in
Prison had been established by the Cranstoun Projects Prisoner’s
Resource Service in the UK.
The development and sustainability of treatment provision

Despite the improvements in the level of treatment provision in some
prisons through the pilot programmes, there was a clear consensus
amongst the policy network that treatment generally remained ad

hoc, patchy and unco-ordinated. The Directorate of Health Care con-
ducted a survey of local drug strategies and found that 90 per cent
provided education and drug awareness activities; 80 per cent had
counselling and support from outside agencies (although the extent of
this support varied); 66 per cent were involved in throughcare and
sentence planning; 30 per cent had voluntary testing units; 30 per
cent had rehabilitation schemes, and the nature and extent of
detoxification was variable (HM Prison Service, 1997a). In particular,
there was a lack of provision for short sentence prisoners (i.e. less than
12 months), who are not subject to sentence planning and for remand
prisoners. Despite the historical emphasis on throughcare and release
in the previous phases of policy and service development, sentence
planning, throughcare and aftercare provision for drug using prisoners
were crucial areas which had not been given sufficient attention
within the 1995 strategy. This was mentioned by almost all those
interviewed, viewed as a key problem on DATs (Duke and MacGregor,
1997), highlighted by the ACMD (1996), and one of the key concerns
of the Department of Health Task Force on drugs (Department of
Health, 1996).
The treatment and throughcare strand remained underdeveloped
because not all prisons received funding or central support for pro-
grammes, whereas every prison had the requirement and resources to
implement MDT and supply reduction measures. In effect, security and
control measures were top-down central initiatives, whereas treatment
was essentially a bottom-up local initiative in the majority of prisons
and depended on local enthusiasm. This was recognised by the civil
servants within the policy network:
The Prison Service has to put its money where its mouth is in terms of
treatment provision. At the moment it has been a fairly unco-ordinated
approach to particular pockets of money in particular parts of the country
… There should be more on the resource planning front to make sure that
there is a totality of provision across the system, rather than just on an ad
hoc basis where some prisons are better off than others. (Interview 02)
We’ve got a disparity of distribution of the contracts because it’s been

done as a bottom-up approach, driven by local enthusiasm and some
places have different priorities and have been slower off the mark. So
we’ve got some very well-resourced areas and we’ve got some which are
very poorly resourced. (Interview 19)
Existing drug treatment provision was being undermined and com-

promised by the real pressures of population increases, budget cuts,
lack of staff, difficulties in transferring prisoners to treatment pro-
grammes, competing priorities within the prisons and other institu-
tional demands. During this phase, the sustainability of drug treatment
was a key concern. Once the pilot drug treatment programmes had
been evaluated, it was unclear as to whether they would be cascaded
throughout the prison system and remain centrally funded and
directed, or whether responsibility for funding and developing all drug
treatment provision would be devolved to governors at the local level.
As discussed in the previous chapter, central policy directives and
guidelines can be ignored at local level. On the other hand, if the pro-
grammes were sustained, centrally funded, and expanded throughout
the prison system, there was also the question of whether the volun-
tary sector could expand to meet the prison system’s need. As a direc-
tor of a drug agency commented:
[The question is] whether the organisations will be able to do it. And a
subsidiary of that is what will they stop doing? The voluntary sector is
notably fragile in terms of expansion … You could see a voluntary sector
with three-quarters of its work in the Prison Service and one-quarter in the
community – a complete warping of that sort of relationship. (Interview
08)
The question of ‘balance’ in the 1995 prison drugs strategy
Despite the improvements in the level of treatment provision

through the activities of the policy network, the strategy remained
imbalanced and intensified the tensions between treatment and
punishment. Punishment, control and security initiatives had clearly
overridden treatment, health and harm reduction initiatives. This
was recognised by civil servants, penal reformers, drug agencies, and
other policy influencers. The development of prison drugs policy
was heavily influenced by the particular context, politics and envi-
ronment in which the Prison Service was operating during this
phase. The policy network was constrained by these parameters in
what they could achieve in their attempts to manage and contain
the growing tensions between treatment and punishment. The penal
policy context was a much more powerful force than the drugs
policy context of Tackling Drugs Together. The escapes from
Whitemoor and Parkhurst prisons and the subsequent Woodcock
and Learmont reports emphasising increased security, as well as

Michael Howard’s law and order agenda meant that supply reduc-
tion and MDT, received a much higher profile, greater priority and
more resources. The Chief Inspector of Prisons, Judge Stephen
Tumin, also added fuel to the political fire in February 1995 when he
published his inspection report on Styal prison which included the
headline-catching rhetoric, ‘enter a shoplifter and leave an addict!’
(HM Chief Inspector of Prisons, 1995).
The political goal was therefore to eradicate the problem and to pub-
licly articulate this goal. This was recognised by the ACMD (1996: 1)
which warned that the Prison Service needed to have realistic expecta-
tions about what could be achieved in terms of reducing drug use:
‘unrealistic public and political expectations put undue pressure on the
Prison Service and make it more difficult to strike the necessary balance
between care and control’. Members of the policy network tended to
view the 1995 prison drugs strategy and its emphasis on control as an
exercise in public relations and a political response to the increasing
pressure to be seen to be doing something about a problem which gen-
erates great political and public concern. The strategy was therefore an
attempt to introduce some order over the drug problem in prisons
which appeared to be ‘out of control’. As a civil servant argued, it had
great appeal because it sounded ‘tough’ and it could be measured, par-
ticularly the MDT element of it:
It sounds tough – maybe more because it’s tangible and measurable … It’s
like the government, the authorities are taking control of the situation. All
the messages from [the] drug culture in prisons are of a situation that the
authorities don’t have control. If you can actually test people and control
them and put them into treatment, it’s like you’re taking control of the
environment … It’s this whole feeling of things spinning out of control, so
the more you can take control over that it’s considered good. It’s the
rhetorical attraction of it. (Interview 07)
Policy development was also affected by the new ‘managerial’ dis-

courses operating in drugs and penal policy. It was much easier to
develop and implement a punitive mechanism in the prison environ-
ment backed up by law and performance indicators, than it was to
develop treatment programmes across the system. As a penal reformer
argued, ‘you couldn’t pass a law to say there will be all these coun-
selling and agencies operating’. (Interview 18). Under the ‘new penol-
ogy’ described by Feeley and Simon (1992: 462), drug testing is used as
a mechanism for classifying prisoners, for measuring the distribution

of risk within the prison population, for filling the gap left by tradi-
tional interventions, and for providing penal agents with ‘a means to
document compliance with their internal performance requirements’.
Thus, mandatory drug testing was a technological solution to a human
problem which could be measured and produce quick, tangible results.
In contrast, treatment and rehabilitation involves individuals working
together over time with results often taking a longer period of time to
achieve. As Seddon (1996) argued, the managerialism within the strat-
egy was too simplistic in the prison context and failed to provide a
long-term solution.
The growing contradiction between treatment and control was also a
manifestation of the divisions within Prison Service Headquarters and
the separate responsibilities of the various directorates. This structural
division is evident both in terms of the work that each directorate does
as well as their geographical locations. During the 1995 strategy, drug
treatment and communicable diseases were the province of the
Directorate of Health Care located in Cleland House, and MDT and the
security functions were the province of the Security group – Order and
Control – located in Abell House. Due to these distinctions and separa-
tions, personalities and willingness to work together cross-directorally
became of paramount importance. Underlying these structural divi-
sions, there was also the notion that health and control issues should
not be integrated or mixed. These divisions and differences within
Prison Service Headquarters also filtered down into the prison system.
Health care staff were not initially encouraged to get involved in the
new drugs strategies as they were mainly seen to be about control and
security. This had an impact on the balance between treatment and
enforcement and it also led to much confusion within government,
the prison system and the treatment agencies. As one civil servant
argued:
There was a view held by previous senior people in the Service that health
and control didn’t mix and shouldn’t mix and therefore health staff were
discouraged from having anything to do with the establishment drugs
strategy. They were told to keep very well clear of anything to do with
MDT … You had therefore people who were quite expert who were dis-
couraged from becoming [involved] because it had to deal with the disci-
plinary side as well. That was sort of a fundamental philosophy that
treatment and mandatory testing and discipline didn’t go together, so they
stayed very separate. (Interview 19)
It became clear during the 1995 strategy that there will always be
some sort of ‘balance’ between treatment and punishment. The
difficulty for policy-makers was to determine the ‘correct’ balance
between the two activities and to accept that the balance might shift.
Within the policy network, there were key differences in how the two
activities were perceived (i.e. as a continuum or two separate activities).
Some described care and control as two separate continuums or dimen-
sions which are not necessarily connected:
Because the two initiatives came from different ends of the political spec-
trum – treatment and punishment. It would be very difficult linking them
from the start … It wasn’t really a proper strategy. MDT was introduced
quite quickly. (Interview 09 with civil servant)
In contrast, others argued that care and control should not be viewed
as separate and independent, but integrated and working together:
At worst one should hope for an uneasy alliance where there will be ten-
sions, but you can rub alongside each other. At best, I’m sure what we can
achieve is an understanding that the two things work hand in glove. They
are two sides of essentially the same coin and they are moving towards
helping individuals make decisions about changing their lives … But they
are also doing that on a macro level … They are doing it for the prison.
They are doing it for the wider community … Although there will be times
where they diverge, they fall out – a prisons blows up and there’s a great
big security issue and everything gets shut down, the balance can be
restored. It just requires an understanding of what these things really are.
(Interview 28 with director of a drug agency)
At the end of this phase, some members of the policy network, par-
ticularly the civil servants, were optimistic that in theory a balance
could be achieved between care and control, while others, mainly rep-
resentatives of drug agencies and penal reform groups, felt that security
concerns would always work to the detriment of any type of treatment
and rehabilitation activities. Their scepticism may be a reflection of
their experience on the ground of working with prisoners and within
prisons. It was not only the drugs strategy which was subject to this
tension between care and control, but it was an enduring conflict
within all prison activities. The balance between treatment and pun-
ishment within the prison drugs policy was affected by the Prison
Service Statement of Purpose which places security as the number one
priority. Working within this context, drug treatment and counselling

are destined to have a lower priority than enforcement and security.
Another consideration is whether ‘care’ or treatment can be facilitated
in a coercive environment such as the prison. This raises a number of
complex issues and questions:
Can you facilitate cure in a coerced environment? Is a prisoner ever free to

make a decision? … Can we then say that he’s a volunteer? I think that
sort of balance faces the Prison Service in virtually everything that it does
and drug treatment is no exception to this. (Interview 18 with penal
reformer)
At the end of this phase, the continuing dilemmas for the policy
network were to grapple with the contradiction between treatment and
punishment, to attempt to shift the focus of policy away from security
and punishment and to make the treatment strand of the strategy
more explicit and defined. Their ideas and activities informed the
review of the 1995 strategy and the next phase of policy development
which will be explored in the next chapter.
Conclusion
During the period 1993 to 1997, important shifts and changes occurred
in the development of prison drugs policy. The first comprehensive
drugs strategy was developed, the Prison Service had been formally
incorporated into drugs policy at the national level, and prisons were
expected to become involved in drug issues outside the prison walls
through local partnerships. The drug issue in prison had finally been
acknowledged at a political level and had become a highly politicised
issue. It was increasingly framed as a problem of order, control and dis-
cipline which threatened the stability of the prison system. The
response was to impose order on a problem which was perceived to be
spiralling out of control. A more explicit prison drugs policy began to
develop and interface with the overall frameworks of both penal and
drugs policy. As policy became more explicit and defined, the contra-
diction between treatment and punishment became more intense.
The political context and the emphasis on managerialism during this
period ensured that the new prison drugs strategy was dominated by
punitive, but measurable, mechanisms such as MDT and increased
security. Drug treatment initiatives emerged as an afterthought in
policy development and in response to pressure from a policy network
which began to lobby for greater emphasis on treatment. This policy

network was led by drug service providers who saw the opportunity for
expanding their work in prisons and securing funding for it. During
this phase, it appears that policy-makers and politicians were less
confident with existing approaches to dealing with the drug problem
in British prisons, failed to consult many of those who had experience
in this area, and looked instead to the United States for policies and
programmes which could be transferred. Despite the attempts of the
policy network to rebalance the 1995 prison drugs strategy, there was a
clear consensus that enforcement, punishment and control aspects
remained the key focus and priority. In May 1997, the Labour govern-
ment was elected to power, presenting new opportunities for the policy
network to express their concerns and views, influence the develop-
ment of policy, and reformulate the existing strategy.
5
1997– : Eradication to Realism?
Introduction
This chapter focuses on the period from mid-1997 and outlines the
main developments in prison drugs policy which are planned for the
next decade. On 1 May 1997, Labour won the general election. Their
victory heralded the opportunity for new ideas, discourses and issues to
infiltrate policy agendas. However, during the lead up to the election,
the party had successfully reinvented and repositioned itself as New
Labour, signalling ‘the end of Old Labour, old policies and old wel-
farism’ (MacGregor, 1998d: 251). ‘Soft’ policies on crime, drugs, welfare
dependency, and the family were replaced by ‘tough’ new policies.
Although there have been significant changes and reforms within
public policy since the election of New Labour, the remnants of Tory
populism remain, and some of the new policies possess a striking con-
tinuity to the old. During this period, ‘policy feedbacks’ or the ways in
which the legacy of established policies and inherited policy structures
shape and constrain what is possible within policy development, have
been significant for the new government (Skocpol, 1992). Policy devel-
opment in all areas, including prisons and drugs, has also been heavily
influenced by transferring the ideas and discourses from the United
States.
This chapter begins by highlighting the main developments in drugs
and penal policy since the 1997 election, which provide the backdrop
for the changes within prison drugs policy. Borrowing ideas from
American drugs policy, an anti-drugs co-ordinator or ‘drugs tsar’ was
appointed who was to guide, co-ordinate and implement the new
national drugs strategy. The new strategy did not, however, mark a
significant departure from the previous one, Tackling Drugs Together.
124
1997–: Eradication to Realism? 125
The ‘managerial’ discourses around assessment, targets, performance,

partnership and co-ordination intensified. Despite the increased focus
on prevention and treatment, it will be argued that the punitive
discourses of ‘enforcement’, ‘control’ and ‘punishment’ have endured.
Policy-makers and politicians have become increasingly preoccupied
with the relationship between drugs and crime and the role of the
criminal justice system in dealing with drugs was further enhanced.
Similarly, developments in penal policy under Labour have not
indicated a fundamental overhaul of previous Conservative policies.
Labour’s ‘tough on crime’ policies have not been successfully
integrated with their ‘tough on the causes of crime’ policies and the
populist punitive rhetoric of earlier phases of policy development has
continued.
In the latter part of the chapter, the nature and extent of the drug
‘problem’ in prison is explored by examining three key pieces of
research commissioned by the Prison Service and their review of the
1995 prison drugs strategy. As Spector and Kitsuse (1977) argue, an
official response or implementation of policy is not the final stage of a
social problem. The process continues whereby ‘second generation’
problems arise through existing policies and form the basis for new
responses or policy reforms. In the construction of second generation
social problems, ‘assertions about the inadequacy, inefficacy, or injus-
tice of the procedures may themselves become the conditions around
which new social problem activities are organized’(Spector and Kitsuse,
1977: 151). Thus, during this phase of policy development, the
concern was not so much around the drug problem itself, but with the
policies and procedures which had been designed to eradicate it and
the growing contradiction between treatment and punishment.
The evaluation of the 1995 prison drugs strategy highlighted prob-
lems around mandatory drug testing (MDT) procedures and inadequa-
cies in treatment provision. The revised 1998 strategy represents an
attempt to ameliorate some of the problems raised by the policy
network during the previous phases of policy development. In many
ways, these reforms denote a new ‘realism’ or pragmatism in relation
to tackling the drug ‘problem’ in prison compared to the previous
strategy and an attempt to rebalance the strategy towards treatment
and care for drug using prisoners. However, the basic punitive frame-
work for delivering the strategy remains intact and the emphasis on
the discourses of ‘security’, ‘control’ and ‘punishment’ has continued.
It remains to be seen whether the balance between treatment and pun-
ishment will be dramatically altered. In the process of attempting to
rebalance the new strategy towards treatment, the policy network

around prison drug issues has been reshaped with drug agencies enter-
ing into more formalised partnerships with the Prison Service. The
final section of the chapter explores the impact of prison drugs policy
on wider policy development and suggests that some of the initiatives
which began in the prison, such as testing and coerced treatment, have
now gained greater acceptance and have been extended outside to the
community.
Drugs policy context: ‘breaking the vicious circle’
The attention given to the relationship between drugs and crime and
the role of the criminal justice system in dealing drugs during 1993–7
was continued and reinforced by the new Labour government. In
opposition, Labour portrayed the drugs and crime problems as inextri-
cably linked and produced a document entitled Breaking the Vicious
Circle, which outlined its proposals to tackle drug-related crime
(Labour Party, 1996). Drawing upon selected pieces of research,
Labour policy on drugs was to be underpinned by the following key
principles: drug treatment works and is cost-effective; coerced treat-
ment is just as effective as voluntary treatment; drug testing helps to
identify drug users and ensure they conform to treatment regimes;
and offenders should be kept in treatment for a minimum of three
months. Within Labour’s election manifesto, three main commit-
ments in relation to drugs were outlined which they pursued once in
office: the appointment of an American-style ‘drugs tsar’; the intro-
duction of a new treatment and testing order based on the US drug
court models in Dade County, Miami; and the extension of access to
voluntary testing for all prisoners.
Appointment of the UK Anti-Drugs Co-ordinator

The concept of a ‘drugs tsar’ was put forward initially by the Bush
administration in 1989 in response to the growing public concern
regarding drugs in the United States. However, successive drug tsars,
including William Bennett and Barry McCaffrey, have been criticised for
failing to meet expectations (Jenkins, 1997). In the UK there were over
200 applications for the position of ‘drugs tsar’ or anti-drugs co-ordina-
tor, including doctors, drugs specialists and academics (The Guardian, 6
Oct. 1997). Many of those working within the drugs field expressed con-
cerns regarding the disproportionate emphasis on enforcement and the
shift towards combative language in the government rhetoric around
the appointment and the American label of ‘drugs tsar’ (see also Jenkins,
1997; Eaton, 1997; Strang et al., 1997). However, civil servants argued
that the appointment was not intended to signal a fundamental shift in
drugs policy and the person’s role was to co-ordinate action on drugs
and build upon the existing strategy, Tackling Drugs Together. It was
important that the person appointed could demonstrate that s/he had
the confidence of all the principal professions and interest groups.
However, it would be difficult to fulfil the expectations of all the actors
involved in drugs policy networks.
In the end, however, two appointments were made. In October
1997, Keith Hellawell, the Chief Constable of West Yorkshire police,
was appointed to the position of UK Anti-Drugs Co-ordinator, and
Mike Trace, the director of the prison-based treatment agency, RAPt
(Rehabilitation for Addicted Prisoners Trust), was appointed as
Deputy Co-ordinator. The appointments were billed as a ‘dream
ticket’ in the media in that both enforcement and treatment aspects
were covered (The Guardian, 15 Oct. 1997). This appeared to signal a
commitment to ensuring that action and policy on drugs would be
balanced between the treatment and punishment dimensions. There
was also the potential to highlight prison issues more prominently
in future drugs policy debates as the Deputy had an established
reputation in prison-based work. The Co-ordinators embarked on an
intense period of familiarising themselves with the existing
approach to drugs, reviewing research and consulting with key
groups and individuals in the drugs field. After six months, they
developed a new national drugs strategy.
The 1998 national drugs strategy: Tackling Drugs to Build a Better

Britain
In April 1998, the government introduced a new drugs strategy entitled
Tackling Drugs to Build a Better Britain. It represents continuity with the
previous phase of policy development, but also signals important
changes. The 1998 strategy was to run over a longer term of ten years.
For the first time, drug problems were seen to be linked to other social
and environmental problems such as unemployment, homelessness,
and social exclusion. Drugs policies were therefore expected to inter-
face with other social policies including welfare-to-work, social exclu-
sion, youth justice, education, public health, and community safety
and with other policy structures such as the Social Exclusion Unit. The
new anti-drugs effort was to be targeted on the geographical areas of
greatest need and risk and upon drugs which cause the most damage,
such as heroin and cocaine. The ‘managerial’ approach to the drug

problem intensified with the various anti-drugs activities being sub-
jected to a programme of rigorous and objective measurement, moni-
toring, evaluation and research. In order to reduce competition
between agencies, performance indicators at the corporate level were to
be developed. Under the new strategy, there was an explicit commit-
ment to base future policy and practice on real ‘evidence’, rather than
rhetoric. This shift was welcomed by professionals and practitioners
working in the drugs field (see Farrell and Strang, 1998).
For the first time, there was also a commitment to re-distribute drugs
spending and transfer resources towards treatment, rehabilitation, pre-
vention and education. The strategy proposed a shift away from reac-
tive expenditure and dealing with the consequences of drug use
towards investment in prevention. New funds were to be generated
from seizing the assets from drugs traffickers and channelling these
into anti-drug programmes. The government’s Comprehensive
Spending Review (CSR) also allocated an additional £217 million to
departments to fund additional proactive anti-drugs work over the
years commencing 1999/2000 (DPAS, 1999).
The strategy is organised around four elements: young people, com-
munities, treatment, and availability. The main aims are to help young
people resist drug use in order to achieve their full potential in society;
to protect communities from drugs-related anti-social and criminal
behaviour; to enable people with drug problems to overcome them and
live healthy and crime free lives; and to stifle the availability of illegal
drugs on the streets (HM Government, 1998a). By 2000, targets were
established for each aim. Similar to the 1995 strategy, emphasis on
enforcement, punishment and the drugs-crime link continued. Under
the aim ‘to protect our communities from drug-related anti-social and
criminal behaviour’, a key objective was to ‘reduce the levels of repeat
offending amongst drug misusing offenders’. In order to achieve this
reduction, one of the main activities was to implement drug treatment
and testing orders and promote ‘caution plus’ schemes in the commu-
nity. Prison-related aims and objectives also figured prominently in the
new strategy. A key treatment objective was to increase the participa-
tion of problem drug users, including prisoners, in drug treatment
programmes. In particular, throughcare and aftercare arrangements for
drugs using prisoners were to be coherent, focused and linked to
provision in the community. The reduction of the supply of drugs
within prisons continued to be emphasised as a key availability
objective (HM Government, 1998a).
The main structures developed under the previous strategy, Tackling

Drugs Together, were to remain intact. The Central Drugs Co-ordination
Unit was renamed the UK Anti-Drugs Co-ordination Unit and contin-
ued to support the monitoring and implementation of the strategy.
Drug Action Teams (DATs) and their associated Drug Reference Groups
(DRGs) continued to be the main mechanism to ensure that the strat-
egy was translated into action at the local level. An interim evaluation
of DATs in 1997 concluded that they had been successfully established
across the country; improved relations and communication between
the various agencies; and many initiatives had been implemented or
co-ordinated by the new structures (Duke and MacGregor, 1997).
However, community safety and criminal justice were viewed as one of
the most difficult areas to impact upon. In particular, prisons were seen
as difficult to engage in DAT and DRG structures.
As highlighted in the previous chapter, structural problems around
coterminosity of boundaries were viewed as real impediments to
partnership work with prisons. A key difficulty with prisons is that
they are neither national nor local structures and therefore do not have
the same commitment as other DAT agencies to the local area. Prisons
were considered to be different ‘culturally’ from the other agencies
represented on DATs as they have no history of joint working, work
within a punitive rather than rehabilitative culture and are often
located geographically away from the community and other agencies.
Other agencies represented on DATs often lacked understanding of
prisons and the constraints within which they work (Duke and
MacGregor, 1997). Under the 1998 strategy, the Prison Service was
encouraged to direct resources from within their budgets to drugs-
specific partnership and give this work priority in their business plan
(HM Government, 1998a).
After the 2001 general election, significant changes occurred in the
co-ordination and delivery of the drugs strategy. The strategy targets
were criticised by professionals in the drugs field as ‘unrealistic’,
‘unworkable’, ‘unmeasurable’ and ‘insufficicently grounded within evi-
dence’ (Home Affairs Select Committee, 2002). Similar to the fate of
their US counterparts, the British drugs tsars were given little power to
make changes within drugs policy and then blamed for failing to meet
the expectations of the government. They stepped down from their
coordinating roles in June 2001. The responsibility for the strategy was
then transferred from the Cabinet Office to the Home Office. The
Home Office Drugs Strategy Directorate replaced the old structure of
the UK Anti-drugs Co-ordination Unit (UKADCU), the Action Against
Drugs Unit (AADU), and the HQ of the Drugs Prevention Advisory

Service (DPAS). A new director, Sue Killen, was appointed to the
Directorate. Another important development was the National
Treatment Agency which was set up in June 2001 to raise standards
and ensure consistency in drug treatment.
Various demands for a major reform of Britain’s drugs law have been
made by the Police Foundation (1999) and the Home Affairs Select
Committee (2002). Most of their recommendations regarding changes
to the law have been deemed too radical by the Labour government.
However, after the Conservatives announced they would be reconsider-
ing drugs legislation following their defeat in the 2001 Election, the
new Home Secretary, David Blunkett, proposed that cannabis be
reclassified from a class B to a class C drug. This means that cannabis
would remain a controlled drug and using it would remain a criminal
offence, but possession of the drug would be no longer an ‘arrestable’
offence. Although this is a far cry from legalisation or decriminalisa-
tion, it does signal a small but significant shift in terms of liberalising
drugs law. It also prompts the question as to how cannabis possession
will be dealt with in prisons.
Penal policy context: ‘tough on crime, tough on the causes

of crime’?
During the early 1990s, the Labour party had begun to challenge the
Conservative government on criminal justice issues. New Labour
altered its traditional image of being ‘soft on crime’ to presenting itself
as the ‘party of law and order’ by promising it would be ‘tough on
crime, and tough on the causes of crime’ if elected (Blair, 1993). By
1997, the opinion polls indicated that the public had gradually become
more confident in Labour’s new populist rhetoric and image (Downes
and Morgan, 1997). The New Labour government introduced and
implemented many of its own law and order ideas, but it also contin-
ued to develop some of the policies which were proposed by the
Conservative government. It is clear that the populist punitiveness of
the Tories has endured.
Although New Labour claimed it was committed to reducing the
prison population, there is no evidence thus far that the ‘prison works’
discourse has been successfully overturned (Morgan, 1999). The prison
ship docked in Portland, Dorset, which had been commissioned from
the New York prison authorities by the Conservative administration in
1997, was put into operation by the Home Secretary, Jack Straw,
shortly after he took office to provide more prison accommodation. By

1998, the average prison population had reached an all-time high of
65,299 with a small decrease to 64,400 in 2000 (see Table A.4,
Appendix). Although various commitments have been made to
improve the provision offered to prisoners such as basic skills, drug
treatment and offending behaviour programmes, there have been no
serious attempts to reduce the prison population. In fact, an extra
2,660 prison places are to be made available (Home Office, 2001). The
Labour government has failed to engage with the more fundamental
question of ‘what are prisons for’. Any debate or proposals which
would involve a radical overhaul or transformation of the prison
system, particularly in terms of its overall aims or purposes, appear to
be absent from the policy agenda.
The government’s ideas for criminal justice are located in the Crime
and Disorder Act 1998 which focuses on three key themes: youth
justice reform, community safety and local partnerships, and improv-
ing the performance of the criminal justice system by reducing delay.
As in other areas of the public sector, the managerialist discourse with
its emphasis on targets, measurement, performance and partnership
has also intensified under the Labour government (McLaughlin et al.,
2001). One key example is the establishment of new local partnerships
to reduce crime and disorder consisting of representatives from local
authorities, police and other statutory agencies. Their role is to conduct
audits of the levels and patterns of crime in their local areas, consult
their local communities, develop strategies and targets for tackling
crime and disorder, and measure and report their performance against
these indicators (see Home Office, 1998a: 5). The Crime and Disorder
Act contains 121 sections introducing wide-ranging provisions such as
anti-social behaviour orders, parenting orders, detention and training
orders, extended supervision for sexual and violent offenders, local
child curfews, the abolition of the doli incapax rule, child safety orders,
a new Sentencing Advisory Panel and an extensive range of measures
to reform the youth justice system (see Home Office, 1998a). The treat-
ment of youth within the Act allows for intervention at an earlier stage
of an offender’s history and signals a fundamental shift in Labour’s
thinking on dealing with crime. For example, there is an increasing
movement away from non-punitive, non-stigmatising and reintegra-
tive strategies which they advocated in the past towards an approach
of deterrence through punishment (Brownlee, 1998).
Although the adoption of the discourse ‘tough on crime, tough on
the causes of crime’ suggests that Labour recognises that offending
behaviour has its roots in social structures rather than individual

pathologies, ministers and spokespersons have chosen publicly to artic-
ulate individual factors at the political level (Brownlee, 1998). In effect,
the discourse has become divided into two separate discourses which
have not been effectively linked either in rhetoric or, as yet, in prac-
tice. Soft and hard approaches are being pursued simultaneously.
Policies are therefore being developed which are ‘tough on crime’ such
as providing more intense punishment for persistent offenders (see
Home Office, 2001) which have not been linked explicitly to its wider
policy agendas such as welfare-to-work, social exclusion, homelessness,
unemployment, and lack of services for young people (Heidensohn,
1998). Since the 2001 General Election, the punitiveness of the
rhetoric and policies has accelerated and deepened. It is clear that
those who do not respond to the new inclusive strategies, such as
Welfare-to-Work, the New Deal and Sure Start, will be dealt with
harshly through the criminal justice system.
Drug treatment and testing orders

Another example of the Labour government’s continuing punitiveness
is the introduction of drug treatment and testing orders (DTTOs),
which run concurrently with regular probation supervision. Their
purpose is ‘to break the links between drug misuse and other types of
offending’ (Home Office, 1998b: 3). The orders are directed at offenders
aged 16 or over ‘who are convicted of crime (s) to fund their drug habit
and who show a willingness to co-operate with treatment’ (Home
Office, 1998a: 16), who are users of opiates, cocaine and ampheta-
mines, and who are considered to have a disproportionately disruptive
effect on their communities or who persistently offend (Home Office,
1998b). They are imposed only with the ‘consent’ of offenders.
However, if they choose not to comply, one option available is to
impose a custodial sentence. The probation service is responsible for
the supervision of the orders and treatment providers undertake the
testing and treatment components.
The new order is supposedly based upon the Miami Drug Court
model which was developed in 1989 in the USA and has been shown
to be successful in reducing drug use and reconviction (Labour Party,
1996). However, as Philip Bean (1996; 1998) illustrates, this policy has
not been transferred as a whole and there are important differences
between the features of the drug court model and the proposed
treatment and testing orders. In the USA, drug courts are a slow-track
treatment system developed and led by the judiciary, rather than the
criminal justice system or drug treatment agencies. Bean (1998: 103)

argues that the most important criteria of the US model is the court’s
direct control over treatment provision. The probation and treatment
services cannot produce the necessary control. He suggests that in
order to replicate drug courts in Britain, there would need to be more
resources; legislative and structural change; a loss of independence and
restructuring for treatment agencies; an increase in the number of
court administrative staff; and the development of rapid response urine
testing and analysis facilities (Bean, 1998).
DTTOs have not received unanimous support within the drugs field
(Barton and Quinn, 2002). Prior to implementation, drug treatment
providers were sceptical about the proposed orders for a number of
reasons. Coerced treatment raises fundamental ethical dilemmas and
places strains on the therapeutic relationship between treatment
providers and ‘clients’. Concern was also expressed about the lack of
resources for treatment provision. Drug agencies have always had
difficulties in coping with the demand for their services and waiting
lists are common (Chadwick, 1997). The orders would generate a new
demand for treatment and there was a danger that existing drug agen-
cies may not be able to expand quickly enough to meet it. Although
those working within drug treatment and the penal reform lobby wel-
comed the diversion of drug offenders from custody, there was the
danger of net-widening with the treatment and testing orders failing to
be utilised as a true diversionary measure, but as an opportunity to
make non-custodial sentences more punitive and tough. They may
concentrate on the small-time offenders or ‘minnows’, rather than the
‘big fish’ who cause the most problems for communities. Moreover,
those who test positive are also at risk of being re-sentenced to custody,
thus increasing the prison population.
The drug testing and treatment orders were piloted and evaluated in
three areas. Although the evaluations indicate that drug use and
acquisitive crime were reduced substantially for offenders who com-
pleted their orders, the research also revealed fundamental problems,
particularly around interagency working and standardisation in rela-
tion to referrals, testing procedures and supervision (see Turnbull,
1999; Turnbull et al., 2000). There were clashes of ideologies, organisa-
tional priorities, working styles, traditions and values between health
care professionals and the criminal justice agencies. In order for DTTOs
to be successful, an effective partnership between health and criminal
justice systems is mandatory. DTTOs were introduced across the
country in October 2000. It is clear that further longer-term research is
required to evaluate their effectiveness and to assess whether these

interagency tensions have been overcome.
These themes of continuity and change in drugs and penal policy
provide the context for the review of the 1995 prison drugs strategy
and the formulation of the new strategy. These developments will be
explored in the next sections.
Review of the 1995 prison drugs strategy
In September 1997, a review of the 1995 prison drugs strategy was

undertaken by the Prison Service with a view to formulating a new
revised strategy (HM Prison Service, 1998a). The reasons for the review
were associated with the appointment of the UK Anti-Drugs
Coordinator, the development of the new national drugs strategy, as
well as the criticisms and questions raised by the policy network in the
previous phase of policy development around the balance between
treatment and control within the existing strategy. The review was
informed by three pieces of research commissioned by the Prison
Service. These included two projects assessing the impact of mandatory
drug testing (Edgar and O’Donnell, 1998; Farrell et al., 1998) and an
evaluation of the pilot drug treatment programmes (PDM Consulting
Ltd, 1998). During the previous phase, the existence of this ongoing
research had enabled the Prison Service to adopt a ‘wait and see’ stance
and to deflect criticism away from the evolving strategy, particularly in
relation to the question of possible switching from cannabis to heroin.
By 1997, interest in drugs and other related issues in prison had
expanded. In addition to the internal review by the Prison Service,
there were also other committees, groups and researchers which had
published reports (see Home Office, 1997b; All Party Parliamentary
Drugs Misuse Group, 1998; Home Affairs Select Committee, 1999;
Health Advisory Committee for the Prison Service, 1997; London Drug
Policy Forum, 1997; MacDonald, 1997; Keene 1997a; 1997b).
Nature and extent of the problem: the impact of the 1995 strategy
A judgement on the efficacy of the 1995 prison drugs strategy depends
on the criteria used to measure effectiveness. Such criteria could
include the proportion of positive mandatory drugs tests, the propor-
tion of prisoners successfully completing drug treatment programmes,
the number of treatment referrals, the number of drug finds in prisons,
rates of recidivism and/or rates of drug use on release. However, the
only systematic objective indicators produced through the monitoring
and research commissioned by the Prison Service related to MDT

results and supply reduction measures.
As we saw in the previous chapter, one of the key objectives of
mandatory drug testing (MDT) was to provide systematic data on the
extent and nature of drug use within the prison system. Evidence
from the research shows that MDT had the greatest impact on recre-
ational cannabis use. For example, the study conducted by the
National Addiction Centre, King’s College London, showed a clear
downward trend in detected cannabis use across the entire prison
system since the implementation of MDT, with a fall in positive tests
for cannabis from 30 to under 20 per cent during the first 18 months
of the programme. However, opiate positivity did not decrease, but
remained fairly constant at a level of 5 per cent (Farrell et al., 1998).
Qualitative research conducted by the Centre for Criminological
Research at Oxford also indicated that MDT had an impact on the
prevalence of drug use with over half (52 per cent) of their sample
claiming that they had either desisted (27 per cent), reduced (15 per
cent) or altered (10 per cent) their drug use as a result of MDT (Edgar
and O’Donnell, 1998: 14). Despite anecdotal evidence from prisoners,
staff, the media and various reports and articles, there was no concrete
evidence of prisoners switching from cannabis to heroin in the com-
missioned research. However, there was evidence of persistent use in
relation to opiates. Thus, the researchers from the National Addiction
Centre concluded that despite the amount of effort and resources
which had been directed towards MDT, it had greatest impact on
recreational cannabis use and little success in deterring those who
may have more serious addiction problems to hard drugs, such as
heroin (Farrell et al., 1998: 6).
Research also underlined other problems around the MDT proce-
dures (Edgar and O’Donnell, 1998). Prisoners perceived the MDT
process as unfair and a means of restricting cannabis use, which they
regarded as a legitimate activity. Similarly, prison staff did not see
cannabis use as problematic for good order and discipline and evidence
was uncovered by researchers that staff continued to ‘turn a blind eye’
when they found prisoners using cannabis. Prisoners also believed that
MDT had increased tension within the prison, increased their resent-
ment of staff, led to switching to hard drugs, and made inmates more
wary. Their perception of MDT was that it was used as a method of dis-
cipline and punishment, rather than a means of identifying prisoners
who needed treatment. In 1996 and 1997, the Prison Ombudsman
received a number of complaints from prisoners over adjudications
relating to the MDT process and procedures (see Prison Ombudsman,

1997; 1998). The research revealed that prisoners were more concerned
about the effect of MDT on privileges such as temporary release, parole,
loss of in-cell television, and risk of being placed on closed visits than
they were about the threat of additional days on their sentence. This
highlighted a fundamental flaw with the MDT disciplinary system of
awarding additional days which ultimately led to increases in the
prison population and overcrowding. For example, the researchers esti-
mated that for the year 1997, 159,000 days were added to prisoner’s
sentences due to MDT, which is equivalent to 360 prisoner years. Thus,
the extra prisoner days in custody can be estimated at approximately
£7 million in additional running costs to the prison system (Edgar and
O’Donnell, 1998: ix).
Given the great emphasis placed on security in the 1995 prison drugs
strategy, the impact of the Learmont and Woodcock recommenda-
tions, and the increased resources for security measures, it is not sur-
prising that efforts to reduce the supply of drugs, such as improved
perimeter security, searching, closed visits, CCTVs, targeting visitors,
use of sniffer dogs, and intelligence gathering had been deemed as
generally successful by the Prison Service in deterring the use of drugs
(HM Prison Service, 1998a). For example, the number of ‘finds’ of
drugs or drug implements fell from 9,503 in 1995–6 to 7,587 in 1996–7
(HM Prison Service, 1998a: 12). Targeting, arresting and punishing
visitors to prisons was also perceived to have a deterrent effect. The
number of visitors arrested for drugs-related offences fell from 1,463 in
1995 to 1,176 in 1997 (HM Prison Service, 1998a: 14).
Although MDT and supply reduction measures were seen as gener-
ally successful in meeting their objectives, the review by the Prison
Service and the evaluation by PDM Consulting Ltd of the pilot drug
treatment programmes indicated that treatment provision required
more fundamental improvements and changes before some of the
programmes and ideas were extended more widely across the prison
system (HM Prison Service, 1998a; PDM Consulting Ltd, 1998).
Although there had been some expansion in drug treatment through
the pilot programmes, provision remained patchy. As argued by treat-
ment providers during the previous phase of policy development, low
cost and low intensity interventions on a large-scale basis were
missing within existing provision. Resources and effort had been pri-
marily concentrated on high intensity and high cost programmes.
The need to match drug treatment programmes with the needs of
individual drug users was also highlighted. More specifically, the lack
of specialist provision for certain groups in the prison system, such as

women, vulnerable groups, young offenders, and those in the disper-
sal system was underlined. Aftercare and follow-up work was viewed
as wholly inadequate and requiring immediate attention. In particu-
lar, prisons needed to initiate joint working arrangements with exter-
nal agencies at the local level in order for the throughcare of drug
using prisoners to be improved. The PDM evaluation and research in
three Leicestershire prisons indicated that prison staff, both those
involved in running treatment programmes and those providing
support to prisoners, still lacked sufficient general knowledge about
drugs and treatment and counselling issues (PDM Consulting Ltd,
1998; Hucklesby et al., 1999).
Response to the ‘problem’: the 1998 prison drugs strategy
Upon completing the review of the 1995 strategy and considering the
research findings, the Prison Service concluded that its basic structure –
tackling supply, demand and the health consequences of drug use –
should remain intact (HM Prison Service, 1998a: 23). The existing strat-
egy would therefore not be subjected to a radical overhaul. In many
ways, the research was used to justify the existing policy framework.
However, there is evidence that some of the lessons from the research
and concerns expressed by the policy network around the 1995 strat-
egy had been taken on board. Their activities and lobbying during the
previous phase had informed and influenced the reformulation of
policy. The new 1998 strategy would place greater emphasis on volun-
tary testing; effective treatment provision; education for young offend-
ers; throughcare; discrimination between dealers and users and
between less harmful and more damaging drugs; and identifying strate-
gies for short-term and remand prisoners (HM Prison Service, 1998b).
The particular needs of women prisoners would be examined sepa-
rately. However, issues relating to race remained invisible within the
reformulated strategy and the particular problems of minority ethnic
prisoners in accessing drug services had not been considered (see
Awiah et al., 1992). Under the new strategy, there was also a commit-
ment to develop the research base around the strategy with an empha-
sis on exploring recidivism rates for those participating in drug
treatment programmes. Plans to develop future policy in relation to
other substance use, particularly alcohol, were also indicated. In a
report on alcohol and prisons, the Health Advisory Committee for the
Prison Service (1997) argued that there was an overlap between the
groups using alcohol and those using other substances and advocated
an integrated approach for future policy development.
Within the 1998 drugs strategy, even more emphasis was placed on
partnership, liaison and co-ordination. As discussed in the previous
chapter, the structural division within Prison Service Headquarters
between the Directorate of Health Care, responsible for health and
treatment concerns, and the Security group, responsible for security
and control matters, was to be overcome by establishing a new single
Drugs Strategy Unit within the Directorate of Regimes. The new unit
would deal with all drugs-related issues and bring together the various
threads of prison drugs policy. Co-ordination and partnership would
also be improved by the appointment of area drugs strategy co-ordina-
tors who would be responsible for a group of prisons within a geo-
graphical area. Their task was to develop the strategy at the regional
and local levels by ensuring consistent application of effective practice
and promoting links between prisons and communities. The Prison
Service was also expected to improve its representation on Drug Action
Teams under the new strategy.
For the period 1999–2002, the Prison Service received an additional
£76 million from Comprehensive Spending Review (CSR) allocations to
fund the new drug initiatives (DPAS, 1999). At the time of the policy
review, members of the policy network were generally optimistic about
the potential for change under the new strategy. Civil servants sug-
gested that under the Labour administration there was now a possibil-
ity of altering the balance between care and control. This balance
would depend on their perception of the ‘problem’ over time:
The current review [has been] approached with particular enthusiasm

because we’ve got a new government and Ministers are particularly inter-
ested. It’s very much interested that we’ve got that ‘balance’, as we see it
at the moment, right. My guess is that it will change from time to time.
We might have a new drugs strategy in a few years and we might change
that balance quite considerably as our perception of the problem changes.
(Interview (14b) with civil servant)
They argued that the Labour government has focused more closely on
the connection between MDT and treatment:
What is particularly important and what Ministers in this administration

are focusing on is that there is actually a connection between the two. In
that testing is not just a punitive or record keeping initiative, but that it
genuinely results in determining appropriate referrals on individuals for

treatment. (Interview 02 with civil servant)
Although the revised strategy was more realistic and pragmatic in its
approach, by targeting problematic drug use and focusing more on
treatment and throughcare, the basic punitive framework for deliver-
ing the strategy, whereby drug users are punished, remains in place.
Moreover, there is some cause for concern around the proliferation of
voluntary testing which has also been incorporated into this frame-
work of punishment. The following sections will briefly examine the
main developments within the new strategy.
Mandatory and voluntary drug testing

Overall, the new policies around mandatory drug testing (MDT) indi-
cate a more flexible, practical and cost-effective approach. Rather than
every prison testing ten per cent of its population per month, gover-
nors are allowed to set their own levels of random mandatory testing
between five and fifteen per cent (HM Prison Service, 1998a). The new
strategy places more emphasis on promoting greater flexibility in the
use of disciplinary and administrative penalties for positive tests.
Where appropriate, both administrative sanctions and the incentives
and earned privileges scheme can be used as responses to positive
testing, rather than relying solely on awards of additional days. Greater
differentiation was to be made between sanctions for cannabis and
class A drugs. Whilst these developments indicate a much more prag-
matic response in terms of MDT, prisoners testing positive for class A
drugs are subjected to more frequent mandatory testing under the new
strategy. This highlights the continuation of the punitive response to
drug use. Unless prisons utilise MDT solely as a means of identifying
those requiring treatment, this group will remain targeted and
punished for their addiction problems.
The election manifesto commitment to extend access to voluntary
drug testing to all prisoners by 2001 was given much prominence in
the new strategy. Since the implementation of the 1995 prison drugs
strategy, voluntary testing units (VTUs) proliferated across the prison
system. This can be attributed partly to the success of the VTU and
treatment programme run by RAPt at Downview prison (Kinchin,
1998). The new VTUs have taken many different forms in terms of
structure and operation, but they are based on the premise of provid-
ing specially designated areas for ‘prisoners who agree to avoid drugs
and to prove it by undergoing regular, but random urine testing’ (HM
Prison Service, 1998a: 17). Many of the existing units were established
with very little central guidance and range from enhanced regimes and
compacts to remain drug-free to relapse prevention units. The 1998
strategy issued detailed guidance to governors identifying the key
issues they should consider when drawing up their own programmes
for voluntary testing (see HM Prison Service, 2000). A single model for
VTUs was not recommended as governors need the flexibility to adapt
VTUs to the physical space of their prison and the needs of their
population.
The key difference between mandatory and voluntary testing is that
positive tests under MDT result in disciplinary action and positive vol-
untary tests result in administrative action. Although VTUs are popular
with prisoners (Kinchin, 1998) and broadly supported by key policy
players, there are a number of important issues raised by their exten-
sion across the prison system. Voluntary testing can be used as a
method of assessing prisoners for greater privileges and for retaining
them. Hence, differential regimes have developed on the basis of drugs
use alone. If prisoners consent to voluntary tests and prove negative,
then they may become eligible for privileges such as temporary release,
in-cell television, desirable jobs or moving to an enhanced regime. This
raises the question of ‘voluntary’ consent because there are penalties
for those who do not consent in that they cannot receive such
benefits. The units have been established mainly for those who have
never taken drugs and those who have given up the habit. As Hewitt
(1996) argues, this has the potential to create scenarios where a recidi-
vist armed robber who has never used drugs is better treated than a ex-
heroin addict who is rehabilitated and occasionally uses cannabis.
Furthermore, those who have real problems with addiction are further
punished by not having access to such privileges. There are also issues
relating to the evidential standards for voluntary testing. Mandatory
drug testing is subject to national standardisation and rigorous eviden-
tial standards (HM Prison Service, 1995b), whereas less stringent proce-
dures are often followed for voluntary testing which take place on-site
and are generally cheaper, such as dip and read tests and urinalysis
machines.
Voluntary testing essentially means more testing and more resources
for the increased volume of testing, staff time and training, structural
alterations to the prison to create VTUs, and additional counselling
provision. Over the period 1999–2002, £17 million was spent on the
voluntary testing programme (HM Prison Service, 1999). Because vol-
untary testing is inextricably linked to rewards and punishments, it
cannot be considered truly ‘voluntary’ and it could become difficult in

the future to distinguish between mandatory and voluntary testing as
they appear to be merging. Furthermore, what appears to be occurring
with the increased use of voluntary testing is the division of the physi-
cal space and populations within the prison on purely ‘drug’ lines. A
director of a drug agency described this emerging demarcation and
classification between users and non-users within the prison:
There is a move now to create voluntary testing for enhanced regimes and
congregate on basic regimes all the drug users and suppliers, so they’ll be
isolated – all the ones who want to stay on drugs and all the ones who are
caught dealing. It’s up to them if they want this very basic, very austere
regime and almost segregated from the rest of the population. The rest of
the population is going to be on enhanced regimes with voluntary testing
which even though it sounds like the people who need the most help are
getting the least … But it does offer a tiered response. (Interview (15)
with director of drug agency)
There is therefore a growing trend towards a bifurcated prison drugs

policy with voluntary testing units and new rewards for prisoners who
conform, while for those who fail to conform or are unable to regulate
themselves, there is mandatory drug testing, greater surveillance and
punishment.
Supply reduction
The measures to reduce the supply of drugs in prisons outlined in the
1995 prison drugs strategy were further enhanced under the revised
strategy. Such initiatives were supported by the Home Affairs
Committee exploring the management of the Prison Service. They rec-
ommended that security measures such as fixed furniture in visits
rooms, CCTV, sniffer dogs, random strip searching of prisoners after
visits, closed visits for prisoners who have received drugs, and rigorous
searching of visitors should be extended across the prison system
(Home Office, 1997b). The review of the 1995 strategy highlighted
various examples of good practice in relation to supply reduction and
deterrence including imposing closed visits on those found guilty of
drugs offences; use of CCTV recordings to provide evidence of passing
drugs for subsequent adjudications; drawing up protocols between
prisons and police for arrest procedures and intelligence gathering; dis-
playing posters and newspaper articles detailing the risk of arrest and
prosecution in visitors centres; and the provision of support to visitors
who feel pressurised to bring drugs into prisons (HM Prison Service,
1998a). Under the 1998 strategy, the Prison Service promised ‘to con-
tinue to target those who seek to profit from the misuse of drugs … we
will not let up on the battle to reduce the flow of illegal drugs into
prisons’ (HM Prison Service, 1998b: 6–7). Three new supply reduction
objectives were introduced: to develop a performance indicator on
action taken against suppliers and dealers; to establish anti-social
drugs-related activity as a key criterion within incentives and earned
privileges schemes; and to disrupt the distribution networks for illegal
drugs (HM Prison Service, 1998b).
In January 1999, supply reduction measures were further enhanced
when Jack Straw announced that visitors who were caught or suspected
of smuggling drugs into prisons would be banned for a three-month
period from further visits (Home Office, 1999). This illustrates that the
government has failed to grasp the dynamics and complexities of drug
smuggling and victimisation in prison and ignored the gender dimen-
sion to the problem as outlined in the previous chapter.
Harm minimisation
As with the previous drugs strategy, harm minimisation measures did
not receive a high profile in the policy review or the 1998 strategy. The
review revealed that Health Care Standard 8 dealing with
detoxification had been implemented in the pilot residential drug
detoxification units, but these were found to be expensive, resource
intensive, and only had the potential to deal with a minority of prison-
ers (HM Prison Service, 1998a). As the ACMD (1996) had warned, com-
pliance with the implementation of Health Care Standard 8 was found
to be variable across the prison system. This further highlights the
enduring problem of the autonomy of prison medical officers in imple-
menting national standards with regard to detoxification and also the
continuing tension between central policy directives and local deci-
sions about implementation. The evaluation of pilot drug treatment
programmes recommended that specialist NHS services should be used
to meet the need for safe and adequate detoxification and to provide
specialist supervision when required (PDM Consulting Ltd, 1998).
Within the 1998 strategy, a key harm minimisation objective was to
provide appropriate interventions within the framework of a revised
Health Care Standard 8, concurrent with Department of Health guide-
lines, to minimise drugs-related harm (HM Prison Service, 1998b).
Subsequent inquiries have further highlighted the continuing inconsis-
tency regarding detoxification and methadone maintenance practices
across the prison system and between prisons and the community
(Home Affairs Select Committee, 1999; 2002).
After a long delay, research commissioned by the Prison Service which
had been conducted in 1994 on HIV/AIDS risk behaviour was finally
published late in 1998 (Strang et al., 1998). This involved interviews
with a random sample of 1,009 prisoners in 13 prisons about their
knowledge, attitudes and behaviour concerning HIV/AIDS. In relation to
drug risk behaviour, the main finding was that the majority of drugs
injectors ceased to inject on entry to prison and the rest tended to inject
less frequently. However, those who continued to inject whilst in prison
were more likely to share needles (Strang et al., 1998). These findings
provide the ‘official’ evidence, which was missing during early phases of
policy development, that there is a group of prisoners who continue to
engage in high-risk drug behaviour and are therefore at greater risk of
transmission of HIV and other blood-borne viruses such as Hepatitis C.
As we saw in the previous chapter, the Prison Service recognised this
threat and was developing a scheme to provide sterilising tablets for
cleaning syringes to prisoners who continue to inject. The pilot scheme
for sterilising tablets was introduced in July 1998 in eleven prisons for a
three month period. Prisoners were to have easy access to the tablets
without having to identify themselves as drug users. However, it is ques-
tionable given the punitive, security-focused culture surrounding drugs
within the prison system whether prisoners would risk the possibility of
being seen accessing the tablets.
It is interesting that no reference was made to the introduction of
sterilising tablets in either the new drugs strategy or the policy review
documents. It may be that the Prison Service was concerned that incor-
porating such an initiative into their drugs strategy document would
appear as an admission of policy failure, that they were condoning
drug use and as a contradiction to their ‘tough’ stance on drugs in
prison. Despite the low profile of harm minimisation in the Prison
Service’s public discourse on drugs, key policy players felt that the new
government was more willing to engage in harm minimisation debates
and implement such measures. As a civil servant commented:
Politically, there’s [been] a shift … in that harm minimisation was

almost a banned phrase in the previous administration … Whereas I
think there’s much more ability to talk in terms of harmful drug misuse
against a backdrop of drug misuse per se and try to make sense of what is
it we’re trying to tackle and where do the problems lie from a rather more
informed sort of base now. (Interview 14a with civil servant)
However, the ‘official’ discourse around harm minimisation is likely to

continue to be articulated ‘privately’, rather than ‘publicly’ for politi-
cal reasons. The public face of the new drugs strategy continues to
project the hard-line abstinence approach of the previous phase.
Despite the greater willingness to adopt harm minimisation principles
within the prison system during this recent phase, overall progress in
this area remains slow and incongruent to policy and practice in the
community. Reflecting on developments in harm reduction since
1988, Strang (1998: 301) argues that the ‘continued failure to use
health opportunities in prisons stands as one of the resistant black
spots’ in the development of policy and practice.
Treatment
As argued by the policy network which emerged around the 1995 strat-
egy and documented in the policy review and the evaluation of treat-
ment programmes, existing treatment provision required much
improvement and change to meet the Prison Service’s goal of every
prison having access to ‘a comprehensive range of prevention, treat-
ment and rehabilitation programmes which meet the needs of all pris-
oners’ (PDM Consulting Ltd, 1998: 1). In order for this to become a
reality, prisons would need to liaise and make treatment referrals to
other prisons in their area. Under the new strategy, treatment provi-
sion was to be developed on an area basis. It was based on the success
of the area-wide model in Kent which established inter-prison and
inter-agency co-operation through a referral system and area co-ordina-
tor (see Appleyard, 1998).
The goal of the new strategy was to develop a drug treatment service
framework which provides ‘an equitable provision of basic and
enhanced specialist services to meet low level, moderate and severe
drug problems’ (HM Prison Service, 1998a: 4). Drug services were
configured to provide low cost and low intensity interventions across
the prison system, with fewer higher cost and higher intensity pro-
grammes offered on an area and national basis. An integrated
Counselling, Assessment, Referral, Advice and Throughcare service
(CARATS) was developed within and across Prison Service areas which
was tailored towards the specific needs of the populations in each
prison (DPAS, 1999). From October 1999, CARATS were to provide a
range of easily accessible interventions and act as the link between
courts and prisons, different departments within an individual prison,
different prisons when prisoners are transferred, and prisons and com-
munity agencies. Prisoners requiring more intensive treatment could
be referred to enhanced drug treatment services, such as residential

programmes and detoxification services. Multidisciplinary teams con-
sisting of drug agency staff, prison officers, probation officers, and
health care staff would deliver the CARATS. The effectiveness of treat-
ment provision was to be subject to independent research and evalua-
tion and performance indicators on increasing treatment referrals,
programme completions and reducing recidivism amongst drugs using
offenders were to be developed (HM Prison Service, 1998b).
Programmes must achieve central accreditation to ensure they meet
the required standards by the Prison/Probation Service Panel.
Preliminary research conducted by Burrows et al. (2000) has shown
that in order for CARATS to be successful in preventing relapse and
recidivism, effective interagency working and throughcare arrange-
ments are vital. There are fundamental problems which must be over-
come both structurally and philosophically (see Home Affairs Select
Committee, 1999; Kothari et al., 2002; Hucklesby and Wilkinson,
2001). Arrangements to share information and deal with confidential-
ity issues need to be established between health professionals and
prison staff. The conflict between the harm reduction ethos of some
drug agencies and the abstinence-based nature of the drug strategy
needs to be addressed. Both prison staff and community agencies need
to develop an understanding and appreciation of each other’s working
practices. Finally, the expansion of treatment provision needs to be
fostered through long-term funding and training.
Although it remains to be seen how CARATS will progress, the devel-
opment of a universal treatment framework with its emphasis on inte-
grating treatment between prisons and between prisons and the
community had been long awaited by the policy network which had
lobbied for many years for a more explicit and defined drug treatment
policy. The new framework was particularly welcomed by many of the
drug service providers (see Hamer, 1998). Under this structure, they
have assumed more prominent roles within prison drugs policy and
have entered into more formalised contractual relationships with the
Prison Service. A mutually dependent exchange relationship has
emerged whereby the Prison Service has become dependent on outside
drug agencies to develop and implement the treatment strand of the
strategy, while the treatment providers have become dependent on the
Prison Service for large and often lucrative contracts. This has altered
and reshaped the traditional policy networks around prison drug
issues. Drug treatment agencies have moved towards the core of these
network structures, rather than operating on the periphery in more
independent roles. Under the new framework, it is unclear as to which

group will lead drug treatment in prisons.
The key question is whether treatment will be led by prison manage-
ment or by service providers? Although the previous arrangements
were often ad-hoc and informal, drug agencies working in prisons did
have a certain degree of autonomy to determine their own styles and
methods of working. The danger involved with these new formalised
partnerships between drug agencies and the Prison Service is that they
could lead to some agencies becoming ‘incorporated’, losing their inde-
pendence and critical stance, and compromising their underlying
ethos, values and philosophies. A director of a penal reform group
offered an alternative view of partnerships arguing that they are often
dangerous, particularly where prisons are concerned, and that the
Home Office had successfully incorporated parts of the voluntary
sector into the punitive framework of the prison environment.
the Home Office has successfully incorporated the voluntary sector. I wish
the voluntary sector could be renamed the independent sector because the
independence is crucial … So you call it partnership. I call it incorpora-
tion. It’s a scary thing … the emulation of one group by the other.
Impact and influence of prisons drugs policy
The development of prison drugs policy has been affected by shifts in

the wider social, political and policy context. However, by the late
1990s, there was also evidence that the reverse process was occurring
with many of the ideas, initiatives and practices within prison drugs
policy influencing the way in which subsequent drugs policy has been
shaped. These include greater acceptance of coerced treatment by
policy-makers and practitioners; increased emphasis on the criminal
justice system as an arena for drug treatment; and the proliferation of
testing across other areas. The developments within prison drugs
policy have laid the foundation for a much more punitive and coercive
system around drugs and drug control.
Coerced treatment has become accepted almost universally within
policy debates. Similarly, there appears to be a sea change in terms of
the willingness of treatment providers to work within the criminal
justice system. As we saw in previous chapters, drug agencies had been
reluctant to accept referrals from the criminal justice system in the past
due to the coercion involved. Because of the new resources being made
available for drug treatment, opportunities are now available for drug
agencies and many have an interest in pursuing contracts within the
criminal justice system. Concern was expressed that treatment
providers had compromised their principles by working with prisoners
who were not entering treatment on a voluntary basis. Key policy
actors maintained that in order for treatment to be effective, it had to
be entered into on a voluntary basis. As a penal reformer argued:
You’ve got the voluntary sector with their vested interests and all their
jobs, and their monies and their fundraising. They shouldn’t work in
prisons where prisoners are punished … They’ve swallowed a lot of the
principles. Drug groups used to argue that they wouldn’t take anybody in
a rehab unless it was voluntary and they were committed to the
programme. Now they’re working with people in prisons who are so-called
committed to the programmes, but if they have a relapse or found with
drugs in their urine, they’re sent down the plonk or they lose their
remission. (Interview 29 with penal reformer)
On the other hand, the view emerging from the service providers was
that they no longer had the luxury of dealing with voluntary clients:
Most drug treatment services are being impacted to a greater or lesser

extent by coercive drug treatment. You’ve got the Crime and Disorder Bill
with the testing and treatment orders … So we’re sort of coming in from
the cold … We used to have the luxury of being entirely voluntary. People
arrived here if they wanted to and we talked to them. That luxury doesn’t
exist anymore. (Interview 26a with director of drug agency)
Increasingly, the criminal justice system as a whole is seen as

having significant potential as a location and opportunity for drug
treatment (Kothari et al., 2002). At each stage of the criminal justice
process – arrest, court, sentencing, probation, prison, and parole –
drug treatment has been developed and provided. In many ways,
British drug treatment appears to be moving towards an American
model of service provision where providers are diverted from their
work in the community and the criminal justice system becomes the
‘front end’ of treatment. A director of a drug agency described this
shift in the following terms:
A lot of the treatment services are now linked to the criminal justice
system, so in a sense the criminal justice system has become the ‘front
end’ of treatment services … Now, services are actively engaging with

prisons and the criminal justice system … So those groups are now more
closely aligned with one another. A lot of it has to do with the flow of the
money, but it actually reflects what is happening in the American
approach … There [are] dangers in having the criminal justice system at
the front end of treatment … Drug agencies need to be quite cautious
about their relationships with the criminal justice system. There are
benefits. There is the potential to meet the needs of individuals. We also
need to think about global consequences of that and what it says about
their role in relation to users. Basically I still believe that it is better if
people who have got drug problems make decisions on their own to seek
help and treatment. (Interview 03)
With the new emphasis on treatment within the criminal justice

system, there is also the potential danger that offenders will be sen-
tenced to prison and community penalties with drug treatment
options in the hope that they will receive help for their drug problem,
rather than as punishment for their offence which may not warrant
such a severe sentence.
In Britain, mandatory drug testing has its antecedent within the
prison system. The new DTTOs are the most obvious examples of
transferring prison policies to community penalties. Similarly, the
Criminal Justice and Court Services Act 2000 includes provision to
drug test for specified class A drugs those charged with property crime,
robbery or class A drugs offences and those under probation service
supervision (see Mallender et al., 2002 for a preliminary evaluation). By
the late 1990s, drug testing had generally become accepted by policy-
makers and practitioners as a key mechanism within drugs control
policy. There was a clear consensus amongst those most involved in
drugs policy development that testing would continue and spread into
other spheres of social life, including education and employment.
The development of drugs policy in prisons has also affected penal
policy and regimes. Drugs had assumed a high priority within the
prison system at a time when other programmes were being cut back.
This impacted upon the treatment programmes in prison in that drug
workers were often having to deal with a range of other problems pre-
sented by those undergoing treatment. However, the priority given to
drugs was subject to change and was contingent upon how much of a
security problem it remained within the prison system. Because drugs
were seen to be connected to issues of order and control, they had
been given more attention. As a director of a drug agency commented:
They’re still juggling and there’s a number of plates spinning at the

moment and drugs is becoming a bigger plate and it spins faster and it
looks like it’s going to fall more frequently so they have to keep giving it
attention. Whether it becomes a greater priority depends on how much of
a major security problem it is. That will be the driving force. They risk
losing control of the prison environment through drugs and they certainly
have come close to that. That’s not about health care, it’s about
maintaining control of the prison. (Interview 28)
Similarly, drugs in prison has remained an important political issue

under the Labour government which appears committed to continuing
Michael Howard’s punitive zero tolerance campaign. This political
commitment may also change, but in the current phase of policy
development, drugs policy in prison has remained high profile and
impacted upon wider policy development and agendas.
Conclusion
This phase of policy development continues to evolve and it remains

to be seen how the new strategy will develop in practice, but it is
possible to reflect on the significance of the proposed changes.
Although some of the recent policy developments represent a new
‘realism’ in responding to the drugs ‘problem’ in prisons, the underly-
ing punitive framework remains within the new strategy. This ‘realism’
is characterised by the increasing recognition that the drug problem
cannot be fully eradicated, the commitment to evidence-based policy
and practice, and by new government interest in attempting to rectify
the balance within the strategy towards the treatment end of the
continuum. It is clear that some of the criticisms raised by the policy
networks around drug issues in prisons have been considered and
taken on board in the new strategy.
There has been some attempt to contain and manage the increasing
contradictions between treatment and punishment which emerged
during the previous phase. This is illustrated by the emphasis on
improving treatment and throughcare provision, the issuing of sterilis-
ing tablets to prisoners who continue to inject, the differentiation
between hard and soft drugs, the partial relaxation of MDT procedures
and the increasing recognition of alcohol in policy development.
However, at the same time, responses which emphasise ‘punishment’
and ‘control’ have also been further improved and enhanced and run
parallel to the more liberal response. The focus on testing, whether it
be mandatory or voluntary, has continued. Similarly, supply reduction

and security measures have been strengthened. The official discourse
remains focused on ‘control’, ‘order’ and ‘punishment’ and these are
the discourses which are often articulated publicly. Moreover, the
policy network around drug issues in prisons has been reshaped during
this phase. Drug agencies have entered into more formalised partner-
ships with the Prison Service and moved from the periphery toward
the core of the policy networks. The key danger for future policy devel-
opment is the ‘incorporation’ of this important sector of the policy
network and the silencing of a critical voice in prison drugs policy.
One of the most significant developments is the influence that
prison drugs policy has had on overall policy development. The prolif-
eration of drug testing in community penalties and other initiatives,
the almost universal acceptance of coerced treatment and the criminal
justice system moving to the ‘front end’ of treatment provision are all
indications of the impact, influence and power of the developments in
prison drugs policy and practice. In many ways, as Cohen (1985) has
argued, this represents the dispersal of control and the blurring of the
boundaries between the prison and the community, setting the stage
for future policy developments.
6
Conclusions: Shifting Agendas and
Policy Networks
The aim of this final chapter is to reflect on the pervasive themes

which have emerged from this history of drugs policy development in
prisons and to consider these in relation to the activities of policy net-
works and future policy agendas. The ‘problem’ of drugs in prisons has
shifted from being a relatively obscure policy issue to a mainstream
one. Over the four phases of policy development, drug issues within
the penal system have become fully institutionalised in government
policies and bureaucracies. The preceding chapters have illustrated a
growing contradiction between treatment on the one hand and pun-
ishment on the other. This contradiction has become more intense,
acute and difficult to contain and manage over time. In response, a
significant shift has occurred from a situation of ‘no policy’ to a more
explicit and defined prison drugs policy. The first phase of policy devel-
opment was characterised by policy which was implicit, unstated,
informal, private and internal. During the second phase, there was a
move towards more formal, documented policy, taking the form of
loose guidelines which were subject to local variations in implementa-
tion. The last two phases were characterised by policy which was much
more explicit, formal, public and overt compared with the previous
phases.
Activating and resisting agendas
Over the four phases of policy development, policy networks have acti-
vated, shaped and reshaped the development of drugs policy in
prisons. In the analysis, policy networks were characterised as primarily
issue-based. They played key roles in the processes of identifying,
defining and framing drugs issues in prisons. The framing process was
151
not only influenced by the reactions, perceptions and experiences of

those involved, but also by real pressures such as increases in drug
addict notifications by prison medical officers and the number of drug
offenders sentenced to custody, the threat of HIV, and the results of
mandatory drug testing. Different policy issues, problems or functions
at various times provided the occasion for the formation of policy net-
works. In the first phase, throughcare and release was the key policy
issue; this was followed by HIV/AIDS; then by mandatory drug testing
and treatment provision; and finally by the review and reformulation
of the 1995 prison drugs strategy (see Table 6.1).
Some of the policy issues were generated exogenously or by external
pressures such as HIV/AIDS, while others were generated endogenously
or by internal factors such as the review of the 1995 strategy. Policy
issues shaped the formation of policy networks. In turn, these net-
works further shaped and defined the issues through their activities. In
some instances, the policy network was aided in the framing process
by research and evidence. For example, during the second phase of
policy development from 1986 to 1993, research, evidence and knowl-
edge began to accumulate which assisted the policy network around
HIV and drug use in exposing the drug ‘problem’ in prison, challeng-
ing the view that it was insignificant and pressuring the Prison Service
for a more liberal and humane response. In effect, this growing
evidence base helped to sensitise policy-makers to the drug issue in
prisons and turn what was perceived as a ‘non-problem’ into a
Table 6.1: Policy issues and policy outcomes in prison drugs policy
Key policy issues Policy outcomes

1980–6 Throughcare & release Service development
(Parole Release Scheme)
1986–93 HIV/AIDS & drug use 1987 Statement on throughcare
of drug using prisoners
1991 Caring for drug users manual
Policies on HIV/AIDS
1993–7 MDT (mandatory drug 1995 prison drugs strategy (MDT,
testing) & treatment increased security measures, & pilot
provision drug treatment programmes)
1997– Review & reformulation 1998 prison drugs strategy (move
of the 1995 prison drugs towards voluntary testing & more
strategy comprehensive treatment provision
i.e. CARATS)
Conclusions 153
‘problem’. However, in the earlier phase from 1980 to 1986, the

framing of the drug problem in prison was hindered by the lack of
research and evidence. The collusion around drugs in prison during
this phase meant that research access was virtually impossible to
negotiate (Pearson, 1990).This lack of research had an impact on policy
development in that in the absence of any evidence of a drugs
‘problem’, it justified a policy of ‘no policy’ or one which was internal
and hidden from outside scrutiny. Although the models put forward by
Weiss (1986) do not allow for such circumstances, it is evident that just
as research may have an impact upon policy, so too does the absence or
lack of research.
As we saw in Chapter 1, one of the key criticisms of the policy
network approach is that it cannot explain policy change. Although it
addresses how policy changes, it does not address why policy changes.
In order to understand the changes within prison drugs policy over the
last twenty years, policy networks need to be integrated with micro
and macro level analyses. The work of the policy network in the
process of framing drug issues in prisons and advocating their solu-
tions was influenced by and occurred within a wider context. The
Wilks and Wright model of policy networks stresses the need to disag-
gregate to the subsectoral level of policy, enabling researchers to
explore how developments within wider policy sectors affect subsectors
(Wilks and Wright, 1987). As outlined in Chapter 1, Rein and Schon
(1993) put forward the idea of ‘nested contexts’ which can be broken
down into internal, proximate, macro, and global contexts. This frame-
work illustrates the complex process by which policy issues overlap
and interact with wider issues, contexts and policy solutions. In the
case of prison drugs policy, the framing and reframing of the drug issue
in prison and the development of policy occurred as the four nested
contexts shifted and impacted upon one another.
The global context of prison drugs policy refers to changes at the
broadest level affecting policy development. At this level, the rise of
New Right ideology with its emphasis on neo-conservative politics and
neo-liberal economics influenced all sectors of public policy. The con-
traction of the welfare state was accompanied by an expansion of the
penal complex (Hudson, 1993). Through a systematic comparative
analysis, Weiss (1998) argues that the world recession of the 1970s rep-
resented the turning point in post-war penality towards an increasing
punitiveness with world-wide increases in imprisonment, sentence
lengths, and severity of penal regimes. During the 1960s and early
1970s, there was a clear consensus amongst penal practitioners and
commentators regarding the correctionalist framework which was

based on notions of reform, treatment and rehabilitation. As David
Garland (1999: 8) argues, such a consensus no longer exists as the old
penological frameworks have disappeared and new ones have not yet
emerged to replace them. Penal policy and institutions are therefore in
a state of transition between different policy regimes. Within this
uncertainty, Garland identifies a number of converging penal trends in
the western world: the erosion of correctionalist ideologies; the shift to
expressive justice and punitive measures; the return of the victim; the
emphasis on public protection; the management of risk; the changing
objectives of community penalties and custodial institutions; the
politicisation of penal policy discourse; the commercialisation of
penality and the drift towards mass imprisonment. As we have seen in
the preceding chapters, most of these penal dimensions influenced and
shaped the development of prison drugs policy in the British context.
A related development has been the increasingly common practice of
importing or transferring policy ideas and procedures, particularly
from the United States. In the UK, this has become a trend in many
areas of public policy, occurring under both the Conservative and
Labour governments. For example, private prisons, boot camps, elec-
tronic monitoring, ‘prison works’, and ‘three strikes and you’re out’
sentencing policies have their antecedents in US penal policy. This
trend is not just evident within the UK, but in other countries such as
Canada (see Roberts, 1998). Garland (1999: 7) observes the growing
‘internationalization in penal matters [which] ensures that purportedly
successful (or merely popular) policy measures emerging in one
context will quickly be emulated elsewhere’. Similarly, various com-
mentators argue that the US ‘war on drugs’ has been exported to other
nations (see Ryan, 1998; South, 1998; Stares, 1996). This has resulted in
the development of a punitive and prohibitionist global discourse
around drugs as opposed to a treatment, public health oriented one. In
the UK, the 1995 prison drugs strategy was heavily influenced by the
US drug testing and abstinence-based treatment programmes. The
appointment of an American-style drugs tsar and the introduction of
the new treatment and testing orders based on the US drug court
models are also key examples of policy emulations or transfers. Given
the failure of the American ‘war on drugs’ and the drift towards mass
imprisonment, it seems absurd to look to the US for policy ideas. As
Elliot Currie (1993: 3) argues, ‘The failure of American drug policy is
depressingly apparent. Twenty years of the ‘war’ on drugs have
jammed our jails and prisons, immobilized the criminal justice system
Conclusions 155
in many cities, swollen the ranks of the criminalized and unemploy-

able minority poor, and diverted desperately needed resources from
other social needs.’
The macro context of prison drugs policy refers to changes in the
overall direction of policy and the influence of wider social, political,
economic and institutional change. The managerial reforms and
restructuring implemented by the Conservative governments from
1979–97 have transformed the public sector beyond recognition.
Moreover, the managerialist trend has continued, even intensified
under the new Labour government. The ‘new public management’
with its emphasis on performance, value for money, privatisation, part-
nership and community has successfully penetrated all areas of public
policy. Although the shift towards managerialism within the criminal
justice system occurred later compared to other policy areas, it was not
immune from these pressures. One of the ways to manage the emerg-
ing uncertainty and contradiction within the penal system has been to
apply managerial techniques, rather than to engage in debates around
penal values and ideology. The three E’s – economy, effectiveness, and
efficiency – began to manifest themselves in prisons during the late
1980s. As we saw in Chapter 3, particular examples include the over-
haul of working arrangements for prison officers and management
structures under the Fresh Start initiative in 1987 and the introduction
of two private prisons in 1989. By 1993, managerialism within the
prison system culminated in the Prison Service becoming a Next Steps
agency. This involved a greater distinction between operational and
policy matters, greater emphasis on ‘strategic’ planning with the for-
mulation of corporate and business plans, the development of perfor-
mance indicators and greater emphasis on co-ordination and
partnership within the criminal justice system. Drugs policy was also
influenced by the managerial discourses of performance and partner-
ship. This can be seen most clearly in the 1995 and 1998 drugs strate-
gies with their emphasis on action plans, performance indicators,
audits and evaluations, and partnership and co-ordination structures.
Managerialism forced the development of a prison drugs policy
which is much more explicit and can be measured. This shift corre-
sponds with the growing patterns of conflict, contradiction and con-
vergence between treatment and punishment and can be seen as part
of the attempt to manage these tensions. Managerialism and its associ-
ated techniques create a myth of rationality, planning and control
within policy-making. However, key players within the policy process
argued that the development of prison drugs policy should not be
viewed as ‘rational’ in any sense. In particular, the 1995 drugs strategy

was perceived to be the result of a number of issues which coalesced
into a policy, rather than the result of a systematic process:
Though it is now presented as the Prison Service drugs strategy, I’m not
sure it was actually conceived as a ‘strategy’. There were different strands
that coalesced into something … It’s never as clean and as neat and as
rational as sometimes in hindsight you like to present it. (Interview (24)
with penal reformer)
Similarly, policy development was compared to a process of ‘osmosis’

and as a reactive, rather than a proactive process:
If one is looking at policy development, it’s a process of osmosis, rather

than anything else sometimes. There aren’t too many think tanks going
on in the [department] … There are bits of research, reports which come
out of incidents or catastrophes – a prison breakout, a death, or several
deaths close together. Then we develop a policy on security or how to treat
prisoners who are at risk of suicide. That’s the way it happens …
Although we call ourselves policy-makers, really we’re very much
resourced to deal with incidents … We have annual planning exercises
where we think about what we’re supposed to be doing and what we will
be doing. We set objectives … That all goes on, but the process at the end
of day is that we spend so much of our time firefighting. The sort of blue
skies type approach, you know, what shall we do to improve the position
of drugs next? It doesn’t develop like that. We need a few deaths or [some-
thing] to go completely haywire before anything gets done or someone to
jump in there and say, ‘this is a disgrace’.
(Interview (12) with civil servant)
It is within this context that the 1995 prison drugs strategy revolved
around the results of MDT as an indicator of its success or failure. The
managerialist trend was paralleled by the growing punitive rhetoric in
penal policy. Within the managerialist dominated framework, MDT
produced tangible, ‘objective’ results very quickly, providing it with
much appeal to policy-makers and politicians. Furthermore, MDT was
attractive because it gave the impression of ‘taking control’ of the drug
problem in prisons by punishing drug users. Sanctions could be
applied immediately to those who tested positive. Drug testing became
a mechanism for managing and classifying prisoners into a risk group
(Feeley and Simon, 1992). In comparison, it is much more difficult to
Conclusions 157
assess the individual effects of treatment and rehabilitation. In theory,

this would involve greater subjectivity and longer time periods to
produce results. Although the delivery of the new CARATS (coun-
selling, assessment, referral, advice and throughcare service)
programme is being assessed, this work has been similarly preoccupied
with monitoring and performance measurement activity which can
have a detrimental effect on the quality of service provision. Following
her experience of managing CARATS, Lowthian (2002: 171) argues,
‘Work is target driven and it is sheer throughput of numbers that
governs the “success” or otherwise of the delivery … this can impact
negatively on the extent to which meaningful interventions can be
offered to prisoners.’
The proximate context of prison drugs policy includes developments
in both drugs and penal policy. However, in the first two phases of
policy development, these two policy areas developed separately with
very little overlap. Prisons generally remained on the periphery of
drugs policy debates, while drugs remained on the periphery of penal
policy debates. During the first phases, prison drugs policy was
relatively insulated from developments in wider penal and drugs
policy. By the early 1990s, however, the interface between these two
policy areas became much more explicit and visible.
Penal policy and the prison environment have generally acted as
constraints on the development of liberal, pragmatic and progressive
drugs policies. For example, the enduring penal ‘crisis’ characterised
by an increasing population, overcrowding, riots, industrial disputes,
lack of resources, and inadequate conditions has limited what can be
proposed and achieved within policy development. Particularly in
the early phases of policy, drugs were kept hidden as they were func-
tional as mechanisms of control within this penal context. The col-
lapse of the rehabilitative ideal and the move towards a just deserts,
punishment and law and order framework also helped to curtail the
development of drug treatment provision. Early attempts at drugs
and HIV policy development were further hindered by implementa-
tion which was strongly localised. By 1993, penal policy started to
influence the direction of drugs policy in prisons with Michael
Howard’s pronouncement that ‘prison works’, his commitment to
tackling the drug problem, and the influence of the Learmont recom-
mendations. Prison drugs policy began to focus more closely on
security, control and punishment, taking on the attributes of the
austere and punitive penal policies which were emerging during this
period. In contrast to developments in treatment provision, the MDT
procedures and Learmont recommendations were universal require-

ments and this ensured that they were implemented across the entire
penal system.
During the first two phases, prisons were generally excluded from
developments and innovations in drugs policy. There were different
discourses operating outside and inside the prison walls. During the
first phase from 1980 to 1986, the re-definition of drug addiction and
the expansion of service provision in the community were not paral-
leled within the prison environment. The new partnership structures
(i.e. District Drug Advisory Committees) and the 1985 national drugs
strategy omitted prisons from their remits. This began to change with
the HIV/AIDS crisis when drug issues in the prison system moved into
mainstream drugs policy debates. However, the new harm reduction
principles and techniques which were operating successfully in the
community failed to fully penetrate the development of HIV and drugs
policies in prison. The constraints of the institutional context and the
concern around the public imagery of such ‘soft’ policies meant that
these principles were greatly modified and adapted within the prison
environment. Under the 1995 national drugs strategy, there was a clear
interface between penal and drugs policy. For the first time, prison-
related aims and objectives were incorporated into policy at the
national level and the Prison Service was expected to become involved
in local and national partnership structures. The national strategy
placed greater emphasis on enforcement, control and punishment and
this was mirrored in the new punitiveness which was being advocated
within penal policy. These two policy discourses had a profound effect
on how the 1995 prison drugs strategy developed. Under the 1998
drugs strategy, the increasing focus on the link between drugs and
crime will ensure that the interface between these two policy areas
strengthens.
The internal context of prison drugs policy has been affected by
changes in the membership and organisation of policy networks and
structures. Depending on the issue at the centre of policy development,
membership within the policy networks has changed and adapted over
the phases. As drug issues in prison gained more prominent positions
on the policy agenda, interest in this area expanded and more players
became involved in the policy process. Some members, however, had
long histories of involvement and were consistently represented over
the various phases, including civil servants within the Prison Service
and some drug agencies such as the Parole Release Scheme. In particu-
lar, the Prison Service played important gatekeeping roles within all
Conclusions 159
the policy networks which emerged. Various committees such as the

ACMD, the House of Commons Social Services Committee, and Home
Affairs Select Committee also played key roles in shaping policy and
often their membership overlaps with the networks.
In the first phase of policy development, the work of the ACMD
(1980) and Social Services Committees (1985; 1986) served to initiate a
small policy network around throughcare and release issues for drug
misusing prisoners. Although the Home Office and the Prison Medical
Service occupied central positions at the core of this network, the
negotiation and planning by SCODA, NACRO, the probation service
and various drug agencies was instrumental in ensuring that a service
was developed for drug using prisoners on release during the early
1980s. In the second phase from 1986 to 1993, the advent of HIV/AIDS
widened interest in prison drug issues, bringing new players into policy
networks including more drug treatment agencies, medical profession-
als, penal reform groups (e.g. Prison Reform Trust), professional associ-
ations (e.g. ACPO, NAPO, POA), social researchers, HIV/AIDS
organisations, and health authorities. During this period, the ACMD
also sought to influence the policy process by producing three
influential reports on drugs and AIDS which covered the penal system
(ACMD, 1988; 1989; 1993). Although civil servants in the Directorate
of Prison Medical Services were the key state actors involved at the core
of this network, the power of the Prison Medical Service was diluted
over time as more agencies gained access to policy networks and to
prisons to work with drug users.
By 1993, interest in prison drugs policy further increased and the
shift towards partnership and multidisciplinary approaches brought
more players into the process. The increasing contradiction between
treatment and punishment within policy development led to an
increase in the number of representatives within the fields of drug
treatment, penal reform, civil liberties and research. These groups were
involved in lobbying against the introduction of MDT and for more
comprehensive treatment provision. Interest in this area also expanded
within the state. As drug issues in prisons became increasingly politi-
cised, the Home Secretary and Director General of the Prison Service
began to occupy powerful positions within policy development. Civil
servants in the Security Group and Health Care Directorate of the
Prison Service and the Central Drugs Co-ordination Unit were also
involved at the core of the network. However, this is not to suggest
that the Prison Service was unified in their interests around policy.
There were structural and philosophical divisions between the Health
Care Directorate and Security Group which led to the control and
treatment elements of the 1995 strategy developing separately. By
1998, the Prison Service Drugs Strategy Unit was established as an
attempt to overcome these divisions and unite policy interest. This
unit is likely to remain at the core of any future policy networks
around drug issues in prisons. With the greater emphasis on treatment
and the growing interdependence between the Prison Service and
service providers, drug agencies are also likely to move from the
periphery towards the core of future networks.
In order to understand policy change, analysis at the micro level
dealing with the role of human agency is necessary. As Rhodes (2000:
86) argues, analyses of governing structures need to be connected with
the beliefs and narratives of individuals. This was recognised by
members of the policy network. In the interviews, respondents
discussed the characteristics of particular individuals such as their
backgrounds, knowledge bases, training, allegiances, preferences,
management styles and their impact on the policy process. As a
director of a drugs agency argued:
I don’t think you can get away from individuals. You’ve got to look at the
people … There might be some good sound policy reasons, but there are
other sociodynamic, psychodynamic forces at work – you’ve got the right
person in the right job at the right time … For me, structures only do so
much … What you’re dealing with at the end of the day is personalities.
(Interview 05)
The ‘institutional embedding’ of the different policy players

influenced the processes of identifying, defining and framing drugs
issues in prisons. There are important differences related to the differ-
ent structural locations and ideological foundations of the various
groups involved. For example, those within the traditional ‘caring’
roles, including drug workers and probation officers, tended to express
the drugs problem in individual, health-related terms, rather than
institutional, enforcement-related terms. In order to gain access to the
policy process, some groups neutralised their discourses and tended to
present themselves in a conservative, rather than radical light. For
example, many of the drug agencies involved advocate abstinence pub-
licly, but privately promote harm reduction practices within the prison
environment. Similarly, most penal reform groups would not present
themselves as overtly ‘abolitionist’. As Ryan (1978) argues, such groups
need to be seen as ‘acceptable’ to government.
Conclusions 161
The framing of drugs policy issues in prison and the activities of

policy networks occurred within these nested contexts. When features
within these contexts shifted, it produced a ripple effect, often leading
to the reframing of issues and renaming of the policy terrain. The
policy networks adapted and changed in response to these shifting
contexts and terrains. The shifts provided opportunities for policy net-
works to influence the policy process, but also set the limits to their
activities. The reverse process also occurred whereby the reframing of
prison drug issues shaped the contexts. This can be seen in the policies
and structures developed by the Conservatives which were then inher-
ited by the Labour government. This policy feedback mechanism set
the parameters for subsequent policy development, often limiting and
constraining what can be achieved. Moreover, the emerging context
and experience of prison drugs policy is influencing wider policy
frameworks. This can be seen in the expansion of drug testing into
other spheres of policy, such as community penalties and policing, and
the greater acceptance by practitioners of coerced treatment.
The role, influence and power of policy networks within the policy
process varied over the different phases. Over time, they demonstrated
an ability to identify opportunities at key moments, articulate their
ideas and respond to agendas within the constraints, pressures and lim-
itations of the wider policy, political, social and institutional contexts.
They were successful in challenging and changing perceptions, policy
and practice. Through this process however, parts of the policy
network were drawn in and incorporated by the state, losing their
independence and capacity for criticism. In the first two phases of
development, policy networks played central roles in drawing atten-
tion to drug issues in prison and placing these on the policy agenda. In
particular, their main concern was the way in which drug using prison-
ers were treated and the lack of congruence and continuity between
the provision in prisons and that in the community. These networks
were instrumental in helping to expose the drug problem in prison and
pressing the Prison Service both to acknowledge the problem and to
develop more explicit and humane policies. During the early stages,
policy development was therefore driven by external interest, emanat-
ing from below or from the fringes of policy networks with drug agen-
cies, professional associations, and penal reform groups playing key
roles. Their success is illustrated by the development of specific services
for prisoners in the first phase of policy and by the formulation of
guidelines for their treatment and throughcare and the cautious HIV
policies which emerged during the second phase (see Table 6.1).
In the last two phases of policy development however, policy net-

works were not as powerful in terms of activating the agenda and con-
tributing to the initial stages of the policy process. Instead, they
responded to and resisted an agenda determined by politicians. As in
other policy areas, the increasing shift towards the populist punitive
and managerial discourses led to less consultation between govern-
ment and experts during the 1990s. Outside groups did not have the
same opportunities to influence policy development (Rock, 1995;
Downes and Morgan, 1997). Although they lost control over the
agenda, the networks around drug issues in prisons adapted to these
new circumstances. Under the punitive drugs policy framework which
emerged from 1995 with its focus on mandatory drug testing and secu-
rity measures, the contradiction between treatment and punishment
became much more acute and pronounced. In response, the policy
network attempted to lobby against the introduction of MDT.However,
given the statutory powers surrounding the testing procedures, these
attempts proved futile. The service providers recognised this and
turned this into an opportunity to argue for an expansion of treatment
within prisons to rebalance the strategy. Their success can be seen in
the pilot drug treatment programmes which emerged during the course
of the 1995 strategy and in the greater prominence given to treatment
under the revised 1998 strategy. There is evidence that some of their
criticisms around the 1995 strategy were taken on board and infiltrated
the new policy agenda which emerged in 1998.
Since 1980, drug treatment agencies have remained important
players in policy networks. In the latter phases of policy development,
the Prison Service increasingly recognised that it needed these agencies
to develop and provide drug treatment programmes in prison and
therefore allowed them greater access to the policy process. Similarly,
the Prison Service provides the drug agencies (many of which previ-
ously had insecure contracts or no contracts at all), with security, sta-
bility and a source of longer-term funding. Under the new CARATS
framework, this mutually dependent exchange relationship was rein-
forced further. In the most recent phase, the policy network therefore
changed shape. Over time, it evolved from a structure which was
diffuse and informal to one which is more identifiable, formal, con-
crete and institutionalised. In a sense, some drug agencies moved from
operating in independent roles on the periphery of policy networks
towards being fully ‘incorporated’ into the core of these networks.
They now have a stake in the continuation and expansion of the
current policy framework. Given their vested interests and dependence
Conclusions 163
on the Prison Service in relation to contracts, it remains to be seen

whether these agencies will continue to play such central roles in
lobbying for change and reform in prison drugs policy in the future. As
their relationship with the state becomes more formalised and
concrete, the danger is that a prominent voice in prison drugs policy
will be silenced.
Future agendas and policy networks
This policy analysis has illustrated the movement towards a more

refined and explicit prison drugs policy. This increasing clarity has
been accompanied by a growing contradiction between treatment and
punishment. Within prison drugs policy development, contradictory
discourses and strategies have co-existed. There are overlapping
systems of regulation including treatment and care and punishment
and control. Particularly in the early phases of policy development,
many prisoners were serving time for drug offences or offences relating
to problematic drug use, but were denied access to appropriate care and
treatment. In the most recent phases, new techniques have been
devised to punish individuals for their drugs use within the prison
environment, while at the same time, they are offered opportunities to
address their problems through new modes of treatment and rehabili-
tation. Similar to other areas of social policy (see MacGregor, 1999b),
the bifurcation within prison drugs policy has become increasingly
polarised. The practice of putting forward ‘soft’ and ‘hard’ approaches
simultaneously within drugs and penal policy has become a potent
theme. For prisoners who conform to the new regulations, tests and
mechanisms of control, there is prevention, treatment and rehabilita-
tion, as well as new incentives and privileges. For those who do not
conform, there is increased surveillance, punishment and harsh treat-
ment. At the same time, these contradictions are converging and
becoming blurred. This can be seen in the greater acceptance of
coerced treatment and so-called ‘voluntary’ drug testing.
The current phase of policy continues to develop and evolve. A key pri-
ority for the Prison Service is to get the CARATS system of drug treatment
established, accredited, and evaluated. Interest in this area continues to
increase and expand. For example, the Home Affairs Select Committee
recently undertook an inquiry specifically to explore drug issues within
prisons under the new 1998 strategy (Home Affairs Committee,
1999).They concluded that the contradictions between disciplinary and
therapeutic responses within the strategy have not been resolved:
Devising a policy for tackling drugs in prison is important. As well

as reducing tensions and criminal behaviour within prison, it has a
major contribution to make to reducing offending outside prison.
The prize at stake for success is high. But there are very real
difficulties which have to be addressed; these include the need to
strike a balance between cracking down on the supply of drugs and
providing humane treatment of prisoners, and a balance between a
disciplinary and therapeutic response to drug use in prison. (Home
Affairs Committee, 1999: para. 173)
However, can such a balance ever be achieved within penal policy?

Although policy networks were influential in their attempts to contain
and manage these contradictory pressures between treatment and pun-
ishment, they had little success in actually resolving them. There are
clear limitations as to what can be achieved within policy in terms of
reconciling such competing objectives within the penal arena.
Fundamental clashes remain between the ideologies, values and
philosophies of some of the community drug agencies which advocate
harm minimisation and the Prison Service drug strategy which is absti-
nence-based. As policy develops and the treatment programmes are
established, it is clear that there is a degree of incorporation and what
Carlen refers to as ‘carceral clawback’ occurring. The limits to prison
reform or ‘carceral clawback’ relates to the involuntary nature of
imprisonment, the priority of keeping prisoners in prisons and the fact
that prisons are for punishment. Carlen (2002: 116) argues that the
possibilities of a benign prison persist and multiply for a number of
reasons including the constant need to legitimate the continued use of
imprisonment, the prison has a key role in the development of new
therapeutic initiatives, and penal reformers have accepted invitations
to shape regimes to reduce the pains and damage of imprisonment. In
the case of prison drugs policy, there was the persistent belief amongst
some members of the policy network that balance or a compromise
could be achieved between the treatment and punishment strands of
the strategy. However, once non-state agencies become involved in
prison administrative discourse, their reforming ideologies are often
neutralised and forgotten. Once they begin to influence within policy
networks, their discourse and critique around prisons becomes less
radical as they concentrate on establishing and accrediting pro-
grammes, monitoring their effectiveness, and delivering value for
money. As Carlen (2002: 120) argues, ‘[the prison] is becoming a lucra-
tive and staple source of financing for many newcomers to the prison
Conclusions 165
industry who appear not at all unwilling to legitimate the use of

imprisonment by reference to the ‘effectiveness’ of their ‘programmes’
in reducing crime.’
The key dilemma for non-state organisations and particularly for
drug agencies in the case of prison drugs policy is whether to refuse
invitations to participate and thus lose their power to influence at all
or accept invitations to participate and become incorporated into
the penal apparatus. Policy networks are structures which both con-
strain and enable agents. The activities of the policy network will
always be limited by the very nature of the prison environment.
Similarly, those engaged with developing policy need to recognise
the limits of drug programmes within the prison environment where
security and control issues will always assume a higher priority.
However, as long as drug users are sent to prison, there needs to be
treatment and rehabilitation on offer for those who wish to partici-
pate. Such programmes need to be developed with the recognition of
the structural obstacles to providing treatment in prisons and of the
ways in which the prison environment amplifies the problems expe-
rienced by drug users (Malloch, 2000). For those prisoners who enter
treatment programmes voluntarily, prison might be the place where
their recovery from problematic drug use begins. The goal of policy
and programme development should be to minimise the detrimental
effects of imprisonment, rather than exacerbate them.
So, what should policy networks around drug issues in prisons con-
centrate their efforts on in the future? Instead of defining drug use as a
‘prison problem’, it must be framed or defined as a problem located
outside the prison walls and linked to wider social issues including
poverty, deprivation, unemployment, racism, and sexism. Various
commentators argue that the real challenge to drugs and prisons must
come at the sentencing stage, rather than tinkering with regimes and
programmes. The emphasis must shift away from developing, accredit-
ing and auditing more and more drug programmes within the prison
system and towards developing and implementing strategies to divert
drug users from custody. The development of ‘real’ alternatives to
imprisonment, rather than another layer of punitive sanctions are
needed. Although the development of the Drug Treatment and Testing
Orders (DTTOs) hold promise in terms of diverting drug users from
custody, their coercive nature, the emphasis placed on testing and the
problems around inter-agency working need to be resolved if they are
to be true ‘alternatives’. The drug programmes which are developed
need to be holistic and address the structural constraints and practical
difficulties which prisoners face such as homelessness, poverty, debt,

unemployment, and childcare, rather than locating the causes of drug
use and offending within the individual. There is also a need to recog-
nise the diversity within drug using population and different
approaches to dealing with drugs. Moreover, as has been long recog-
nised by drug agencies and increasingly acknowledged by policy
makers, the throughcare of prisoners receiving drug treatment needs to
be properly co-ordinated and resourced. Prevention and treatment
need to be viewed along a continuum from the community to the
prison and back to the community.
The increasing interest in drug issues in prisons and subsequent
policy development have influenced the research agenda. The new
policies have generated both commissioned and independent research
on drug issues within the penal system. Compared with the first phase
of policy development in the early 1980s, there has been a prolifera-
tion of studies on drugs issues in prisons and the criminal justice
system. This interaction between research and policy illustrates the
complexity and reflexivity of the relationship between the two areas.
The political, economic and social context of research utilisation has
been important during this period of policy development. The domi-
nance of managerialism has influenced the types of research and
researchers which are favoured, commissioned and used by govern-
ment. The type of research which fits into this context focuses on the
‘management’ of the criminal justice system. It is generally quantita-
tive in the form of evaluations, audits and surveys, emphasises inputs,
outputs, throughputs, monitoring and efficiency, and produces statis-
tics or measures of performance and clear recommendations for action
and intervention (Pollitt et al., 1992). In the case of prison drugs
policy, the concern of much of the research has been on the rates of
positive MDTs and the incidence of switching to class A drugs. The
focus of future research is likely to extend to completion rates for treat-
ment programmes and recidivism rates. The emphasis has therefore
been on what happens rather than on the meanings, choices or behav-
iours associated with drug use or why prisoners begin or continue to
use drugs both within and outside custody. Moreover, research which
explores and probes the causes of drug use and crime and their wider
social, political and economic contexts would assist the policy network
in defining and framing the drugs problem and how it relates to the
prison system.
Policy analysis itself could also play an important role in the future
development of policy. By studying policy networks, we can better
Conclusions 167
understand the dynamics and contradictions within policy-making. As

Edwards (1990: 30) argues, ‘what needs to be more firmly acknowl-
edged is that policy analysis focused on drug dependency issues is
becoming a necessary tool for further policy development, rather than
being seen as mere academic diversion’. In the areas of drugs and crim-
inal justice, there is a need for research at the micro level, which exam-
ines the beliefs, values and ideologies of policy actors and how these
become influenced and altered when they become engaged in policy
networks. The focus could be on the biographies of key actors and how
their backgrounds, knowledge bases, beliefs and values interface and/or
conflict with the work and activities of policy networks. Connecting
this level of analysis with an examination of the ways in which the
global, institutional and internal contexts of policy-making shift and
impact upon one another would further illuminate the processes of
incorporation and issues around power, influence and dependence.
Appendix
Table A.1: All drug addicts1 notified to the Home Office by prison
medical officers by addict status 1981–96
New drug % of all Renotified % of all All drug % of

addicts notifications2 drug notifications addicts all
addicts3 notified notifications
19814 320 14 — — — —
1982 322 12 — — — —
1983 472 11 — — — —
1984 819 15 — — — —
1985 1 138 18 — — — —
1986 1 102 21 — — — —
1987 685 15 653 11 1 338 12
1988 689 13 622 9 1 311 10
1989 624 11 535 6 1 159 8
1990 730 11 690 6 1 420 8
1991 955 12 792 6 1 747 8
1992 1 268 13 1 318 9 2 586 10
1993 1 941 17 1 823 11 3 764 13
1994 2 080 15 1 843 9 3 923 12
1995 2 602 18 2 464 11 5 066 14
1996 3 665 20 3 269 13 6 934 16
Sources: Home Office Statistical Bulletins, Issues 6/92, 15/93, 10/94,17/95, 15/96, 22/97,
‘Statistics of Drug Addicts Notified to the Home Office, United Kingdom’, Tables 8a and 8b.
Notes: (1) The statistics relate to notifications under the Misuse of Drugs Regulations 1973,
which required doctors up until 30 April 1997 to send the details of people they
considered to have been addicted to any of the following 14 controlled drugs to the Chief
Medical Officer at the Home Office: cocaine, dextromoramide, diamorphine (heroin),
dipipanone (Diconal), hydrocodone, hydromorphone, levorphanol, methadone
(Physeptone), morphine, opium, oxycodone, pethidine, phenazoncine, and piritramide.
(2) The other sources of notifications include general medical practitioners, police
surgeons, and hospitals/treatment centres. (3) Full data on renotified addicts are available
for the years 1987 onwards. (4) Data on notifications by prison medical officers is only
available for the years 1981 onwards.
168
Appendix 169
Table A.2: Drug offenders and custodial sentences 1980–2000
Year Number of persons found Number Average sentence

guilty, cautioned or sentenced to length (months)
dealt with by compounding immediate
for drugs offences1 custody
1980 17 158 1 676 15.8

1981 17 921 1 931 17.0
1982 20 356 2 248 15.4
1983 23 442 2 819 17.9
1984 25 240 3 694 18.8
1985 26 958 4 535 19.2
1986 23 905 3 928 19.8
1987 26 278 3 939 20.9
1988 30 515 3 523 21.3
1989 38 415 3 855 23.6
1990 44 922 3 402 23.9
1991 47 616 3 268 21.6
1992 48 927 3 366 24.0
1993 68 480 4 835 23.3
1994 85 691 5 596 20.8
1995 93 631 7 086 21.1
1996 95 198 8 788 21.2
1997 114 627 10 580 22.8
1998 130 503 11 052 17.7
1999 120 777 11 428 20.2
2000 103 540 9 386 19.6
Source: Home Office Statistical Bulletins, Issues 18/84, 25/88, 10/98, 4/02, ‘Statistics of
Drugs Seizures and Offenders Dealt With. United Kingdom’.
Notes: (1) Drug offences include unlawful possession and trafficking (unlawful production
of drugs other than cannabis, unlawful supply, possession with intent to supply
unlawfully and unlawful import and export).
170 Appendix
Table A.3: Number of new and renotified drug addicts1 notified to the
Home Office and percentages addicted to heroin 1980–96
New drug % Renotified % All drug % addicted

Addicts addicted Drug addicted addicts to heroin
to heroin2 addicts3 to heroin notified
1980 1 600 72 — — — —
1981 2 248 74 — — — —
1982 2 793 76 — — — —
1983 4 186 66 — — — —
1984 5 415 91 — — — —
1985 6 409 93 — — — —
1986 5 325 91 — — — —
1987 4 593 89 6 123 83 10 716 86
1988 5 212 89 7 432 83 12 644 85
1989 5 639 87 9 146 83 14 785 84
1990 6 923 84 10 832 80 17 755 82
1991 8 007 79 12 813 68 20 820 72
1992 9 663 79 15 040 62 24 703 69
1993 11 561 78 16 415 60 27 976 68
1994 13 469 78 20 483 57 33 952 66
1995 14 735 79 22 429 58 37 164 66
1996 18 281 84 25 091 61 43 372 70
Sources: Home Office Statistical Bulletins, Issues 18/83, 25/88, 6/92, 10/94, 17/95, 15/96,
22/97, ‘Statistics of Drug Addicts Notified to the Home Office, United Kingdom’.
Notes: (1) The statistics relate to notifications under the Misuse of Drugs Regulations 1973,
which required doctors up until 30 April 1997 to send the details of people they
considered to have been addicted to any of the following 14 controlled drugs to the Chief
Medical Officer at the Home Office: cocaine, dextromoramide, diamorphine (heroin),
dipipanone (Diconal), hydrocodone, hydromorphone, levorphanol, methadone
(Physeptone), morphine, opium, oxycodone, pethidine, phenazoncine, and piritramide.
(2) Heroin addicts can be addicted to other drugs. (3) Full data on renotified addicts are
available for the years 1987 onwards.
Appendix 171
Table A.4: Annual average1 population in Prison Service establishments

in England and Wales by sex 1975–2000
Year Males Females Total
1975 36 601 1 219 37 820

1976 40 161 1 282 41 443
1977 40 212 1 358 41 570
1978 40 409 1 387 41 796
1979 40 762 1 458 42 220
1980 40 748 1 516 42 264
1981 41 904 1 407 43 311
1982 42 381 1 326 43 707
1983 42 072 1 390 43 462
1984 41 822 1 473 43 295
1985 44 701 1 532 46 233
1986 45 163 1 607 46 770
1987 46 722 1 704 48 426
1988 47 113 1 759 48 872
1989 46 736 1 764 48 500
1990 43 378 1 597 44 975
1991 43 250 1 559 44 809
1992 43 157 1 562 44 719
1993 42 991 1 561 44 552
1994 46 810 1 811 48 621
1995 48 983 1 979 50 962
1996 53 019 2 262 55 281
1997 58 439 2 675 61 114
1998 62 194 3 105 65 298
1999 61 523 3 247 64 771
2000 61 252 3 350 64 602
Sources: Home Office, Prison Statistics, England and Wales 1985, 1989, 1994, 2000.
Notes: (1) Figures on the prison population are based on counts of prisoners at Prison
Service establishments. These counts are usually made on the last day of the month. The
annual average population is an average for the monthly returns.
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abrupt withdrawal, 6, 48, 49, 77 Anti-Drugs Co-ordination Unit, 13,

abstinence-based policy, 38, 58, 86, 129, 134
92, 109, 119, 154, 160, 164; Anti-Drugs Co-ordinators, 124, 126–7,
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Advisory Council on the Misuse of attitudes to drug use: effect of
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103, 109, 110–11, 112, 119; drug
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guidelines, 79, 117; on HIV Berridge, V., 4, 5, 10, 17, 38, 48, 58,
education in prisons, 82–3, 110; 59, 60, 61
HIV/AIDS reports, 58–9, 61, 62, 82, Blair, Tony see New Labour
85, 159; prevention advice, 38; Blunkett, David, 130
Treatment and Rehabilitation body searches, 6, 106
group, 43 boredom: escape from, 70, 101
Advisory Council on the Penal Bottoms, A. E., 95
System, 40 Bramley, G., 7
Advisory Group for Drug Education: Breaking the Vicious Circle (policy
Caring for Drug Users, 75, 76–9 document), 126
aftercare services, 6, 51–3, 76, 117, Bristol prison, 81
128, 137; Parole Release Scheme, British Medical Association (BMA), 114
51–2, 78 Brittan, Leon, 35, 41
agencies: Prison Service as, 97–8; see Burrows, J., 145
also drug agencies; interagency
working cannabis, 2, 101, 102, 104; collusion
AIDS see HIV/AIDS issues over use, 45–6, 54, 68, 113–14, 135;
AIDS Advisory Committee (Prison and mandatory testing, 111, 112,
Service), 81, 82, 86–7, 109–10 135, 139; reclassification, 130
‘AIDS: Information for People in ‘carceral clawback’, 164
Prison’ (training package), 82 Caring for Drug Users (guidelines), 56,
‘AIDS Inside’ (training package), 82 75, 76–9, 87
‘AIDS: Inside and Out’ (training ‘caring’ measures, 6; see also
package), 82 treatment
Akhter, Dr, 49 Carlen, P., 97, 106, 112, 164–5
alcohol in prison, 100, 137–8 cautions for drug offences, 68, 96;
anti-drugs campaigns, 37 ‘caution plus’ schemes, 128
194
Index 195
Cavadino, M., 66 condom distribution, 59, 84–5, 109,

Cavanagh, M., 27 110
CCTV monitoring, 6, 105, 106, 141 confidentiality issues, 47, 80, 81, 108
cell searches, 6, 106 Conservative governments:
Central Drugs Co-ordination Unit commodification of research, 19;
(CDCU), 13, 93–4, 129, 159 drugs policy, 2, 23, 31–9, 89–123,
Central Funding Initiative (CFI), 36, 155, 161; New Right ideology and
59 policy, 21–2, 153; penal policy,
Centre for Criminological Research, 39–42, 60, 63–7, 89, 95–8, 130,
Oxford, 135 157–8; public policy in 1980/90s,
characteristics of drug users, 13, 43–4 56–7, 59–60, 155
civil servant interviews, 27, 28; on contracting out of prison services, 22,
denial of drugs problem in prisons, 63, 115–16
49–50, 68; on destabilising control: control activities, 6, 11, 69;
influence of drugs, 99, 100, 107; on and framing of drugs problem in
firefighting approach to policy, prisons, 98–102, 119, 125, 148–9,
156; on harm minimisation, 84, 86, 150, 157–8; mandatory drugs testing
143; on HIV issues, 73, 79; on as, 104, 119–21, 135–6; medical vs
mandatory testing, 105, 119, 120, penal control, 3–4, 5, 44–6, 47–9, 54;
121, 138–9; on patchy treatment research on, 3–4; and routine use of
provision, 117 drugs in prison, 68–9; see also
Clarke, Kenneth, 95 medical control; penal control
class, 13; and prison conditions, 15, Controlled Drug (Penalties) Act
48 (1985), 37
class A drugs: and drug testing, 111, correctionalist ideology, 154
112, 135, 139, 148; reclassification, Council of Europe: AIDS study, 71
130; see also cocaine; heroin counselling, 6, 33, 76, 78, 117, 137;
classification: of drugs, 130; of see also therapy
offenders, 4, 119–20, 141, 156–7 Counselling, Assessment, Referral,
cocaine use, 57, 60, 128 Advice and Throughcare Service
coerced treatment, 6, 146–8, 163; see (CARATS), 144–5, 157, 162, 163
also mandatory drug testing; courts: drug courts, 21, 126, 132–3,
voluntary drug testing 154; managerialism in, 22
Coffey, A., 26 crack cocaine, 57, 60
Cohen, S., 150 Cranstoun Project, 116
‘cold turkey’ see abrupt withdrawal Crime and Disorder Act (1998), 131,
Coleman, W., 11 147
Collison, M., 60 ‘crime and drugs link’: drug treatment
commodification of research, 19 and testing orders, 132–4, 147, 148,
communities: comparative 154, 165; impact on policy, 92–3,
conditions, 15, 48, 161; involve- 100–1, 126, 128, 158, 165, 166
ment in drug policies, 22–3, 61–2, Crime, Justice and Protecting the Public
115, 116; protection of, 128; ‘pun- (White Paper), 63
ishment in the community’, 42, 63, Criminal Justice Act (1991), 63, 64–5,
64–5, 96, 148 95
Community Drugs Project, 49 Criminal Justice and Court Services
community service, 41, 42, 63, 96 Act (2000), 148
Comprehensive Spending Reviews criminal justice system: enforcement of
(CSRs), 128, 138 national drugs strategy, 37–8, 125;
196 Index
HIV issues, 61, 84; managerialism in, Downes, D., 64, 95

22, 42, 63, 95, 131, 155, 166; New Downview prison, 115, 139
Labour reforms, 131–2; in Drew, Phillipa, 113–14
partnership initiatives, 62; Thatcher Drug Action Teams (DATs), 22, 94,
reforms, 32; treatment 117, 129, 138
interventions, 64–5, 92, 114, 146–8; drug addicts: in prison, 1–2, 67, 99,
see also penal policy 168, 170; statistics on, 1, 34, 57, 90;
criminological research, 19, 24, 36 terminology, 33
Cross, M., 57 drug advisory committees see District
culture: of drugs in prison, 99–100; of Drug Advisory Committees
Prison Service, 129 drug agencies, 2, 13, 33, 34, 164; and
Curran, Len, 72, 73, 83, 85 coerced treatment, 146–8; HIV
Currie, Elliot, 154–5 work in prisons, 70–1; inability to
custodial sentences, 169; ‘positive cope with demand, 118, 133;
custody’ concept, 40; reduction in increased funding in 1980s HIV
1980s, 41, 42, 52, 63, 64–5, 68; crisis, 59–60, 71; individualised
treatment as alternative to, 133, approach, 98, 102, 108, 160;
165–6 interviews with, 27, 28, 44, 46, 53,
Custody, Care and Justice (White 67, 68, 71, 75, 78, 81, 86, 93, 101,
Paper), 66 109, 113, 115–16, 118, 121, 141,
Cutler, T., 22 147–8, 149, 160; involvement in
release arrangements, 51–2, 53, 55,
Dade County see Miami drug courts 109, 159; limited access to prisons,
decentralisation of Prison Service, 76; loss of autonomy, 146, 150,
97–8 161, 162–5; partnership working,
Dedicated Search Teams, 106 61–2, 70–1, 77–8, 126, 129, 145–6,
deinstitutionalisation, 42 150, 162; in policy networks, 158,
demand for drugs: policy to reduce, 159, 160, 161, 162–4; and prison
103; see also supply of drugs drugs strategy 1995, 107–8, 118,
Denselow, Robin, 74 162
Department of Health, 2, 4, 62, 94, drug courts, 21, 126, 132–3, 154;
117, 142 shortcomings of UK system, 132–3
detoxification, 6, 11, 77, 142–3 drug dealers, 37; in prison system,
deviance, 14, 15, 43 99–100, 101, 106–7; see also drug
Dignan, J., 66 offenders
Directorate of Health Care, 114, 117, ‘drug dependants’, 33
120, 138, 159–60 drug dependency units, 32–3
Directorate of Prison Medical Services drug-free wings, 6
see Prison Medical Service Drug Misuse in Prison: Policy and
Directorate of Regimes, 138 Strategy (policy guidelines), 103–10
discipline, 47 drug offenders: enforcement of
District Drug Advisory Committees national drugs strategy, 37; increases
(DDACs), 33, 61–2, 78, 94 in, 1, 34, 90–1, 99; sentencing and
district health authorities, 71, 94 punishment, 64–5, 100–1, 163;
documentary analysis, 25–7 statistics on, 57, 67–8, 99, 169; see
dogs see sniffer dogs also drug dealers; drug traffickers
Dolan, K. A., 73 drug prevention teams, 61–2
Dorn, N., 37 Drug Reference Groups (DRGs), 94,
Dowding, K., 113 129
Index 197
drug services: accessibility, 59, 60, shift in attitudes towards, 43–4;

102, 137; development of, 36–7, supply networks, 101–2, 105–7,
53; impact of HIV on, 59–60, 61–2; 142; violence and intimidation, 84,
prison drug services model, 78–9, 99, 100, 102, 106–7; see also
115–16; see also drug agencies; high-risk behaviour; mandatory
treatment drug testing; research on drug use
drug testing see drug treatment and in prison; treatment
testing orders; mandatory drug drugs policy see national drugs
testing; voluntary drug testing strategy; prison drugs policy
drug traffickers, 64, 100–1; Drugs Prevention Advisory Service
confiscation of assets, 37, 38, 128; (DPAS), 130
enforcement of national drugs Drugs Strategy Unit, 138, 160
strategy, 37–8; harsher penalties in drugs tsars, 124, 126–7, 129, 134, 154
1980s, 65; in prison, 79, 99–100,
101–2, 106–7; see also drug Edelman, M., 60
offenders education of drug users, 59, 82–3,
Drug Trafficking Offences Act (1986), 109, 110, 117
37 Edwards, G., 167
drug treatment centres, 49, 51, 71, ‘end of denial’, 67, 68, 87
102; see also drug agencies; enforcement of drugs policy, 36,
treatment 37–8, 92, 125, 158; see also control;
drug treatment and testing orders security issues
(DTTOs), 132–4, 147, 148, 154, enlightenment research model, 18,
165; evaluation of, 133–4 29, 74
drug use in prison: acknowledgment escapes from prison, 39, 96, 100,
of ‘problem’, 8, 42–4, 49–51, 54, 118–19
67–9, 70–1, 72–3, 83, 87, 152–3; ethnicity see race issues
availability of drugs, 45, 101–2, European Court of Human Rights, 8
105–7, 128; as classificatory risk European Network of Drug and
factor, 4, 119–20, 141, 156–7; and HIV/AIDS Services in Prison, 116
conditions of confinement, 101; European Union: drug use in prison,
control of access to drugs, 79; as 1–2
control measure, 44–6, 54, 69, 157; Everthorpe prison, 96
culture of, 99–100; framing of evidence-based practice, 128
‘problem’, 6, 13–16, 26, 67–75, 90, Exeter Drugs Project, 78
98–102, 125–6, 151–67; HIV issues, expenditure see funding
61, 69–75, 92, 143, 158; illegality
issues, 100, 130; impact of family of prisoners see visitors
mandatory drug testing, 135; Feeley, M. M., 4–5, 119–20
increase in 1980s, 43–4, 68–9; and Feltham Young Offenders Institute,
informal economy, 69, 84, 99–100; 50
initial assessments, 47–8; official fieldwork see semi-structured
rates, 1–2, 67, 99, 135, 168, 170; interviews
patterns of, 2; and policy see prison Fitzgerald, M., 39, 40, 94
drugs policy; pre-existing use, 1, 2, ‘frame shifts’, 16
73; profile of drug user, 2; reasons framing drug problems, 6, 14–16, 26,
for, 2, 101; reconceptualisation in 67–75, 90, 98–102, 125–6, 151–67
1980s/90s, 67–75; responses to Fresh Start initiative, 63, 155
‘problem’, 75–87, 103–23, 137–46; friends of prisoners see visitors
198 Index
funding: CFI, 36, 59; cut for Hewitt, A., 140

therapeutic units, 50; for drugs high-risk behaviour, 2; homosexual
control enforcement, 92, 117; for activities, 70, 73, 84–5;
HIV policies, 59–60, 71; lacking for needle-sharing, 70, 73, 74, 85, 143;
treatment programmes, 117–18; for research evidence, 72–5; see also
mandatory testing scheme, 2–3, 117; HIV/AIDS
for national drugs strategies, 36, 128, Hill, M., 7, 8–9
138; for pilot drug treatment HIV/AIDS, 11, 56–88; as catalyst for
programmes, 114, 118; for policy development, 56, 58, 69–75,
prevention and treatment, 3, 128; 87, 152; harm minimisation
for voluntary testing units, 140 policies, 57–61, 83–7, 108–10, 158;
ignored by 1995 prison drugs
Garland, David, 20–1, 23, 154 strategy, 108, 158; infection in
gender, 13; see also women mid-1980s, 57–8, 69; involvement
general practitioners, 33, 34 of outside agencies, 70–1; panic by
generalist approach to work with drug prison staff, 79–80; and
users, 34, 36–7, 52, 59 reconceptualisation of drugs
Gillick v. West Norfolk, 85 problem, 69–75, 159; research
Glenochil prison, 110 evidence, 72–5, 143; response to
global policy context, 21, 153–5, 167 problem, 75–87; stigmatisation of
Gordon, I., 7 sufferers, 81; superseded by ‘drugs
government see Conservative and crime link’ in policy, 92;
governments; New Labour testing of prisoners, 80; see also
Grendon Psychiatric Prison, 50 high-risk behaviour
Gunn, L. A., 8, 9 HM Inspectorate of Probation, 78, 79
HM Prison Service see Prison Service
Ham, C., 8–9 Hogwood, B. W., 8, 9
harm minimisation policies, 6, 11, 38, Holloway prison: Holloway
57, 58–61, 83–8, 91–2, 115, 164; Therapeutic Unit, 50; strip
prison drugs strategy 1995, 103, searches, 106
108–10, 158; prison drugs strategy Home Affairs Select Committee, 2,
1998, 142–4 130, 141, 159, 163–4
Health Advisory Committee for the Home Office, 4, 13, 53, 94, 159;
Prison Service, 137–8 influence on policy, 95–6; links
health authorities, 71, 94 with pressure groups, 40
Health Care Service for Prisoners, 66–7 Home Office Drugs Prevention
Health Care Standard 8, 109, 142; Initiative, 61–2
revised edition, 142–3 Home Office Drugs Strategy
Heclo, H., 46 Directorate, 13, 129–30
Hellawell, Keith, 127 homosexual activities in prison, 70,
Hepatitis C, 110, 143 72, 83, 84–5, 110
heroin, 2, 102, 128, 170; House of Commons Social Services
acknowledgment of use in prisons, Committee, 33, 159; misuse of hard
68; anti-heroin campaigns, 37; drugs report, 43, 45–6, 49, 50–1,
decrease in use in 1970s, 32–3; 52–3; Prison Medical Service report,
‘heroin epidemic’ of 1980s, 34–5, 43, 44–5, 47, 48, 52–3
57; increase in use in 1990s, 90; Howard, Michael, 23, 95, 96, 97, 115,
and mandatory drug testing, 111, 116, 119, 149, 157
112, 135; on prescription, 17 Howard, Roger, 62
Index 199
Howard League for Penal Reform, 64, intimidation in prison, 84, 99, 100,
111 102, 106–7
Hudson, B., 20, 64
Jenkins, W. I., 7
ideology, 13 Jerwood Award, 115
illegal activities in prison, 84–5, 100, joint working see interagency
130 working; partnership initiatives
incapacitative policies, 95–6 Jones, T., 21
Independent on Sunday, 29 ‘just deserts’ approach, 39, 54, 63, 64,
individualised approach to policy, 4, 96, 157
98, 102, 108, 160 ‘justice’ concept, 65–6
informal prison economy, 69, 84, juvenile offenders, 42, 112, 131
99–100
injecting practices: harm key performance indicators (KPIs), 98,
minimisation policies, 58–61, 143; 103, 105, 113
high-risk behaviour, 2, 70, 73, 143; Kilgour, John, 80
HIV cases in mid-1980s, 57–8, 72; Killen, Sue, 130
see also HIV/AIDS Killer Inside, The (TV documentary), 74
Inquest, 40 knowledge-driven research model, 16
‘institutional embedding’, 15, 160
‘institutionalised collusion’, 46, 49, Labour government see New Labour
54, 113–14, 135 Lart, R., 23
institutionalist approach, 12–13, 15, Learmont Report, 95, 96, 100, 105–6,
160 118–19, 136, 157–8
intelligence gathering, 6, 105, 106, Lee, M., 64–5
141 legalisation debate, 29, 130
interactive research model, 16–17, 74 legitimacy debate, 39, 42, 64, 65–6
interagency working, 22–3; ‘less eligibility’ discourse, 15, 48, 77
Anti-Drugs Co-ordinator, 127; Lewis, Derek, 97, 104
CARATS scheme, 144–5; for drug local drugs strategies, 103, 109, 112,
testing and treatment orders, 117
133–4, 147, 148, 165; for effective local partnerships, 131
treatment, 33–4, 144–5; national London Research Centre, 62
drugs strategy 1985, 36–7; national Lowthian, J., 157
drugs strategy 1995, 93–5; and
policy formation, 38; in McCaffrey, Barry, 126
preventative policies of 1980s, 59, McClelland Report, 58
60, 61–2; prison drugs strategy MacGregor, S., 5, 20
1998, 138, 144–6, 150; in Prison macro policy context, 21, 153, 155–7
Service, 62, 67, 70–1, 76–7, 77–8, Maden, A., 102
129, 150, 164–5; release maintenance prescribing, 6, 17, 48,
arrangements, 51–2, 55, 109, 159; 109; as control mechanism, 44–5,
see also partnership working 54, 105; denied to prisoners, 77;
intermediate treatment, 42 inconsistency of practice, 142–3;
internal policy context, 20, 153, limitations of, 33; as preventative
158–60, 167 measure, 59
intertextuality, 26 Major government, 89–123, 157–8
interviews see semi-structured managerialism, 4–5, 21–3, 56–7, 90,
interviews 155–6; in criminal justice system,
200 Index
22, 42, 63, 95, 131, 155, 166; National Association for the Care and
influence on research, 166; in Resettlement of Offenders
national drugs strategy, 91, 125, (NACRO), 52, 53, 64, 159
128, 155; in Prison Service, 42, 63, National Association of Probation
90, 98, 119–20, 155 Officers (NAPO), 45–6, 64, 76
mandatory drug testing (MDT), 2–3, National Drugs Intelligence Unit
6, 11, 90, 96, 103–5; campaigns (NDIU), 37
against, 111–14, 162; as control national drugs strategy: 1985, 35–9,
mechanism, 104, 119–21, 135–6, 60, 158; 1995, 91–5, 103–23, 118,
148, 156–7; evaluation of, 125, 134, 158, 162; 1998, 29, 127–50; see also
135–6; flexibility of 1998 prison prison drugs strategy
drugs strategy, 139, 140; as policy National Health Service (NHS), 50, 142
priority, 4–5, 149–50; policy National Local Authority Forum on
transfer from US, 21, 104, 154; and Drug Misuse, 62
treatment referral, 104, 105, 107–8, National Prisoners Movement (PROP),
113–18, 126, 132–4, 138–9; and 39–40, 44
voluntary testing, 140–1 National Treatment Agency, 130
marginalised groups, 89 National Treatment Outcome
Marsh, D., 9 Research Study (NTORS), 92
mass imprisonment, 154 needle exchange schemes, 58, 84, 85
May Report, 40 needle-sharing, 70, 73, 74, 85, 143
media, 2, 29, 95; anti-heroin nested contexts, 19–24, 153–61
campaigns, 37; and drugs tsars, 126, networks see policy networks
127; and HIV awareness, 73–4; and new institutionalism, 12–13, 23
supply reduction measures, 106 New Labour: drugs policy, 2, 23–4,
Medical Committee Against the Abuse 29, 124–150, 155, 161; penal
of Prisoners by Drugging, 44 policy, 125, 130–4
medical control, 3–4, 5, 44–6, 47–9, new public management, 21–2, 155
54, 69, 157 New Right ideology, 21–2, 31–2, 153
medical model in drugs policy, 34, Newburn, T., 21
38, 48, 49–50, 59, 85 Next Steps agencies, 22, 155
methadone prescribing, 17, 59, 109, ‘nothing works’ doctrine, 17
142–3; accelerated withdrawal in
prison, 77 official documents, 25, 26
Miami drug courts model, 126, 132–3, OPCS survey, 102
154 opiate drugs, 2, 112, 135; see also
micro-level policy context, 160, 167 heroin
Ministerial Subcommittee on the overdose: deaths in prison, 45; release
Misuse of Drugs, 93 risk, 51, 78
Morgan, R., 25, 64, 96
Morris, T., 40 Panorama (TV series), 74
Morrissey, C., 73, 85 Parkhurst prison, 96, 100, 118
Mountbatten Report, 39 Parole Release Scheme (PRS), 51–2,
mules see drug traffickers 53, 78, 158
multi-agency working see interagency parole restrictions, 41, 51
working partnership working, 22–3, 61–2,
77–8, 129, 158, 162–3; New
National Addiction Centre, London, Labour’s local partnerships, 131;
135 prison drugs strategy (1998), 138,
Index 201
145–6; shortcomings of, 62, 129, framing of policy discourse, 14–24,

146, 165; see also interagency 153–67; ‘second generation’
working problems, 125; see also national
PDM Consulting Ltd, 114, 136–7 drugs strategy; prison drugs policy
Pearson, G., 23, 38, 45, 84 policy analysis, 8–9, 29, 153–67; and
Pearson, Tony, 113–14 policy formation, 166–7
Penal Affairs Consortium (PAC), 63–4, policy communities, 10, 38, 40, 113
111 policy content, 8, 26
penal control, 3, 4, 5, 39–40, 96, 119; policy convergences, 20–1
compromised by drugs in prison, policy feedbacks, 23–4, 124, 161
100–1, 148–9; through medication, policy networks, 5–6, 9–13, 151–67;
44–6, 54, 157 and aftercare services, 51–3, 55;
penal policy: and ‘crisis’ context, changes in composition of, 158–60;
39–42, 54, 63, 157; global context, critique prison drugs strategy, 90,
153–5; hardline shift under Major, 110–18, 119, 121–2, 122–3, 125,
95–8, 130, 157–8; managerialism 159; critiques of, 11; framing of
in, 4–5, 42, 63, 90, 95, 119–20, 125, drugs problem in prison, 99,
131, 155–6; New Labour’s ‘tough 151–67; and HIV/AIDS policies, 71,
on crime’ policies, 125, 130–34; 74, 159; new treatment framework,
‘nothing works’ doctrine, 17; policy 145–6; and prison drugs policy,
networks approach, 10–11; populist 11–12, 26, 71, 74, 150, 151–2,
approach, 95, 124, 125, 130, 162; 161–2; in research, 16, 27, 28; see
reform attempts in 1980s/90s, also drug agencies; penal reform
63–7; and social policy, 20; see also groups
criminal justice system; Prison policy process, 8
Service; prisoners; prisons; policy spillovers, 20
punishment/treatment dichotomy policy subsystems, 19–24, 26–7
penal reform groups, 13, 40–1, 63–4, policy transfers, 20–1, 90, 115, 116,
71, 97; interviews with, 27, 28, 69, 123, 147; drug courts, 21, 126,
71, 97, 100, 122, 146, 147, 156; in 132–3, 154; drugs tsars, 124, 126–7,
policy networks, 159, 160, 161 154; as global trend, 154; mandatory
Pentonville prison, 50 drug testing, 21, 104, 154
performance evaluation, 98, 103, 105, policy universe, 10
113, 119–20, 128, 155; of drug political research model, 17
supply reduction, 142; of polydrug users, 33, 90–1
mandatory drug testing, 125, 134, ‘populist punitive’ approach, 95, 124,
135–6; prison drugs strategy 1995, 125, 130, 162
125, 134–7, 156–7; research style, ‘positive custody’ concept, 40
166; of treatment provision, 125, Power, R., 37
136–7, 157 prescription drugs: as control
Phoenix House, USA, 115, 116 mechanism, 44–6, 54, 69, 105, 157;
pilot drug treatment programmes, see also maintenance prescribing
114–16, 118, 134, 136–7, 142, 162 pressure groups see drug agencies;
Police Foundation, 130 penal reform groups
policing of drugs, 37–8 prevention: anti-heroin campaigns,
policy: absence of policy, 8, 31; 37; co-ordination for effectiveness,
contexts of research, 19–24, 26–7, 166; funding for, 128; harm
153–61, 167; definitions of, 7–8; reduction strategies, 38, 57, 58–62,
evidence-based practice, 128; 83–7, 91–2, 108–10
202 Index
Prison Department: denial of drugs distribution, 85; HIV research,

problem, 50–1, 67; implicit policy 72–5, 143; HIV testing, 80; reforms
on drug use, 31; see also Prison of 1992, 66–7; throughcare
Service guidelines, 75–6, 77–8, 159; use of
prison drugs policy: abstinence-based drugs to control prisoners, 44–6,
approach, 86, 92, 109, 114–15, 119, 54, 69, 157
164; AIDS education, 82–3, 109, Prison Officers Association, 64, 79–80
110; ‘crisis of invisibility’, 94–5; Prison Ombudsman, 135–6
early policy documents, 56; Prison Reform Trust (PRT), 40, 64
evaluative research on, 3, 125–6, Prison Service, 13, 114, 117, 120, 138;
134–7, 166; framework for research, acknowledgment of drug ‘problem’,
7–24, 151–67; harm minimisation, 8, 42–4, 49–51, 54, 67–9, 70–1, 83,
84–7, 108–10, 142–4, 158; 87, 152–3; agency status, 97–8, 155;
historical development, 5–6, 49–55, collusion over drug use, 45–6, 49,
155–6; HIV/AIDS: as catalyst for 54, 67, 113–14, 135; contracting out
explicit policy, 56–7, 69–75, 87; of services, 22, 63, 115–16;
HIV/AIDS: responses to ‘problem’, Corporate Plan, 98, 103; Dedicated
75–87; implicit policy, 31; Search Teams, 106; Drug Misuse in
individualised approach, 4, 98, 102, Prison, 103–10; education and
108, 160; influence on national training in HIV/AIDS and drug use,
drugs policy, 146, 150, 161; 82–3, 108, 137; evaluative research,
institutionalist approach, 12–13, 3, 112, 125–6, 134–7, 166; Health
15, 160; involvement of outside Advisory Committee, 137–8; and
agencies, 62, 67, 70–1, 78, 94–5, HIV/AIDS crisis, 69–72, 79–87;
162–5; lack of consultation, 111, illegality issues, 84–5, 100, 130;
162; managerialist influence, industrial action, 40, 79–80; and
155–7, 166; national strategy 1995 informal economy, 69, 84;
see prison drugs strategy; omitted involvement with outside agencies,
from national strategy, 37–8, 158; 62, 67, 70–1, 108, 129, 138, 150,
phases of, 30, 151; policy contexts, 158, 162–5; management of
57–62, 153–67; policy networks, HIV-infected prisoners, 79–81;
11–12, 26, 71, 74, 150, 151–2; managerialism in, 42, 63, 90, 98,
policy responses, 75–87, 103–23, 119–20, 155; and national drugs
137–46; pressures for official policy strategy, 93, 103–23; and policy
formation, 31–55; prison drug formation, 2, 159–60; policy
services model, 78–9, 115–16; networks role, 158–60; prison drugs
‘prison works’ agenda, 97–8, 157–8 strategy review, 134–7; reforms in
prison drugs strategy: 1995, 29–30, 1980s, 63; resistance to treatment
89, 103–23, 155–7, 158, 162; paradigm, 108; Security group, 120,
evaluation of 1995 strategy, 125–6, 138, 159–60; Statement of Purpose,
134–7, 152; question of balance, 91, 121–2; structural divisions, 120,
90, 96, 103, 110, 118–23, 125–6, 138, 159–60; throughcare policy, 56,
138–9, 163–4; revised 1998 75–6, 77–8, 87, 117, 159; and
strategy, 125, 137–46 treatment framework, 3, 108,
prison governors, 76, 97 114–18, 144–6; see also Directorate of
Prison Governors Association, 64 Health Care; Prison Medical Service
Prison Medical Association, 45 ‘prison works’ agenda, 96, 97, 157–8
Prison Medical Service (PMS), 43, prisoners: attitudes to drug use, 43–4;
47–9, 53, 159; condom awareness of treatment services,
Index 203
102; HIV-infected prisoners, 79–81; public protection, 154

increases in prison population, ‘punishment in the community’, 42,
39–40, 41, 42, 95, 130–1; measures 63, 64–5, 96, 148
to reduce prison population, 41, Punishment, Custody and the
42, 52, 63, 130, 131; view of Community (Green Paper), 63
mandatory drug testing, 135–6; see punishment/treatment dichotomy, 6,
also drug offenders; juvenile 13, 48, 54, 60, 108, 149–50, 162;
offenders; remand prisoners; balance in policy, 90, 96, 103, 110,
women’s prisons/women prisoners 118–23, 125–6, 138–9, 163–4; and
prisoners’ rights movements, 39–40, drug testing, 120, 140–1
40–1
prisons: comparative conditions and race issues, 13, 65, 112, 137
outside community, 15, 48, 161; Ralli, Roger, 78
crisis contexts, 39–42, 54, 63, 96, random searches, 6, 105, 106, 136
100–1, 157; drug use as escape from random testing see mandatory drug
conditions, 101; escapes, 39, 96, 100, testing
118–19; informal economy, 69, 84, recidivism and drug use, 137, 145,
99–100; legitimacy debate, 39, 42, 166, 170
64, 65–6; new build programmes, reclassification of drugs, 130
41, 96; riots, 39–40, 63, 65; Woolf rehabilitation, 4, 33, 36, 42, 117;
inquiry recommendations, 65–6; see ineffectuality of, 17, 63, 64; prison
also penal policy; Prison Service; drugs strategy 1995, 103; see also
prisoners treatment
privatisation in prisons, 63, 155 Rehabilitation for Addicted Prisoners
privileges, 6, 96, 136, 139, 140 (RAPt), 115, 127, 139
Probation Service, 62, 71, 79, 148; Rein, M., 14, 15, 19–20, 23, 153
commissioning role in treatment, Reiner, R., 57
64–5; drug treatment and testing release arrangements, 11, 51–3, 109,
orders, 132–4; throughcare 117, 158, 159; education on
guidelines, 76, 77–8, 159 HIV/AIDS, 82, 110; overdose risk,
‘problem drug takers’, 34, 38, 48, 90; 51, 78; see also aftercare services
as definition, 33; as targets for remand prisoners, 2, 48–9, 117
treatment, 128 repeat offenders, 4, 128, 132–3
problem-solving research model, 16, research contexts, 19–24, 26–7,
17 153–61
professional associations, 13, 71, 159, research on drug use in prisons: on
161; harm minimisation conflict, control issues, 3–4; design and
58; interviews with, 27, 28, 71–2, methodology, 24–30; documentary
74, 102, 104, 108, 113 analysis, 25–7; framework for,
Protecting the Public (White Paper), 96 7–24, 153–67; on HIV and drug use,
proximate policy context, 20, 153, 71, 72–5, 143; limitations on, 3, 24,
157–8 45–6, 72, 153; and policy
psychiatry in prisons, 50 formation, 166; on recidivism rates,
public expenditure see funding 137, 166, 170; semi-structured
public health policies, 38, 57–62 interviews, 27–30
public information: AIDS campaign, research utilisation, 16–19, 74, 166
82; anti-heroin campaigns, 37 Rhodes, R. A. W., 9, 160
public opinion, 95, 124, 125, 130, riots, 39–40, 63, 65
162 risk see high-risk behaviour
204 Index
risk management, 154 social constructionism, 14

risk reduction measures see harm social control of drugs, 3–4
minimisation policies social deprivation, 35, 127–8, 131–2,
Rock, P., 21, 95 165–6
Rolleston Committee, 5, 48, 77 social model of treatment, 34, 48
Ross, M., 77 social policy and penal policy, 20,
Rothschild Report, 19 131–2
Royal College of Psychiatrists, 47, 49 Social Services Committee see House
Ruggiero, V., 101 of Commons Social Services
Runciman, Ruth, 61 Committee
Ryan, M., 160 South, N., 38
Sparks, R., 63, 69, 100
Sabatier, P., 29 Spear, B., 25
sanctions, 6; see also privileges Spector, M., 125
Saughton prison, 74 Stafford prison, 74
Schon, D., 14, 15, 19–20, 23, 153 Standing Conference on Drug Abuse
Scott, J., 25 (SCODA), 33, 51–2, 53, 159
searches see random searches statistics: documentary analysis, 25–6
‘second generation’ problems, 125 sterilisation provision, 109, 110, 143
Security Group, 120, 138, 159–60 Stimson, G. V., 23
security issues, 6, 11, 79, 90, 110, 125; Stoke Heath Young Offenders
escapes, 39, 96, 100, 118–19; and Institute, 106
supply reduction, 105–7, 108, 119, Strang, J., 143, 144
128, 136, 141–2 Straw, Jack, 130–1, 142
Seddon, T., 120 strip cells, 77
self-harm: HIV risk, 70 strip-searching, 106
sentences, 169; alternatives to, 42, Styal prison, 119
133, 165–6; Criminal Justice Act suicide: HIV risk, 70
framework, 64; for deterrence, supply of drugs: networks in and out
96–7, 131; global context, 154; of prison, 101–2, 142; policy to
increases in 1980s, 37, 38; reduce, 103, 105–7, 108, 119, 128,
mandatory minimum sentences, 1, 135, 136; target of 1998 national
96; parole restrictions, 41; sentence drugs strategy, 128, 141–2
planning, 117; to reduce prison surveillance, 39; see also CCTV
population, 41, 42, 52, 63, 64–5, monitoring
68; treatment stipulations, 63–4, syringe exchanges, 58, 59
92; see also drug treatment and
testing orders Tackling Drugs to Build a Better Britain
Sexual Offences Act (1956), 84 (policy document), 127–30
‘shooting galleries’, 58 Tackling Drugs Together, 91–3, 118,
short sentence prisoners, 41, 117 124, 127, 129
Sim, J., 39, 40, 47, 94 tactical research model, 17–18
Simon, J., 4–5, 119–20 target setting see performance
Skocpol, T., 12, 23 evaluation
Smart, C., 4 Tarling, Roger, 95–6
Smith, G., 18 tattooing: HIV risk, 70, 73
Smith, M. J., 12–13 testing: for HIV, 80; see also
sniffer dogs, 6, 45, 105, 106 mandatory drug testing; voluntary
snowball sampling, 28 drug testing
Index 205
Thatcherism, 21, 31–55, 89 maintenance prescribing;

therapy/therapeutic communities, 33, withdrawal programmes
50, 76, 78; see also counselling Tumin, Judge Stephen, 65, 71, 119
Thom, B., 17 Turnbull, P., 80
Thomas, P. A., 72
throughcare services, 6, 51–3, 117, 128, UK Anti-Drugs Co-ordination Unit,
137, 166; Parole Release Scheme, 13, 129, 134
51–2, 158; policy guidelines, 56, unemployment and ‘heroin
75–6, 77–8, 87, 159 epidemic’, 35
Tizard, B., 17, 18 United Nations Convention Against
Trace, Mike, 82, 127 Illicit Traffic in Narcotic Drugs and
training in HIV/AIDS and drug use Psychotropic Substances (1988), 37
issues, 83, 108, 137 United States: crack cocaine crisis, 57,
tranquillisers, 44–6 60; rates of drug use in prison, 1;
treatment, 11; abstinence-based ‘War on Drugs’ failure, 1, 154–5; see
approach, 114–16; access and also policy transfers
awareness of prisoners, 102, 137; unsafe behaviour see high-risk
area-wide services, 144–5; changes behaviour
in approach in 1970s, 33, 36, 40;
coerced treatment, 6, 146–8, 163; violence and drug use in prisons, 84,
criminal justice interventions, 99, 100, 102, 106–7
64–5, 92, 114, 146–8; drug Viral Infectivity Restrictions (VIR),
treatment and testing orders, 80–1, 87
132–4, 147, 148, 154, 165; visitors and drug supply, 6, 101–2,
evaluation of provision, 125, 106–7, 136, 141–2
136–7, 157; funding for, 3, 92, 114, voluntary drug testing, 117, 126,
117–18, 128; lack of provision in 139–41, 149–50, 163
1995 prison drugs strategy, 107–8, voluntary sector see drug agencies
120, 122–3, 162; and less-eligibility
discourse, 48, 77; mandatory drug Waine, B., 22
testing referrals, 104, 105, 107–8, Wandsworth prison, 74, 81
113–18, 126, 132–4, 138–9; ‘War on Drugs’, 1, 154–5
meeting demand, 118, 133; Weiss, Carol, 16–18, 153
National Treatment Agency, 130; Whitemoor prison, 96, 118
New Labour focus on, 126, 128; Wildavsky, A., 8
‘nothing works’ doctrine, 17; Wilks, S., 10, 11, 153
objectives of, 165; pilot drug Wilson, C., 10
treatment programmes, 114–16, withdrawal programmes, 47, 48;
118, 134, 136–7, 142, 162; policy abrupt withdrawal methods, 6, 48,
transfer from US, 21; and prison 49, 77; ACMD recommendations,
drugs strategy 1998, 144–6; 48–9; see also maintenance
probation orders stipulations, 64–5; prescribing
and punishment see Wolds remand prison, 63
punishment/treatment dichotomy; Women in Prison (WIP), 40, 64
recidivism rates, 137, 145, 166, women visitors, 101–2, 106–7, 142
170; scarcity of programmes in women’s prisons/women prisoners:
1980s, 49–50, 54; sidelined in drug control of prisoners, 44; drug
policy, 4–5, 107–8, 119–20, 122–3, offenders, 1, 65; fear of disclosure
162; see also drug agencies; of drug status, 47; and mandatory
206 Index
drug testing, 112; neglected by Wormwood Scrubs: Annexe, 50;

research, 73; not addressed by condom distribution, 85
Woolf inquiry, 65; prison drugs Wright, M., 10, 153
strategy 1998, 137; research on Wymott prison, 96
drug users, 3; strip searches, 106
Woodcock Report, 95, 105–6, 118–19, York Drugs Resource Scheme, 78
136 Young, Jock, 14, 19
Woolf inquiry, 65–6, 71, 81; failure of young offenders, 42, 112, 131
implementation, 66, 96 young people as drugs policy targets,
World Health Organisation (WHO), 71 128

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Drugs, Prisons and

1 Analysing Prison Drugs Policy: Problems, Networks

2 1980–6: Prelude to Policy Development 31

3 1986–93: The HIV/AIDS Crisis and Fears of

4 1993–7: Coming Clean and Taking Control? 89

The question of ‘balance’ in the 1995 prison drugs

5 1997– : Eradication to Realism? 124

6 Conclusions: Shifting Agendas and Policy Networks 151

In her analysis of imprisonment around the world, the prominent

drug issues in prisons and their involvement in agenda setting, lobby-

health agenda which were successfully operating in the community.

I am indebted to many people for their guidance and assistance with

during this research. They must remain nameless as I promised to

ACMD Advisory Council on the Misuse of Drugs

PGA Prison Governors’ Association

The drug issue in prisons is a global phenomenon and has become a

and/or injecting drug users represent up to 50 per cent of the prison

mandatory drug testing. For the three years commencing 1999/2000,

between medical and criminal justice concerns (see Berridge, 1978;

ments, interventions and programmes. As Feeley and Simon (1992:

complex in their structure and operation over time. It will be argued

I am using the term ‘treatment’ to cover a wide range of therapeutic

Towards a framework for analysing prison drugs policy

Key dimensions of policy

A set of interrelated decisions taken by a political actor or group of

This deﬁnition has a number of strengths encapsulating several key

achieved within the authority of the state. However, in the arena of

argue that policy analysis must be a multidisciplinary pursuit and its

Policy networks have been conceptualised in a variety of ways (see

policy networks have interacted over several different issues such as

Policy level Policy actors

Policy area Health,Criminal Justice Policy universe

agencies, penal reform groups, professional associations, the Prison

terms: ‘group power depends on state recognition and state power

Framing the drug ‘problem’ in prisons

the capacity to win attention quickly. Proximity refers to whether the

It is important to examine the naming and framing of policy issues

Role of research, evidence and knowledge

planners, and clients. There is no linear relationship from research to

and depends on various factors. These factors have been discussed by

The impact of related policy subsystems and the wider context

value for money, a performance-based culture, the disaggregation of

therefore been drawn into the management of the contemporary drug

between Conservative and Labour penal policy (see Brownlee, 1998;

Research design and methodology

developed over time, which factors inﬂuenced this development and

in order to explore the extent and nature of the ‘problem’ of drugs in

level (i.e. documents relating to drugs, penal and criminal justice

prisons and drugs, their role as mediators within policy development

The period from 1980 to 1986 marked the beginning of external

Drugs policy context: the heroin ‘epidemic’ and shifting

sector and general practitioners were beginning to play increasingly

any person who experiences social, psychological, physical or

that prisons were not expected to provide membership to these new

Drug abuse is a disease from which no country and no section of

The heroin ‘epidemic’ was associated with a younger group of ‘new

1985 national drugs strategy

policy development. In 1984, a Ministerial Group on the Misuse of

As South (1998: 91) argues, these developments ‘placed the police,

Penal policy context: containing and managing the ‘crisis’