Alex Stevens

Telling Policy Stories: An Ethnographic Study of the Use of Evidence in Policy-making in the UK

Based on participant observation in a team of British policy-making civil servants carried out in 2009, this article examines the use that is made of evidence in making policy. It shows that these civil servants displayed a high level of commitment to the use of evidence. However, their use of evidence was hampered by the huge volume of various kinds of evidence and by the unsuitability of much academic research in answering policy questions. Faced with this deluge of inconclusive information, they used evidence to create persuasive policy stories. These stories were useful both in making acceptable policies and in advancing careers. They often involved the excision of methodological uncertainty and the use of ‘killer charts’ to boost the persuasiveness of the narrative. In telling these stories, social inequality was ‘silently silenced’ in favour of promoting policies which were ‘totemically’ tough. The article concludes that this selective, narrative use of evidence is ideological in that it supports systematically asymmetrical relations of power.

Quasi-Compulsory Treatment of Drug Dependent Offenders: An International Literature Review

This paper reports on a review of the literature on the quasi-compulsory treatment (QCT) of drug dependent offenders in five languages; English, German, French, Italian and Dutch. The findings of this review on previous reviews and on the availability, process, and outcomes of QCT are summarized. The review found that previous, anglophone reviews have tended to present positive outcomes from QCT, but that there are some problems with this research. QCT is increasingly available internationally, but may be applied at different stages of the criminal justice process, and to different types of offender. Research on the process of QCT is comparatively rare. The available research does suggest problems of system integration between criminal justice and treatment agencies in implementing QCT. The research in languages other than English shows a wider range of outcomes (including negative effects) for QCT than was found in the English literature. We conclude that the international literature shows that QCT does not inevitably produce worse outcome than voluntary treatment, but that we need more multimethod, multisite studies of QCT in order to inform policy and practice, which is currently being made in the absence of reliable evidence in many countries.

Survival of the Ideas that Fit: An Evolutionary Analogy for the Use of Evidence in Policy

This paper explores bias in the use of evidence in policy. It argues that existing models of the evidence–policy relationship neglect the tendency for attention to be paid only to that evidence helpful to the interests of powerful social groups. An evolutionary analogy is used to explain how this bias arises, without the need for irrationality or conspiracy on the part of policy makers. Examples are given in the fields of drug, asylum and other policies, and the possible responses by researchers to the biased use of research evidence are discussed.

When two dark figures collide: Evidence and discourse on drug-related crime

This paper explores the socio-political construction of drug-related crime; a concept that has dominated recent developments in UK drug policy. It has been assumed that the perceived overlap between known offenders and drug users is also present among the much larger groups of unknown offenders and drug users. This assumption has led to inflated claims of scale, precision and causality in political discussions of the drug-crime link. The discourse coalition approach is used to analyse how such methodologically suspect knowledge has been translated into policy since 1997. It is argued that the concept of drug-related crime has been influential because it is tactically and structurally useful to powerful groups in discursive struggle.

Whose Harm? Harm Reduction and the Shift to Coercion in UK Drug Policy

Building on Stimson’s (2000) analysis, this paper examines the shift from a focus on health towards one of crime within UK drug policy. The increased use of coerced or compulsory treatment of drug users is discussed with reference to harm reduction theory and the question of whose harm is prioritised in shaping drug services. We also identify mechanisms by which the efficacy of treatment approaches based on coercion may be lessened or reduce the efficacy of other existing services. Failure to consider these may be an important omission in any appraisal of the impact of policies that increasingly prioritise crime prevention and coercion over heath and voluntarism.

The Relationship between Legal Status, Perceived Pressure and Motivation in Treatment for Drug Dependence: Results from a European Study of Quasi-Compulsory Treatment

This paper reports on intake data from Quasi-Compulsory Treatment in Europe, a study of quasi-compulsory treatment (QCT) for drug dependent offenders. It explores the link between formal legal coercion, perceived pressure to be in treatment and motivation amongst a sample of 845 people who entered treatment for drug dependence in five European countries, half of them in quasi-compulsory treatment and half ‘voluntarily’. Using both quantitative and qualitative data, it suggests that those who enter treatment under QCT do perceive greater pressure to be in treatment, but that this does not necessarily lead to higher or lower motivation than ‘volunteers’. Many drug-dependent offenders value QCT as an opportunity to get treatment. Motivation is mutable and can be developed or diminished by the quality of support and services offered to drug-dependent offenders.

Early Exit: Estimating and explaining early exit from drug treatment

BackgroundEarly exit (drop-out) from drug treatment can mean that drug users do not derive the full benefits that treatment potentially offers. Additionally, it may mean that scarce treatment resources are used inefficiently. Understanding the factors that lead to early exit from treatment should enable services to operate more effectively and better reduce drug related harm. To date, few studies have focused on drop-out during the initial, engagement phase of treatment. This paper describes a mixed method study of early exit from English drug treatment services.MethodsQuantitative data (n = 2,624) was derived from three English drug action team areas; two metropolitan and one provincial. Hierarchical linear modelling (HLM) was used to investigate predictors of early-exit while controlling for differences between agencies. Qualitative interviews were conducted with 53 ex-clients and 16 members of staff from 10 agencies in these areas to explore their perspectives on early exit, its determinants and, how services could be improved.ResultsAlmost a quarter of the quantitative sample (24.5%) dropped out between assessment and 30 days in treatment. Predictors of early exit were: being younger; being homeless; and not being a current injector. Age and injection status were both consistently associated with exit between assessment and treatment entry. Those who were not in substitution treatment were significantly more likely to leave treatment at this stage. There were substantial variations between agencies, which point to the importance of system factors. Qualitative analysis identified several potential ways to improve services. Perceived problems included: opening hours; the service setting; under-utilisation of motivational enhancement techniques; lack of clarity about expectations; lengthy, repetitive assessment procedures; constrained treatment choices; low initial dosing of opioid substitution treatment; and the routine requirement of supervised consumption of methadone.ConclusionEarly exit diminishes the contribution that treatment may make to the reduction of drug related harm. This paper identifies characteristics of people most likely to drop out of treatment prematurely in English drug treatment services and highlights a range of possibilities for improving services.

The Victimization of Dependent Drug Users Findings from a European Study, UK

This article contributes to the literature on drug users, victimization and offending using data on 545 dependent drug users entering treatment in four European countries. Members of the sample were exposed to high levels of criminal victimization. Sub-groups who were particularly vulnerable to crime were women (and especially sex workers), the homeless, recent offenders and those with a history of poor mental health. Multivariate analysis indicated that frequent drug use, recent offending and histories of depression and anxiety were significantly predictive of violent victimization, and only gender and a history of anxiety were significantly predictive of property victimization. The article discusses how these findings relate to theoretical approaches to victimization, in both positivist and critical frameworks.

Legally flawed, scientifically problematic, potentially harmful: The UK Psychoactive Substance Bill

This journal has often analysed legislation in the field of drug policy. Rarely has it discussed a proposed law that has such deep problems in its legal and scientific bases. The Psychoactive Substances Bill, which is currently proceeding through the UK Parliament, will (if enacted) create a ‘blanket ban’ on the production, importation, exportation and supply of all psychoactive substances for human consumption, except for those that are specifically exempted. The Bill provides for a range of civil and criminal penalties, with a maximum seven-year prison sentence.

Assessing UK drug policy from a crime control perspective

Over the entire last quarter of the 20th century the British drug problem worsened, despite the implementation of a variety of approaches and commitment of substantial criminal justice and other resources. The link between chronic use of expensive drugs and property crime makes this experience important for understanding trends in crime and justice in Britain. The worsening of the problem can be seen in the growing number of new heroin users each year over almost the entire period 1975—2000, on top of which was layered, starting in the late 1990s, the first major outbreak of chronic cocaine use. This was not the common pattern in Western Europe over that time and by 2000 the UK had Western Europes most serious drug problem. One component of the response has been increasing enforcement against drug markets; in just the decade 1994—2005 the number of prison cell years handed out in annual sentences has tripled. Even with this expansion we estimate that the annual probability of incarceration for a class A drug dealer is only approximately 6 per cent. Since 2000 there has also been a massive increase in treatment resources linked to the criminal justice system. The number of treatment assessments in recent years has been as large as 58 per cent of the number of persons estimated to be problematic users of Class A drugs. The government believes that drug policy has contributed to the decline in crime in the UK since 2000. Using what is known about treatment outcomes, we argue that despite impressive evidence of effect on individual level offending, the effect of treatment expansion in reducing overall crime rates is likely to have been limited.