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Home > Drug Treatment Matrix cell E5: Treatment systems - safeguarding the community.

Drug and Alcohol Findings. (2018) Drug Treatment Matrix cell E5: Treatment systems - safeguarding the community. Drug and Alcohol Findings Drug Treatment Matrix .

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The Drug Treatment Matrix is concerned with the treatment of problems related to the use of illegal drugs by adults (another deals with alcohol-related problems). It maps the treatment universe and for each sub-territory (a cell) lists the most important UK-relevant research and guidance. Across the top columns move from specific interventions through how their impacts are affected by staff, the management of the service, and the nature of the organisation, to the impact of local area treatment systems. Down the rows are the major intervention types implemented at these levels.

 

What is this cell about?

Constructing local, regional or national systems featuring treatment for adults whose criminal or other undesirable behaviour has made them subject to legally backed sanctions or controls. In these contexts, treatment is offered or imposed not because it has been sought by the patient, but because it is thought that treating their substance use problems could reduce crime or otherwise benefit the community. Typically the targets are offenders who commit acquisitive crimes to fund drug purchases in illegal markets, to some extent driven by their dependence on those drugs. Also includes treatment systems which benefit the community by identifying and/or responding to problem drug use, such as by protecting the user’s children and family. As with commissioning in general, involves organising treatment provision to meet the needs of the relevant population in the context of resource constraints and national policy.

Research on treatment systems is rarely of the ‘gold-standard’, randomised trial format. Whole areas and multiple coordinating agencies cannot easily be randomly assigned to implement new systems of care, while others must stand still or do the conventional thing to form a comparator; communities have their own lives, politics and event-driven diversions beyond the researcher’s control. Instead, researchers usually look for patterns in what naturally happens rather than manipulating it to test the consequences; nearly all this cell’s key studies used variants on this methodology. The apparent practice implications of these studies are weakened by the fact that the observed patterns may not be due to the presumed cause-and-effect mechanisms, but instead reflect influences which randomisation would have taken out of the equation by evening them up across intervention and comparison systems.

Treatment systems developed for criminal justice and allied purposes are usually derived from those centred on patient welfare and the overcoming of dependence; the impact of treatment in general on crime is the reason why it was adopted for criminal justice purposes. This means that for more research and ideas we can refer you back to cells dealing with treatment systems generally, with medical treatments, and with psychosocial therapies.

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