Coerced drug treatment in the criminal justice system
| Published date | 01 August 2007 |
| DOI | 10.1177/1748895807078867 |
| Date | 01 August 2007 |
| Subject Matter | Articles |
Criminology & Criminal Justice
© 2007 SAGE Publications
(Los Angeles, London, New Delhi and Singapore)
and the British Society of Criminology.
www.sagepublications.com
ISSN 1748–8958; Vol: 7(3): 269–286
DOI: 10.1177/1748895807078867
269
Coerced drug treatment in the criminal
justice system:
Conceptual, ethical and criminological issues
TOBY SEDDON
University of Manchester, UK
Abstract
A striking phenomenon in many western countries is the increasing
use of the criminal justice system as a means of channelling and
coercing drug users into treatment. Despite somewhat equivocal
research evidence about its effectiveness, this approach has
continued to expand, including in Britain. This article takes a step
back and explores some of the critical background issues that have
been largely overlooked to date. Some conceptual, ethical and
criminological aspects of coerced treatment in the criminal justice
system are considered. It is argued that coerced treatment is a
central issue for both contemporary criminology and criminal justice
policy.
Key Words
coerced treatment • criminal justice • drugs • drug treatment
• ethics
Introduction
One of the articles of faith of many drug workers in this country is that prob-
lem users cannot be coerced into treatment.
(Hough, 1996: 36)
In Britain, this was no doubt true in 1996 but there has been a sea change
in attitudes over the last decade. Starting with the introduction of the Drug
269-286 CRJ-078867.qxd 2/7/07 4:08 PM Page 269
Treatment and Testing Order (DTTO) pilots in 1998 (Turnbull et al., 2000)
and most recently with the ‘Tough Choices’ initiative, coerced treatment has
become a key part of British drug policy and practice (Hunt and Stevens,
2004). This development has occurred in the context of a broader policy
shift which since 1998 has focused on ‘a major expansion of services within
the criminal justice system using every opportunity from arrest, to court, to
sentence, to get drug-misusing offenders into treatment’ (Home Office,
2002: 4). Coercive approaches that utilize the leverage of the criminal just-
ice system are thus part of a wider programme of ‘voluntary’ referral from
all stages of the system.
Although coerced treatment is a relatively new departure in Britain,1some
countries have a much longer experience of using criminal justice leverage in
this way. The most obvious example is the United States, where the idea can
be traced back to the ‘narcotic farms’ of the 1920s right through to the
California Civil Addict Program in the 1960s (Anglin, 1988), but other coun-
tries have been following this route for several decades, notably Australia and
several European countries (Webster, 1986; Stevens, 2004).
The rationale for the policy of coerced treatment, certainly in its con-
temporary British form, is based on three foundational principles:
1. that there is a strong causal connection between drug ‘addiction’ and acquisi-
tive crime;
2. that treatment is effective in reducing this ‘drug-related’ crime;
3. that coerced treatment is effective.
The strength of the evidence base for these three principles varies. Principle
One has been the subject of a long-running and unresolved debate. While the
association between certain types of drug use and involvement in property
crime is indisputable, the causal nature of this relationship is far from clear
(see Seddon, 2000) and the concept of addiction on which it rests is prob-
lematic and contested (e.g. Grapendaal et al., 1995). Evidence for Principle
Two is much stronger. In the British context, the National Treatment Out-
come Research Study has indicated that treatment can contribute towards
substantial reductions in offending for some individuals (Gossop et al., 2001,
2005, 2006). On the other hand, there is limited British evidence in support
of Principle Three, the main substantive contribution currently being the
recent report by McSweeney and colleagues (2006). Reviews of the inter-
national research reveal a wide range of outcomes for coerced treatment, with
some studies suggesting coerced clients do no worse than those entering treat-
ment voluntarily and that legal pressure can aid treatment retention but with
others showing negative effects (Klag et al., 2005; Stevens et al., 2005b).
The aim of this article, however, is not to revisit the evidence base for
these three principles. Rather, it seeks to consider some of the critical con-
ceptual and theoretical issues underpinning coerced treatment. The first sec-
tion examines some of the basic conceptual building blocks in this area,
looking specifically at the idea of coercion itself and the related concept of
motivation, as well as the notion of treatment as it is used in this context.
In the second section, some of the ethical issues posed by coerced treatment
270 Criminology & Criminal Justice 7(3)
269-286 CRJ-078867.qxd 2/7/07 4:08 PM Page 270
To continue reading
Request your trial