Its easier to get addiction treatment in prison than in the community


The information in this article is taken from a 6,000 word research assignment: ‘Identify the Challenges facing the New Zealand Alcohol & Other Drug Court (AODTC)’ prepared for my Honours degree in Criminology at VUW.

The prison population has dropped by over 2,000 since the Labour coalition came to power in 2018. Nevertheless, the ‘tough on crime’ mantra espoused by political parties of virtually every persuasion has driven the prison population to record highs. In March 2018, the muster reached 10,820.  In the last 20 years, this pressure – known as penal populism – has forced successive governments to build six new prisons. It has pushed Corrections’ costs from $361m in 1997 to $2.4 billion in 2020 ($1,843 million in operating expenses plus $603 million in capital expenses). That’s a six-fold increase over 20 years.

Whichever political party has been in power, the Corrections Minister at the time has then claimed his Department had a responsibility to rehabilitate these extra inmates. In 2012, the National Government ratified this responsibility announcing that Corrections had to reduce reoffending by 25%. 

The demand to rehabilitate these inmates has enabled the number of prisoners accessing addiction treatment in prison to jump from 174 a year in 2005 to 500 in 2008, and then to 1,000 in 2011. In the 2019 ‘Wellbeing’ budget, Corrections Minister, Kelvin Davis, announced even more funding would be made available enabling 1,200 inmates to attend prison based treatment. That’s a seven-fold increase.

Corrections provides addiction treatment via intensive Drug Treatment Programmes (DTP) in nine of its 18 prisons. The Department claims these programmes have “delivered a consistently positive reduction in reimprisonment, though typically modest in scale”.  Modest is right. Corrections’ Annual Reports show these programmes reduce reoffending by only 5% in the first year after release. In 2015, the figure was 4.8%; in 2021, it was less than 1%. 

Addicts dying on waiting lists

While prison programmes have expanded exponentially, the availability of addiction treatment in the community has contracted – bearing in mind, addiction services receive only 11%  of total public expenditure on mental health and addiction services.  In 2005, the NZ Herald reported that, due to years of underfunding, so many treatment centres in New Zealand had closed, the number of residential beds in the community had more than halved. The headline read: Addicts ‘dying’ on waiting lists.

In 2019, the National Committee for Addiction Treatment reported that 150,000 New Zealanders experience problems with substance use every year, but less than one third can access help.  In some parts of the country, addicts wait up to six months for treatment.  The same year, the Drug Foundation said: “strict criteria, long waiting lists, difficult locations and unsuitable services all prevent people from accessing help” and called for funding for addiction services to be doubled from the current figure of $150 million a year.

In other words, penal populism has given the Minister of Corrections more influence over government spending on addiction treatment than the Minister of Health, such that it is now easier to get substance abuse treatment in prison than in the community.  This is a travesty when you consider that prison programmes reduce reoffending by only 5%, while the drug court in Auckland (known as the AODTC) achieves a 54% reduction in reoffending in the 12 months after treatment. In other words, the drug court is 10 times more effective than drug treatment in prison.

The MOJ’s flawed cost-benefit analysis

Given their effectiveness, it’s strange the Government seems so reluctant to roll them out nationwide.  It was only in 2019 that former Justice Minister, Andrew Little, agreed to establish a new one – in Hamilton.  In October 2020, the Government announced another one would be set up in Hawkes Bay.  Before making a decision to expand, Mr Little ordered the MOJ to conduct a cost benefit analysis of the AODTC. This was completed in June 2019 and claims the AODTC provides very marginal savings (returning $1.33 for every $1 in cost).

Unfortunately, the Ministry’s analysis is seriously flawed. To begin with, it compared the cost of running a drug court with the cost of a traditional court even though these serve entirely different purposes – one to treat and heal, the other to punish.  It would have made more sense, and been a great deal more informative, to compare the cost of treatment in drug court with the cost of drug treatment in prison – where the purpose is the same: to reduce drug related offending and keep drug addicted defendants out of prison.

The MOJ also failed to take long term benefits into account. For example, their analysis claimed the savings achieved by one defendant in the AODTC avoiding prison for 12 months was only $12,847. Based on this figure (which applied to 220 graduates), total savings to the taxpayer were only $3.32 million.  The MOJ appears to have used the $12,847 figure because the total number of offenders going through the AODTC, and avoiding prison is so small, it has negligible impact on Corrections’ operational costs.

The crux of the problem is that the AODTC only deals with 100 offenders at a time, leading to a very limited number of graduates who manage to avoid a prison sentence. But if ten or twenty times that number were put through drug courts, economies of scale would kick in, and hundreds would stay out of prison. Corrections could lay off staff and possibly close a prison. The resultant savings would have a huge impact on the cost benefit ratio. Unfortunately, the Ministry failed to take into account the cost savings that would accrue if sufficient drug courts were established such that they actually led to a drop in the prison population. On this basis, they mistakenly concluded that the financial benefits from the AODTC are marginal.

Who is Andrew Little listening to?

In summary, the prison population has exploded due to penal populism – which, in simple terms, is the result of politicians listening too closely to the ‘lock ‘em up’ brigade.  Cabinet then listened to every Minister of Corrections, each of whom argued for more drug treatment in the new prisons they were building. More recently, as Minister of Justice, Andrew Little commissioned a flawed cost-benefit analysis from his own Ministry – the same Ministry that produced projections claiming we needed more and more prisons.

Now that he’s Minister of Health, let’s see if Mr Little is willing to listen to health professionals and treatment providers and request an independent cost-benefit analysis of the AODTC – one that compares the benefits of addiction treatment in the community with treatment in prison. And let’s see if that analysis takes a long-term view, preferably one that covers 15 years, which is how long Mr Little said it would take to reduce the prison population by 30%.  Without that, sooner or later, we’ll be back to building more prisons.

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