The effectiveness and cost effectiveness of diversion and aftercare programmes for offenders using Class A drugs: A Systematic Review and Economic Evaluation

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Class A drugs, such as heroin and crack cocaine, are believed to have a high impact on society, with a cost of about £15B per year. Most of this cost is thought to be due to drug-related crime. Identifying people who commit crimes and also use drugs to direct them into drug treatment (as part, or instead, of their sentence) may reduce drug-related offending. This is referred to as diversion and typically takes place in the criminal justice system, when a person is arrested. This study asked whether or not diversion improves outcomes or reduces costs, compared with not doing this. To answer these questions, we reviewed other studies already carried out on this topic. We developed an economic model. The economic model used data from a sample of English arrested heroin and/or crack users, national databases and published studies to look at the costs and possible benefits of diversion.

The review of studies, which identified mostly US-based research, found that diversion may reduce drug use. However, the effect on reducing offending was unclear. The review did not find any studies able to answer the question of whether or not diversion can save money. The economic model, which focused on the use of the Drug Interventions Programme in the UK, found that diversion may be cost-effective. However, there is a lot of uncertainty about the relevance and quality of data. This uncertainty means that it is not clear whether or not diversion is clinically effective or cost-effective.

More research is needed to identify whether or not diversion is clinically effective in the UK and who may benefit from diversion into treatment.

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References:

Hayhurst KP, Leitner M, Davies L, Flentje R, Millar T, Jones A, King C, Donmall M, Farrell M, Fazel S, Harris R, Hickman M, Lennox C, Mayet S, Senior J, Shaw J. Health Technol Assess. 2015 Jan;19(6):1-168, vii-viii.