two drugs that are generally identified with these crime-spree situations are cocaine
or crack and opium that consist of heroin or morphine (LeBoutillier & Love, 2010).
29% of drug users use cocaine, which is the third most widely used
illegal drug in the United Kingdom (Mann, 2014). Among hard drugs the general
perception of Britons is that they consider heroin to be the most harmful to health
followed by crack, crystal meth and cocaine. Amid heroin users, crime related
activity levels are high with an estimate of the social cost of drug-related
crime being between £65,000-100,000 per user entailing a cumulative cost amidst
all heroin users in the England and Wales to be in the range of £3.5 to 10.5
billion (Bryan, Bono, & Pudney, 2013). Research reveals that about
three-quarters of acquisitive crime among heroin users is attributable to drug
use, but essentially no violent crime (Bryan, Bono, & Pudney, 2013). It was
reported that the amount of property crime was high in heroin users but there
was no compelling indication of any violent crimes being committed by these
users. (Bryan, Bono, & Pudney, 2013). However, this study does not take
into account the level of acquisitive crime that would have been committed by
these drug users or suppliers if they had not been on drugs and hence that is
Most Britons aged 16-24 believe that high levels of street
crime are directly or indirectly related to the use to drugs, linking 50% of
all street crimes to drugs, and that decriminalisation of these would result in
lesser crime rates (Mann, 2014). However, reports suggest that a huge mass
(95%) of the drug users denied committing a crime to get these drugs.
In the year 2009, self-reported drug use displayed that
cannabis was the most frequently used drug (8.9%), after which there was
cocaine (2.4%), ecstasy (1.6%), amphetamine (1.3%), amyl nitrate (1.2%), and
hallucinogens (1.1%) (LeBoutillier & Love, 2010).
Cognitive Behavioural Therapy or CBT is a form of therapy
that targets an individual’s attitude and thought process to develop a pattern
which helps to cope with the distress. The change in cognition helps to reduce
symptoms and is usually a short-term solution but reformed cognitive
functioning is a long-term aspect to this method of therapy (Gaudiano,
2008). Motivational Interviewing or MI
is the form of therapy where the client is motivated by the counsellor who
supports them and helps them reflect up on their behaviour. CBT and MI share
some common aspects like empathy and collaboration between the client and
counsellor. MI can be used together with CBT, which is theory based, to make it
more effective (Carter, 2011).
The 12 Step Programme is a type of therapy where the
individuals at first recognize that there is a problem and try to address the
issue by taking part in 12 steps or activities and following general guidelines
during the recovery process (Donovan, Ingalsbe, Benbow, & Daley, 2013).
Findings report that individuals who attend the meetings regularly have higher
rates of continence as compared to those do not attend the meetings often.
The RAPt (Rehabilitation of Addicted Prisoners Trust) offers
a paradigm of abstinence based treatment which has been established from the 12
Step programme in nine prisons in the United Kingdom. Graduates from the RAPt
have shown significant and constant minimization of drug use and offences and
their rate of reconviction was also lower that the predicted rate (McSweeney,
Turnbull, & Hough, 2008).
In a study conducted by Maude-Griffin et al., (1998) to
check whether CBT was more effective than the 12 Step facilitation for reducing
the amount of cocaine abuse in adults, participants were randomly allocated to
CBT or the 12 Step facilitation. They received one individual counselling
session and three group therapy sessions for a total of 12 weeks. Abstinence
was established as sobriety from the use of cocaine for 30 days and a drug free
urine sample. The participants of this study on an average, took part in 5 out
of 12 individual therapy sessions and 14 out of 36 group sessions, which shows
that client effort is required even in accord to the most effective treatment
method (Palinkas, 1999). The results showed that there were more participants
who attained four weeks of abstinence from the CBT type of treatment as
compared to those who took part in the 12 Step facilitation. It was also found
that at each point of the assessment, participants who took CBT were more
abstinent as opposed to those who underwent the 12 Step facilitation
(Maude-Griffin et al., 1998).
Another study conducted by Crits-Christoph et al., 1999,
included patients who were cocaine dependent. The participants were randomly
designated into four categories individual drug counselling plus group drug
counselling, group drug counselling plus cognitive therapy, group drug
counselling plus support-expressive therapy or just group drug counselling.
Reports were taken during treatment every month and at 9 and 12 months after
baseline. The results reported that the most effective treatment on the
Addiction Severity Index-Drug Use Composite score was individual drug
counselling plus group drug counselling (Crits-Christoph, Siqueland, &
Blaine, 1999). This shows that the combination of individual and group setting
provides effective reduction in cocaine users.
These reports suggest that there is a gap in research
conducted regarding group vs individual therapy sessions among cocaine and
Thus, the present study aims to compare the
outcome of Self-Reported drug usage scores among participants taking cocaine
and heroin in the group as well as individual type of session. It also looks at
the types of treatments like Cognitive Behavioural Therapy (CBT) with
Motivational Interviewing (MI), 12 Step Programme and Standard Care or
Treatment as Usual and aims to establish which is more effective among these
drug users. It is also examined whether there is a significant interaction
effect among the type of session and type of therapy.