In this section the discretion of treatment staff – using Lipsky’s (1980) con- cept – in certain situations is analysed and discussed. Firstly, we explore the way in which random urine tests influence cannabis treatment programmes in various ways. Secondly, we analyse the way in which treatment goals are redirected owing to the particular situation in which treatment is performed:
the prison setting. And lastly, we analyse and discuss the nature of the coop- eration between prison guards and treatment staff.
Mandatory random urine tests:
adversary or assistant to cannabis treatment?
Random mandatory urine tests were, as noted above, introduced in the Prison Service in 2004 as part of the new control techniques implemented with the policy of zero tolerance. In 2003, 13,000 inmates were tested owing to well-founded suspicion, on imprisonment, or before and after leave. In comparison, 40,000 tests were taken in 2005, 70 % of these being the new random mandatory urine tests. 27,600 of these tests were taken in the thir- teen Danish prisons (5 maximum security prisons and 8 low security prisons with a total capacity of approx. 3,100 inmates). The disciplinary sanctions following a positive urine test are: fines, punitive cell, withdrawal of rights to go on leave, or restrictions on social participation. Since 2004, the number of disciplinary sanctions within the Prison System has increased by 38 %, an increase that is due in all probability to the new politics of zero tolerance (Kriminalforsorgen 2006).6
So random urine tests were well implemented when the cannabis treat- ment programmes were introduced in January 2007. They are part of the basis for practising cannabis treatment in prisons. In general, the treatment staff are not in favour of this control aspect. They see it as counterproductive to treatment, fearing, for instance, that disciplinary sanctions following a positive urine test may undermine their attempts to establish trusting rela- tionships with clients. For instance, one counsellor reported that her loyalty had been tested because she was regarded as an object of suspicion owing to the random urine test:
You are sometimes tested out. I have clients who have lied about using drugs. They then admit that they use drugs the next time we meet to find out whether they would be given a urine test when they got back to their wing. Or they tell me about cannabis or other drugs in some of the wings. They leak something to see if I will betray them.
Counsellors explicitly tell their clients that as treatment staff they have noth- ing to do with the urine tests and the disciplinary sanctions. Instead, their aim is to motivate through trusting dialogues with the inmates, as stated by this counsellor:
We are not strong supporters of urine tests. If inmates relapse, we would rather intervene and work with the problem.
On the other hand, ambivalence exists among treatment staff regarding the use of random urine tests. Some counsellors, for instance, experienced that the urine test was a highly motivating factor for inmates to start treatment. They pragmatically note that they would not have as many clients in their programme if there were no urine tests:
The random urine tests are definitely a motivational factor. I am not to- tally sure, but at least 80-90 per cent of our clients begin treatment simply to ensure that their urine tests will be negative so they can keep their right to go on leave.
As a consequence of the disciplinary sanctions following a positive urine test, many inmates have their leave suspended. By starting treatment, inmates try to abstain from drug use and thereby regain their right to go on leave. However, this motivational factor is mainly found in inmates who are eli- gible for leave7, or those who have obligations on the outside (children and spouses, for instance). And this is mainly the case in low-security prisons, where inmates are serving a shorter sentence and are therefore eligible for leave more quickly. Furthermore, counsellors doubted the sincerity of the motivation arising from the new disciplinary sanctions following a positive urine test, as explained by this prison nurse:
The only reason to stay off cannabis is to be able to go on leave. The clients simply have to stay off in order to get their leave. So, sadly enough, the primary reason is not to stay off cannabis.
Finally, counsellors reported that it was primarily the less affected drug users who could switch this motivation on and off:
We have actually experienced, after we got the zero-tolerance policy and the random urine tests, that inmates use cannabis just for fun – Saturday evening, or only in their spare time. The ones who are not drug addicts, they are the ones who are able to stay off cannabis.
Counsellors know that urine tests motivate inmates to start treatment, and this has led them to involve themselves more directly in the way the prison sanctions positive tests:
If one of the inmates enrolled in our cannabis programme is caught with a positive urine test, we get to know immediately. Normally there are certain consequences, such as the withdrawal of leave for 30 days. But if I can vouch for him, reporting that he has participated in the treatment programme, has been active and shown motivation to get off cannabis, then he might get his leave earlier.
Such involvement contradicts the way treatment staff distance themselves and their programme from urine tests in general with a view to creating a trusting relationship with the inmates, as shown above. But instead of seeing this as an inconsistency, we analyse it as part of the way in which counsel- lors exercise discretion, i.e. the active and reflective transforming of formal rules and regulations into practice. Counsellors perform their treatment in dissimilar frameworks and distinct situations, and act in different ways when it comes to random urine tests, for instance.
However, the fact that urine tests motivate some inmates to discontinue their drug use does not mean that they necessarily abstain from drug use in either the short or the long run. Treatment staff find that some inmates start using cannabis again shortly before their sentence expires, in the period when they are not eligible for leave anyway. Even if they have a positive urine test, this will not have any effect on their leave or their term of imprisonment.8
It is my experience that the random urine tests help motivate people with a one-year sentence, for instance. But people with 60-day sentences or less might prefer to say: “It’s only two weekends I can’t go on leave. So I don’t care.” They don’t really want to bother with treatment.
In other words, inmates with short sentences or with a short time remaining before their sentence expires are not particularly motivated to quit cannabis altogether. It should also be emphasised that treatment staff also find that inmates who are unable to terminate their problematic drug use, and who do not start treatment for various reasons, are continually exposed to dis- ciplinary sanctions as a consequence of their drug use. And as a result they often isolate themselves and become resigned, as a counsellor in one of the high-security prisons reported: “We have an inmate here who has not been on leave for almost two years due to positive urine tests for cannabis use”. So according to treatment staff, it is only one particular group of inmates that profit from and start cannabis treatment programmes.