It is against this backdrop that two further (linked) debates continue to haunt drug policy and in particular the implementation of recovery models:
1. harm reduction versus recovery
2. professional versus peer roles in supporting recovery pathways.
The two debates overlap and are laid out here as choices or dichotomies although there is no reason that they have to be seen as such. In Scotland, the transition from the Road to Recovery (Scottish Government, 2008) to Rights, Respect and Recovery (Scottish Government, 2018) is seen as the pendulum swinging back in the direction of harm reduction in response to drug-related deaths and several of our key informants felt the same was the case for the 2017 UK drug strategy (HM Government, 2017) – seen as a ‘balancing’ of recovery and harm reduction.
But who makes those decisions, particularly the ones about implementation? When we did the research it was very hard – particularly in England – to identify or speak to those who were responsible for shaping and implementing drug policy. Yet this leads to a real concern that power (and money) remains in the hands of vested interests including a small cabal of treatment providers, a cosy network of ‘experts’ and the hegemonic influences of their disciplinary backgrounds and the continuing shadow of the pharmaceutical industry.
The shared concern in both the US and the UK is that increased investment and increased public concern and attention have not led to new ways of thinking but have largely ended up in doing more of the same. More treatment workers, more treatment services and very little of the crucial lessons from recovery – jobs, houses and pathways to community capital and resources. In Scotland, McGarvey (2018) has referred to this as the self-preservation of the ‘poverty industry’
Recovery policies are very hard to implement effectively yet there are great examples from the US outlined in John Kelly and William White’s 2011 book “Addiction Recovery Management”. While there are always opportunities (and needs) to improve treatment, the commitment to meaningful recovery-oriented systems of care is essential if short-term gains are to be translated into lasting and meaningful changes in communities and families. It is notable that almost no funding has been allocated to researching recovery-oriented systems of care in the US or UK in the last decade.
For more Recovery in Policy and Practice on Both Sides of the Atlantic — (rec-path.org)
(The Dalgarno Institute has for over a decade now, argued in a similar fashion that Harm Reduction ONLY ideologies that should lead to drug use exiting recovery, have not. Instead, it appears a cynical strategy has been in play that has seen Harm Reduction hijacked by certain ‘gate-keepers’ of drug policy to simply sustain a ‘damage management’ model that takes a non-accountability stance toward self and community harming drug use.
Even though ‘right’ words are often used and the Australian National Drug Strategy has put Demand Reduction as the priority pillar, we still see interpretation of policy and the continued relentless promotion of harm reduction principles used to enable, equip, and even endorse ongoing drug use, rather that actively facilitating reduction, remediation, and recovery from drug use.
This is not a secret; however, it is entrenched bureaucracy that continues to guard the ‘poverty industry’ mentioned in this article. Political will and a removing of the strangle-hold of pro-drug advocates on policy interpretation is what is needed to see a genuine change, in not only policy direction, but the positive health benefits it brings.)
- Contingency Management for Abstinence as a Recovery Tool?
- Abstinence: Not the only option, but clearly the best one for your well-being
- Overcoming the pains of recovery
- Maintaining Hope and Health During Drug Abuse Recovery (Of course, the irony is that all the following factors are also key in the #Prevention and #DemandReduction space.