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From maintenance to recovery: Exploring the reorientation towards recovery in British drug policy during a time of reform and economic austerity.
[Thesis]. Manchester, UK: The University of Manchester; 2018.
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Abstract
Over the past decade, a significant shift has taken place in British drug policy. The publication of the 2010 drug strategy shifted the primary focus of treatment away from attracting and retaining drug users in services, towards encouraging individuals to complete and exit treatment in 'recovery'. The introduction of the recovery agenda emerged alongside widespread reform to the public health system and during a period of sustained economic downturn that has witnessed the introduction of pervasive austerity measures by successive UK governments. With the reorientation towards recovery in this climate, important questions have been raised over the shape of drug treatment provision on the ground. However, despite much speculation, there remains a lack of empirical research in this area. This thesis presents a qualitative, exploratory study of the impact of the shift to recovery in two local authorities in the north of England. Through a total of 36 semi-structured interviews with drug treatment commissioners, staff and service users, this research provides an original contribution to the field by demonstrating the impact of the shift to recovery on local level policy and practice during a time of reform and economic austerity. It is argued that cuts to funding and changes to the commissioning of drug treatment services have created a highly competitive treatment system in which the success of providers is measured primarily through their ability to record successful completions of drug treatment. This has generated perverse incentives within the sector, giving rise to risky practices performed by treatment providers in the aim of demonstrating success. It is argued that these developments are best understood as the manifestation of neoliberal notions of competition, risk, choice and responsibility at the level of practice. This thesis concludes by offering important policy and practice recommendations.