Harm reduction to recovery: An exploration of worker perceptions of the 2010 National Drug Strategy

In the 2010 National Drug Strategy (NDS) the coalition government outlined their vision for reimagining drug treatment for the approximately 400,000 problematic drug users in the UK. This strategy drew heavily on the recovery model of treatment that was already being used within Scotland to reported success. It was argued that this model would increase the successful outcomes of treatment by encouraging those within treatment to become abstinent from drug use and to reengage with the community. In parallel with the coalition vision of the ‘Big Society’, the new treatment model would also work with communities to ensure reengagement and meaningful life post-addiction, encouraging a social life outside of drug use and a return to work. Coupled with this change in treatment model, the government also started to trial ‘Payment by Results’ (PbR) pilots throughout the UK, with payments for the service provider made on the basis of the client leaving treatment and meeting a number of criteria. In the preparation for the reform of the treatment services, those administering the treatment were not consulted by government before the reforms were implemented and are largely absent from academic research into recovery itself.

This qualitative research explores the views of drug workers, employed in three different sites within one local authority area, in relation to changes to the recovery model of treatment. Within these sites, accounts from 26 practitioners including treatment centre managers, locality managers, commissioners and front-line drug workers were generated using semi-structured interviews to gain an insight into their perceptions of recovery and their relationship with the 2010 NDS. This research found that all workers supported the recovery model to an extent, with abstinence seen as being a more positive outcome than is reflected within existing research. There was less support for the measures of successful treatment, with most workers from all sites viewing measures of success within drug treatment as lacking rigour and being open to abuse by treatment providers. There was some evidence that this was seen to be a problem that was eliminated by the PbR system, with workers feeling that their results were more accurate given the additional scrutiny that PbR brings.