Producing the ‘problem of drugs’: A cross national-comparison of ‘recovery’ discourse in two Australian and British reports

Abstract

Australian report on the place of 'recovery' in drug policy.• The problem of drugs was represented as 'dependence' alone in both documents, with the implication that not all illicit drug use is problematic.• People who use drugs problematically were constructed as either 'responsibilised' (Britain) or 'patientised' (Australia).• Conditional citizenship, associated only with treatment and recovery, is reinforced in both documents.• The perceived authority of the UKDPC and ANCD was critical to the recovery debates at the time the reports were produced.• As 'recovery' discourse continues to evolve, discussing its contested meanings and effects will be an ongoing endeavour. AbstractThe notion of 'recovery' as an overarching approach to drug policy remains controversial. This crossnational analysis considers how the problem of drugs was constructed and represented in two key reports on the place of 'recovery' in drug policy, critically examining how the problem of drugs (and the people who use them) are constituted in recovery discourse, and how these problematisations are shaped and disseminated. Bacchi's poststructuralist approach is applied to two documents (one in Britain and one in Australia) to analyse how the 'problem of drugs' and the people who use them are constituted: as problematic users, constraining alternative understandings of the shifting nature 3 of drug use; as responsibilised individuals (in Britain) and as patients (in Australia); as worthy of citizenship in the context of treatment and recovery, silencing the assumption of unworthiness and the loss of rights for those who continue to use drugs in 'problematic' ways. The position of the organisations which produced the reports is considered, with the authority of both organisations resting on their status as independent, apolitical bodies providing 'evidence-based' advice. There is a need to carefully weigh up the desirable and undesirable political effects of these constructions. The meaning of 'recovery' and how it could be realised in policy and practice is still being negotiated. By comparatively analysing how the problem of drugs was produced in 'recovery' discourse in two jurisdictions, at two specific points in the policy debate, we are reminded that ways of thinking about 'problems' reflect specific contexts, and how we are invoked to think about policy responses will be dependent upon these conditions. As 'recovery' continues to evolve, opening up spaces to discuss its contested meanings and effects will be an ongoing endeavour.

Rethinking recovery

“…This model is consistent with the findings of Laub & Sampson's [3] longitudinal study of desistance from offending where the mechanism of change is seen as being a result of the 'informal social controls' delivered through meaningful relationships and employment or training activities that are rewarding. This…”

“…The measures put forward by treatment providers in Neale's study [7] accord with McKay's [1] concerns and other definitions of 'recovery' developed by experts internationally [14,15], by focusing not only upon reduced drug use and improved health, but also upon notions of citizenship, roles and responsibilities. As I have argued elsewhere [3], underpinning this idea is a set of neoliberal assumptions about work, productivity and what it means to live a 'contributing life' which fail to take into account the differences in the normative and social contexts of people's lives. Moreover, it implies that people who use drugs who are not 'in recovery' always already exist somehow outside of community and cannot live meaningful and fulfilled lives.…”

“…While the notion of 'recovery' is not new [2], in recent years there has been renewed discussion about 'recovery' as an organizing concept in drug policy and treatment delivery [3][4][5]. 'Recovery' is described frequently as a complex and contested concept [6] which eschews definition [3]. Despite the contentious debate, there has been increasing agreement that 'recovery' means more than abstinence or reduction in substance use, and should encompass improvements in other areas of clients' lives, including housing, relationships, employment, participation and wellbeing [6,7].…”

“…This research has demonstrated the ways in which the everyday practices of treatment delivery constitute 'clients' as particular kinds of political subjects. 'Recovery' discourse and the practices of treatment delivery constitute drug-using subjects in complex and sometimes contradictory ways: as rational agents who are capable of control over their 'problematic' drug use, and as irresponsible and untrustworthy 'addicts'; as 'patients' in need of help and care, and as 'risky' populations requiring surveillance and control [3,16,18]. Treatment services do not simply treat a group of marginalized and stigmatized clients; rather, treatment practices can confirm and reproduce these identities.…”

“…While the notion of 'recovery' is not new [2], in recent years there has been renewed discussion about 'recovery' as an organizing concept in drug policy and treatment delivery [3][4][5]. 'Recovery' is described frequently as a complex and contested concept [6] which eschews definition [3].…”