Stakeholders in Opioid Substitution Treatment Policy: Similarities and Differences in Six European Countries

Abstract

Based on the research papers within this special issue, this overview discusses similarities and differences in stakeholding in drug user opioid substitution treatment policy in Britain, Denmark, Italy, Austria, Poland, and Finland. It explores factors that have influenced stakeholder activity, including the importance of crisis, the impact of evidence, the availability of resources, the wider political context, the influence of moral frameworks and ideologies, and the pressure of external influences. The paper highlights the important differences in the emergence and evolution of stakeholder groups and in the political, cultural, and economic circumstances, which both constrain and enable their activities.

Keywords :

• stakeholders
• substitution treatment
• drug user treatment policy
• Europe
• abstinence
• harm reduction
• evidence-based policy
• addictions
• window of opportunity
• problem stream
• policy stream
• political stream

THE AUTHORS

Betsy Thom, PhD, is Professor of Health Policy and Head of the Drug and Alcohol Research Centre at Middlesex University, UK. She is an editor-in-chief of Drugs: education prevention and policy and has published on issues of alcohol and drug policy and practice. Current research includes the study of stakeholder groups in Europe; partnership approaches to implementing alcohol policy at local level, and workplace interventions/ models of response to alcohol and drug use-related problems.

Karen Duke, PhD, is Principal Lecturer in Criminology at Middlesex University, UK. She has published widely on the development of drugs policy in prisons, the interfaces between drugs and criminal justice policy, and the relationship between research, politics and policy-making. She is an editor-in-chief of Drugs: education prevention and policy and the author of Drugs, Prisons and Policy Making (2003, Palgrave Macmillan).

Vibeke Asmussen Frank, Ph.D., Anthropologist, is the Director of the Centre for Alcohol and Drug Research, School of Business and Social Sciences, Aarhus University, Denmark, and an Associate Professor in social science drug and alcohol research. Her research activities are mainly based on qualitative research. She is involved in the management and conduction of several research projects. Current projects focus on prison-based drug user treatment, domestic cannabis cultivation, and implementation of drug policies in welfare institutions, including both control and welfare policies. She has published various articles about opioid substitution drug user treatment in Denmark.

Bagga Bjerge, PhD, is Assistant Professor the Centre for Alcohol and Drug Research, School of Business and Social Sciences, Aarhus University, Denmark. She is trained within anthropology and sociology. Her research activities are mainly based on qualitative methods. She is in involved in studies of policy processes in the Danish drug and alcohol field. Further, she is involved in EU-based projects focusing on anthropological perspectives on drugs as well as stakeholders in the drug and alcohol intervention field.