Social construction and the evidence-based drug policy endeavour (original) (raw)
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Evidence based practice has been the mantra for several years and may be held up as the gold standard for professional practice, as the method for driving policy: ‘Evidence based policy’. However, much of the focus in the topic has been on the methodologies, and discussions, around the various merits or otherwise of methodological approaches, say between quantitative and qualitative research, or the strengths and weaknesses of RCTs. There is also a need to take a wider perspective on evidence and understand that the use of evidence, no matter what research method underpins it, has a social and often political dimension to it. Evidence based policy is ‘socially constructed’. Social and political issues also affect what gets researched, how it gets published and perhaps what topics are off limits. To illustrate this process, an examination of the laws around the use of substances, be they caffeine, alcohol or ecstasy, indicates that public policy often has a tangential relationship to evidence. An argument is that the evidence should drive our policies; however it may well be the case that the policy comes first (drug prohibition) and then there is a search for the evidence to back that policy – ‘policy based evidence’. Other issues that may well fall into this category: climate change, fracking, economic austerity or even nursing staffing levels. The argument presented here is that ‘evidence based’ policy is socially constructed and may actually have little to do with evidence! Drugs policy will be used to illustrate the dynamic and oft contested nature of evidence and its use.
Evidence in European social drug research and drug policy
2016
Evidence as a metaphor for knowledge characterised by the positivist traits of objectivity, validity and value-free truths is a contested commodity within the social science community, not least in the field of drugs research. The politics of knowledge production — including how research is produced, funded and interpreted through a lens clouded by values and ideology — is an ongoing topic for debate and enquiry. Nonetheless, the demand for objective data to inform evidence-based policy and practice, and to demonstrate the effectiveness of ‘what works’ and what is value for money, continues to grow exponentially. Research funders increasingly prioritise studies that have a demonstrable input into or impact on policy. The contributors to this book cast a critical gaze on the concept of evidence. They challenge the positioning of evidence as the neutral product of an apolitical process and demonstrate, through case studies and policy analysis, the social construction of evidence by th...
Drug and Alcohol Review, 2007
Issues. Evidence-based policy is promoted as the ideal in drug policy, yet public policy theorists suggest that policy-based evidence may be a more fitting analogy, where evidence is used selectively to support a predetermined policy direction. Approach. The following paper assesses the resonance of this notion to the development of the Illicit Drug Diversion Initiative (IDDI), an apparently pragmatic reform adopted in Australia in 1999 through the Federal Coalition 'Tough on Drugs' strategy. It utilises interviews with key informants from the Australian drug policy arena conducted in 2005 to assess the role of evidence in the design and implementation of the IDDI. Key Findings. The current paper shows that while policy-makers were generally supportive of the IDDI and viewed drug diversion as a more pragmatic response to drug users, they contend that implementation has suffered through a selective and variable emphasis upon evidence. Most notably, the IDDI is not premised upon best-practice objectives of reducing harm from drug use, but instead on 'Tough on Drugs' objectives of reducing drug use and crime. Implications. This paper contends that policy-based evidence may facilitate the adoption of pragmatic reforms, but reduce the capacity for effective reform. It therefore has both functional and dysfunctional elements. Conclusion. The paper concludes that greater attention is needed to understanding how to mesh political and pragmatic objectives, and hence to maximise the benefits from policy-based evidence. [Hughes CE. Evidence-based policy or policy-based evidence? The role of evidence in the development and implementation of the Illicit Drug Diversion Initiative.
Elusive Evidence: Hard-to-Reach Drug Users and the Missing Values in Drug Policy Decision Making
The 1997 Labour Government's commitment to research-based criminal justice policy held the promise of greater clarity in the drugs/crime link and evaluation of measures to tackle drug use. This article gives a critical assessment of the introduction of drug testing arrestees at police stations as part of the move to force drug users into treatment. The account supports the equivocal findings on the effectiveness of drug testing. It identifies how the rush for evidence with emphasis on quantitative methods conspired to leave the most marginalised problematic drug users hidden from the evaluation.
2012 marked the 100th anniversary of the first international treaty on tackling international drug flows. Since the International Opium Convention in 1912 and the UN Single Convention on Narcotic Drugs in 1961 (and its amendment in 1971) were agreed, development, implementation and assessment of counter-narcotic (CN) activities aimed at reducing the harm caused by illicit drug industries received considerable attention from practitioners and researchers. Studies reveal that, due to the complexity and breadth of the impact of both the illicit drug industry and CN interventions on societies, drug control interventions may result in an array of consequences that are not intended yet may significantly impact societies overall or particular societal groups (Strang et al 2012; Reuter 2009). This paper is concerned with understanding the socio-psychological drivers of the unintended consequences (UCs) of CN interventions aimed at motivating attitudinal and/or behavioural change to prevent ...
The Role of Research Evidence in Drug Policy Development in Australia
Politicka Misao, 2012
The mantra of "evidence-based policy" is continuing to gain ground, with calls for public policy to be informed by scientific evidence. However, in many areas of public policy the role of evidence and science is highly contested. This is amply demonstrated in the area of illegal drugs policy. Illegal drugs policy, concerned with governments' approaches to controlling the sale and use of drugs such as heroin, cocaine, and cannabis, is a highly contested area, and hence a fruitful case example of the complexity of policy. The features of illicit drug policy explored in this paper are: government actors, which span multiple departments; political ambivalence and multiple stakeholders outside government; community attitudes and a high media profile. These features need to be taken into account in understanding the relationship between policy and research evidence. In this context, the role of research evidence can be fraught. Examination of a number of current 'hot topics' in drug policy demonstrates the variety of ways in which evidence is used in drug policy processes.
Social Policy and Drug Addiction: A Critical Study of Policy Development
Addiction, 1984
The drug addict or ‘problem drug taker’ is the focus of a number of overlapping systems of regulation from moral to medical and penal. It is consequently difficult to analyse the development of policy in this area without lapsing into oversimplifications which imply either a process of medicalization or the unity of a totalitarian system of social control. It is argued here that we cannot adequately understand the development of policy in the field of drug addiction by reference to the medicalization of social problems and that a more fruitful course is opened up by analyzing developments of ‘rational knowledge’ which underpin policy shifts. In the light of this argument the apparent shifts in policy in the 1960s following the Second Brain Report are re-evaluated.
MOJ Addiction Medicine & Therapy
subordinate alternative model; INCB, international narcotics control board; WHO, world health organization; ECOSOC, economic and social council; UNODC, united nations office on drugs and crime; ASEP, south american agreement on narcotics and psychotropic drugs, INGEBI, institute in genetic engineering and molecular biology; EOL, lacanian orientation school; GRETA, research and study group on toxicomania and alcoholism This conception interprets the addictive phenomenon in different ways, but all of them have the common denominator of responding to
Role of Science in Drug Policy Formulation
The use of scientific evidence in the policy formulation process is rather recent. Babor et al. (2010) argue that it was only 1970s onwards that scientific community began to systematically apply the disciplines of epidemiology, economics, and social research to understand the prevalence and distribution of drug use, and explore the causal links (1). At the same time, the scientific evidence base grew as the scientific community pushed the frontiers of knowledge to understand addiction as a medical problem rather than a moral issue. Nevertheless, the movement to understand drug addiction as a medical rather than moral problem had begun in the early 1950s. In 1953, the American Medical Association recognized alcohol addiction as a medical problem and supported medical treatment and care (2). Arthur Blume et al. (2013) argue that scientific evidence was not the sole reason that led to this recognition. In fact, the move also had commercial interests as it led to the rapid expansion of privatized treatment services for the patients with alcohol abuse problem (2). This is a classic case that demonstrates that scientific community too is not immune from the influence of factors other than scientific evidence.
Recasting Participation in Drug Policy
Contemporary Drug Problems, 2018
Calls for “evidence-based policy” and greater community “participation” are often heard in the drug policy field. Both movements are in different ways concerned with the same questions about how “drug problems” ought to be governed and the place of “expertise” and “engagement” in democratic societies. However, these calls rely on the assumption that knowledges, publics, expertise, and issues of concern are fixed and stable, waiting to be addressed or called to action, thus obscuring ontological questions about what “participation” (be that lay or expert) may do or produce. There has been limited research in the drugs field that has taken “participation” as an object of study in itself and through critical examination attempted to open up new possibilities for its remaking. In this article, we draw on science and technology studies scholarship that has sought to illuminate the relations between public deliberation and government decision-making in public affairs involving technical c...
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Nordic Studies on Alcohol and Drugs
Background and aims: Increasingly, efforts to counteract perceived problems in drug treatment at residential rehabilitation centres have come to rely on measures drawing on evidence-based practice (EBP). However, the Swedish media, government inquiries, and international research have identified a number of problems regarding both residential rehabilitation and EBP. This suggests that caution should be exercised when placing expectations on EBP. The aim of this study is to investigate how the responsible authorities have handled increasing demands for EBP with administrative control while facing critical evaluations of their steering and implementation efforts. The study examines the maturation of a widespread treatment ideology, which aims to be based on evidence, in a country known for its restrictive drug policy and its goal of becoming a drug-free society. Methods: Through a qualitative textual analysis of 17 years (2000–2016) of inquiries, directives, and authority archives we ...
Policy Studies
This study found that the problem-solving capacity of a public organization can be understood in terms of the legitimacy of the formulated problems and solutions. Increasing the problemsolving capacity depends on not only the acceptance of problems and how to solve them but also on formal structures and processes. Sensemaking and framing are important keys to unlocking how legitimacy is built, and consequently, how problem-solving capacity is built in a complex organization. We contend that although governance theory recognizes complexity through concepts such as networks and multi-levelness, empirical research tends to downplay what complexity can entail, thus limiting the theoretical development and practical usability of governance theory. Using complexity as a sensemaking framework, we analyze how the top-tier managers of a capital understand the challenges and solutions of coping with rapid growth. We argue that although complexity theory is no panacea to unlocking the difficulties of public sector challenges, it can be a valuable guide to future research on governance.
Harm Reduction Journal, 2021
Introduction Peer involvement of people who use drugs within HIV and harm reduction services is widely promoted yet under-utilised. Alongside political and financial barriers is a limited understanding of the roles, impacts, contexts and mechanisms for peer involvement, particularly in low- and middle-income settings. We conducted a rapid review of available literature on this topic. Methods Within a community-academic partnership, we used a rapid review approach, framed by realist theory. We used a network search strategy, focused on core journals and reference lists of related reviews. Twenty-nine studies were included. We developed thematic summaries framed by a realist approach of exploring interventions, their mechanisms, outcomes and how they are shaped by contexts. Results Reported outcomes of peer involvement included reduced HIV incidence and prevalence; increased service access, acceptability and quality; changed risk behaviours; and reduced stigma and discrimination. Mech...
Transforming evidence for policy and practice: creating space for new conversations
Palgrave Communications
For decades, the question of how evidence influences policy and practice has captured our attention, cutting across disciplines and policy/practice domains. All academics, funders, and publics have a stake in this conversation. There are pockets of great expertise about evidence production and use, which all too often remains siloed. Practical and empirical lessons are not shared across disciplinary boundaries and theoretical and conceptual leaps remain contained. This means that we are not making the most of vast and increasing investment in knowledge production. Because existing lessons about how to do and use research well are not shared, funders and researchers are poorly equipped to realise the potential utility of research, and waste resources on-for exampleineffective strategies to create research impact. It also means that the scarce resources available to study evidence production and use are misspent on overlynarrow or already-answered questions. Patchy and intermittent funding has failed to build broadly relevant empirical or theoretical knowledge about how to make better use of evidence, or to build the communities required to act on this knowledge. To transform how we as a community think about what evidence is, how to generate it, and how to use it well, we must better capture lessons being learned in our different research and practice communities. We must find ways to share this knowledge, to embed it in the design of our research systems and practices, and work jointly to establish genuine knowledge gaps about evidence production and use. This comment sets out one vision of how that might be accomplished, and what might result.
Prostitution policy, morality and the precautionary principle
Drugs and Alcohol Today, 2016
Purpose The purpose of this paper is to explore the contemporary regulation of sex work in England and Wales, placing this in the context of debates concerning morality, evidence and the efficacy of policy. Design/methodology/approach This brief paper is based on reflections on the authors’ research and their contribution to policy debates over the last two decades. Findings This paper presents prostitution policy as morality policy and suggests that it remains overwhelmingly based on the idea that prostitution is immoral and hence must be inherently harmful. Practical implications The paper makes a strong case for evidence-based policy in an area where morality tends to promote a partial and selective reading of evidence. Here, parallels are drawn with policies regulating other pleasurable but “sinful” activities, including the consumption of drugs and alcohol. Social implications It is argued that the dominance of a particular policy approach to sex work perpetuates stigma for tho...
The Meaning of Stigma About Illegal Drug Use and Its Contribution to Public Policymaking in Colombia
International Journal of Mental Health and Addiction
The objective of this study is to understand the meaning of the stigma about illegal drug consumption and its contribution to public policymaking in Colombia from the perspective of experts on this topic. Research was carried out based on the methodological perspective of the grounded theory. Twenty participants with extensive experience in the design of regulations, plans, or programs about demand reduction in Colombia were interviewed, using tools such as in-depth interviews and analytical memos. The analysis was performed by means of open, axial, and selective coding techniques and the development of a conditional/consequential matrix. The findings are presented according to the structure of the pattern matrix to show the social process found and include (a) the phenomenon, the fear of being stigmatized as a promoter of more liberal public policies; (b) the context, the Colombia’s history and the policymaking to reduce drug consumption; (c) the conditions, control of governance b...
Community Pharmacies in Poland—The Journey from a Deregulated to a Strictly Regulated Market
International Journal of Environmental Research and Public Health, 2020
Community pharmacies are the primary entities providing drugs to individual patients in Poland. The pharmacy market has been changing for many years due to significant changes in market regulations. These changes significantly affect the profitability of pharmacies, which may impact the quality of pharmacotherapy. The small number of pharmacies, which resulted from changes in the law in 2017, can influence the level of patient care. The article presents the community pharmacies market in Poland. Particular attention is paid to the legal regulations affecting community pharmacies and the impact of these regulations on the overall shape of the market. The Polish system’s specificity, including the pharmacy market indicators, has been compared with data from other European Union countries.
Recasting Participation in Drug Policy
Contemporary Drug Problems, 2018
Calls for “evidence-based policy” and greater community “participation” are often heard in the drug policy field. Both movements are in different ways concerned with the same questions about how “drug problems” ought to be governed and the place of “expertise” and “engagement” in democratic societies. However, these calls rely on the assumption that knowledges, publics, expertise, and issues of concern are fixed and stable, waiting to be addressed or called to action, thus obscuring ontological questions about what “participation” (be that lay or expert) may do or produce. There has been limited research in the drugs field that has taken “participation” as an object of study in itself and through critical examination attempted to open up new possibilities for its remaking. In this article, we draw on science and technology studies scholarship that has sought to illuminate the relations between public deliberation and government decision-making in public affairs involving technical c...