Are drug treatment services only for 'thieving junkie scumbags'? Drug users and the management of stigmatised identities.

This article uses qualitative interviews with 53 problematic drug users who had dropped out of treatment in England, UK to explore how they describe the stigmatisation of drug users and drug services. It discusses the construction of the category of the junkie through its association with un-controlled heroin use and criminality. It shows how some drug users carefully manage information about their discreditable identities by excluding themselves from this category, while acknowledging its validity for other drug users. The junkie identity was generally seen as shameful and therefore to be avoided, although it holds attractions for some drug users. For many of the interviewees, entry to treatment risked exposing their own activities as shaming, as they saw treatment as being a place that was populated by junkies and where it becomes more difficult to manage discreditable information. The treatment regime, e.g. the routine of supervised consumption of methadone,was itself seen by some as stigmatising and was also seen as hindering progress to the desired ‘normal’ life of conventional employment. Participation in the community of users of both drugs and drug services was perceived as potentially damaging to the prospects of recovery. This emphasises the importance of social capital, including links to people and opportunities outside the drug market. It also highlights the danger that using the criminal justice system to concentrate prolific offenders in treatment may have the perverse effects of excluding other people who have drug problems and of prolonging the performance of the junkie identity within treatment services. It is concluded that treatment agencies should address these issues, including through the provision of more drug services in mainstream settings, in order to ensure that drug services are not seen to be suitable only for one particularly stigmatised category of drug user

Tackling concentrated worklessness: integrating governance and policy across and within spatial scales

Spatial concentrations of worklessness remained a key characteristic of labour markets in advanced industrial economies, even during the period of decline in aggregate levels of unemployment and economic inactivity evident from the late 1990s to the economic downturn in 2008. The failure of certain localities to benefit from wider improvements in regional and national labour markets points to a lack of effectiveness in adopted policy approaches, not least in relation to the governance arrangements and policy delivery mechanisms that seek to integrate residents of deprived areas into wider local labour markets. Through analysis of practice in the British context, we explore the difficulties of integrating economic and social policy agendas within and across spatial scales to tackle problems of concentrated worklessness. We present analysis of a number of selected case studies aimed at reducing localised worklessness and identify the possibilities and constraints for effective action given existing governance arrangements and policy priorities to promote economic competitiveness and inclusion

Reproducing vulnerabilities in agri-food systems: tracing the links between governance, financialisation and vulnerability in Europe post 2007-2008

Interconnected sets of vulnerabilities have emerged in the European food system since 2007–2008, raising concerns about food security in a region with arguably some of the most advanced and prosperous economies and environmental governance frameworks. Historically, this is suggesting the current “double jeopardy” problem in food system vulnerability—with systemic declines both in sustainability (the ability of the food system to ecologically renew itself) and food security (the ability of a population to access sufficient nutritional foods and feed itself). By focusing on both drivers and impacts of food system vulnerabilities in the European Union and United Kingdom, this paper explores a grounded and relational approach to financialization—recognized as a key expression of recent growing vulnerabilities. Through the prism of the current socio‐economic pressures facing food producers, and the emergence of potentially “stranded assets” in the agri‐food system more generally, the analysis seeks to show how the combined relationships between neo‐liberalized governance and the market volatilities encouraged by new rounds of financialization are creating “nested” vulnerabilities. As we conclude, a critical, grounded, and systemic understanding of food system vulnerabilities thus becomes a key feature and precursor for potentially developing more resilient agri‐food systems—both regionally and globally

Drug policy constellations: A Habermasian approach for understanding English drug policy

Background: It is increasingly accepted that a view of policy as a rational process of fitting evidence-based means to rationally justified ends is inadequate for understanding the actual processes of drug policy making. We aim to provide a better description and explanation of recent English drug policy decisions. Method: We develop the policy constellation concept from the work of Habermas, in dialogue with data from two contemporary debates in English policy; on decriminalisation of drug possession and on recovery in drug treatment. We collect data on these debates through long-term participant observation, stakeholder interviews (n=15) and documentary analysis. Results: We show the importance of social asymmetries in power in enabling structurally advantaged groups to achieve the institutionalisation of their moral preferences as well as the reproduction of their social and economic power through the deployment of policies that reflect their material interests and normative beliefs. The most influential actors in English drug policy come together in a ‘medico-penal constellation’, in which the aims and practices of public health and social control overlap. Formal decriminalisation of possession has not occurred, despite the efforts of members of a challenging constellation which supports it. Recovery was put forward as the aim of drug treatment by members of a more powerfully connected constellation. It has been absorbed into the practice of ‘recovery-oriented’ drug treatment in a way that maintains the power of public health professionals to determine the form of treatment. Conclusion: Actors who share interests and norms come together in policy constellations. Strategic action within and between constellations creates policies that may not take the form that was intended by any individual actor. These policies do not result from purely rational deliberation, but are produced through ‘systematically distorted communication’. They enable the most structurally favoured actors to institutionalise their own normative preferences and structural positions

How will alcohol sales in the UK be affected if drinkers follow government guidelines?

Aims: The proportion of alcohol consumption that is above government guidelines ('risky drinking') has been estimated in several countries, suggesting that reductions in risky drinking would lead to significant declines in total alcohol consumption. However, this has not previously been conducted transparently in the UK. Furthermore, existing studies have under-explored the importance of several methodological decisions, as well as not closely examining the meaning of these figures for debates on 'corporate social responsibility' (CSR). Methods: Secondary analysis of the amount of alcohol consumption above various government guidelines in four British datasets for 2000-2002: the National Diet and Nutrition Survey; the General Household Survey; Smoking, Drinking and Drug Use among Young People; and the March 2002 ONS Omnibus Survey. Results: Risky drinking accounts for 55-82% of the total consumption by 18- to 64-year olds, depending on the definition of risky drinking used. If only alcohol above the government guidelines is counted, this falls to 22-475. Consumption by underage drinkers accounts for 4.5% of the total consumption, while consumption by drink-drivers accounts for 0.5-8.0% depending on the assumptions made. Conclusions: Methodologically, the study shows that at least two decisions have considerable importance: the definition of risky drinking used and whether we count all drinking (as in most previous studies) or only drinking above guidelines. Substantively, these studies do not directly show that drink companies' profitability would be affected by declines in risky drinking. Nevertheless, they are valuable for present debate in themselves and form the basis of a more complex analysis of alcohol CSR

Assessing UK Drug Policy from a Crime Control Perspective.

Over the entire last quarter of the 20th century the British drug problem worsened, despite the implementation of a variety of approaches and commitment of substantial criminal justice and other resources. The link between chronic use of expensive drugs and property crime makes this experience important for understanding trends in crime and justice in Britain. The worsening of the problem can be seen in the growing number of new heroin users each year over almost the entire period 1975–2000, on top of which was layered, starting in the late 1990s, the first major outbreak of chronic cocaine use. This was not the common pattern in Western Europe over that time and by 2000 the UK had Western Europe’s most serious drug problem. The response initially took the form of increasing enforcement against drug markets; in just the decade 1994–2005 the number of prison cell years handed out in annual sentences has tripled. Even with this expansion we estimate that the annual probability of incarceration for a class A drug dealer is only approximately 6 per cent. Since 2000 there has also been a massive increase in treatment resources linked to the criminal justice system. The number of treatment assessments in recent years has been as large as 58 per cent of the number of persons estimated to be problematic users of Class A drugs. The government believes that drug policy has contributed to the decline in crime in the UK since 2000. Using what is known about treatment outcomes, we argue that despite impressive evidence of effect on individual level offending, the effect of treatment expansion in reducing overall crime rates is likely to have been limited

Personal budgets in adult social care: the fact and the fiction of the Care Act 2014

Personal budgets have been heavily promoted in government policy in England as a means of increasing the personalisation of public services, particularly in the field of adult social care. The Care Act 2014 for the first time creates a statutory requirement for personal budgets to be allocated to all individuals using state funded social care. This article examines how a particular rhetoric has developed in social care policy around personal budgets, which draws freely on the language of the disabled people’s movement and suggests that grassroots ideas are the central purpose for the introduction of personal budgets into policy. It considers whether the promises made in policy are embedded in the 2014 Act and finds that there is a mismatch between claims in social care policy on the one hand and the model of personal budgets created by the 2014 Act on the other. It concludes that the policy rhetoric around personal budgets directly appropriates the language and ideas of the disabled people’s movement while promoting a wholly distinct agenda of public sector marketisation