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Treatment for drug use in the UK, a one billion pound industry, is undergoing the biggest change to have occurred over the last twenty years with the emphasis that is now being given to ensuring that treatment services work to enable clients to become drug-free. The focus on drug users’ recovery is presenting drug treatment services with new challenges and fundamental questions: how many drug users can reasonably be expected to become drug-free? To what extent are staff within drug treatment services skilled to enable clients to recover? What does ‘recovery’ mean when clients remain without employment, stable housing, and estranged from their families? To what extent can a ‘harm reduction’ focus of treatment be combined with the new focus on facilitating drug abstinence and recovery? And can drug treatment services legitimately target recovery in individuals who are not yet expressing an interest in ceasing their drug use? These are some of the questions that are challenging providers and funders of drug treatment in the UK, and they are the focus of a special issue of the journal Drugs: Education, Prevention and Policy.

In this special issue, some of the UK’s top addictions experts consider the challenges facing drug treatment in a time of increasing austerity in the public funding of drug treatment and research. Born from two public debates between Professor Neil McKeganey and Professor Stanton Peele in Scotland in October 2011, drug experts in the UK and US respectively, the contributors to this issue discuss the direction of drug treatment policy in the UK and the likelihood that drug treatment services will be able to fulfil the goals of the new recovery-focused policy. In the view of Neil McKeganey, treatment services have been misguided for the last twenty years in their focus on reducing the harms associated with drug use rather than reducing the prevalence of drug use itself. In opposition to this view, Stanton Peele argues that the focus on abstinence which is beginning to characterise treatment services is misplaced, dangerous and indicative of the increasing power of treatment organisations, such as those based in a ‘Twelve-Step’ philosophy.

This special issue takes an uncompromising look at the current state of addictions treatment in the UK and includes contribution from those at the top of politics, academia, drug treatment, and drugs policy. The review will be of interest to all working at the front-line of drug treatment, designing drug treatment services, and funding drug treatment. The debate, which plays out within the issue, will also be of interest to individuals and families who are being affected by drug problems.

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