Australian drug policy: harm reduction and ‘new recovery’

The concept of “recovery” within alcohol and other drug treatment is far from new, and features in the demand reduction section of the Australian National Drugs Strategy.

Recent ‘recovery-oriented systems of care’ is a US-born concept that is shaping drug treatment policy in the United Kingdom, and is now in the early stages of being promoted in Australia. Leading proponents of the new recovery rhetoric do not claim it has a strong evidence base at the systems level.

Resourced properly, new recovery could build upon harm minimisation and harm reduction programs that have been so successful in Australia. Such programs have managed to control the spread of disease and have opened up opportunities for treatment, thus making a positive contribution to public health promotion in this country.

Recovery systems most prominently promoted in the US appear to now value some harm reduction interventions such as pharmacotherapy, but link its value to abstinence, including even from alcohol. It would be unpopular and counter-productive if that narrow United States conceptualisation of recovery processes and outcomes was to take hold in Australia.

If new recovery was to become an agreed strategy, it should only evolve over many years at the frontline. Transformation toward new recovery approaches would require large-scale investments.

A lesson from the United Kingdom is that the new recovery philosophy is driving policy, but no additional resources required for systems-level transformation are forthcoming. If that was to be replicated in Australia it would most likely be highly disruptive and create harm that our public health approach seeks to prevent.

New recovery recognises that interventions to combat complex behavioural difficulties need more holistic responses, and far better co-ordination of a range of government and community services, particularly at grass-roots levels.

Recovery pathways are contingent upon matters such as housing, work, access to education, child welfare, protection of vulnerable people, health services more generally and the ability to meaningfully participate in communities.

As such, to use an Australian colloquialism, if it is to be fairdinkum then it has to be far more than merely a re-badging of harm minimisation, which has served various governments and the community well for more than 25 years.

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