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‘Ripping up the rulebook’: Experiments in post-pandemic substance use treatment

Funder: Wellcome TrustProject code: 224712
Funded under: Social Sciences Funder Contribution: 331,217 GBP

‘Ripping up the rulebook’: Experiments in post-pandemic substance use treatment

Description

If we take death as the ultimate harm, the UK has never been a more harmful place for people who use substances. Death rates from both drug- and alcohol- specific reasons are at their highest ever level. Moreover, some areas are experiencing their worst HIV outbreaks among injecting drug users in 30 years, and alcohol-related liver disease is rising steeply. As Covid-19 works to ‘expose and amplify’ existing inequalities, the fear is that these deaths/harms will increase further. However, Covid-regulations have also brought drastic changes to the sector, including long-sought flexibilities in treatment options and regimes. Prominent practitioners refer to these as ‘ripping up the rulebook’ and a ‘natural experiment’ with ‘potential for a lot of learning’. This project studies these experimental practices and what they open-up for improving treatment attractiveness and responsiveness. It maps experiments in service provision through a UK-wide survey and carries out ethnographic inquiry to establish how these practices re-work treatment and the role of service users’ own experimentations in these processes. Extending this experimentality through its methodology, the project brings together key stakeholders in a theatre-informed workshop to quite literally ‘rip up the rulebook’ (clinical/policy guidelines) to provoke further thinking and action on treatment possibilities. UK death rates from both drug- and alcohol-specific reasons are at their highest ever level. Moreover, there are ongoing HIV outbreaks among injecting drug users, and alcohol-related liver disease is rising steeply. As Covid-19 works to ‘expose and amplify’ existing inequalities, the fear is that these deaths/harms will increase further. However, Covid-regulations have also brought drastic changes to treatment provision, including long-sought flexibilities in options and regimes. Prominent practitioners refer to these as ‘ripping up the rulebook’ and a great 'natural experiment'. I will study these experimental practices and what they open-up for improving treatment attractiveness and responsiveness (to diverse needs). I will do this by surveying UK services, conducting ethnographic inquiry at specific sites, and facilitating theatre-based workshops with key stakeholders to provoke new thinking and action, which will then be developed into a play and film for engaging wider policy and practice audiences for engendering lasting change.

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