Home > Service user perspectives of Irish drug policy: toward the development of a human rights based approach.

Healy, Richard (2019) Service user perspectives of Irish drug policy: toward the development of a human rights based approach. PhD thesis, Maynooth University.

External website: http://mural.maynoothuniversity.ie/13895/1/richard...

This thesis makes a number of key contributions to contemporary Irish Methadone Maintenance Treatment (MMT) discourse and practice. As a harm reduction modality, the annual number of clients availing of MMT in Ireland has continually increased, (EMCDDA 2017, 2018, 2019). Due to the recurrent absence of positive outcomes in the lives of clients, (Carew & Comiskey 2018, 2018a), human rights have emerged as a valid platform to frame a new approach to this recovery model, (CAN & SURIA 2018, Barrett 2010). Heroin use and MMT embody what is arguably the primary example and hegemonic response to problematic drug use in Ireland, (EMCDDA 2019). Therefore, both are explored as examples of deleterious Irish drug use and the predominant recovery model it employs.

A Foucauldian Approach, predominantly underpinned by genealogy and governmentality, informs the tracing of the continual and ephemeral construct of the Irish drug user (and drug service user), (Foucault 1991, 2000, 2008). This advances a cogent overview of the socio- historic trajectory of the service user and the concomitant societal and administrative responses to Irish problematic drug use. An analysis of this trajectory explicates that human rights and methadone use are not sudden manifestations of Late Modernity. Rather, they are the consequence of broader socio-political and economic contexts within which drug policy has always been framed.

A ‘two-step’ methodology, a combination of Participatory Action Research and Narrative Analysis, employed over a three-year period, enabled the compilation of rich, in-depth qualitative data from what is traditionally regarded as a vulnerable and hard to reach populace. This research asks important questions of Irish MMT. As a recovery modality, it is delineated as a mode of social control, a harmful harm reduction service and a method of governing and maintaining the docility of a population with little value to a society of frenetic consumerism, (Baumann 2000, Lee 2006, Palese 2013).

Human rights-based recovery advances treatment practices that promote dignity, respect and agency. Participation, autonomy, non-discrimination, equality and accountability are also values which should translate as tangible entitlements of rights based care, (Barrett 2010, Vizard 2011). Although Ireland is a signatory of several human rights instruments that ratify the Right to Health and The Public Sector Duty Act, these rights are rarely made manifest in contemporary Irish MMT practice. The findings of this thesis suggest that the methadone apparatus requires an urgent review of policy, governance and practice if the model is to rehabilitate, re-integrate and reduce the harm for those who have difficulties with opioid use.

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