Working in drug treatment and health care facilities

Background: Little research exists on professional practices in the field of treatment and harm reduction. The existing literature is fragmented between on the one hand, testimonies of a few practitioners working in addiction care facilities and on the other hand guidelines and policy recommendations. Few studies explored the implementation of interventions dedicated to drug users and the human and social sciences approach is poorly represented. Little is known about the day-to-day activities, the perspectives and experiences of the professionals involved with drug users seen in the facilities.

The research caried out by the OFDT aims at expanding our knowledge of the routine activities of these professionals. Using a comprehensive sociological approach, the research seeks to provide a better understanding of their perception of their work, their relationships with their colleagues, the way they make individual and collective choices regarding drug users who are seeking help.

Methods: 65 Semi-structured interviews were conducted with practitioners from 12 treatment and/or harm reduction facilities: psychiatrists, psychologists, social workers, nurses, general practitioners. Collective semi-structure interviews were conducted with each team. About 200 hours of observation were completed (consultations, clinical meetings)

Results: Preliminary results show that despite the variety of drug users seen in the facilities, professionals face similar challenges. Two typical cases are violent drug users or patients whose health do not improve. Professional deal with a broad spectrum of personal and collective emotions on a day-to-day basis. Team dynamics are very much influenced by tolerance and emotional healing in the group as well power relations between so-called prestigious occupations (psychiatrists, psychologist) and all other occupations (social workers, peer support workers).

Conclusion: Sociological analysis of everyday work in addiction care facilities provides new insight on public health responses to drug harms. It helps identifying what is at stake between each professional, the care team and the drug user’s.