The relationship between recovery and harm reduction - the attitudes and beliefs of the addiction sector in Ireland

Background:

In Ireland to date, drug policies have been dominated by harm minimisation strategies with little recognition of addiction recovery. Recovery is not well represented in research, treatment data or funding allocations. As harm reduction services and progressive policies leap forward in Ireland, there is still no visible recovery movement and no cross governmental strategy to support people and communites to thrive. This study, completed in Trinity College Dublin in 2021, asks sectoral leaders and frontline staff what their beliefs and attitudes are regarding harm reduction and recovery. 

Methods:

This study used a mixed methods approach, capturing qualitative data from leaders in the sector and quantitative data from frontline workers.  One to one interviews were conducted with 11 sectoral eladers and a survey was condcted with 53 frontlien staff. All data was captures across three large cities in Irleand; Dublin,Cork and Limerick.  

Results: 

The data showed disparities between the beliefs of leaders in the sector and frontline workers in relation to knowledge of recovery in the sector and polarisation between recovery and harm reduction.

Summary of qualitative findings:

• The sector knows that the meaning of recovery has evolved by it is now vague and open to wide interpretation, which makes it hard to grasp.
• The sector is not motivated, informed or being led towards a common goal of recovery.
• The sector is motivated, informed and led towards a common goal of reducing harms. The sectors roots in medical responses to addiction have shaped this. 
• There are tangible interventions firmly rooted in harm reduction in Ireland which do support recovery.

Summary of the quantative findings:

• 84% understood the term “recovery capital” 
• 81% were confident working with people to build recovery capital
• 84% felt improvements could be made in in how harm reduction services contributed to building recovery capital
• 72.23% understood how harm reduction and recovery capital are linked
• 79.63% disagreed that harm reduction was anti-recovery 

Conclusion:

Ireland faces similar barriers to supporting recovery as the country did forty years ago. A system focused on supporting people to stay safer, connect with services and rehabilitate was and is an admirable achievement. It is understandable that, without the voices of those in recovery being heard, an overwhelmed system keeps working to meet the needs of the large number of people seeking help for acute addiction supports. However, as Ireland becomes a leader in terms of progressive social policy and indeed progressive harm reduction policy, this research has provided some insights into the risk of addiction recovery being left even further behind. 

While there are tangible interventions to be seen in a system which do support recovery capital, more work must be done to place recovery capital at the centre of any KPIs which are being set, alongside objectives to keep people alive and as healthy as possible.