The Challenges of Replicating Drug Consumption Room Policy in Australia and Canada

: A Comparative Exploration of Policy Transfer

Abstract

The development of government policy to respond to the use and impact of illicit drugs is marked by controversy and the contestation of ideas. The aim of this thesis is to understand why some policy ideas succeed and others fail by exploring the challenges of replicating drug consumption room policy. Drug consumption rooms are government-sanctioned facilities that allow drug users to legally consume illicit substances under supervision to reduce the harms associated with drug use. Formal evaluations attested to their success as public health interventions, yet the body of evidence supporting their effectiveness has not resulted in the interventions becoming mainstream policy. The focus of this thesis is the challenges and barriers to the replication of policy both nationally and sub-nationally in Australia and Canada. The research applies a multiple case study methodology which combines documentary analysis and thematic analysis of semi-structured interviews with key informants, focused on four cities in the two countries.

Through the theoretical lens of policy transfer, this thesis identifies the different sources of policy change which have constrained or facilitated the replication of policy. Comparative analysis undertaken of successful and failed policy diffusion in the case study sites demonstrates the interactions between the structures of the state, ideas and agents. The thesis finds there is a tendency towards conservatism within institutional structures which constrains policy learning. The dominant ideology of drug prohibition and other ideational factors such as stigma serve to inhibit change. Crisis and civil disobedience are the two factors found to be significant where change has occurred. The actions of civil society challenge institutional power from the bottom up; a factor inadequately captured by the policy transfer framework with its focus on top down change. Following an appraisal of the framework, a modification is suggested to include civil society as a fifth source of policy change.

Date of Award	May 2019
Original language	English
Supervisor	Ann-Marie Gray (Supervisor), Karl O'Connor (Supervisor), Gordon Marnoch (Supervisor) & Gillian W Shorter (Supervisor)