1. "It's going to get pretty tippy": Stakeholder perspectives on the (dys)function of a four pillars drug strategy.
- Author
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Greer A, Zakimi N, and Ritter A
- Subjects
- Humans, Stakeholder Participation, Law Enforcement, Canada, Health Policy, British Columbia, Qualitative Research, Interviews as Topic, Harm Reduction, Substance-Related Disorders prevention & control
- Abstract
A 'drug strategy' is a policy document that structures the priorities and directions for interventions for drug related issues within a particular jurisdiction and/or context. A 'pillars' drug strategy concentrates efforts through clustering separated columns of activity, such as law enforcement, harm reduction, treatment, and prevention. In this study, we examined drug policy stakeholders' perspectives on the structure, function, and fit of a four pillar drug strategy framework in Vancouver, Canada. Utilizing qualitative interview data from fifteen drug policy stakeholders, we examine perspectives on Vancouver's four pillar drug strategy that was implemented over 20 years ago. Our findings are organized under three main themes: (1) the notion of 'balance' of efforts, resources, and attention across the pillars; (2) how the pillars function as a cohesive whole; (3) whether the pillars' architecture is still fit-for-purpose. The architecture of four discrete pillars did not enable a sense of cohesion and collaboration of efforts, and instead elicited a sense of competition, conflict, fragmentation, simplicity, and rigidity of the strategy as a whole. These findings suggest that, in practice, a four pillars framework may be structurally dysfunctional in working towards a common goal. Our study questions the effectiveness of a commonly used 'pillars' framework and whether it needs to be reenvisaged., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Author(s). Published by Elsevier B.V. All rights reserved.)
- Published
- 2024
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