Purpose: The purpose of this paper is to explore a range of key deliberations with regards to adopting participatory action research (PAR) and privileged access interviewer (PAI) approaches and methodologies within research on substance use.Design/methodology/approach: This paper is a reflective piece; it adopts a mixture of applied practice and theory considerations. These conceptualisations capture what are still relatively early understandings and uses of such methodologies, acquired across several decades of research and service provision experiences. The paper is structured around some of the sequences of the research process and as such provides a broad framework for such approaches.Findings: PAR and PAI approaches utilise several key theoretical considerations. There are many critical issues associated with adopting these approaches, including those of ethics, funding, involvement, language, resources and support. Three key principle reasons (moral, political and research based) help explain why the authors should see more adoption of such approaches in substance use-related research.Research limitations/implications: This paper represents authors’ views which are by their nature very subjective.Practical implications: Implementation of the key considerations highlighted within this paper can lead to an active adoption of PAR and PAI methodologies within alcohol and drug research. Increasing the use of such methodologies will allow commissioners, researchers and service providers to develop a more nuanced understanding of the experiences of and responses to alcohol and drug use.Originality/value: This paper captures critical conversations at a time of increased calls for service user involvement across all aspects of alcohol and other drug provision, including evaluation and research

There is widespread support for the introduction of Drug Consumption Rooms (DCRs) in Scotland as part of a policy response to record levels of drug-related harm. However, existing legal barriers are made more complex by the division of relevant powers between the UK and Scottish Governments. This paper reports on a national, qualitative study of key decision-makers in both local and national roles across Scotland. It explores views on the political barriers and enablers to the adoption of Drug Consumption Rooms and the potential role of these facilities in the wider treatment system. It also considers approaches to evidence, especially the types of evidence that are considered valuable in supporting decision-making in this area. The study found that Scottish decision-makers are strongly supportive of DCR adoption; however, they remain unclear as to the legal and political mechanisms that would make this possible. They view DCRs as part of a complex treatment and support system rather than a uniquely transformative intervention. They see the case for introduction as sufficient, on the basis of need and available evidence, thus adopting a pragmatic and iterative approach to evidence, in contrast to an appeal to traditional evidence hierarchies more commonly adopted by the UK Government.

Aim: Minimum Pricing for Alcohol (MPA) was enacted in Wales on March 2^nd 2020. During the legislative process (i.e. consultation and parliamentary discussion), concern was expressed about the possibility of some drinkers switching to using other substances in response to any rise in the cost of alcohol. This paper reports on findings from a study which explored these pre-implementation concerns and how the policy was shaped. Method: The research involved surveys (n=193) and interviews (n=87) with drinkers (predominantly harmful or treatment seeking) and providers of services. Survey responses were detailed, thus when combined with the interviews, provided a wealth of qualitative data, which are drawn upon in this paper. Results: The findings highlight an expectation that most drinkers would respond to the new policy with adaptations of their coping mechanisms to maintain alcohol use at pre-legislative levels. This was either by switching alcohol products and adjusting their lifestyle to maintain an affordable drinking habit or developing new behaviours to manage additional costs. A small group of those with previous experience of drug use were identified as likely to switch from using alcohol to some other substances. Conclusions: Prior to the legislation being implemented awareness of the detail of the policy was found to be low, and the perceptions of increased potential harm for certain groups, including switching, were linked to concern about a lack of treatment capacity.

There is limited provision of inpatient detoxification relative to other treatments for alcohol and other drug (AOD) use. This means people often need to wait prior to detoxifying. However, waiting for healthcare is generally perceived as negative and stressful. This paper aims to understand patients' experiences of waiting for inpatient AOD detoxification to ascertain whether and how service-level policies and practices might be improved. Semi-structured telephone interviews were conducted with 32 people (20 males, 12 females; aged 25-67 years) who were waiting for inpatient detoxification. Data collection was part of a wider evaluation of a policy initiative started in 2021 to increase detoxification service capacity in England, UK. Interviews were professionally transcribed and data on waiting experiences were coded using qualitative software. Analyses were informed by new materialist thinking and undertaken via Iterative Categorisation. We found that waiting was constituted through five dimensions: i. duration; ii. support; iii. information; iv. preparations; and v. emotions. These five dimensions were multi-faceted and operated in and through wider interacting social, material, and affective forces (e.g., professional judgements, formal and informal relationships, the availability of beds and funding, bureaucratic procedures, the utility and relevance of information, and participants' diverse feelings, including desperation for treatment). Not all accounts of waiting were negative. The experience was complex, non-uniform and variable over time. Moreover, it affected how people felt and how they behaved. Changes to service-level policies and practices can potentially minimise the stress of waiting for inpatient AOD detoxification. The negative impact of waiting may be reduced if professionals more consistently engage patients in a wider range of constructive pre-treatment activities, offer regular 'check-ins' to mitigate any anxiety, explain changes in wait duration to help with planning and demonstrate fairness, and facilitate contact between those waiting to lessen feelings of isolation.

Contribution analysis (CA) is being increasingly favoured as a policy evaluation tool. This includes application to evaluate alcohol and drug policies. This paper reflects on one such example and begins by providing a brief overview of CA as an evaluative research method. It then describes the way in which CA was applied to evaluate alcohol and drug policy in Wales, one of the constituent countries of the UK. This paper reports on two issues. First, how the theory of CA was translated into practice. Second, the key learning points for us as evaluators that arose out of the utilisation of this method. The article highlights that our use of CA enabled a rich exploration of programmes within their contextual setting, and had a range of limitations and considerable challenges associated with identifying and explaining causalities. Within these methodological discussions, we also illustrate how the policy was more successful in elements closer to its nomenclature framing; i.e. harm reduction, than it was to other incorporated aims. The analysis presented in this paper will be useful across a range of jurisdictions where the need to evaluate drug and alcohol policy and practice initiatives may arise.

Supporting people with substance use disorder to work has become a key policy objective internationally. Meanwhile, interventions, such as Individual Placement and Support (IPS), have evolved to facilitate this. This article utilises the concept of emotional labour to explore the feelings and emotions experienced by people receiving treatment for alcohol and other drugs (AOD) who engaged with IPS and secured paid work. Data were generated (January 2024 to August 2025) during a mixed methods evaluation of IPS in community AOD services across England. Forty-eight new IPS clients participated in a longitudinal qualitative telephone interview study. Interviews (up to four per participant) were audio recorded and transcribed. Participants who secured paid work at any of their interviews were identified (n=16) and their interview transcriptions (n=57) were indexed and analysed inductively via Iterative Categorisation. All data relating to participants' feelings and emotions were grouped under one of six headings: "The desire to work"; "Emotional challenges to job seeking and starting work"; "Managing uncertainty in the pre-work phase"; "Positive feelings and emotions about working"; "Negative feelings and emotions about working"; and "Feelings about future employment". Analyses pointed to both positive and negative effects of emotional labour and highlighted an 'emotions journey'. People in treatment for AOD can become happy and satisfied employees. However, they need to be prepared for the complex feelings associated with seeking and securing employment. Professionals working in AOD and specialist employment services, such as IPS, are well positioned to assist clients through this emotional process.