Revised ‘Steps to Reintegration’ Model by Julian Buchanan

In an earlier series of blog posts starting here, I highlighted Julian Buchanan’s classic paper Tackling Problem Drug Use: A New Conceptual Framework in which he describes his ‘Steps to Reintegration’ Model, a model which I consider to be both very pertinent and important.

Julian’s paper is based on his twenty years of research and practice with dependent drug users in Liverpool, England. It draws upon three separate qualitative research studies that involved semi-structured interviews with 200 problem drug users. The studies sought to ascertain the views, suggestions and experiences of drug users in respect of what was helping or hindering them from giving up a drug-dominated lifestyle.

The paper highlights ‘the debilitating nature of marginalisation and social exclusion that many long term problem drug users have experienced. It concludes by suggesting a new social model to understand and conceptualise the process of recovery from drug dependence, one that incorporates social reintegration, anti-discrimination and traditional social work values.’

Julian’s ‘Steps to Reintegration’ model model is based on the stage-orientated model of Prochaska and DiClemente. He describes six phases, four of which occur before what he terms the Wall of Exclusion and two afterwards.

‘The Wall of Exclusion is not a phase but a barrier that makes it extremely difficult for recovering drug users to become accepted into the structures and networks of everyday life. The propaganda designed to deter people from trying illegal drugs by portraying drug users as a deviant enemy, has led to a war on drug users themselves. This has resulted in discrimination at every level. For many drug users relapse is not attributable simply to the physical craving or a change in motivation, but as a consequence of their frustration at trying to break into mainstream community life and finding themselves constantly shunned and excluded. At the very time when recovering drug users need assistance and support from the non drug using population to establish alternative patterns of social and economic life they are often prevented by the wall of exclusion.’

Julian recently contacted me from New Zealand, where he now lives, and sent me a revised figure of his ‘Steps to Reintegration’ Model which includes an additional feature, details of the Bricks in the Wall of Exclusion—Government Voices, Community Voices, Media Voices, and Drug User Voices. The quotes are real! I realised straight away I needed to post a blog about this revised model.

You might like to check out another of Julian’s papers, Understanding Problematic Drug Use: A Medical Matter or a Social Issue?