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The drive to time-limit OST – Is it austerity or ideology? Is it good science and good practice?

First published: 09 May 2019 | Last updated: 20 May 2019

Treatment for heroin users is often motivated by ideology, politics and the economic climate of the time. Between 2008 and 2015, a battle has occurred in England and Scotland about ‘recovery-orientated drug treatment’ and the purpose of opioid substitution treatment (OST) for heroin users. Some politicians called for a time-limiting of OST, citing poor outcomes and variation in the quality of OST. However, the confounding context of financial cuts framed under ‘austerity’ has taking this situation deeper into shark, or politician – infested waters. This presentation discusses this period of acute conflict and change in the zeitgeist in OST – with its arguably positive aspects and significant risks.

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Report Author

Ms. Annette Dale Perera

Director ADP Consultancy UK


I have worked in substance misuse since being a volunteer at Leeds Addiction Centre in 1982. I was a practitioner for 6 years working in community services and therapeutic communities,   I was a research fellow for 6 years at the Centre for Drugs and Health Behaviour, University of London, I was Director of Policy at SCODA/DrugScope for 6 years, Director of Quality at the National Treatment Agency on Substance Misuse (NTA) for 7 years, and Strategic Director of Addiction and Offender Care for CNWL NHS Foundation Trust for 5 years until November 2014.
I have been a member of the Advisory Council on the Misuse of Drugs since 2010 and co-chair of the Recovery Committee
I was a commissioner on the UK Drug Policy Forum for 6 years.
I have authored and co-authored over 50 research, policy, practice and national guidance documents in these roles.

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