Between Care and Order: Street-Level Workers’ Discretion and Drug Policies in Amsterdam (the Netherlands) and Porto Alegre (Brazil)

This comparative study analyses the implementation of policies on so-called ‘problem drugs’ (crack cocaine and heroin) for the cities of Amsterdam (in the Netherlands) and Porto Alegre (in Brazil). Using a variant on the street level bureaucracy approach, the study assumes that workers’ discretion has a central role in understanding the processes through which official public policies come into grounded existence. Workers’ discretionary choices involve the creation of strategies to cope with the gaps between the goals and expectations from official policies and the actual conditions of work at the street level. In the case of drug policies, this also includes negotiating between different approaches towards people who use drugs, which range from human rights and health care for users to law enforcement to ensure public order. Workers engage with organizational rules, goals and regulations plus other workers and users in making discretionary decisions on both problem definitions and possible solutions for drug use. All these factors are found to shape the ways in which workers’ discretion is exercised.
The research focuses on State supported workers in the social, health and law enforcement fields to analyse the dilemmas workers encounter in their daily interactions with drug users, and how they develop strategies to cope with them.
More specifically, it looks at how dilemmas and strategies vary across workers’ different working territories, differing interpretive beliefs around drug use, levels of support and constraints coming from their organizations, differing patterns of collaboration within and between sectors, and experiences of relationship with drug users.
The comparison between two cities enables the research to explore the impact of different socio-economic and historical circumstances on local opportunities for discretion and approaches to the exercise of discretion. Ethnographic techniques were used to gather information through direct observation and testimonies of 80 street level workers from 40 different services in the health, social and law enforcement sectors. In depth interviews were combined with extensive observation of workers’ activities in developing grounded analytical understanding of the forms and causes of discretionary decisions.
The study approaches discretion by combining theories from the fields of the global discourse on drugs and drug policies, street level bureaucracy, and governmentality. The analysis and interpretation of the primary data benefited from these approaches, but also allowed to challenge the use of these concepts as mono-disciplinary explanations. Workers’ discretionary choices in the studied cities were neither only determined by a self-centred behaviour nor only by a willingness to serve the clients, as different scholars from the street level bureaucracy field suggest. A more integrated and nuanced approach composed of different combinations was found.
The extent to which workers feel supported by their organizations have a role in discretionary decisions. Organizations perceived as more supportive, as commonly the case in Amsterdam, facilitate combinations of organizational rules and expectations with professional needs and/or the needs of users in workers’ discretionary decisions. Organizations perceived as less supportive, as commonly the case in Porto Alegre, lead to an increased tendency for workers to bend organizational rules towards the needs of users and/or themselves. Professional commitments and interpretive beliefs that workers hold as to ‘best practices’ towards drug users are also fundamental to define discretion.
While drug policy scholars suggest disputes around public health and public order are reflected as exclusive alternatives so that workers would hold one or other position, the findings of this study point at a more nuanced picture. Street level workers produce different combinations when swaying between care and order, continuously creating different meanings and practices of civil rights, public health and public order in Amsterdam and Porto Alegre.
In Amsterdam workers from all professional sectors have a higher tendency to share meanings and professional commitments towards care and order than their peers from Porto Alegre. In Porto Alegre, these meanings and commitments present more variations, especially between social and health sectors when compared to the law enforcement sector. In addition to differences, there are also surprising similarities in the underlying processes patterning how discretion is exercised and the experiences of users caught between care and order. By clustering the various experiences of workers, the study proposes five main discretionary postures workers can take when combining care and order in their daily activities. At the extremes of the spectrum, strong rights engagement with drug users can be contrasted with a frustrated withdrawal into alienated behaviour. In the middle of the spectrum where most workers in both cities operate, workers may combine care and order by using benefits, persuasion or enforcement of rules to promote behavioural changes among drug users.