Demand-driven care: can it work in the addiction field?

In the addiction field, the approach to the client is being discussed because the care that is offered is apparently not fully effective, efficient or of sufficient quality. In the Netherlands the new policy direction in the addiction field aims at improving the quality and innovation of care and prevention by use of evidence-based research. One of the spearheads is 'Social Addiction Policy', which focuses on material context (housing, work, etc.) and social circumstances in which addicts live. This paper outlines the concept of demand-driven care and discusses its applicability in the addiction field. Quotations from drug users and clients of various services are used to illustrate the issues and attitudes discussed in the article. The new policy in the addiction field encompasses so called 'assertive outreach', which implies that care providers actively try to reach those marginalized groups that do not seek help themselves. Although this seems to be in contradiction with the general concept of demand-driven care, it is argued that demand-driven care in the form of assertive outreach is both necessary and possible. Four main characteristics of the addiction field are discussed in relation to the principles of demand-driven care, and are compared with characteristics of the healthcare sector. A demand-driven approach seems to be worth the effort, also in the addiction field.