Making change happen: A case study of the successful establishment of a peer-administered naloxone program in one Australian jurisdiction

Analysis of how policy processes happen in real-world, contemporary settings is important for generating new and timely learning which can inform other drug policy issues. This paper describes and analyses the process leading to the successful establishment of Australia's first peer-administered naloxone program. Within a case study design, qualitative data were collected using semi-structured interviews with key individuals associated with the initiative (n = 9), and a collaborative approach to data analysis was undertaken. Central to policy development in this case was the formation of a committee structure to provide expert guidance and support. The collective, collaborative and relational features of this group are consistent with governing by network. The analysis demonstrates that the Committee served more than a merely consultative role. We posit that the Committee constituted the policy process of stakeholder engagement, communication strategy, program development, and implementation planning, which led to the enactment of the naloxone program. We describe and analyse the roles of actors involved, the goodwill and volunteerism which characterised the group's processes, the way the Committee was used as a strategic legitimising mechanism, the strategic framings used to garner support, emergent tensions and the evolving nature of the Committee. This case demonstrates how policy change can occur in the absence of strong political imperatives or ideological contestation, and the ways in which a collective process was used to achieve successful outcomes.