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The impact of this approach, also known as managerialism, has not been examined in addiction treatment, where the opioid epidemic has intensified the need for services. Using qualitative semi-structured interviews, we explore how managerialism has affected the workforce, service delivery, and the quality of care in New York City addiction treatment programs. Front-line and managerial staff identified threats to working conditions, including high caseloads and productivity demands; threats to service quality including standardization of practice, loss of professional discretion and serving only those most likely to succeed; and threats to worker well-being marked by stress, burn-out, and low morale. The contradictions between the goals of managerialism and addiction treatment threaten the ability to meet the needs of people struggling with addiction.<\/jats:p>","DOI":"10.1177\/10482911211041615","type":"journal-article","created":{"date-parts":[[2021,8,20]],"date-time":"2021-08-20T03:40:25Z","timestamp":1629430825000},"page":"259-270","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":6,"title":["On the Front Lines: The Impact of Managerialism on the New York City Addiction Treatment Workforce"],"prefix":"10.1177","volume":"31","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0739-6584","authenticated-orcid":false,"given":"Jocelyn","family":"Lewiskin","sequence":"first","affiliation":[{"name":"Licensed Clinical Social Worker, New York, NY, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mimi","family":"Abramovitz","sequence":"additional","affiliation":[{"name":"The Graduate Center, The City University of New York, New York, NY, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jennifer","family":"Zelnick","sequence":"additional","affiliation":[{"name":"Touro College, New York, NY, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2021,8,20]]},"reference":[{"key":"bibr1-10482911211041615","doi-asserted-by":"publisher","DOI":"10.1093\/sw\/swaa024"},{"key":"bibr2-10482911211041615","doi-asserted-by":"publisher","DOI":"10.4159\/harvard.9780674735880"},{"key":"bibr3-10482911211041615","volume-title":"Regulating the lives of women: social policy from colonial times to the present","author":"Abramovitz M.","year":"2018"},{"key":"bibr4-10482911211041615","doi-asserted-by":"publisher","DOI":"10.1093\/oso\/9780199283262.001.0001"},{"key":"bibr5-10482911211041615","unstructured":"Abramovitz M, Zelnick JR. 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