Drug Policy Debate Research Articles

Situating the Local in Global Drug Policy Debates: Historical Overview of Political and Drug Market Developments in Azerbaijan

Situating the Local in Global Drug Policy Debates: Historical Overview of Political and Drug Market Developments in Azerbaijan

When self-direction meets conformity: Surfacing Schwartz's 10 basic human values in drug policy dialogue with lived/living experience participants

BackgroundResearch on values is gaining in popularity within drug policy scholarship. To date, research has focused on analysing values within policy, through documentary analysis and interviews with key stakeholders. We extend this research enquiry to investigate the values that emerge from drug policy debate with those who have lived and/or living experience of using drugs. MethodsWe used workshop data collected from the ESRC-funded Drug Policy Voices project as the basis for our analysis. Within the workshops, participants were given a range of drug policy scenarios to discuss. We selected three scenarios for this paper which discussed policies related to cannabis, heroin, and MDMA/ecstasy. We coded the workshop data using Schwartz's ten basic values, which is a framework that perceives values as the core ‘motivators of action’ that underpin choices, attitudes and behaviours. ResultsWe found that the values of ‘self-direction’, ‘security’ and ‘conformity’ were prominent across this participant group, when discussing these policy topics. Yet the drug policy preferences discussed in the workshops revealed that it is the combinations of values that nuance preferences. Security combined with self-direction supports policies that enhance personal responsibility for change; self-direction combined with hedonism supports freedom to use drugs, whereas self-direction combined with conformity and achievement supports recovery policies; and conformity combined with tradition and power supports abstinence-based drug prevention. ConclusionSchwartz's ten basic values provided a useful framework for surfacing values that underpin drug policy preferences. These exploratory findings demonstrate that identifying values within dialogue is a complex process and reinforces opposing values can explain policy preference differences. More importantly, policy preferences were underpinned by combinations of values including those that are apparently opposing in Schwartz's circumplex.

Can drug policies modify cannabis use starting choice? Insights from criminalisation in Italy

A key question in the ongoing drug policy debate is whether legalising cannabis leads to an increase in cannabis use. In Europe although no country has yet moved to legalisation, many have decriminalised personal possession. However, some jurisdictions are still discussing increased sanctions or have further strengthened penalties for the possession of illicit substances in order to deter widespread cannabis use. This is the case in Italy, where a law introduced in 2006 and repealed in 2014 de facto criminalised personal drug possession, and a potential increase in penalties is currently being debated as a policy option. Despite the intense public debate surrounding the legal status of cannabis, limited empirical research has been conducted in Europe to assess the population-level effects of drug policy reforms, mainly due to data availability constraints. In this study, we analyse the effect of criminalisation on the age of onset of cannabis use using an unique dataset that combines seven waves (2001–2017) of the nationally representative Italian Population Survey on Alcohol and other Drugs with relevant socio-economic data. The final dataset comprises 77,650 observations. Leveraging the rare opportunity to examine the effects of a policy that remained in force for a limited period, our empirical investigation employs a Complementary Log-Log model to analyse the starting rate, that is, the transition rate from non-use to use. To do so, we use self-reported data on the age of first cannabis use. Our results suggest that the implementation of stricter punishments has a significant effect in reducing the likelihood of early cannabis use initiation. The observed impact of criminalisation is limited in younger ages and diminished as adulthood approaches. This paper also discusses other considerations related to the social costs of criminalisation, which should also be taken into account in the ongoing policy debate.

Debating the Drug Policy in Sweden: Stakeholders’ Moral Justifications in Media 2015–2021

Drug-related harms continue to increase globally and governments struggle in search of effective and legitimate countermeasures. The choice between policy options is intertwined with the arguments that dominate drug policy discussions, which in turn are closely related to who has access to the policy debate. In this study, we examine stakeholders’ visibility and moral justifications of argumentation in the Swedish drug policy debate in the media (2015–2021). Justification analysis (JA) is used as a methodological and theoretical tool to illustrate the moral principles behind the claims by the stakeholders. The results show that the most visible stakeholders were politicians, government agencies and molders of public opinion. Furthermore, the stakeholders with successful active attempts to participate in the debate were molders of public opinion, NGOs, and politicians. The silent stakeholders in the media were people who use drugs and significant others. Stakeholders generally revolve around a dividing line regarding the restrictive features of Swedish drug policy, and were divided into proponents, opponents and neutral ones. All stakeholder groups included all three sides, hence reflecting the ingroup dissonance that may explain the continuing deadlock in Swedish drug policy. Justifications that value evidence-based policymaking ( industrial worth) was used in the argumentation by the majority of the stakeholder groups, often combined with other moral justifications. This notion challenges the dichotomy of evidence and values in drug policy debates. Proponents relied more on the justifications that value paternalism ( domestic worth), while opponents leaned toward the justifications valuing civil rights and social justice ( civic worth). The development of Swedish drug policy may depend on the relative strength of these two value positions ( domestic versus civic worth) in society and among stakeholders in power. This study continues the discussion of making contesting values explicit in the drug policy, serving a riveting case for international comparison.

Doing autoethnographic drugs research: Some notes from the field.

This article is concerned with the processes of doing research with people who use drugs, as someone who has a history of using drugs. It offers a brief introductory review to autoethnographic research methods and how they might be used to enhance the practice of drugs research. Through illustrative examples from the author's own experiences of researching heroin use, the article cautiously makes the case for an increased focus upon our drug-using experiences in drugs research. The positive and negative implications of this for research methods in drug studies are discussed, as well as their potential intersections with drug policy debates.

Legalization as more effective control? Parallels between the end of alcohol prohibition (1927) and the legalization of cannabis (2018) in Ontario, Canada.

In the 1920s, eight of nine Canadian provinces legalized alcohol sales, ending prohibition in favor of government control. Much has been written about the rise and fall of Prohibition in North America, but there is little work examining these events in the light of current drug policy debates. This paper attempts to fill some of these gaps. The aims of this paper are primarily exploratory and descriptive. Following a literature review, it draws from secondary and some primary sources to explore the debate around ending alcohol prohibition (i.e. legalizing its distribution) in Ontario between 1920 and 1927. It then uses material drawn from a comprehensive search of the Canadian House of Commons debates on cannabis legalization between 2016 and 2018 to draw parallels with the debates around alcohol legalization in Ontario about 90 years earlier. While alcohol and cannabis legalization occurred in very different social and political contexts, there are similarities in both the arguments in favor of ending prohibition (ineffectiveness at preventing consumption and collateral social harms) and post-legalization debates around regulation (most notably the optimal way to replace the illicit market). The Canadian cannabis legalization debates of the 2010s echo the alcohol legalization debates of the 1920s in remarkable and relevant ways. Ultimately the most striking parallel may be the extent to which the political leaders advocating for legalization emphasized that their policy was not liberalization, but more effective control.

Further implications of the harm to others framework for drug policy debates.

Harm to others research has a long association with advocacy for alcohol control. However, because current drug laws create harms specifically arising from the prohibition of markets, such research could also support drug policy reform advocacy. Wilkinson and Ritter's excellent paper on the alcohol harm to others (AHTO) paradigm raises some critical questions. It should stimulate much-needed debate on how approaches developed within alcohol research apply across other substances. The authors note that a primary motivation for the recent development of AHTO research was ‘to increase political will for enacting alcohol policy’ [1]. This places AHTO in a much longer lineage. Specifying and quantifying the social costs of drinking was a key strategy in the 19th and early 20th-century temperance movements [2, 3]. Then, as now, advocates understood that focussing on social harms, rather than only individual risks, could more effectively shift the political dial. The explicitly instrumental, policy-oriented purpose of AHTO research reflects the degree to that the alcohol research community has accepted the principle that research should serve the purposes of public health advocacy and support specific policy solutions [4, 5]. This is understandable in the context of enormously powerful and badly regulated ‘addiction industries’ [6]. Nevertheless, Wilkinson and Ritter rightly warn against this leading to biases in research, such as attribution errors arising from a lack of attention to wider social and psychological contexts. They could also have added that reporting proportions of respondents experiencing ‘one or more’ harms from a list that varies considerably in severity may, while producing more eye-catching headline numbers, imply all harms are equal [7]. The paper also notes that AHTO research, by necessity, side-lines the critical role that pleasure plays in individual drinking choices. This is not insignificant, even when the purpose of a study is specifically to quantify harm [8, 9]. How many respondents reporting issues like nuisance would also, given the opportunity, add that alcohol has more often been a source of pleasure? Highlighting the trade-offs and ambivalences that characterise attitudes to alcohol provides deeper sociological insights, but is liable not to feature in research designed to support stronger control policies. In focusing on the relationship between AHTO research and advocacy, this paper raises an important—as yet unanswered—question. Could, or should, AHTO research be used to advocate for drug policy reform? The harms of alcohol fall primarily on the side of consumption and the risk of increased consumption under lax regulation. By contrast, an enormous proportion of the harms to others currently associated with illegal drugs arise from the prohibition of supply: from the violence and exploitation endemic in the supply chain, to the adulteration of products and the widespread stigmatisation of even low-level use [10]. Starting where we are, it is hard to imagine that a body of research that considered ‘all harms inclusive of supply and consumption’ [1] would not, to some degree at least, strengthen the case against drug prohibition. The paper also highlights (both explicitly and implicitly) an unfortunate, but often unavoidable consequence of existing drug laws on the conceptual framing of substance use: the widespread tendency to divide psychoactive substances into alcohol on the one side and ‘drugs’ on the other. This misleading dichotomy is rooted entirely in social history and legal status, not effects, risk, chemistry or patterns of use [6, 11, 12]. Phrases such as ‘alcohol and drugs’ entrench this problem, and alternatives (such as ‘alcohol, tobacco and other drugs’) go only some way to resolving it. Although sociologically meaningful (insofar as it is a condition within which ‘drug cultures’ and consuming behaviours emerge) it is, in other respects, absurd that substances as different as, say, psilocybin and heroin are lumped together in the analysis of harm or the implementation of policy, whereas drugs with at least superficial parallels in use patterns and risk profiles (e.g. alcohol and cocaine) are dealt with separately [11]. This paper shows the real need for harm to (or from) others studies to be applied to illegal drugs, but also that such research needs to be granular. This would greatly improve our ability to comparatively assess the harms caused by illegality with those directly linked to use. It would help with modelling how the latter may increase, or decline, under a range of alternative regulatory systems: a vital question in addressing the future development of drug policy. Hopefully, this paper will create momentum toward such programmes of work. Transform Drug Policy Foundation receives donations from a range of trusts and foundations, including the Open Society Foundation, as well as individual donors. Transform does not accept funds from cannabis, tobacco, alcohol or pharmaceutical companies.

The Meaningful Participation of ‘Stakeholders’ in Global Drug Policy Debates—A Policy Comment

This policy comment seeks to address three key questions relating to the participation of civil society in international drug policymaking. Firstly, who are the relevant ‘stakeholders’ and what options do they have to participate in drug policy discussions at the United Nations level? Secondly, have certain ‘stakeholders’ been able to positively influence the direction of global drug policies? And thirdly, who are the ‘most affected’ communities and what could be done to improve their meaningful engagement in the definition of drug policies that directly impact their lives? Unpacking the terminology around civil society, stakeholders, and most affected communities, the chapter argues for a clearer distinction between ‘rights-holders’ and ‘duty-bearers’. Masking the inherent power imbalances between the different stakeholders risks underplaying the rights of affected communities and legitimising a place at the table for corporations as ‘equal actors’ in spite of fundamentally different interests. The commentary concludes that the increased involvement over the past decade of civil society as well as other United Nations entities around the 2016 United Nations General Assembly Special Session on the World Drug Problem (UNGASS) has markedly influenced the global drug policy debate by shifting more attention towards health, human rights and development concerns.

Pasado y presente de los usos medicinales del cannabis en México

Este artículo tiene dos objetivos. Por un lado, examinar la historia de los usos terapéuticos y medicinales del cannabis en México; por el otro, exponer el proceso histórico que ha dado lugar a una compleja discusión sobre los usos médicos del cannabis en el México contemporáneo. La primera parte del artículo documenta la manera cómo la planta cannabis y sus derivados fueron incorporados en la farmacéutica mexicana durante el siglo XIX y principios del XX. La segunda parte expone el proceso tras el cual la planta cannabis dejó de ser considerada por los discursos oficiales un medicamento, para convertirse en una droga prohibida en el siglo XX. A la luz de esos antecedentes, la tercera sección expone de manera puntual el debate legislativo que actualmente busca reivindicar los usos medicinales del cannabis en México. Para la elaboración de este artículo se sistematizaron fuentes documentales de naturaleza diversa, las cuales fueron abordadas desde perspectivas ancladas tanto en la historia cultural e institucional, como en el debate actual de política global de drogas.

Making drug policy in summer-drug checking in Australia as providing more heat than light.

There was an exceptional drug policy debate in Australia over the summer of 2018-2019 regarding the availability of drug checking (pill-testing) services at festivals. Drug checking is not a new intervention and has been available across Europe for many years. This paper aimed to analyse the nature of the policy debate. Data were sourced from public domain sites; online, TV and radio media, alongside documentation of advocacy actions. Analysis of the contents of the public debate was conducted through the theoretical lens of Science and Technology Studies, notably the work of Stengers. The narratives identified in favour of pill-testing focussed on the evidence available to date, the importance of informed choice and accessing a population to provide information and education. The arguments against pill-testing included the belief that there is no such thing as safe drug use, the false sense of security that pill-testing would engender and that the evidence to date is equivocal. Both those for and against pill-testing shared the same goal-saving lives. However, the beliefs and values underpinning this goal differed. As the heat increased over summer, the debate became more polarised, but shedding little light. Drug policy debate, which becomes polarised, and remains focussed on matters of fact, rather than matters of concern, seems unlikely to result in productive resolutions. A more 'civilised' mode of debate that situates knowledge, engages values, is conducted with humility and encourages hesitation (following Stengers) may be more productive.

What Could an Asymmetrical Strategy Against Organised Crime Look Like? A Lesson from the Drug Policy Debate

The debate regarding the ideal response to organised crime is quickly evolving, although it remains often remarkably disconnected from the even more rapidly moving discussion on drugs. One important connection between these two debates is the application of a similar set of terminology – namely that of harm reduction. Harm reduction focuses on examining policy responses in ways which both highlight prevention and individual and community impacts, including the impact of law enforcement itself. If such a lens is applied to organised crime it is suggested that the three areas of focus should be: the reducing of violence; protecting political processes, and reducing impunity through high level and “symbolic” prosecutions.

Evidence and morality in harm-reduction debates: can we use value-neutral arguments to achieve value-driven goals?

It is common to argue that politicians make selective use of evidence to tacitly reinforce their moral positions, but all stakeholders combine facts and values to produce and use research for policy. The drug policy debate has largely been characterised in terms of an opposition between evidence and politics. Focusing on harm reduction provides useful ground to discuss a further opposition proposed by evidence advocates, that between evidence and morality. Can evidence sway individuals from their existing moral positions, so as to “neutralise” morality? And if not, then should evidence advocates change the way in which they frame their arguments? To address these questions, analysis of N = 27 interviews with stakeholders actively involved in drug policy and harm reduction debates in England, UK and New South Wales, Australia, was conducted. Participants’ accounts suggest that although evidence can help focus discussions away from values and principles, exposure to evidence does not necessarily change deeply held views. Whether stakeholders decide to go with the evidence or not seems contingent on whether they embrace a view of evidence as secular faith; a view that is shaped by experience, politics, training, and role. And yet, morality, values, and emotions underpin all stakeholders’ views, motivating their commitment to drug policy and harm reduction. Evidence advocates might thus benefit from devising strategies to morally and emotionally engage audiences. This paper aims to develop better tools for analysing the role of morality in decision-making. Using tools from disciplines such as moral psychology is relevant to the study of the politics of evidence-based policymaking.

Changes in the Estonian Cannabis Debate

The article analyses the discussion of cannabis regulation in the Estonian media. In the past five years, there has been a noticeable shift in discussion of drug policies in some Western countries and regions (the US, Canada, Latin America, etc.) from a punitive focus towards a more liberal approach. The Global Commission on Drug Policy recommends that countries put an end to civil and criminal penalties for drug use and possession. In this context, the article examines how the Estonian press has reacted to the situation. Which approach to cannabis (continuing to ban it vs. advocating legalisation) prevails in opinion pieces? What are the main arguments both for and against its legalisation? The media could play a prominent role in determining public opinion about illicit drugs and shaping relevant public policies. Hence, the author looks also at how the coverage has changed over time. A content analysis of 57 opinion articles, editorials, comments, interviews, and summaries of public speeches was carried out to study the political debate surrounding cannabis in 2009 and 2015, both years in which it was high on the media agenda. The content analysis was complemented by the method of close reading. The findings indicate that press coverage of cannabis has become more tolerant towards ‘softer’ drug policies. The chorus of ‘voices’ has become more complex, which reflects development of the drug-politics discourse. While the 2009 debate was launched by pro-legalisation lawyers and the discussion involved various professional experts (among them medical doctors, lawyers, and specialists in drug prevention), cannabis more often made headlines in 2015 because of work by civil activists, columnists, writers, etc. A strong dichotomy between traditional law-enforcement discourse and cannabis-legalisation and harm-reduction discourses has emerged. The author expresses the opinion that a shift in the global drug-policy debate alongside softened media coverage may pave the way for changes in the national drug policy.

'Naloxone works': The politics of knowledge in 'evidence-based' drug policy.

For over 20 years, drug policy experts have been calling for the wider availability of naloxone, to enable lay overdose witnesses to respond to opioid overdose events. However, the 'evidence base' for peer-administered naloxone has become a key point of contention. This contention opens up critical questions about how knowledge ('evidence') is constituted and validated in drug policy processes, which voices may be heard, and how knowledge producers secure privileged positions of influence. Taking the debate surrounding peer-administered naloxone as a case study, and drawing on qualitative interviews with individuals (n = 19) involved in the development of naloxone policy in Australia, we examine how particular kinds of knowledge are rendered 'useful' in drug policy debates. Applying Bacchi's poststructuralist approach to policy analysis, we argue that taken-for-granted 'truths' implicit within evidence-based policy discourse privilege particular kinds of 'objective' and 'rational' knowledge and, in so doing, legitimate the voices of researchers and clinicians to the exclusion of others. What appears to be a simple requirement for methodological rigour in the evidence-based policy paradigm actually rests on deeper assumptions which place limits around not only what can be said (in terms of what kind of knowledge is relevant for policy debate) but also who may legitimately speak. However, the accounts offered by participants reveal the ways in which a larger number of ways of knowing are already co-habiting within drug policy. Despite these opportunities for re-problematisation and resistance, the continued mobilisation of 'evidence-based' discourse obscures these contesting positions and continues to privilege particular speakers.

Rethinking ‘flexibilities’ in the international drug control system—Potential, precedents and models for reforms

BackgroundMuch international drug policy debate centres on, what policies are permissible under the international drug treaties, whether member states are openly ‘breaching’ these treaties by changing national regulatory frameworks and shifting priorities away from a ‘war on drugs’ approach, and what ‘flexibility’ exists for policy reform and experimentation at national and local levels. Orthodox interpretations hold that the current system is a US-led ‘prohibition regime’ that was constructed in an extremely repressive and restrictive manner with almost no flexibility for significant national deviations. This paper challenges these orthodox interpretive frameworks and suggests no absolute and clear dichotomy between strict adherence and ‘breaches’ of the international treaties. MethodsThis paper uses historical analysis to highlight the flaws in orthodox policy analyses, which assume a uniform interpretation, implementation and set of policy trajectories towards a ‘prohibition regime’ in the 20th century. It challenges some existing legal interpretations of the treaties through recourse to historical precedents of flexible interpretation and policy prioritisation. It then examines the legal justifications currently being formulated by member states to explain a shift towards policies which, until recently, have been viewed as outside the permissible scope of the conventions. It then examines a functionalist framework for understanding the likely contours of drug diplomacy in the post-UN General Assembly Special Session (UNGASS) 2016 era. ResultsThe paper highlights that, contrary to current policy discourses, the international control system has always been implemented in a ‘flexible’ manner. It demonstrates that drug control goals were repeatedly subsumed to security, development, political stability and population welfare imperatives, or what we might now refer to under the umbrella of ‘development issues.’ The paper further demonstrates that policy prioritisation, inherent treaty ambiguities and complexities as well as the recognition of broader issues of security and development were just some of the ways in which member states have flexibly implemented the treaties over the last century. This has frequently occurred in spite of apparent contradictions between national policies and reigning interpretations of international drug control obligations. ConclusionUNGASS 2016 inaugurated a new era based on an evolving understanding of the UN drug control system. In this ‘post-‘war on drugs’ era’, national and local policy choices will increasingly hold greater relevance than international ones. Further, based on numerous historical precedents, international legal interpretations will likely continue to evolve and serve a reactive functional role in providing the formal scope to justify national and local deviations from past global norms. These shifting interpretations are, and will continue to be, reflected in an interim reliance on treaty ‘flexibilities’ to explain sustained international cooperation, even as that cooperation shifts to an entirely new implementation framework.

Doctors, their leaders, and the drug policy debate

Despite the odd shout and whisper for reform, most doctors’ professional organisations have little to say about policies such as the criminalisation of people who use drugs. <b>Richard Hurley</b> reports

Evidence-based policy? The re-medicalization of cannabis and the role of expert committees in the UK, 1972–1982

BackgroundCannabis was introduced to the UK as a medical product in the nineteenth century. However, with questions over its safety, efficacy, and possible harms its medical role diminished and by the 1950s it was viewed as a drug of misuse. Nonetheless, scientific and lay knowledge around cannabis expanded from the 1960s and cannabis re-appeared in different therapeutic forms. In re-medicalizing cannabis, science-policy transfer proved important and was enabled by the developing mechanism of expert committees, most notably the Advisory Council on the Misuse of Drugs (ACMD). MethodsThis article draws upon previously unknown archival material on the ACMD held at the National Archives and covers the period 1972–1982. It considers how expert groups were established, their membership, and the evolving discussion over therapeutic cannabis within the broader drug policy debate. ResultsThree distinct periods emerged: 1972–1976 with the creation of the Working Group on Cannabis; 1977–1979 when the Working Group focused on potential amendments to the Misuse of Drugs Act and recommended downgrading cannabis from Class B to Class C; 1980–1982 when the Expert Group on the Effects of Cannabis recommended downgrading cannabis and encouraged research into cannabis as a medicine. Sources reveal that driven by drug control imperatives the ACMD stimulated research on cannabis leading to increased research on medical applications. ConclusionExpert advice was critical in the process of re-medicalization. Initially, discourse occurred in the closed expert committees of the ACMD. The drug problem had been framed under the criminal justice system but as the limitations of this were revealed, and there was continuing uncertainty over cannabis’ impact, new approaches to cannabis were sought. It was this combination of more relaxed attitudes towards cannabis, research incentives, as well as a developing desire to draw medical needs away from discussion of drug control that was to allow re-medicalization to develop.

The international dimension of drug policy reform in Uruguay

BackgroundIn 2013, Uruguay became the first country in the world to legally regulate cannabis from seed to smoke. A growing body of research addresses drug policy reform in Uruguay. However, existing studies have almost completely elided its international dimension, treating the process as exclusively domestic phenomenon. MethodsTo consider the international dimension of drug policy reform in Uruguay, the paper draws on primary and secondary sources such as existing studies, media reports, official documents, parliamentary debates and interviews with stakeholders and policy analysts from Uruguay and elsewhere. ResultsThe paper shows that, when, and, how international factors and actors contributed to Uruguay's drug policy reform process. Two ways in which the international dimension manifested itself are identified. First, as drug policy debate around the world changed, the context for reforms in Uruguay evolved. This resulted in a rather mixed international reaction to Uruguay's reform proposal. Second, international actors became directly involved in the process. Drug policy experts informed and legitimated cannabis reform and transnational advocates supported campaigning and mobilisation in Uruguay. ConclusionBy unearthing the international dimension of Uruguay's drug policy reform, the paper adds a novel perspective to the study of drug policy reform in the Uruguay.

UNGASS 2016: Insights from Europe on the development of global cannabis policy and the need for reform of the global drug policy regime

This article is framed by the forthcoming United Nations General Assembly Special Session on drugs (UNGASS) debates on global drug policy. It explores European drug policy experiences to draw out important lessons and insights that could be applied to wider global drug policy regimes. European experiences with (i) diverse cannabis policies and (ii) longstanding attempts to harmonise or coordinate diverse national drug policies in general are examined and the results are extrapolated to global drug policy debates. The diversity of drug policy seen within EU borders should be viewed (i) as a strength, (ii) flexibility under the international conventions is possible, but has limitations, (iii) changes to the global drug policy regime should seek to increase flexibility, and (iv) the importance of international institutions in providing a framework and an evaluatory role should not be under emphasised. Collectively, the evidence suggests the need for the loosening of controls restricting the development of diverse drug policy innovations, and the development of international drug policy frameworks and international standards of drug-related data collection.

Governing drug use otherwise: For an ethics of care

Contemporary drug policy debates are riven by a protracted antagonism between discourses that emphasise addiction, habit and despair, and those that endorse recreation, pleasure and self-control. This article eschews this antagonism by examining drug use in relation to what Michel Foucault called an ethics of care. My goal is to begin to imagine how drug use may be governed otherwise, in ways that avoid the normalisation associated with existing policy responses to drug problems. I ground this discussion in qualitative research conducted in 2012 in Melbourne, Australia with 31 drug consumers, and 15 health service providers. I explore how consumers govern their own drug use, and how these practices fit within consumers’ broader efforts to promote or maintain their health. I then use these findings to sketch a novel approach to drug policy formulation, less concerned with the amelioration of drug problems and more interested in promoting an ethics of care.