The collapse of communism in 1989/1990 was not good news for millions of the citizens of the former Soviet Union and Eastern Bloc countries. Communism as practised in these countries may not have been sustainable, but for the ordinary citizens it had many benefits. They were assured of employment, education, housing, health-care and even holidays. Basic needs, and more, were met. Economists and bankers have been able to track the collapse of the economies of these countries. For example, in the case of Ukraine between 1990 and 1994, the gross domestic product (GDP) dropped by 45.6%, industrial output by 40.4%, and agricultural output by 32.5%. In 1994 alone, GDP decline was 22.9%. From having virtually no one unemployed, by 2000 the number of unemployed had reached 2,707,000 (11.7% of the economically active population 15 /70 years of age) and of these 63.5% had been unemployed for more than a year (Balakireva et al., 2001). Some countries did worse, a few did better, but all economies have contracted. If the transition has been bad for people and communities as well as economies, then where might we see that evidence. This is one of the themes of the article by Martin McKee (2002). He points out that evidence to date has come from journalists and travel writers. They graphically document the collapse of societies and a growing health crisis. McKee argues that Russia has undergone a demographic crisis with plummeting birth rates and rising mortality. Underlying this he says, ‘‘was a massive increase in substance use, primarily alcohol, which had long been a major factor in low life expectancy in the Soviet Union, but, increasingly, drugs’’. The problem is that it is very hard to research. McKee looks to both the journalistic accounts and travel writers for the determinant of substance use during periods of transition. He elegantly brings in writing from other diverse sources from Dickens through Engels to Irvine Welsh’s ‘Trainspotting’ to show how alcohol and anomie feed into poor life chances and lowered life expectancy. He notes that weak social cohesion is an additional issue. This is an important and innovative article. More can and should be said. Is problematic substance use determined by social conditions or is it a determinant of them? The answer is, of course, both. However, a recent book (Barnett & Whiteside, 2002) suggests that social cohesion can be made up of either social control or civil society. Control derives from the exercise of centralised and homogenising authority over people. This may take the form of religious control, as in the case of some devout communities where there is little distinction between the public and private spheres and where ‘‘private’’ behaviour of all kinds, including sexual behaviour, is very closely regulated. Similarly, the application of a particular political ideology may have the same effect. This was so in the Soviet Union where it was impossible to travel without permission, book a hotel room without authority, and where in most aspects of life individual ‘‘private’’ behaviour was subject to state surveillance. An extreme form of authoritarian control of sexual behaviour existed in apartheid South Africa and in Nazi Germany. In each of these, legislation proscribed some sexual mixing. Social capital is the stuff of social cohesion in nonauthoritarian societies. The idea of social capital has Corresponding author E-mail addresses: whitesid@nu.ac.za (A. Whiteside), a.renton@ic.ac.uk (A. Renton). International Journal of Drug Policy 13 (2002) 465 /467