Drugs, risk and society: Government, governance or governmentality?

Abstract

This themed issue of Health, Risk & Society on Drugs, Risk and Society brings together six articles reflecting the importance of drugs in the study of health risks. The articles fall into three groups. The articles by Davis and Abraham (2011) and Gardner and Drew (2011) explore the government of risk and the ways in which regulators use scientific expertise to identify and control risks. Both articles show the limitations of such expertise and the influence of other processes. Davis and Abraham (2011) examine the ways in which political pressure on the US Federal and Drug Administration has made it more sympathetic to pharmaceutical companies. Gardner and Drew (2011) analyse the ways in which regulators in New Zealand were forced to respond to patient and media claims that a new formulation of Eltroxin caused side effects even though there was no scientific evidence for such claims. The second group of articles (Himmelstein et al. 2011, Jin et al. 2011) explore the governance of drugs and the ways in which governments seek to influence drug use through public health measures. This approach involves the sharing of the responsibility for the management of the potentially harmful effects of drugs with experts providing potential users with information on these effects and encouraging rational and the responsible use of drugs. Both articles show that this approach is likely to have limited effects if it does not address the underlying reasons for drug misuse, in the case of Chinese villages the pressure on local doctors to prescribe and sell antibiotics to their patients to maintain their incomes (Jin et al. 2011), or there is a lack of awareness or trust of the source of information, as is the case of parents in the UK and US buying over-the-counter cough and cold medicines for their young children (Himmelstein et al. 2011). If governments and their agents disregard individual understanding and perceptions they can be seen as using risk to construct social problems; those threatening the established order of society. The papers in the final section of this issue consider ways in which individual drug users resist such control and develop their own assessment of risk and their own patterns of drug use. Harrison and her colleagues (2011) consider the Australian government efforts to control the consumption of alcohol, in order to minimise its harmful effects and in particular to reduce young people's harmful ‘binge’ drinking habits. The participants in this study saw themselves as engaging in ‘controlled drunkenness’. These young people were interested in the pleasurable not the harmful aspects of alcohol consumption. In terms of the public health guidelines, most of these young people were binge drinking however they saw their drinking as reasonable and safe. McGovern and McGovern (2011) examine crack cocaine: an illegal ‘heavy-end’ drug which drug regulators consider causes considerable harm to its users and others and wish to prohibit. However for the crack cocaine users it was a purposeful activity. It enabled users to create meaning in otherwise meaningless lives. Crack cocaine enabled individuals to develop and demonstrate specialist and valued skills and knowledge and negotiate the dangerous ‘edge’ inherent in heavy-end crack cocaine use and control the uncontrollable.

Keywords:

• risk
• drugs
• government
• governance or governmentality