The politics of drugs: perceptions, power and policies

Drug policy in the UK and across the globe is at a crossroads. In recent years, various developments have called into question the legitimacy and resilience of the three UN Conventions that provide the framework for global, multi-lateral drug control. Various countries are legislating for alternatives to outright prohibition to regulate drugs (especially cannabis) and drug users. At a more localised level, organisations such as the The Loop have reinvigorated harm reduction in more ‘recreational’ drug scenes by pioneering multi-agency site testing (MAST) at music festivals. An absence of direct investment from central government in other services such as Drug Consumption Rooms and Heroin Assisted Treatment for those with entrenched opiate addictions means that the number of drug-related deaths has risen to record levels (ONS, 2017). On top of this, new drugs and modes of obtaining them have become consolidated in markets across the world.

This book is, therefore, timely. As the respected commentator, Harry Shapiro, notes on the back cover, this is ‘a much-needed comprehensive analysis of the cut and thrust of UK drug policy’. ‘Comprehensive’ is right, as is ‘cut and thrust’. As MacGregor (p. 13) notes, rationalistic accounts of the policy process offer only limited value in explaining drug policy outcomes. Instead, decision-making in this policy area takes place in shadowy and hidden spaces where, following the line of argument of Gordon (1994), ‘shadow agendas’ are just as important as the ‘declared action agenda’.

Over a series of meticulously researched chapters combined with insights from various elite interviews with key policy personnel, MacGregor charts the various continuities and changes in drug policy at the local, national and international levels. The book moves on to document the influences on policy. This includes the role of ideas (e.g. harm reduction, abstinence, recovery), interests (those who mobilise ideas, e.g. NGOs at the national and international level and the strategies and tactics they employ), evidence and expertise, before arriving at the penultimate chapter which neatly summarises the politics of drug policy ‘as a continuing tension between opposing views, with a settlement or compromise being periodically negotiated between key players’ (p. 282). This settlement is maintained for a while before various forces, shifting agendas and debate occur again and change ensues. As MacGregor notes, rarely are these processes evidence-driven; they are more frequently driven by tension and unpredictability.

Various analytical devices are employed along the way enabling MacGregor to demonstrate the murky and often hidden world of drug policy making with impressive concision and clarity. Careful interweaving of documentary analysis with the insights of key informants is one. There is the eclectic, but in this case necessary use of policy theory to explain the volatile drug policy process. Arguably, however, the greatest device is MacGregor’s ability to display recent drug policy developments by the sophisticated use of typologies to illustrate continuity and change. MacGregor shows how recent drug policy should be understood against a backdrop of broader social policy. MacGregor notes how the post-War history of social policy, at least in the US and UK, depicts a move from the welfarism of the War on Poverty (1940s to 1960s) to the crime-focused War on Drugs (1970s to 1990s) to the security oriented War on Terror (2000s to present). It is no surprise that over time we have witnessed a disinvestment in programmes of heroin-assisted treatment, common in the era of the War on Poverty, and a reluctance to reintroduce these measures on a national scale in the present era as they are currently inconsistent with broader and strategic policy dynamics.

In discussing the direction of UK drug policy as characterised by successive central Government drug strategies, MacGregor notes how a transition from harm reduction (1980s and 1990s) to an emphasis on the drug-crime link (1990s and early 2000s) to a focus on recovery (2010 onwards) is discernible. (Broadly, this is an accurate depiction, but it does hide the fact that investment in law enforcement approaches to drug control has tended to be the strategic priority of successive Governments.) The emergence of measures in the 1980s in the UK to combat the public health crisis around HIV/AIDS such as needle and syringe exchange services, for instance, is, however, on the one hand a divergence from the broader movement away from the welfarism of the War on Poverty, but consistent with the strategic direction of policy at the time which was based on harm reduction. Such paradoxes are consistent with the conflict and tensions political battles that characterise drug policy and such complexities are precisely what the book carefully explains.

If I have quibbles with the book, they are minor. One could get bogged down in the detail of the different internal structures developed by Government to govern drug policy over the years. Fortunately, there is a comprehensive glossary to help out here. More prosaically, there is some inconsistency in chapter presentation. In chapter five we are given a list of key questions in a box that can be used to stimulate discussion. This is valuable as this book should be on every university reading list across the country for drug policy studies. The main drawback is that this is not repeated for all the other chapters and one is left wondering why.

My overarching recommendation is that this book is essential for anyone wanting to understand the way that drug policy works (or does not work) and why. MacGregor approaches head-on the impact of politics on policy. Such accounts can be superficial equating to a politics is bad, evidence is good calculation and so if we have more evidence we have better policies. MacGregor avoids this trap by painstakingly showing how the politics of drug policy operates, the key players involved, how decisions are made and the strategies employed by a range of different stakeholders over time to influence debate. It is an invaluable insight from a commentator of renown with a dedication to the making of better drugs policy.

Mark Monaghan

Loughborough University, Loughborough, UK

[email protected]