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Mass Observation was an independent social research organization which, between 1937 and 1949, documented the attitudes, opinions and everyday lives of the British people, using a combination of anthropological fieldwork, opinion surveys and written testimony. The Pub and the People is a classic text for its distinctly sociological approach, seeing patterns of drinking and socializing in context, rather than focusing primarily on pathological consequences. The main conclusions were that the pub is a living social organism and that the traditional approach of British sociology which, Mass Observation argued, focused on 'the drink problem' and the links between alcohol, crime and delinquency, failed to take account of the full social context. Mass Observation's focus on the pub as a place anticipates themes taken up in work on alcohol in cultural geography. Later alcohol researchers and epidemiologists have continued this orientation, recognizing the importance of physical and social environments in relation to alcohol consumption. Other studies have built on the MO initiative by looking at how drug and alcohol consumption links to identity, friendship and sociality or at the connections between intoxication and pleasure. The value of this classic text is that it reminds us that paying attention to the social context is not just a useful supplement, but absolutely central to understanding the use of alcohol or drugs.

This chapter discusses the controls on drug users in Britain, especially as they operate through the treatment and care system. ‘The most important lesson of the British system is the lesson of pragmatism’. The British approach has never in practice been much like the coherent and self-contained orthodoxy it is imagined to be by overseas commentators. The contrast between abstinence-based and harm-minimisation policies formed the fulcrum of discussion. ‘Politics is the art of the possible’ said R A Butler, a leading post-war Tory politician. In the 1980s, despite this being seen generally as the decade of conviction politics, British drugs policy evidenced a sophistication of approach, a nice balancing of competing pressures, which indicated that the arts of negotiation and compromise remain central skills of the main players in this field. Partnership as the new mode of regulation appears at the end of our story as much in the drugs field as in other areas of British social policy.

This interdisciplinary collection examines the role that alcohol, tobacco and other drugs has played in framing certain groups and certain spaces as 'dangerous' and in influencing the nature of formal and informal responses to the perceived threat. The book brings together a range of case studies drawn from different countries and across different time periods.

In the introduction, we introduce the key concepts used in the chapters to examine the role of substance use in perceptions of particular individuals, social groups or spaces as a threat to society. Theories on frames and framing processes provide the conceptual framework for the book as a whole; in each chapter, we consider how a particular problem definition, causal interpretation, moral evaluation and/or treatment recommendation come into being and influence perceptions of substance use and of people and spaces. The concepts of ‘risk’ and ‘danger’ are closely related, although use of the term ‘risk’ has become widespread and dominant in recent research and policy and the groups of concern in this book are frequently defined as being ‘at risk’ as well as being seen to constitute a risk to the social status quo in one way or another. The chapters explore different aspects of risk perception and responses to perceived risk and danger across time and across different spaces. Finally, we provide a brief introduction to each chapter.

This introduction presents an overview of the key concepts covered in the subsequent chapters of the book. The book indicates various ways in which attempts are being made to knit together members of partnerships, in the interests of effectiveness and integration. It offers remarkably topical discussions of cities and urban policies in the 1990s whilst, at the same time, locating current trends in a broader context. The renewal of theoretical and empirical work in urban sociology has been brought about by a recognition of the significance of cities within the forms and dynamics of western capitalism. The restructuring of urban employment relations has been a global process, generating new international divisions and connections between capital, labour and resources. Governance can be defined as 'the control of an activity by some means such that a range of defined outcomes is attained'. There is a need for detailed empirical studies of the place of partnerships within restructured urban institutions, organisations and relations.

This collection examines the profound transformations that have characterised cities of the advanced capitalist societies in the final decades of the 20th century. It analyses ways in which relationships of contest, conflict and cooperation are realised in and through the social and spatial forms of contemporary urban life. In particular, the essays focus on the impact of economic restructuring and changing forms of urban governance on patterns of urban deprivation and social exclusion. These processes, they contend, are creating new patterns of social division and new forms of regulation and control.

The relationship between international evidence, politics and policy is never straightforward. Politicians sometimes cite comparative findings from social science evidence collected and analysed by...

This paper explores the competing influences which inform public health policy and describes the role that research evidence plays within the policy-making process. In particular it draws on a recent English alcohol policy case study to assess the role of evidence in informing policy and practice. Semi-structured interviews with key national, regional and local policy informants were transcribed and analysed thematically. A strong theme identified was that of the role of evidence. Findings are discussed in the context of competing views on what constitutes appropriate evidence for policy making.

Regional Alcohol Managers (RAMs) were employed in the nine English health regions over 2008–2011. Their mission was to impact on the ‘hard target’ of Alcohol-Related Hospital Admissions (AHRAs) through the ‘soft methods’ of persuasion and influence: working with local partners on evidence-based interventions. Drawing on a qualitative evaluation, this article shows how a central government policy imperative (ARHAs) led to ‘government at a distance’ responses, including the introduction of RAMs. The processes involved in shaping and delivering this function bore the hallmarks of a complex, interactive policy network model, involving individuals whose bearings and roles were flexible and sometimes ambiguous. While there were overlaps and blurring of boundaries, there were three levels of policy network: central government, regional and local. As the ‘network in the middle’, the RAMs were pulled in both directions by conflicting agendas but were also able to have an impact on central and local policy.

This chapter gives an overview of the international context within which drug policies have developed. It shows how Britain has been and is linked to the rest of the world through foreign policy and trading relationships. It illustrates the impact of drugs around the world in cities like Rio de Janeiro and Prague, and in countries ranging from the USA to Africa and Afghanistan, Mexico and Colombia. It notes recent trends in globalisation and the growth of organised crime. The international drug control system is outlined with its Conventions, institutions and agencies. A brief review of some of the activities of those for and against drug policy reform is given, paying especial attention to UNGASS 2016.

This chapter illustrates how the drugs ‘problem’ appears at the local level, that is, the view from below. It demonstrates the mismatch between the ways the issue is seen at the national level and at the local level. It is shown that ‘drugs’ interlink with a wide range of other social factors, especially those relating to poverty and inequality. Some examples are given of how experiences and policies developed from the 1980s through the 1990s/2000s to the present. This chapter considers some of the effects of austerity policies on local services.

This chapter gives an overview of the development of UK drugs policy since the MDA 1971. After noting changes in the social context, three phases are identified: the turn to harm reduction; the drugs-crime agenda; and the move to recovery. Continuities and changes are noted in the perception of the ‘problem’ (HIV/AIDS, acquisitive crime and welfare dependence) and solutions proposed (expansion of treatment, partnership, localism and recovery). Current issues are highlighted including the effects of stop and search, imprisonment and the impact of austerity budgets.

In this chapter, MacGregor contextualizes the issue of universal health coverage. She summarizes moves towards the adoption of universal health coverage as a goal of international policy. Arguments for universal health coverage are reviewed, noting references to human rights, social justice, security and social integration. Competing ideas are considered—universalism versus selectivism, welfare state versus neoliberalism and social investment. The chapter looks at the political mobilization of ideas in high-income and middle-income countries. Issues of implementation, variations in financing mechanisms and state capacity are noted. The conclusion is that politics matters—even more so as new challenges appear.

Where ideas and values clash, the question then often turns to ‘what does the evidence say?’ This chapter demonstrates the growth in information and evidence on drugs in recent years and its wider availability. The institutions within which evidence is located are illustrated, as is the role of networks and collaborations in creating a standard body of information and shared understandings. The ways in which evidence is linked to policy are discussed, looking at the role of experts and the special function of the Report. Examples are given of reports which have or have not influenced policy. The over-riding impact of moral frames and politicians’ preferences is indicated.

This chapter begins with a consideration of the arguments mobilised in the UNGASS debates, including views contained in documents from INCB and the Global Commission on Drug Policy and in the Outcome Document. It looks in more detail at debates between supporters of ‘harm reduction’ versus ‘prohibition’ or a ‘drug-free world’. This chapter shows how these sets of ideas influence policies through images of drug users, how various explanations of drug taking have developed over time and how these link to policy proposals.

This chapter considers the complex world of policy where competing forces rise and fall in influence on the political stage, justifying the commonly applied term ‘messy’. This complexity is analysed using theories and concepts such as ‘window of opportunity’ and ‘policy streams’. The perspectives of elected politicians are reviewed, demonstrating the pressures against arguing for radical change. The role of the media is discussed. Possibilities for incremental change are illustrated and the potential for parliamentarians to raise issues on the agenda. Examples are given of the way various forces come together at critical moments, indicating the key role of political leadership, especially of government Ministers.

This chapter introduces the themes of the book. Over a 40 year period, ‘drugs’ have become a more familiar aspect of British life and increased in importance as a social issue. There have been changes in patterns of drug taking. While heroin use has receded, use of novel psychoactive substances has increased. The drugs problem cannot be said to have gone away even if reported drug crimes are going down. What we see is a more complex pattern of use. This chapter introduces the key concepts and theoretical perspectives which will inform the analysis of the drugs policy process.

This chapter draws together the arguments of previous chapters, showing how ideas, interests and institutions interconnect and the ways in which evidence and reasoning can contribute. It looks at the current international situation regarding the debate on drugs policy. It considers key issues for British discussion on drugs today, such as drug-related deaths and NPS. The chapter discusses the potential for progressive reform in Britain and reviews proposals to place public health and wellbeing at centre. This chapter concludes that to make progress we will need to improve the way issues are debated and, in devising policies, we will need to recognise the links between drugs, culture and other social needs.

This article is an analytic commentary which focuses on how politicians in the UK view the drugs problem and the relative influence on them of values and evidence. It draws on a wider qualitative case study of the contemporary British drugs problem and policies. The context is one where over-arching narratives play a dominant role and in this the mass media have been shown to be important. Politicians rarely challenge these narratives. Many see drugs as a toxic issue, one best avoided. Where drugs have appeared on the political agenda, the issue has been used as a weapon in a political game. Scientific evidence and calm appraisal have been subordinated to electoral concerns.

Background From the mid-1990s, UK governments developed partnerships to tackle drugs nationally and locally. Over time, increased resources focused on communities and localities in greatest need. This reflected growing awareness of the concentration of problems in deprived areas, with social and spatial segregation being a feature of post-industrial urban areas. Methods A review of English drug policy since the 1990s, drawing on:- analysis of documents; a review of sociological studies; an illustrative case-study of one northern town; interviews with local policy players; statistical analysis of key indicators with some of these data presented using Geographical Information System (GIS) mapping. Results In-depth sociological studies demonstrate interconnections between historical patterns, socio-economic change, cultural complexity, deprivation, limited opportunities and illicit drugs. At local level, there are links between concentrated multiple deprivation, poor health, acquisitive crime and problematic drug use. Partnership policies, encouraged by the provision of ring-fenced funds, have been effective in containing problems. Underlying issues of inequality are however neglected in political debates. The article argues that post-industrial towns and cities are characterised by an increase in problems related to poverty and drugs. Both the real shape and perceptions of what is the problem change over time. In England, the profile of the problem drug user was described in a number of sociological studies conducted from the 1980s onwards. Key features were the concentration of problems in certain social groups (such as the poorly educated or unemployed) and in certain areas (inner cities or outer estates). Responding to rising public concern, national drug strategies developed and the New Labour Government after 1997 prioritised the issue of drugs, directing increased resources to drug treatment with tight control over the use of these new monies through target setting and measurement of performance. The emphasis was on the most dangerous drugs and most disadvantaged areas. Conclusion There is local variation in the pattern of problems and in implementation of national policies. In UK after 1997, New Labour policy aimed to promote a fair and cost-effective distribution of resources and improved availability and quality of treatment services and local policing. Tensions appeared between the drive to meet national targets and local perceptions of need. Ideas of localism, promoting market solutions and flexibility in provision, are now gaining ground in English social policy with the arrival of a Coalition (Conservative/Liberal Democrat) Government. These, together with an emphasis on abstinence and recovery, raise questions about the future adequacy of (a) attention to marginalised problems and stigmatised groups and (b) the distribution of resources in a context of severe fiscal restraint.

This article provides a brief outline of the key innovations in Tackling Drugs Together, the UK Government's 1995 White Paper. It discusses the background to the emergence of this policy initiative and assesses issues of continuity and change in UK drugs policy.

This article considers the fears and tensions surrounding debate on treatment issues in the 1990s and the contribution of Tackling Drugs Together and the related Effectiveness Review to establishing the principle that ‘treatment works’ and the role of scientific evidence in the policy process.

This overview report summarizes the outcome of Phase One of the Drugs Misuse Research Initiative, which was funded through the Policy Research Programme at the Department of Health. The views expressed are those of the author and are not necessarily those of the Department of Health. The brief summaries of key messages and findings from each project are drawn from their final reports and executive summaries, and from commentaries on and discussions of these reports. The selection of what are “key” findings and lessons for research, policy, and practice are those of myself, as author of the overview report, but derive directly from the substantial reports produced by project teams. I hope I have done justice to their work, while recognizing that the interpretation and contextualization are my own, as is responsibility for any errors. The authors of the executive summaries which follow the overview report are the project teams themselves.

(2004). Editorial: The department of health (policy research programme) drug misuse research initiative. Drugs: Education, Prevention and Policy: Vol. 11, No. 4, pp. 277-280.

Eileen Gambrill has criticized the RAE (Research Assessment Exercise) process on the basis of her experience as one of eight non-UK experts advising the Social Policy and Administration and Social Work panel. Her criticisms have some validity, especially with regard to the role of non-UK experts. However, other comments give a misleading picture of how the panels operated.

Drug use among older people is a neglected topic. Not all older drug users are a social problem; they have varying needs and live in different situations within and between countries. Most policies focus on the young but numbers of older problem drug users are rising. There are high levels of unmet need and co-morbidity. Mainstream services will have to adapt to the changed profile of this population. A variety of proposals have been suggested by researchers and practitioners. There is a need to expand harm reduction services, provide services in the community and involve primary care physicians, encourage services to be more sensitive to the needs of this group, recruit and train staff appropriately, initiate innovations, link generic and specialist practitioners and coordinate health services with social care and housing provision. Key dilemmas are how to organise and finance services and whether these should be specialist or mainstream.

(2000). Editorial: The Drugs-Crime Nexus. Drugs: Education, Prevention and Policy: Vol. 7, No. 4, pp. 311-316.

This article presents an overview of three tendencies in advanced capitalist societies as far as social policy is concerned. These are characterised as ‘welfare state’, ‘neo-liberal’ and ‘new paternalist’. The article characterises each phase and shows how each is a response or reaction to what went before. Related sets of theories and key concepts can be seen to perform both explanatory and ideological roles. The article ends by setting out an alternative way forward towards a society organised around principles of social justice, equality and democracy.