Thinking historically about HAT

In early 2016, when I was drafting my chapter on drugs for the ‘Oxford Handbook of Criminology’, I made a passing reference to Dr John Marks’ heroin prescribing practice in the 1980s. I had assumed that somewhere there would be a definitive summary or account of Marks’ work which I could cite. It soon became apparent that this was not the case. For an episode that has always been so frequently referred to, this struck me as both odd and unsatisfactory. With my Handbook chapter completed soon after, however, I moved on to other things.

At the tail end of 2018, at the start of a period of research leave, I began to think about new projects I might develop. My vague thought was to do something that involved historical research that might lead to a rethinking or reassessment of an important contemporary issue. This led to two ideas: one on cannabis law reform that I will write about another day, and one revisiting John Marks. Arguably the most pressing drug policy issue of the last couple of years has been the crisis of drug-related deaths and Heroin Assisted Treatment has been much discussed as a potential tool for managing it. It seemed to me that filling this peculiar gap I had found in material about Marks could be a perfect vehicle for a project to think historically about a key contemporary policy problem and hopefully generate some new insights.

In the spring of 2019, I wrote to John Marks to share my idea and ask for his support. Had he not responded at all, or responded negatively, I would probably have abandoned the project. In fact, he replied quickly and positively, and offered to help in any way he could. His generosity and openness throughout the project was invaluable. In particular, his donation to me of many of his personal papers took the research up a level from what would have been possible otherwise.

The first stage of the project is now complete and a paper has been published in the International Journal of Drug Policy. I have created a page to house materials on the project and in due course this will include uploads of some of John’s donated personal papers, so that other researchers can also explore this fascinating and important body of work.

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Drug law reform

I have created a new page to bring together my previous and current work on drug law reform. Links to downloads where available.

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Drinking guidelines

Listening to the Today programme this morning, I was interested to hear the Chief Medical Officer, Dame Sally Davies, defending the new guidelines on weekly limits for safe drinking. She was particularly keen to stress their basis in science and evidence. It reminded me of a passage in Betsy Thom’s book Dealing with Drink where she describes the somewhat arbitrary way in which the original guidelines were created, particularly the figures for weekly unit limits. It made me wonder whether the new figures were really as ‘scientifically’ based as she was suggesting.

She also didn’t answer the question put to her about why there are government warnings about safe alcohol consumption but not similar warnings about other common risky practices. The suggestion that this was a bit ‘unscientific’ didn’t go down well! Of course, the actual reason is political and socio-cultural but this is difficult for a Chief Medical Office to say when there is this attachment to the idea that health policy can and should be strictly and solely based on ‘scientific evidence’. As I have argued before, this is particularly short-sighted and unrealistic when it comes to drug and alcohol policy.

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Free downloads

As part of the general sprucing up of this website, I have added a page for ‘Papers’ which includes free-to-access articles and reports. I’ll continue to add to this. In the meantime, feel free to share and if there are other articles you require, please email me:

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Revamped blog & website

To start the new year, I’ve revamped this blog and website, to include new pages covering my books, papers and projects. Work is ongoing to build up the content but do take a look round.

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Laying down the lasso

A recent report in The Guardian, on a ‘huge rise’ in illicit online sales of pharmaceuticals, reminded me of one of the best books I read in 2014: legal scholar Anupam Chander’s The Electronic Silk Road. Chander’s great insight, to my mind at least, is that as internet commerce and digital technologies are remaking the world before our eyes, we need to draw deep from the well of our creativity and imagination to build a new regulatory infrastructure for cybertrade. Trying to bend what he calls ‘Trade 2.0’ into the old legal frameworks is like a rancher trying to stop a car with a lasso.

Chander is mainly concerned with licit online trade but the challenge is arguably even steeper in relation to the growing use of the internet for illicit retail – whether of pharmaceuticals, psychoactive substances, or other counterfeit or prohibited goods. My own main interest is in online drug markets. Here, the sheer velocity of change in the last few years has been breath-taking, as the drug trade has been transforming in ways that even the sharpest-eyed observers can still only dimly discern. The one certainty is that policy-makers have not even started to grasp the nature and enormity of the new challenge, let alone to devise adequate new solutions – the drug-policy lasso remains very much in evidence. As I have argued recently, we need to be prepared to engage with genuinely new ideas if we are to achieve the kind of regulatory paradigm shift that is required. And it will be scholars like Anupam Chander who will be the most helpful guides as we seek to re-make global drug policy for the twenty-first century.

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Regulation and global drug policy

On December 4th, I will be giving a public lecture in Manchester. The lecture’s premise is that we have reached a dead-end in our thinking about global illicit drug problems. The argument I will make is that the way out of this intellectual and policy impasse is to view matters through the lens of regulation. Preparing this lecture has prompted me to reflect on how my ideas on this have developed over time and, more broadly, on my personal history of engaging with the ‘wicked problem’ of drugs.

My first entry into the drug policy world was nearly 20 years ago in January 1994 when I started as a Research Assistant at the drugs charity ISDD (now DrugScope), under the tutelage of Nicholas Dorn from whom I learnt a great deal. In those early years, the debate about drug law reform struck me as a largely uninteresting cul-de-sac. This was partly because I felt sure it was never going to happen and so discussing it at any length seemed self-indulgent. It was certainly not on ISDD’s official agenda. I also thought that there was a narrowness to the reform debate that was both politically and intellectually untenable: in a nutshell, too much emphasis on decriminalising possession for young people in richer countries, too little on the potential development consequences for poorer producer countries.

In 1998, I began my doctoral research, heavily influenced by Foucault and by the idea of governmentality as a different way of seeing the world. Although I came to view some aspects of the Foucauldian approach as unproductive, what stayed with me was the habit of questioning and pulling apart every assumption, concept and idea that I encountered. And inevitably, this ethos of critical thinking led me to revisit many of the positions I had held up to this point, including the question of drug law reform. Over the next few years, I began to think more and more about relationships between globalization and legal regimes, including the UN Drug Conventions and national drug laws.

A crucial turning point came in 2005. I can no longer remember exactly how it came about but throughout that summer, holed-up in my broom-cupboard of an office at the University of Leeds, I began to devour the work of people like John Braithwaite, Peter Grabosky and others in what was to me the then unfamiliar field of regulation. With perfect timing, at the end of 2005 an opportunity arose at the University of Manchester for a Senior Research Fellowship in Regulation which seemed to offer an ideal chance to explore these new ideas. The presence on the interview panel of scholars like Anthony Ogus, whose work I was starting to delve into, confirmed it was the right move for me and fortunately I was offered the job. The move to Manchester in early 2006 was a green light for me to press ahead with pursuing this agenda of reframing the drug problem as a regulation issue and during my first summer in Manchester I drafted a paper on the regulation of heroin which was my first public foray into this new territory.

My ESRC-funded project on criminal justice aspects of drug policy, later published as the Tough Choices book, proved fertile ground for continuing this work over the next couple of years. By early 2009, I was in the thick of working on what would become my second book, A History of Drugs. I consciously saw this as an exercise in bringing together Foucauldian critical analysis with a regulation perspective, partly inspired by the unique work of the South African scholar Clifford Shearing who visited Manchester a couple of times during this period. In March of that year, I presented a paper at the ISSDP conference in Vienna which tried to bring together my ideas at that point. Unaware of anyone else working along these lines, I fully expected the paper to be greeted with bemusement or indifference. In fact, my session was chaired by Australian drug policy researcher, Alison Ritter, who revealed she, too, was working on some similar ideas. Alison has since become a valued ‘critical friend’ for my work.

The Vienna paper became chapter six of A History of Drugs and led indirectly to an invitation to present at the 10th anniversary RegNet conference at ANU in Canberra in the spring of 2011. My paper went down well at the conference and informal conversations during my week at ANU with people like John Braithwaite, Peter Grabosky, Colin Scott, Philip Stenning, Peter Drahos and others, convinced me all over again that my intellectual agenda was proving fruitful and worthwhile.

In the last couple of years, I have been focusing on further developing the theoretical and conceptual ideas underpinning this agenda, with the aim of laying down the intellectual building blocks for what I now conceive as a substantial ongoing and future research programme. I hope some of you will be able to come along to my public lecture to catch up on my latest thinking.

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HASC, Clegg and drug policy reform

The publication of the Home Affairs Select Committee report on drug policy, followed by Nick Clegg’s intervention on the matter, raised a huge amount of interest in the field, prompting a flurry of media appearances, tweets, blogs and the like. My own response was more muted than all that and I couldn’t think of anything very constructive to say about it. And then I remembered a ‘Dear Minister…’ letter I was invited to write for Criminal Justice Matters in the run-up to the 2010 General Election, and realised this still pretty much said it all for me. So, I’ve reproduced it below…

 ‘What is to be done?’ Lenin once famously asked in his blueprint for a revolution. Some of this radical spirit will be needed by the new government if it is to get to grips with a key challenge for the coming decade: the problem of alcohol and other drugs.

 A Saturday-night tour of any police station or hospital A&E department teaches us a sharp lesson about the domestic failures of our current approach; whilst the violence and corruption in places like Afghanistan and Colombia remind us that this is a problem with a global span. How have we got things so wrong? And how can we put them right?

 There is no easy answer. We know that the old solutions do not work. Any politician who claims that the way forward lies in reviewing drug classifications or tightening supply controls or any of the other stock responses, is either misguided or dishonest. We desperately need fresh thinking.

 This will be difficult. It involves removing the comfort blanket of some of our moral, cultural and political certainties. Specifically, three habits of thought need to be overturned before we can make progress:

 1)      We must look beyond the law. Regulation scholars have taught us that the law is not the only game in town when it comes to regulating markets and human behaviour. The construction of a new legal framework is not a magic bullet.

2)      We must look beyond the state. State institutions, and supranational bodies like the UN, are only one set of actors in the field, and it is myopic to see them as the sole or even primary agencies involved.

3)      We must have an integrated approach. We should not assume that existing legal categorisations reflect actual differences between substances.

 The new government has the opportunity to be in the vanguard of a radical new approach. Will it have the courage and imagination to start a revolution?


Postscript. Two further thoughts about HASC/Clegg. First, calls for a Royal Commission are misguided, in my view. What is it about drug policy that we don’t already know? A Royal Commission would simply be an elaborate and expensive way of kicking the issue into the long grass. Second, a few days after Clegg’s statement, I heard a political commentator describing how the new LibDem political strategy involves disagreeing with their coalition partners as often as possible, as part of an attempt to avoid electoral meltdown in 2015. It’s hard to avoid the conclusion that Clegg’s intervention on drug policy is driven by rather more calculating and self-interested motives than some have suggested.

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More politics, less evidence!

A familiar trope in drug policy debates is the idea that policy-makers should pay closer attention to research and that there is a choice to be made between, on one side, ‘science’ and ‘evidence’, and on the other, ‘dogma’ and ‘politics’. And we are usually left in little doubt about which side the angels lie on!

Drug policy researchers and campaigners often appear to believe that if only they can make the evidence a bit more compelling or authoritative then they’ll eventually win the policy argument. But I’ve observed over many years that that just isn’t the case. There are many ‘controversial’ drug policy questions where the evidence is reasonably settled and clear – e.g. heroin prescription, needle exchanges – but which remain hotly contested. In fact, I would say it’s actually quite rarely the problem that the evidence base is lacking. So why is evidence not enough? One answer is that policy-makers simply find the lure of ‘playing politics’ too powerful to resist. Perhaps that’s partly true. But I’ve come to think that it’s actually misguided to believe that drug policy questions are always capable of being resolved by appeal to ‘science’. There are (at least) two reasons why this is the case.

The first involves thinking about what ‘playing politics’ really means in this context. Usually, we say this when we believe policy has departed from rationality because populist politicians are ‘playing to the gallery’. But this, it seems to me, is a caricature. Politics, at least in part, is about attempting to engage with the social and cultural anxieties and preoccupations of the time. It can be messy, even ugly sometimes, but it requires excessively narrow vision to see it solely as vote-grubbing behaviour by politicians. And this helps to explain why often we can’t rely on science to adjudicate for us between contested policy options. Drug policy isn’t a purely technical exercise – there are other matters in play and it’s a mistake to treat them as somehow inferior or illegitimate concerns.

The second reason is more fundamental. Drug policy and drug laws are, at root, about the relationship between the state and the individual. And this, in my view, makes them deeply political. Rather than shying away from this, we need to address the politics head on, with every bit the same rigour as we do other aspects of policy. And here we might ask where are the serious and penetrating analyses of the profound questions of power, authority and rights that underpin and run through drug policy? It’s a lamentable feature of much of the research literature that it focuses so much on investigating relatively minor issues, whilst, at the same time, pretending that it’s the big political questions that are trivial. In fact, I would go further and say that attempts to depoliticize drug policy are positively dangerous because they obscure what’s really at stake.                  

The title of this post is, of course, meant to be provocative and I’m not necessarily calling for less research to be done – this turkey is not quite ready to vote for Christmas just yet! – but I am arguing that we need to take the politics of drug control much more seriously, rather than seeing it as an unwelcome distraction. We need to understand that drug policy is politics.

[For further discussion of the politics of drug policy, see chapters 2 and 3 in Tough Choices]

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The politics of recovery

There is a widely-held view that drug policy in Britain (and elsewhere) is in the throes of a major transformation. Whereas for the last decade or longer, the policy obsession seemed to be with crime and criminal justice, over the last year or two, this focus has ebbed somewhat, as a new recovery agenda has emerged and rapidly come to the forefront.

One way to read this shift is in ‘epochal’ terms: a ‘governing-through-crime’ strategy giving way to a recovery-oriented one. And for many in the drug field, it certainly feels as if big change is in the air. A noisy grassroots recovery movement even talks of a paradigm shift.

But I am not convinced. In my view, at a strategic level, continuity is much more apparent than change. As I noted in my last post, the new direction in drug policy retains much in common with the previous crime-focused strategy (and, indeed, the earlier harm reduction approach): the same problematization (heroin/crack users as sources of risk to the community); the same conception of drug users (rational calculating choice-makers); and the same strategic response (encouraging/cajoling responsible choice-making to reduce risk).

What has changed is that the most significant type of risk posed by drug users is now seen as being a burden on the public purse by drawing benefits and failing to contribute as a tax-payer. What we are seeing then is not so much a new era of drug policy but rather a new politics of drug policy. In a time of economic recession and public sector cuts, there is a novel set of social and cultural preoccupations and anxieties (coded in the language of ‘cuts’, ‘austerity’ and ‘efficiency’) which is shaping how we frame drug policy – and the emerging recovery agenda fits perfectly with this reframing. But underneath all that, I would suggest that the fundamental strategic pattern in fact remains pretty much the same as it has done for the last 30 years. Plus ça change…

[This post is an adaptation of pages 166-7 in this book]

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