The misuse of drugs act – a user perspective

Purpose This paper aims to demonstrate the ways in which the Misuse of Drugs Act (MDA) militates against the interests and situations of people who use drugs. The author reflects on the author’s journey as a drug user, drugs workers and drug user organiser to critique the MDA. The author describes the impact of the MDA on the author’s early experimentation with substances and highlights the limitations of simplistic drugs prevention. The author describes how the MDA maximises drug-related risks and undermines the creation of healthy cultural norms and community learning among people who use drugs. The author talks about the author’s work as a drugs practitioner and mourns the vandalism of the UK’s harm reduction and drug treatment system. This paper describes the opportunity to use drug policy reform as a progressive electoral agenda to begin the journey towards racial and social justice. This paper calls for the rejection of the Big Drugs Lie and the repeal of the failed MDA. Design/methodology/approach Personal reflection based on experience as drug user, drugs worker and drug user organiser. Findings Successive UK Governments have used the MDA as a tool of social control and racial discrimination. The Big Drugs Lie undermines science-based and rights-compliant drug policy and drug services and criminalises and puts young people at risk. There is the potential to build a progressive political alliance to remove the impediment of the MDA and use drug policy reform as tools for racial and social justice. Practical implications The MDA maximises the harms faced by people who use drugs, stokes stigma and discrimination and has undermined the quality of drug services. The MDA needs to be exposed and challenged as a tool for social control and racial discrimination. Delivering drug policy reform as a progressive electoral strategy could maximise its potential to improve social and racial justice. Originality/value This paper represents the view of people who use drugs by a drug user, a view which is seldom expressed in the length and level of argument shown here.

More harm than good? Cannabis, harm and the misuse of drugs act

Purpose This paper aims to consider the nature of cannabis-related harms under the UK’s Misuse of Drugs Act (MDA). Written for the specific context of this four-paper special section on 50 years of the MDA, it argues that the MDA may cause more harm than it prevents. Design/methodology/approach An opinion piece offering a structured overview of cannabis-related harms under prohibition. It summarises existing evidence of the ways in which prohibition may exacerbate existing – and create new – harms related to the production, distribution, use and control of cannabis. Findings The paper argues that prohibition of cannabis under the MDA may cause more harm than it prevents. Originality/value It has long been argued that the MDA does not accurately or fairly reflect the harms of the substances it prohibits, and much existing research points to different ways in which drug prohibition can itself be harmful. The originality of this paper lies in bringing together these arguments and developing a framework for analysing the contribution of prohibition to drug-related harm.

Fifty years of the UK Misuse of Drugs Act 1971: the legislative contexts

Purpose The purpose of this paper is to illustrate the history of relevant legislation before and after the 1971 Misuse of Drugs Act (MDA). Design/methodology/approach A chronological narrative of laws and reports with concluding discussion. Findings That UK legislators have not made use of the evidence base available to them and have favoured enforcement rather than treatment approaches. That current UK practice has exacerbated not contain the use of and harms caused by illegal drugs. Research limitations/implications The paper does not cover all relevant documents, especially those from non-governmental sources. Practical implications The practical implications centre on the failure of consecutive governments to reflect on and review the impact of current legislation, especially on people who use drugs. Social implications That the situations of people who use drugs are currently ignored by the government and those proven responses which save lives and reduce harm are rejected. Originality/value The paper attempts to show the historical contexts of control and dangerousness of which the MDA is one instrument.

Benefits and barriers associated with take-home-naloxone in the view of Italian service providers

Purpose Spanning almost 30 years, Italy’s experience with take-home-naloxone (THN) provides an interesting case study on the international scene because of its specific history, regulation and trends in overdose (OD) rates. Accordingly, this study aims to contribute to the evidence base for THN and its delivery in a different setting. Design/methodology/approach The study focuses on service providers’ perceptions of the benefits, risks and barriers associated with THN provision. Data was collected using a mixed-methods approach as follows: an online structured questionnaire (no. of respondents = 63) and two focus groups (no. of total participants = 18). Findings Findings show that service providers believe the benefits of THN far outweigh the risks and accrue to services, as well as users. The study also suggests that the barriers in Italy are mostly ideological and political, and illustrates how resistance to administering THN can re-emerge when ODs are no longer a social emergency. Furthermore, the study found that health and social workers have different attitudes which are also reflected at the level of public and private services, thereby shaping slightly different models of THN supply. Originality/value The study suggests that barriers associated to THN are more ideological and political rather than concrete, which explains why, even where it seems long established, can easily re-emerge once ODs are no longer a social emergency.

“We don’t have any answers within the current framework”: tensions within cannabis policy change in Ireland

Purpose International policy approaches to cannabis production and use are changing rapidly, and within the Irish context, alternatives to prohibition are being considered. This study aims to explore policymaker’s attitudes towards the decriminalisation and legal regulation of cannabis for recreational use in the midst of an unfolding policy process, examining the degree which a “policy window” might be open for the implementation of cannabis policy change. Design/methodology/approach Semi-structured interviews were held with eight key informants within the policy field in Dublin, Ireland. Kingdon’s (2014) Multiple Streams framework was used to consider whether the problems, policy and political streams were aligning to support progressive policy change. Findings Irish policymakers indicated broad support for the decriminalisation of cannabis. The legal regulation of cannabis received more qualified support. Existing policy was heavily criticised with criminalisation identified as a clear failure. Of particular interest was the willingness of policymakers to offer opinions which contrasted with the policy positions of their organisations. While a policy window did open – and close – subsequent governmental commitments to examine the issue of drugs policy in a more deliberative process in the near future highlight the incremental nature of policy change. Originality/value This study provides unique insight into the opinions of policymakers in the midst of a prolonged period of policy evolution. A latent aspiration for historical policy change was situated within the realpolitik of more traditional approaches to policy development, demonstrating that the alignment of Kingdon’s (2014) problem, policy and political streams are essential for change in cannabis policy.

Mapping “drug places” from below. The lived cities of marginalized drug users

Purpose On top of their legal, economic, social and institutional marginalization, marginalized drug users (MDUs) also experience political marginalization: drug policies shape their lives without their political participation. From a scientific as well as a political perspective, the inclusion of their various viewpoints and situated knowledge is a major challenge, and one to which this paper aims to contribute in light of the experiences and imaginaries of MDUs urban spaces in several German cities. Design/methodology/approach Following a socio-geographical approach, this paper interrogates how MDUs appropriate and imagine the city, drawing on Lefebvre’s Production of Space and mixing critical cartographic with grounded theory, in the attempt to both understand and reconstruct the world from the situated perspective of MDUs based on their own words, drawings and emotions. Findings The narratives and drawings of participants show another cityscape, radically different from the hegemonic discourses and mappings antagonizing MDUs and making their existence a social problem. Space appears as a means of marginalization: there are barely any places that MDUs can legitimately appropriate-least of all so-called “public space.” By contrast, MDUs’ imaginaries of an ideal city would accommodate their existence and address further social justice issues. Originality/value The notion of “public places” appears unable to express MDU’s experiences. Instead of focusing on the problem of public spaces, policymakers should tackle the question of placemaking for MDUs beyond the level of solely drug-related places.

Marginalised identities between fatalism and desperation – experiences of low-level cannabis street dealers in Frankfurt

Purpose This paper aims to research people who sell cannabis in public spaces known as “drug places” in Frankfurt, Germany. A particular focus is set to the relations of identity formation, relations to other dealers and law enforcement, taking into account the concept of “street capital” as social and cultural capital accumulated in the practice of drug dealing in public. Design/methodology/approach Nine biographically oriented qualitative interviews were conducted directly within the respective “drug places” in the inner city and the margins of the local open drug scene with exclusively male subjects. Interviews were conducted in German, audio-recorded and transcribed. Data was analysed with structured qualitative content analysis. Findings All respondents had some degree of migration background, ranging from German citizens up to refugees with illegal residence permit status. Social deprivation, socio-cultural conflicts with parents, combined with often early own drug use (mainly cannabis and cocaine) and stigma had contributed to a precarious existence. Experiences of criminalisation did not discourage the respondents from the continuation of their selling activity. Violence in these settings was likely but assessed in highly different ways depending on attitudes and experiences. The same is true for diverging experiences with police, however, the threat of being criminalised is always present. Originality/value As mostly independent and solitary dealers, this study researched a rarely investigated group. While these respondents have developed skills or street capital to survive in the respective setting, they are caught between unfavourable social conditions, social exclusion, violence, law enforcement and own drug use, leading to a desperate and fatalistic mindset. Somewhat paradoxically, this fatalism may be regarded as a result of keeping control over their own actions.