Methodology and approach

In order to better understand the factors and mechanisms influencing policy targeting heroin, cannabis, tobacco and gambling, we use qualitative, exploratory case studies outlining and analysing the structures, principles and processes, the interactions in the force-field between the different stakeholders, interests and other relevant, interfering factors. We started with a stocktaking exercise how policy in the four fields is implemented in the five sample EU Member States.

We developed a topic guide and – based on that – a country report format to systematically collect relevant information in the five selected Member States and to review relevant literature. The information collected was the basis for writing the case studies.

2.3.1 Stocktaking and topic guide

We started with reviewing literature relevant for understanding drug policy governance. This included literature on policy making and governance theory as well as on policy making and implementation.

For selecting, reviewing and analysing relevant information from France, Slovenia, Spain and the UK we were assisted by colleagues from our partner organisations in these countries. As part of the information we needed for this study was not directly accessible for us (among others due to language barriers and the partly reflective character of the information), national experts were consulted by our partners in the five sample Member States.

We produced a topic guide for the systematic collection of relevant information, the basis for describing and analysing policy making and implementation and for identifying key factors and forces involved in policy and governance processes in the selected Member States. We used the elements of the Health Policy Triangle to structure this topic guide:

Policy content

 What is the content of the current policies?

Context

 Which economic factors play an important role in the context of these policies?

 Which political factors (including international factors) contribute to the policy context?

 Which historical / social-cultural factors contribute to the policy context?

 Which situational factors, or focusing events, contribute to the policy context?

 Which other factors contribute to the policy context?

Actors

 Who are the main actors / stakeholders involved in the policy process and why?

 What are their main interests and arguments?

 What is their mutual relationship e.g. in terms of power balance and position?

 How are these actors / stakeholders influencing the policy content or how are they influenced by it?

Process

 How, when and where: A short description of the key policy processes (e.g. agenda setting, formulation and implementation).

31 2.3.2 Country reports and literature review

As mentioned above, we decided to focus with each trend-substances / behaviours combination on one or two selected cases of policy governance. In order to describe and analyse these two cases we needed a basic overview of relevant factors in the preparation, enactment and implementation of important measures. We decided to make use of country reports to collect relevant information from the sample Member States. Based on the topic guide we developed a detailed format – similar to a structured questionnaire – facilitating a methodical comparison between the selected Member States. The country report format followed the structure of the Health Policy Triangle, built up around the following four concepts: policy content and process, stakeholders and context:

 Description of the actual situation regarding the three selected substances and gambling o Short general information on the Member State;

o Indicator data / information on the situation regarding the selected substances and gambling;

o Governance: formal policy documents and assessment of relevant policy measures taken, including a short description of existing mechanisms, structures and procedures for policy development in the Member States.

 Description / analysis of the four trends (i.e. the general convergence trend and the three specific trends mentioned above)

o Assessing the influence of stakeholders (taking into account factors like access to decision makers, etc.);

o Assessing the influence of arguments / interests;

o Assessing the influence of existing structures and procedures, a.o. policy coordination, rules regarding transparency, accountability, etc.;

o Assessing the influence of interfering factors (facilitators and barriers), including strategies of stakeholders, lobbying, 'windows of opportunity' (Kingdon 2003), etc.

We developed one country report format per selected substance / behaviour. These formats were sent to our partners in the respective Member States to guide their desk research. We asked our partners to provide us with draft country reports, which we reviewed. Matching the sample Member States with the selected substances and gambling and the selected trends resulted in the following list of country reports:

 Harm reduction and regulation of tobacco in France (see Appendix 1) produced by Maitena Milhet and Cristina Diaz Gomez, OFDT;

 Regulation of gambling in France (see Appendix 2), produced by Maitena Milhet and Cristina Diaz Gomez, OFDT;

 Harm reduction and decriminalisation of heroin in Slovenia (see Appendix 3), produced by Matej Kosir, Inštitut Za Raziskave In Razvoj UTRIP;

 Regulation of gambling in Slovenia (see Appendix 4), produced by Matej Kosir, Inštitut Za Raziskave In Razvoj UTRIP;

 Harm reduction and decriminalisation of heroin in Spain (see Appendix 5), produced by Maria Estrada, Departament de Salut – Generalitat de Catalalunya;

 Decriminalisation and regulation of cannabis in Spain (see Appendix 6), produced by Maria Estrada, Departament de Salut – Generalitat de Catalalunya;

 Decriminalisation and regulation of cannabis in the UK (see Appendix 7), produced by David Miller and Claire Harkins, University of Bath;

 Regulation of gambling in the UK (see Appendix 8), produced by David Miller and Claire Harkins, University of Bath.

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As to complement the country reports produced by the partner countries, for the Netherlands Trimbos Institute evaluated the decriminalisation of heroin and cannabis and the regulation of tobacco / cannabis by using its own available data collection from its National Drug Monitor and research publications.

For harm reduction (heroin and tobacco) and regulation (cannabis / tobacco), three research reports were produced by students of the Vrije Universiteit Amsterdam’s Master in Management Policy Analysis & Entrepeneurship, supported and supervised by researchers of the Trimbos Institute. These research reports were written on the basis of the common country report format:

 Describing and analysing current and past practices and trends in the governance of illegal and legal substances in the EU. Opioid substitution treatment in the Netherlands by Sophie Henken;

 Did the Dutch smoking ban vanish into thin air? Analysis of the policy process and governance practice of the Dutch hospitality sector, by Elke Elzinga;

 The development of local cannabis and coffeeshop policy in Amsterdam and Utrecht, by Sophie Henken.

If needed we sent additional questions to the partners. We then analysed and compared the data from all country studies. On issues where data were scant, of poor quality or simply not available we consulted other experts from the respective sample Member States. To receive additional and background information we used (parts of) the country report format as basis for this consultation and for an additional literature search. For the expert consultation we used interviews consisting of specific questions to obtain lacking information and to clarify information we had received through the country reports. For Slovenia we consulted an expert of the Ministry of Health, for France experts of the OFDT, for UK experts of UKDPC and RAND Europe, and for Spain experts of the Transnational Institute in Amsterdam and a representative of the social club movement. In the Netherlands we organised two focus groups for experts on e-cigarettes and tobacco harm reduction. The partners in the Members State assisted with collecting (and where necessary translating and summarising) relevant information. For collecting the required information on the Netherlands we used a comparable approach, using the country report formats to structure our scan of the available literature.

2.3.3 Case studies

The country reports and the reviewed literature formed the basis material for the three case studies, one per selected trend, i.e. the wider acceptance of harm reduction, the trend towards a decriminalisation of use of illicit drugs and thirdly the growing interest in exploring the feasibility of regulation as drug control instrument. In the study of the decriminalisation trend we also focus on the other side of the coin: the tougher, more punitive approach to the supply of illicit drugs.

For these three trends we looked into processes, driving forces, stakeholders involved, the different interests / arguments playing a role, interfering factors and principles. With analysing these aspects in each case study we intend to identify and better understand forces and factors behind the selected drug policy trends. In the concluding discussions (see 7) we analyse and compare the developments of these trends in policies targeting the selected substances and gambling.

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