Selected stakeholders

131

barriers as well as facilitators for the wider implementation of harm reduction and decriminalisation of use.

132

illicit drugs (see 7.2.2) and the strong influence of economic interests of the producers (lobby) in the field of licit drugs and gambling, the influence of science has been substantial and – at least from time to time – decisive. Evidence has played an important role in many policy decisions. The changes in Dutch drug policy in the 1970s (see 4, 5 and 6.1) and the increasingly stricter tobacco control policies (see 6.2) are good examples of the latter.

Nevertheless, the critics about the still rather limited impact of science on drug policy and governance have a point. The radical change in Dutch drug policy, culminating in the 1976 drug law, may be one of the few examples of a drug policy change which for an important part was guided by evidence. Politicians and policy makers consulted scientists and took on board the then available evidence as the fundament for their decisions, at a time when evidence base was not yet a prominent issue in (drug) policy making. The then existing policy and health service responses could not effectively deal with the problems young people faced. Science was one of the elements contributing to a window of opportunity. In the 1980s the research evidence for effective HIV prevention contributed to the wider implementation of harm reduction strategies in many countries.

Still, generally speaking, political and ideological arguments dominated policy decisions in the field of illicit drugs in many countries. This is also true for the Netherlands, where after a promising start in the 1970s and 1980s political and ideological motives gained importance, particularly in the field of cannabis policy. In different countries one can find examples showing that scientific evidence is simply ignored or overruled by political or ideological agendas (see 5.3.3).

The complexity of the ‘evidence’ concept

However, the issue of scientific evidence is more complex than frequently suggested. Though there are cases of rather indisputable evidence – the proof of harmfulness of tobacco is one example – in most cases there is no uncontested evidence base for drug policy decisions. The debates about comparing the harmfulness of different drugs are one example. Here, the evidence consists of a composition of different indicators for different elements of harmfulness, among others physical, psychological and social harms to users and a wide variety of harms to others e.g. injury, crime, environmental damage and economic costs (Nutt et al. 2007; Nutt et al. 2010; Van Amsterdam et al.

2010). These indicators cannot be weighed (against each other) ‘objectively’ or unambiguously, to come to one integrated ‘fact-based’ drug harm indicator. For some of these indicators it is even difficult to find a solid measurement. This is true for social harms related to drug use, which are difficult to define. It is hard to establish unambiguously a relationship between drug use and these harms. These definitions are susceptible for being charged by values and beliefs. This means that, similar to what we said about paradigms, determining harmfulness is based on expert consensus rather than on scientific facts. There is no purely scientific, objective evidence neither for rankings of harmfulness of different drugs nor for policy decisions (see 5.3.3).

Another complicating factor is conflicting evidence. Harmfulness of cannabis is a prominent example, as the ongoing discussion shows. The recent debates about whether high THC content results in an increase of psychosis among users underline this. In a politicised and polarised debate ambiguity of evidence results in selective use of evidence. The different camps tend to select the evidence which supports their position.

There is no easy way out of these dilemmas. As Monaghan shows, it is rather complicated. While evidence-based decision making is seen as a key element of good governance Monaghan emphasises that policy decisions are not just a technocratic process of following the ‘evidence’. Policy choices are made in a process of democratic decision-making, weighing the available evidence and taking into account other considerations of a government (Monaghan 2014).

133 7.3.2 The supply lobby

There are different lobbies active in the drugs and gambling market. There are lobbies pro and con stricter control policies. We decided to focus here mainly on the most powerful lobby: the supply lobby. As can be taken from the alcohol and tobacco market the producers’ lobby is due to their economic power clearly the most influential stakeholders lobby. However also the ‘sellers’, the retail and hospitality business play a significant role (see 6.2.5). Alcohol and tobacco producers are an influential party in the political arena regarding the decision making process.

Our case study on the trend towards stricter tobacco control policies shows that in this area the supply lobby is, besides science and research, the other influential stakeholders group. Due to the focus of our study – stricter tobacco regulation in the hospitality sector – the supply lobby included besides the tobacco industry also the organisations representing the interests of hospitality entrepreneurs and interest groups of smokers. The first is clearly the most powerful in the lobby against stricter tobacco regulations and plays the role of natural adversary of science and research, which are advocates of more restrictive tobacco control policies (see 6.2.4). This picture reveals another moralist perception in the area of drug policy making and governance. While scientists and researchers are generally seen as the good guys the lobbyists of producers and sellers of drugs are generally seen as the bad guys. This is in fact very similar to the moralist view behind the tougher approach to suppliers of illicit drugs (see 5.5.2). Negative intentions are attributed to drug producers and sellers, while science and research are rather seen as been driven by altruistic motives, disregarding the economic interests of science and research (salary, research funding) and the urge to become a name both as an individual and as an institution.

There is one intriguing consequence of the shift from prohibition towards regulation of cannabis supply. For obvious reasons openly lobbying for the interests of cannabis suppliers was non-existent under prohibitionist rules. In the Netherlands, where the selling of cannabis through so-called coffee shops is tolerated, unions of coffee shop owners have emerged in the margins of the still illicit but condoned cannabis market, acting as a lobby for the interests of cannabis retailers. They are formally organised as for instance the 'Bond Cannabis Detailisten' (BCD, the Union of Cannabis Retailers) and nowadays participate openly in the debate about coffee shop policy (see 6.1.1). The Federation of Cannabis Clubs in Spain is another example of trade organisations openly lobbying for their interests, emerging in the margins of the illicit drugs market, where prohibition is replaced by condoning policies (see 6.1.2).

7.3.3 Social movements

From the 1960s onwards a – relatively⁹³ – new stakeholder appears on the scene in different EU Member States, claiming a say in drug policy debates. Social movements of mainly young people emerged all over Europe, opposing the established social order, which – in the view of the protesters – was predominantly conservative and restrictive. These social movements differed regarding their scope and political orientation (see 4.1.1). In some countries the drug issue appeared on their agenda. In four of our five sample Member States social movements popped up, opposing the generally repressive policies which targeted the use of the then emerging new illicit drugs.

93In the history of drug control policies one can find more social movements that have played a role in the policy making process. One of the well-known examples is the temperance movement, a social movement urging personal moderation in the consumption of alcohol and promoting complete abstinence. The ‘teetotalists’ use their political influence to pressure governments to enact alcohol laws to regulate the availability of alcohol or even its complete prohibition.

134

They were an important element in the bottom-up forces pushing for new approaches, setting the trends which we covered in our case studies: the introduction of harm reduction, the push for decriminalisation of use and regulation instead of a prohibition regime.

These social movements differed substantially per country. In the Netherlands changing the drug policy was an important issue on the agenda of the Provo’s, the most prominent ‘group’ in the Dutch protest movement. The alternative youth services, which formed the basis for alternative drug services and the harm reduction movement, were another important player. This broad social movement gained wider support rather quickly, paving the way for fundamental change, covering the introduction of harm reduction, decriminalisation of use and partial regulation of cannabis. In Slovenia and Spain the drastic social and political changes from a totalitarian state to a democracy were the breeding ground for wider societal changes, including drug policy changes. Needless to say that the processes of social change in both countries differed substantially due to the specifics of their national history (see 5.3.1). There were also differences regarding the changes in drug policy: in Slovenia the changes started with a focus on developing harm reduction services due to a particularly strong harm reduction movement, which started to emerge before the social changes set in (see 4.1.1). The changes in Spain took off with a focus on decriminalisation of use, in particular cannabis use. Spain has had a strong cannabis social movement since a long time (see 5.3.1). Here too the first steps had been made before the fall of the Franco government. In the UK it started with harm reduction. Tying in with the tradition started in the 1920s with the work of the Rolleston Committee (see 4.1) the harm reduction movement took off in Liverpool in the 1980s without being embedded in a substantial wider social movement.

These differences show that the national social context in these four countries shaped the scope and orientation of the social movement. The social movements were definitely not the most powerful stakeholders in the drug policy changes. Still, they were clearly influential. They provided new answers to pressing questions and helped setting the agenda of the drug policy debate. They were successful in claiming a place at the negotiating table, also because their ideas were rather quickly embraced by policymakers and politicians. They simply seem to have been at the right time at the right place with their ideas for better managing the drug use (and HIV) problem.

In many cases they were not a permanent factor in the drug policy arena. They were a temporary phenomenon, being of importance at a certain phase of drug policy development. The Provo’s have gone, the harm reduction movement has faded into the background in many EU Member States. This may be a side effect of the stagnation of the heroin epidemic and the eroding support for harm reduction (see 4.3). At the same time the cannabis social movement has gained influence in several European countries (see 5.3.1). Here the current – worldwide – debate about cannabis regulation policies, based on the doubts about the appropriateness of cannabis prohibition, is an important contextual factor (Decorte et al. 2011; Apfel et al. 2014).