By Virginia Berridge:
As a historian of drug policy, my natural inclination is to turn to the past. An encounter in the mid-19th century Cambridge market place came to mind. A character in Charles Kingsley’s novel Alton Locke relates what the “druggist’s shop” was selling: “you’ll see the little boxes, doozens and dozens a’ ready on the counter…Opium, bor alive, opium!” Opium was on open sale in the 19th century; after 1868 pharmacists were in charge with minimal regulation. In the absence of much by way of effective therapeutics, the drug was central to medical practice and a mainstay of self-medication—the aspirin or paracetamol of its day.
Cannabis was a different matter. Its widespread use in the Far East was never replicated in the home country. Queen Victoria did not, despite recent claims, use cannabis in childbirth, although her physician, William O’Shaughnessy, wanted to introduce the drug into medical practice. Uncertainty of its action limited its use and differentiated cannabis from opium, whose alkaloids, codeine, morphine, and later heroin, gained it a central role in developing professional therapeutics.
It is a far cry from the minimal regulation of the 19th century, to the world in which these two books operate. Drug Policy and the Public Good has been written by an impressive team led by Thomas Babor and aims to “evaluate critically the available research on drug policy, and to present it in a way which informs both the policy maker and the scientific community”. Its scope is intended to be comprehensive and international, to inform the debate in countries where research is thin on the ground as well as in those that produce more of it. The book’s contributors write about why people use drugs, who uses drugs, and trends in use. Illicit drug use is associated with a range of harms, disease, disability, mortality, criminality, and other social harms. However, as the authors point out, for most countries, the burdens, harms, and costs of illicit drugs are less than those attributable to alcohol and tobacco. We learn about how and why drug markets operate and their effect on price. Strategies—prevention, services for drug users, supply control, prescription regimes, and criminal sanctions—are carefully examined. Drugs operate within a system of international control that, despite increasingly vociferous attempts from civil society organisations in recent years, shows little sign of change. National policies must conform to these international principles, although the national experience does differ; country studies from Nigeria to Sweden illustrate the point. The book ends with ten conclusions from the evidence: these range from the assurance that there is no “magic bullet” for drug problems, to the importance of a country’s pharmacy system in regulation. Perhaps not so far, then, from the 19th century.