Drug Policy: Human Rights & Harm Reduction

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Addiction: A Response to Enduring Personal Pain and Structural Alienation

drugs, addiction, addicts, junkies, problematic drug use, unemployment, chavs, social exclusion, poverty


1. Most harm arising from adult illicit drug use does not arise from the drug itself but arises from drug policy abuses – the drug laws and policies that do much more harm than good.

2. Whereas chronic problematic drug use and/or addiction is largely caused by personal, social and political dislocation (Alexander 2008), and those struggling with drug centred lifestyles also endure considerable harm from drug policy abuse.

The main problems are caused by Prohibition and the not the drug.
Drug taking is not of itself a ‘problem’. We would not be anxious upon learning someone was using the legal drugs caffeine, tobacco or alcohol, so nor should be anxious about a person using other (illegal) drugs. However, it is right to be concerned that a person using illegal drugs faces considerable risks – arising from drug policy harm, caused not by the drug, but by the regime of prohibition (Buchanan 2008). Here are seven ways that Prohibition increases the risks.

The person using a prohibited drug:

“1. Has no idea of the strength of the drug – it could be so strong it could result in risk of overdose or death.

2. Has no guarantee about the purity or indeed content of the drug – it could contaminated or even mixed with toxic ingredients that could cause serious harm even death.

3. Has to buy the drug ‘underground’ – exposing the person to the vagaries of a potentially dangerous criminal underworld.

4. Buying, using and sharing illegal drugs puts the person at risk of serious criminal sanctions such as a community sentence with a drug rehabilitation requirement or even imprisonment.

5. A person using an illegal drug risks acquiring a criminal record for a drugs offence – which could have lifelong consequences upon employment prospects, opportunities for world travel and housing.

6. Has to use the drug in secret. For some people this may mean using in an isolated location which could be potentially dangerous especially when intoxicated – such as a condemned building, under a railway bridge, a canal etc.

7. Has to hide the use of illegal drugs making it more difficult to manage and harder to seek help, support or advice if a problem arises.”

Aside from drug policy harms, adult use of prohibited drugs poses risks that are not dissimilar to those posed by state approved substances caffeine, sugar, alcohol and tobacco. Indeed, some illegal substances are  less harmful than the state approved drugs.

Chronic addiction is more of a social problem than a health Issue.
People using illegal drugs don’t have a health problem and don’t need ‘treatment’.  Only a small minority of people who struggle with chronic problematic drug use, (estimated to be around 3-6% of those who use drugs) will need treatment and/or professional support. In addition to their struggle with chronic addiction this small group will face very serious challenges posed by drug policy abuse including; stigma, discrimination, criminalisation, exclusion, enforced abstinence, punishment, degrading and poor health and social care services,

While most of us can temporarily lose control of habitual behaviours, it is important to note, most people who do lose control, successfully regain control without professional help or medication. Just ask ex-tobacco users, most will have had a period of serious uncontrolled tobacco addiction, yet most manage to regain control without seeking professional help. However, there is a small vulnerable group who become addicted to drugs who lack the resources, support networks, personal agency, social and cultural capital and/or positive life experience, and for this group addiction can sometimes become an entrenched and fixed state, and unlike others who regain control, this group struggles to regain control. Indeed, for this group chronic addiction becomes an all-embracing lifestyle and the term ‘addict’ (an obnoxious label), sometimes becomes as internalised identity. The term ‘addict’ becomes a label that defines the person, tells others all they need to know about ‘them’ and all we need to know about how ‘they’ should be treated.

Problematic drug use (and indeed drug use) should never have been constructed as a crime problem, but neither should it be constructed as a medical problem or a disease. Chronic problematic drug use or addiction is largely caused by personal, social, cultural and political pain and suffering (and at times may also include psychological, physiological and legal issues). This is something I first observed working on Merseyside in the mid-1980s as a probation officer and drug worker working with people struggling with chronic addiction, and subsequently spent many decades researching as an academic.

Experience as a drug worker and my academic research suggests chronic problematic drug use is largely driven by enduring personal and structural alienation, factors that were serious issues long before drugs became a problem. For this group, while drug addiction is a serious issue, it needs to be understood as a symptom of a long-standing and painful struggle to overcome chronic social and psychological damage, disadvantage and exclusion.

Here are eight articles/book chapters you can download where I explore these issues further:

  1. Buchanan, J. & Young, L. (2000) ‘Examining the Relationship Between Material Conditions, Long Term Problematic Drug Use and Social Exclusion: A New Strategy for Social Inclusion’ in J. Bradshaw & R. Sainsbury (eds) Experiencing Poverty, pp. 120-143 click here
  2. Buchanan J & Young L (2000) Problem Drug Use, Social Exclusion and Social Reintegration – the client speaks Understanding and responding to drug use: the role of qualitative research Greenwood G & Robertson K (eds.) pp155-161 EMCDDA click here
  3. Buchanan, J. & Young, L. (2000) ‘The War on Drugs – A War on Drug Users’. Drugs: Education, Prevention Policy, 7(4), 409-422 click here
  4. Buchanan, J. (2004) ‘Missing links? Problem drug use and social exclusion’ Probation Journal, 51(4) click here
  5. Buchanan, J. (2006) ‘Understanding Problematic Drug Use: A Medical Matter or a Social Issue?’. British Journal of Community Justice, 4, (2)  click here
  6. Buchanan J (2005) Problem Drug Use in the 21st Century: A Social Model of Intervention in Social Work in T. Heinonen & A. Metteri (eds.) Health and Mental Health: Issues Developments and Actions. click here
  7. Buchanan, J (2015) ‘Ending Prohibition With a Hangover’ British Journal of Community Justice, Vol. 13, No.1 pp.55-74 click here
  8. Roy, A., and Buchanan, J. (2016) The Paradoxes of Recovery Policy: Exploring the Impact of Austerity and Responsibilisation for the Citizenship Claims of People with Drug Problems. Social Policy & Administration, 50: 398–413. click here


*I was delighted to be cited by the much respected Owen Jones in his book Chavs: The Demonisation of the Working Class featured in the image above.

References: Alexander, B.K. (2008). The globalisation of addiction: A study in poverty of the spirit. Oxford: Oxford University Press. 



  1. jjosephcollins says:

    I have had many mental health professionals openly refuse to accept that certain issues, mostly related to my PTSD, predate my drug use by over a decade. The fact I grew up in poverty, violence and then abandonment isn’t responsible for my bouts of depression, it’s “drugs”, even when I spend six months totally abstinent just to prove the point.


  2. […] Alongside this new legal freedom must be easy access to sensible and truthful balanced information about the risks posed by all drugs. Drug education, addiction prevention and addiction treatment should be informed not by ideological belief or moral crusade but by evidence-based research. These services must promote harm reduction and human rights. We should not be in the business of preventing drug use, in the same way, that we shouldn’t seek to prevent people from having a cup of coffee, glass of wine, or cigar — instead we must be in the business of preventing drug policy harms caused by prohibition policies, and preventing and treating drug addiction. […]


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