In contrast with the critical, innovative ideas developed between the 1960s and the 1980s regarding the way we deal with illegal drugs in our societies, the current dominant approaches frame the issue of drugs as a matter of crime, public order, and control. Pleasurable substances have always existed and always will, and so the efforts to cope with them. However, we witness today remarkable developments at local, national and international levels in the fields of drug policies (on cannabis for example), drug trafficking (new routes, new actors) and drug use (new substances, new drug cultures), all of which deserve our attention and push us to think beyond the repressive paradigm. This contribution, which also serves as an introduction for this special issue of ToCC on drugs, aims to present an overview of the main developments taking place, and challenges ahead, within the three above-mentioned fields. There are new markets and trends in the use of legal and illegal pleasurable substances, particularly regarding synthetic drugs (amphetamines, methamphetamines and new psychoactive substances or NPS), tobacco and alcohol. Illegal drugs are supplied from changing countries and through new routes, while retailing increasingly takes place through the so-called cryptomarkets (online). Effective policies are rendered impossible by the fundamental repression paradox: the more intensive and effective the repression, the larger the profits of drug traffickers and the balloon effects (displacement). Despite the harms and negative effects of repressive policies have extensively been documented, a societal debate towards the regulation of illegal drugs is hindered by the use of false dichotomies or presuppositions, by the use of ethical or moral appeals, or by lack of political will. Also the debate in the media is static, superficial and full of clichés. Scientific research on drugs also follows specific agendas and it is focussed on particular aspects of the problem. Changes to end the ‘war on drugs’, certainly regarding cannabis, are however underway in many places at local and national level (Uruguay, Canada, US, Spain, etc.), this despite UN bureaucracies and international conventions that fiercely resist those changes.

It has become evident that the use of performance and image enhancing drugs (PIEDs) is becoming an important societal issue, with ramifications extending beyond elite sport. A particular concern of authorities is that the majority of PIEDs are not legally obtained through a physician, by means of a prescription, but instead are illegally purchased on the illicit market. Currently little research exists on the illegal production and supply of PIEDs. However, understanding illicit PIED markets is important for policy decisions as knowledge on the production and supply of these substances may assist in designing law enforcement efforts, harm reduction initiatives and other measures. This article will, therefore, focus on the production and supply of PIEDs in Belgium and the Netherlands. Specifically, it will examine the general characteristics of PIED suppliers and the ways in which the behaviour of dealers are influenced by cultural factors. In particular the role of the legal profession of PIED suppliers is examined, taking the fitness industry as an example. This research is based on a content analysis of 64 PIED-dealing cases initiated by criminal justice agencies in the Netherlands (N=33) and Belgium (N=31). This article illustrates that the dealing of PIEDs is a rather specialised business and that not everyone has the suitable ties, opportunities and/or knowledge to enter the PIED market. Many PIED dealers are already devoted to a gym, sport, medical, or other subculture before becoming involved in dealing. Importantly, the embeddedness of PIED-related supply-side activities in legitimate professions, roles, and institutional settings form an integral part of the market culture these dealers engage in. We, therefore, need to examine the production, distribution and use of PIEDs, as embedded within a diverse combination of social, economic and cultural processes, in which none is simply reducible to the other.

Cannabis Social Clubs (CSCs) are a model of non-profit production and distribution of cannabis among a closed circuit of adult cannabis users. The CSC model can thus be seen as a middle-ground option between prohibition and full (legal) commercialization. Initially founded in Spain during the 1990s, this form of collectives has emerged elsewhere in Europe (notably in Belgium), mainly as a result of grassroots initiatives and self-regulation. Uruguay remains the only jurisdiction to have legalized and regulated the CSC model. This paper discusses the goals and practices of CSCs against the backdrop of the drug user movement. Our goal is to draw a comparison to other drug users’ organizations and to identify knowledge gaps to be addressed in future research into CSCs. In this analysis, we rely on a review of the relevant literature in this field and on preliminary findings from an ongoing study examining CSCs in Belgium. A preoccupation with reducing the harms associated with drug use seems to be an underlying guiding principle for CSCs and other drug users’ organizations, but further research into CSCs’ practices is needed to understand whether and how those are implemented. We found other common points between the broader drug user movement and the efforts of CSCs, both in terms of potential pitfalls and areas for positive impact. We suggest that the model warrants additional attention from both the research and policy-making community.

GHB is an anaesthetic that in Netherlands since the 1990s is used as a drug by various groups. Although GHB is often defined as a ‘party drug’, particularly in rural areas it is also used in street cultures. GHB is mainly used recreationally, but a minority uses the drug frequently and/or becomes addicted. GHB use and associated problems are disproportionately spread across the Netherlands and are concentrated in certain rural areas (‘trouble spots’), especially in low SES villages or neighbourhoods. Predominantly based on qualitative research, this article describes supply and use of GHB in rural ‘trouble spots’. The profile of experienced current GHB users in rural areas is characterized by a wide age range, a low level of education, often multiple psychosocial problems and poly drug use. They are almost exclusively ‘white’, in majority male users, of whom a large part has been arrested on several occasions. From a supply perspective, GHB could spread quickly because of the short distribution chain, the limited social distance between dealers and users, as well as the closeness an reticence of user groups. Even though as a drug GHB is very different from methamphetamine, there are striking similarities in set and setting characteristics between rural GHB use in the Netherlands and rural methamphetamine use in the US.

Various studies show that the views on the drug problem and appropriate policy responses have undergone profound changes from the 1960s onward. This article is analysing one of these changes, the decriminalisation of drug use, reflecting a fundamental change of view: understanding drug use as a health issue and not as crime. A useful heuristic to understand this type of change is Thomas Kuhn’s paradigm concept. He sees a paradigm as a set of beliefs that are shared by a scientific community and accepted by a wider community. A paradigm change is therefore a socio-psychological process rather than rooted in new scientific or research facts.
The author analyses the change from the dominance of a crime to the dominance of a health paradigm reflecting its social-historic context, starting with the widely shared concerns about substance use related health problems in the 20th century. These concerns translated into two different views on the essence of these problems, a crime and a health paradigm. The first served as fundament of the international drug control efforts, resulting in the still governing drug prohibition. Yet, the health paradigm was also of influence from the start and gradually gained weight. From the 1970s onwards the health paradigm became more important as part of a wider reform movement. It started in the Netherlands and the UK as bottom-up process criticising criminalising the users of illicit drugs as inappropriate, detrimental for their health and inhumane. The health paradigm was seen as more appropriate.
The author reflects on the benefits and disadvantages of the health paradigm. Its primary benefit is that it helps to understand the health problems related to drug use. A key disadvantage is its close relationship with the disease paradigm. The latter fits well with the generally negative view on drugs as dangerous or evil. It is encompassing the risk of ‘pathologising’ all forms of drug use and denying phenomena of unproblematic use for, among other things, recreational or spiritual purposes. Like the crime paradigm it can serve for control purposes. The drug user remains subject of control or disciplining policies and is not in charge of his/her own life. An additional problematic issue is that ‘softening’ the approach towards the users seems to be mirrored by a harder, more punitive approach to the producers and sellers of the substances, which are seen as villains, making available the drugs which deserve harsh punishment for ‘devastating’ the lives of users.
The author concludes with a short discussion of the well-being paradigm as possible alternative for the health paradigm. It covers a broader spectrum than the health paradigm and helps to grasp the negative impact of (problem) drug use, reducing well-being, but is also useful in understanding the positive sides, enhancing well-being.

This contribution aims to discuss the main outcomes of the recent UNGASS (United Nations General Assembly Special Session) on Drugs that took place in New York from 19 to 21 April 2016. Based on my own participation in the preparatory discussions and political negotiations as civil society representative (through the work of NGO Transnational Institute), I argue that political divisions and entrenched institutional dynamics have transformed what could have been the beginning of the end of the war on drugs into a wasted opportunity for changing the status quo of the present world regime regarding the production, trafficking and use of illegal drugs. Despite high initial expectations after several governments expressed a clear concern about the effects of purely repressive policies, and the UN decision to organize the session 3 years earlier than planned, very soon it was clear that the session would not imply real changes in the current policies. The agenda setting was non-transparent and controlled by the most conservative factions and countries, largely excluding the views from NGO’s and academics in the final adopted resolution. The final document poorly reflects the rich discussions and developments that are taking place in many countries of the world, particularly the debates and policy developments in ‘the Americas’. A positive note is that the unchanged international UN conventions on drugs can hardly cope with developments taking place on cannabis policies in countries such as Canada, Uruguay, United States or Jamaica. Also other countries are more and more prepared to push for change on other essential questions, including the application of death penalty for drug offences, the access to controlled medicines, or the explicit application of ‘harm reduction’ approaches.

Despite the fact that Peter Cohen has not written about drugs for the past 10 years, he remains one of the most influential and radical thinkers and researchers in the Netherlands in the field of drug use and drug policy. The former director of the CEDRO (Centrum voor Drugsonderzoek) at the University of Amsterdam is certainly a ‘significant other’ in the European drug landscape as he challenged, in the 1980s and 1990s, mainstream views and discourses on drugs held by the political, academic and health service establishments. In this interview we first discuss with him some of the key life events and intellectual sources that shaped his early choices first as student and later as young researcher, illustrating why and how he came to study drugs and remained at the university. Further, we focus on Cohen’s particular relation with the Amsterdam political elite in the 80s, which allowed him to develop the first large-scale studies in the Netherlands on different types of drug users. He further expands on his critique to the way in which drug use was at the time socially constructed in discourse and practice. During the second part of the 1990s, a new generation of politicians and managers (local and national government, but also at universities), changed on the one hand the political agenda about drugs, and imposed on the other serious limitations to conduct innovative research within the university. He finally explains some of his key ideas about the ways in which drug policies and interventions resemble religious wars and crusades, his growing disenchantment with present developments at European level, and he reflects on the future of drugs commenting on the present attempts to regulate cannabis.