This book aims to provide an introduction to illicit drug policy for social policy students, and a wider audience who may be studying or training in the drugs field. The focus in on domestic policy, but some important international themes are touched on. As the editors concede in the introduction, drug use and drug policy are ‘deeply politicised’ areas, with dimensions that cut across policy boundaries and perspectives. In presenting this complexity, the book covers a lot of ground in a relatively short space, and, whilst each of the nine chapters covers a distinct theme, a number of essential points emerge: firstly, that drugs are not consumed in a void but are grounded in a variety of contexts – social, personal, historical and spatial; secondly, that policy responses to drug use are varied, contested and often based on an incomplete appraisal of the complexity of the phenomena.

This inherent complexity is explored in Chapters 1–4, in the context of social exclusion, gender, ‘youth’ and race. In the first, Joanne Neale attempts to unpack the relationship between social exclusion and drug use, and provides a useful introduction to this oft-used (and misused) concept. Social exclusion, as a compound of related social problems is closely linked to drug use, and this is recognised, albeit in a narrow sense, by official policy. However, she cautions against an over-reliance on the concept, and suggests that it cannot account for all forms of contemporary drug use.

In Chapter 2, Trish Harding shows that, whilst men and women have both common and contrasting experiences of drug use, policies, treatment strategies and even cultural norms predominantly favour male drug users. She asserts that a more gender sensitive approach to drug policy is required, at both a structural and a strategic level, and a new paradigm needed, that empowers women and recognises broader shifts in gender relations. Margaret Melrose then frames ‘youth’ as a notion that has over the years been redefined to suit various political agendas. In reality there is not one youth but several, whose experience of growing up in modern Britain is so polarised as to be barely comparable. She highlights an important distinction between problematic and recreational use, and asserts that those growing up in deprivation are the more likely to engage in the former. Such a distinction could have significant policy implications, but successive governments have so far failed to grasp this point. In Chapter 4, Kazim Khan is highly critical of the fragmentary and ad hoc nature of race equality measures in drug services, which are still directed primarily toward the needs of white drug users. He argues that terms like ‘multiculturalism’ do little to address persistent racism, and when ‘intertwined’ with public, media and official discourse perpetuate myths that submit drug and non-drug using minorities alike to a form of ‘double stigma’. He concludes that a better understanding of race equality issues is needed in drug services, and that greater responsibility and accountability is essential, particularly at management levels.

Chapters 5–8 give some flavour of the ways in which drug use is framed within formal policy, and in particular explore emergent tensions between enforcement and welfare responses. Michael Shiner casts a critical eye over the prohibition/legalisation debate in Chapter 5 and attempts to chart what could be called a ‘common sense’ course between the two poles, advocating a ‘reconfigured role for the law’ with a greater emphasis on ‘restorative justice’, and a more therapeutic, less punitive approach overall.

In Chapter 6, Hughes and Anthony trace the re-emergence of the ‘law and order’ agenda in drug policy, which preferences crime reduction over harm reduction. This strategy is based on the simplistic notion that drugs lead to crime, and ignores the wider dynamics of drugs and criminality and common roots in structural and social inequalities. They argue that policies to address entrenched and widespread social exclusion would produce more satisfactory and sustainable results. This theme is continued in the next chapter, in which Rachel Lart charts the changing relationship between health practitioners, drugs and policy. She begins with a damming statement from a leading commentator, who described New Labour's current trajectory as a ‘switch from a healthy drugs policy to an unhealthy one’ (p. 92). This switch is traced to the publication in 1998 of Tackling Drugs Together to Build a Better Britain, and the omission of ‘public health’ as an explicit objective. This signalled a move away from the ‘centrality of health issues’ to a ‘conflation’ of drugs with crime, which has had potentially damaging consequences for public health, by coercing people into treatment via the Criminal Justice System, thereby weakening the ability of voluntary agencies to offer independent and effective treatment. This criticism is balanced by a recognition that co-ordination between agencies is improving, and that developments such as the establishment of the National Treatment Agency and its publication in 2002 of Models of Care constitute a move in a more positive direction. In Chapter 8, Bergeron and Griffiths describe the situation at European level and argue that a gradual convergence on drugs policy is occurring, with the emergence of common structures, coordinating actions, and improved information sharing between member states, although they are perhaps being over-optimistic in claiming that there has been a ‘paradigm’ shift from punitive to therapeutic measures.

Calls for a more nuanced approach are echoed in the final chapter, in which Paul Higate considers some interesting theoretical developments. He discusses the concept of ‘risk society’ and its applications, particularly in illuminating the narrow formulations of rationality that underpin much drug policy. He also explores empirical research which offers a more sophisticated appreciation of the spatial, social, cultural, and physiological frameworks in which drugs are consumed, in stark contrast to pathological and linear explanations. He argues that such theories allow for a much broader and, crucially, more positive conceptualisation of drug taking.

As a relative newcomer to the drugs field, I welcomed the chance to read and review this book. The editors and authors manage to balance a measure of pessimism about current and future drug policy with some recognition of more optimistic developments. Whilst avoiding excessively political statements the book provides an understated critique of the present system and advocates an approach rooted in common sense and empirical research. There is some unavoidable repetition between chapters, particularly when tracing chronological developments and a concluding chapter would have been useful, but other than these minor quibbles I struggled to find anything negative to say.