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Drug Policy (drug + policy)
Selected AbstractsSCIENCE AND NON-SCIENCE IN UK DRUG POLICYADDICTION, Issue 7 2010DAVID NUTT No abstract is available for this article. [source] HARM REDUCTION IS NOW THE MAINSTREAM GLOBAL DRUG POLICYADDICTION, Issue 3 2009ALEX WODAK No abstract is available for this article. [source] State Prescription Drug Policies, Cost Barriers, and the Use of Acute Care Services by Medicaid BeneficiariesJOURNAL OF CONSUMER AFFAIRS, Issue 1 2009SHARON TENNYSON This paper examines the relationship between Medicaid pharmacy benefit restrictions and reports of prescription cost barriers by beneficiaries, and the relationship between prescription cost barriers and hospitalizations. The analysis uses data for adult Medicaid beneficiaries from the 2000,2001 and 2003 Community Tracking Survey household surveys, combined with data on states' Medicaid pharmacy benefit restrictions and characteristics of local health-care markets. Estimation results show that state Medicaid restrictions are associated with a higher incidence of reported drug cost barriers and that Medicaid recipients who report prescription cost barriers experience a greater number of hospitalizations. [source] School, Parent, and Student Perspectives of School Drug PoliciesJOURNAL OF SCHOOL HEALTH, Issue 3 2007March 2007 issue of Journal of School Health No abstract is available for this article. [source] Drug Policy and the Public Good: a summary of the bookADDICTION, Issue 7 2010Drugs, Public Policy Group ABSTRACT Drug Policy and the Public Good was written by an international group of scientists from the fields of addiction, public health, criminology and policy studies to improve the linkages between drug research and drug policy. The book provides a conceptual basis for evidence-informed drug policy and describes epidemiological data on the global dimensions of drug misuse. The core of the book is a critical review of the cumulative scientific evidence in five general areas of drug policy: primary prevention programmes in schools and other settings; health and social services for drug users; attempts to control the supply of drugs, including the international treaty system; law enforcement and ventures into decriminalization; and control of the psychotropic substance market through prescription drug regimes. The final chapters discuss the current state of drug policies in different parts of the world and describe the need for future approaches to drug policy that are coordinated and informed by evidence. [source] The Socio-Cultural Context of Drug Use and Implications for Drug PolicyINTERNATIONAL SOCIAL SCIENCE JOURNAL, Issue 169 2001Molly Charles Cultural diversity in India has nurtured the use of mind-altering substances over centuries, with-out causing any great alarm about drug abuse. This paper, using research conducted by the authors and other secondary data, attempts to present socio-cultural-religious, functional patterns of drug use in the country and examines some of the factors responsible for the drastic changes that have occurred since the 1980s. Specifically, it points out that the Narcotics Drugs and Psychotropic Substances (NDPS) Act, 1985, took the responsibility of drug abuse control away from the community to the near-defunct legal establishment; that by criminalising socio-religious-cultural-recreational use of opium and cannabis, it has promoted the pro-liferation of alcohol, heroin, and other moreharmful pharmaceutical drugs; that it has given a new lease of life to organised crime syndicates; and that denial of access to low cost, accessible health care at the hands of traditional healers is an unintended consequence needing immediate rectification. It makes certain policy recommendations to the UN bodies, their member states and to policy makers in India in particular. [source] "New Governance" and Associative Pluralism: The Case of Drug Policy in Swiss CitiesPOLICY STUDIES JOURNAL, Issue 4 2003Sonja Wälti Throughout the 1990s, hierarchical administrative governance structures have been replaced by self-governing networks for various motives, one of which is to improve the authenticity and democratic quality of public decisions. Thus, "new governance" has been praised for its propensity to provide a plurality of civil society organizations with access to the decision process. This article explores these claims based on the case of drug policy in Swiss cities. We show that self-governing networks indeed seem to have increased the involvement of civil society organizations in the policy process. However, we also find evidence that self-governing networks may in the longer run induce state control over civil society organizations, thus ultimately reducing associative pluralism. They do so either by imposing a policy paradigm or by excluding actors who do not comply with the dominant paradigm from the networks. We conclude by arguing that self-organizing networks should not be dismissed, given that former hierarchical bureaucratic approaches to drug-related problems have failed even worse. Rather, their long-term effects should be subject to further examination aimed at developing adequate responses to their shortcomings. [source] Ten years after the United Nations General Assembly Special Session (UNGASS): assessing drug problems, policies and reform proposalsADDICTION, Issue 4 2009Peter Reuter ABSTRACT In 1998 the United Nations General Assembly Special Session resolved that governments would reduce drug production and consumption greatly within 10 years. With that period now elapsed, there is an interest in reviewing how successful this was and considering how drug policy could be improved. The demand for drugs in the world has stabilized mainly as a result of the interaction of epidemic forces, culture and economic development. Supply has become more concentrated and the menu of drugs has changed surprisingly slowly. Drug policy is shifting to a more explicitly tolerant configuration in Europe and a few other countries, but retains its ferocity in most of the world. The most prominent innovations under discussion have limited potential effects (heroin maintenance), have as yet been unproductive of policy interventions (,addiction is a brain disease') or have no political appeal (legalization). The option with the most scope is increased effort at diverting arrested drug users out of criminal justice systems. No prevention, treatment or enforcement strategies have demonstrated an ability to substantially affect the extent of drug use and addiction. The best that government interventions can do is to reduce the damaging consequences of drug use and drug control. More attention should be given to reductions in the intensity of drug enforcement, which has many unintended adverse consequences and yields few of the claimed gains. [source] Drug policy and the public good?ADDICTION, Issue 3 2004Jim McCambridge No abstract is available for this article. [source] 1985 and all that: The establishment of Australia's Drug StrategyDRUG AND ALCOHOL REVIEW, Issue 2 2009NEAL BLEWETT Abstract A national drug summit in the mid-1980s played a pivotal role in the establishment of Australia's National Drug Strategy. It transformed the delivery of drug policies in Australia and gave us the instruments to understand our drug problem, namely national Centres of Excellence, including the National Drug Research Institute. This paper examines how a ,bundle of compromises' came together in the political context of the mid-1980s to give rise to, for the first time, a cooperative national campaign that continues to drive Australia's drug strategy today.[Blewett N. 1985 and all that: The establishment of Australia's Drug Strategy. Drug Alcohol Rev 2009;28:96,98] [source] What would evidence-informed drug policies look like?ADDICTION, Issue 7 2010WAYNE HALL No abstract is available for this article. [source] Drug Policy and the Public Good: a summary of the bookADDICTION, Issue 7 2010Drugs, Public Policy Group ABSTRACT Drug Policy and the Public Good was written by an international group of scientists from the fields of addiction, public health, criminology and policy studies to improve the linkages between drug research and drug policy. The book provides a conceptual basis for evidence-informed drug policy and describes epidemiological data on the global dimensions of drug misuse. The core of the book is a critical review of the cumulative scientific evidence in five general areas of drug policy: primary prevention programmes in schools and other settings; health and social services for drug users; attempts to control the supply of drugs, including the international treaty system; law enforcement and ventures into decriminalization; and control of the psychotropic substance market through prescription drug regimes. The final chapters discuss the current state of drug policies in different parts of the world and describe the need for future approaches to drug policy that are coordinated and informed by evidence. [source] Commentary on Hickman et al. (2009): The place of risk in drug policiesADDICTION, Issue 11 2009ROBIN ROOM No abstract is available for this article. [source] A cross-national comparison of school drug policies in Washington State, United States, and Victoria, AustraliaJOURNAL OF SCHOOL HEALTH, Issue 4 2005Jennifer M. Beyers Documented substance-use policies were prevalent in Washington and Victoria but less prevalent in primary schools, especially in Victoria. Victorian school policy-setting processes were significantly more likely to involve teachers, parents, and students than processes in Washington schools. Consistent with expectations based on their respective national drug policy frameworks, school drug policies in Washington schools were more oriented toward total abstinence and more frequently enforced with harsh punishment (such as expulsion or calling law enforcement), whereas policies in Victorian schools were more reflective of harm-minimization principles. Within both states, however, schools more regularly used harsh punishment and remediation consequences for alcohol and illicit-drug violations compared to tobacco policy violations, which were treated more leniently. (J Sch Health. 2005;75(4):134-140) [source] The Simple Analytics of Illicit Drug PolicyTHE AUSTRALIAN ECONOMIC REVIEW, Issue 3 2008D. P. Doessel The impact of alternative drug policy objectives, specifically harm reduction/harm minimisation or prohibition, is unclear. The literature is confusing. This article conceptualises the causal connection between drug consumption and health harm (or reduced health status) then clarifies the implication of ,drug related harm'. By applying some geometrical tools from economics, the choice of policy objective is analysed. The preferences of policy advocates are then incorporated. Policy advocates are conceived as arguing that decision-makers and consumers should adopt their preferences between drugs and health harm. With this approach, the difference between alternative drug policies, in particular prohibition and harm minimisation/reduction, is demonstrated. [source] A review of drug prevention system development in Romania and its impact on youth drug consumption trends, 1995,2005DRUG AND ALCOHOL REVIEW, Issue 4 2009CSABA L. DÉGI Abstract Issues. A tremendous growth occurred in the reported drug use and abuse in Romania from 1995 to 1999. Lack of concern by government and little policy attention contributed to the surprising delay of drug policy and drug prevention system development. General public stigmatize drug users and drug consumption is considered a matter of personal fault and responsibility. There is some but not sufficient research and evaluation on drug use, abuse problem. Approach. Drug use, abuse and prevention are discussed from research-based, user-focused and prevention system development perspectives. Prevalence and trends of drug use, abuse in the past decade (1995,2005) are summarized. Prevention issues are discussed based on research data from adolescents, parents and teachers. The Romanian primary drug prevention system has been evaluated based on our experiences in drug use prevention activities carried out in schools and recreational environments. Key Findings. Public and scientific perspectives on drug consumption in Romania, between 1995 and 1999, were dominated by an idealistic, non-realistic perception. Since 1995, drug use among adolescents increased almost four times in less than 4 years. The first law against drug traffic and consumption was issued only in 2000. Now primary drug prevention strategies are in action, but in general they are lacking standard evaluation procedures. Implications/Conclusion. Conclusions are drafted for new perspectives in prevention activities. More long-term, user-focused, demand-centred prevention activities should be carried out in more and more diversified settings and evaluation should be thoroughly considered.[Dégi CL. A review of drug prevention system development in Romania and its impact on youth drug consumption trends, 1995,2005. Drug Alcohol Rev 2009;28:419,425] [source] The size and mix of government spending on illicit drug policy in AustraliaDRUG AND ALCOHOL REVIEW, Issue 4 2008TIMOTHY J. MOORE Abstract Aim. To estimate how much governments in Australia spend on reducing and dealing with illicit drug problems. Methods. Government documents and supplementary information sources were used to estimate drug-related expenditure for the financial year 2002,03, in Australian dollars. Public sector expenditure on reducing drug problems (,proactive expenditure') was classified into four policy functions: prevention, treatment, harm reduction and enforcement. Expenditure related to the consequences of drug use (,reactive expenditure') was included as a separate category. Results. Spending by Australian governments in financial year 2002,03 on all drug-related activities was estimated to be $3.2 billion. Proactive expenditure was estimated to be $1.3 billion, comprising 55% on enforcement, 23% on prevention, 17% on treatment, 3% on harm reduction and 1% on activities that span several of these functions. Expenditure on dealing with the consequences of drug use was estimated to be $1.9 billion, with the majority the result of crime-related consequences. Conclusion. Several insights result from estimating these expenditures. First, law enforcement is the largest drug policy component, with Australian governments also spending significant amounts on treatment and prevention programmes. Secondly, apart from the prevention component, Australia's drug policy mix is strikingly similar to recent international estimates. Finally, expenditures associated with dealing with the consequences of illicit drugs are large and important for assessing drug-related public sector expenditure. [source] Newspaper coverage of drug policy: an analysis of pre-election reporting of the Greens' drug policy in AustraliaDRUG AND ALCOHOL REVIEW, Issue 1 2008SANDRA C. JONES BA Abstract Introduction and Aims. With the headline ,Ecstasy Over The Counter' in a popular daily newspaper, the debate on drug policy officially entered the arena of the 2003 New South Wales (Australia) State Election. The debate resurfaced in the lead-up to the 2004 Australian Federal Election. This paper analyses the pre-election coverage of drug policy issues in four Australian newspapers. Design and Methods. Four high-circulation daily newspapers were monitored for a one-month period prior to both elections and analysed for their coverage of drug policy, particularly with respect to the policy of the Greens. Results. The newspapers took different perspectives on drug policy issues, with two framing it in emotive terms as a moral debate and two framing it as political manoeuvring. Discussion and Conclusion. The newspapers focused upon emotive and sensationalist factors. They did not provide their readers with information or a rationale for the formulation of drug policy, be this from a harm minimisation or zero tolerance perspective. [source] Evidence-based policy or policy-based evidence?DRUG AND ALCOHOL REVIEW, Issue 4 2007The role of evidence in the development, implementation of the Illicit Drug Diversion Initiative Abstract Issues. Evidence-based policy is promoted as the ideal in drug policy, yet public policy theorists suggest that policy-based evidence may be a more fitting analogy, where evidence is used selectively to support a predetermined policy direction. Approach. The following paper assesses the resonance of this notion to the development of the Illicit Drug Diversion Initiative (IDDI), an apparently pragmatic reform adopted in Australia in 1999 through the Federal Coalition ,Tough on Drugs' strategy. It utilises interviews with key informants from the Australian drug policy arena conducted in 2005 to assess the role of evidence in the design and implementation of the IDDI. Key Findings. The current paper shows that while policy-makers were generally supportive of the IDDI and viewed drug diversion as a more pragmatic response to drug users, they contend that implementation has suffered through a selective and variable emphasis upon evidence. Most notably, the IDDI is not premised upon best-practice objectives of reducing harm from drug use, but instead on ,Tough on Drugs' objectives of reducing drug use and crime. Implications. This paper contends that policy-based evidence may facilitate the adoption of pragmatic reforms, but reduce the capacity for effective reform. It therefore has both functional and dysfunctional elements. Conclusion. The paper concludes that greater attention is needed to understanding how to mesh political and pragmatic objectives, and hence to maximise the benefits from policy-based evidence. [Hughes CE. Evidence-based policy or policy-based evidence? The role of evidence in the development and implementation of the Illicit Drug Diversion Initiative. Drug Alcohol Rev 2007;26:363,368] [source] Were the changes to Sweden's maintenance treatment policy 2000,06 related to changes in opiate-related mortality and morbidity?ADDICTION, Issue 9 2010Anders Romelsjö ABSTRACT Aims To analyse whether changes in maintenance treatment of opiate-dependent subjects in Sweden were related to changes in opiate-related mortality and inpatient care from 1998 to 2006. Design We collected data from surveys of methadone maintenance treatment units, of buprenorphine and methadone sales, and of mortality and inpatient care in Sweden. Setting Sweden. Participants Patients in maintenance treatment. Measurements Survey data of treatment policy to all units in 2003 and 2005. Trend tests and correlation analyses of data on sales, mortality, inpatient care and forensic investigations. Findings The surveys showed a marked change to a less restrictive policy, with increased use of ,take-away doses' and a reduction of discharges due to side misuse. The one-year retention rate stayed high. Sales of buprenorphine and methadone and the number of patients in treatment increased more than threefold from 2000 to 2006, with the greatest increase for buprenoprphine, introduced in year 2000. There was a significant 20,30% reduction in opiate-related mortality and inpatient care between 2000,2002 and 2004,2006 but not of other drug-related mortality and inpatient care. This decline was larger in Stockholm County, which had a less restricted treatment policy. However, a significant increase in buprenorphine- and methadone-related mortality occurred. For the study period 1998,2006, statistically significant declines occurred only in Stockholm County. Conclusions The liberalization of Sweden's drug policy correlated with an increase in maintenance treatment, a decrease in opiate-related mortality and inpatient care and an increase in deaths with methadone and buprenorphine in the tissues. [source] Drug Policy and the Public Good: a summary of the bookADDICTION, Issue 7 2010Drugs, Public Policy Group ABSTRACT Drug Policy and the Public Good was written by an international group of scientists from the fields of addiction, public health, criminology and policy studies to improve the linkages between drug research and drug policy. The book provides a conceptual basis for evidence-informed drug policy and describes epidemiological data on the global dimensions of drug misuse. The core of the book is a critical review of the cumulative scientific evidence in five general areas of drug policy: primary prevention programmes in schools and other settings; health and social services for drug users; attempts to control the supply of drugs, including the international treaty system; law enforcement and ventures into decriminalization; and control of the psychotropic substance market through prescription drug regimes. The final chapters discuss the current state of drug policies in different parts of the world and describe the need for future approaches to drug policy that are coordinated and informed by evidence. [source] Seeing America,diary of a drug-focused study tour made in 1967ADDICTION, Issue 6 2010Griffith Edwards ABSTRACT In 1965 the British government was forced to admit that the country had an escalating heroin problem, with the supply coming mainly from prescribing by private practitioners. Within the official responses to what was seen at that time as a very worrying public health situation was the decision to fund the setting-up of the Addiction Research Unit (ARU) at the Institute of Psychiatry, London. The US National Institute of Mental Health (NIMH) generously sponsored a study tour for the nominated director of the ARU shortly before the opening of the British research centre. Extensive contemporaneous diary notes of a visit included contact with administrators, researchers, clinicians, parish priests, narcotic agents and addicts themselves. From a mass of often conflicting advice, some insights could be derived. In particular, these included the need for an awareness of any country's way of dealing with drug problems as a dynamic, multi-factorial total system,a holistic ,national response'. A further conclusion was to see policy itself as a complex subject for analysis: drug policy should be as much an issue for research as drug taking. Besides these broad conclusions, the experience provided many specific leads to development of a British addiction research programme, and fostered professional friendships of immeasurable worth. [source] Addiction research centres and the nurturing of creativity: Centre for Social Research on Alcohol and Drugs (SoRAD), Stockholm University, SwedenADDICTION, Issue 3 2010Kerstin Stenius ABSTRACT The Centre for Social Research on Alcohol and Drugs (SoRAD) was established as a national research centre and department within the Faculty of Social Science at Stockholm University in 1997, following a Government Report and with the aim to strengthen social alcohol and drug research. Initially, core funding came from the Swedish Council for Working Life and Social Research and from the Ministry of Health and Social Affairs for several long-term projects. Today, SoRAD, with 25 senior and junior researchers, has core funding from the university but most of its funding comes from external national and international grants. Research is organized under three themes: consumption, problems and norms, alcohol and drug policy and societal reactions, treatment and recovery processes. SoRADs scientific approach, multi-disciplinarity, a mix of qualitative and quantitative methods and international comparisons was established by the centre's first leader, Robin Room. Regular internal seminars are held and young researchers are encouraged to attend scientific meetings and take part in collaborative projects. SoRAD researchers produce government-funded monthly statistics on alcohol consumption and purchase, and take part in various national government committees, but SoRADs research has no clear political or bureaucratic constraints. One of the future challenges for SoRAD will be the proposed system for university grants allocation, where applied social science will have difficulties competing with basic biomedical research if decisions are based on publication and citation measures. [source] Heroin-assisted treatment in Switzerland: a case study in policy changeADDICTION, Issue 1 2010Ambros Uchtenhagen ABSTRACT Background Switzerland introduced a pragmatic national drug policy when the former conservative abstinence-orientated politics proved unable to cope with an escalating number of users and related negative consequences for public health and public order. The high visibility of ,needle parks' and the size of the acquired immune deficiency disorder (AIDS) epidemic called for a new approach and for national leadership. Aims To describe the intentions, the process and the results of setting up the new treatment approach of prescribing heroin to treatment resistant heroin addicts, as an example of drug policy change. Materials and Methods A systematic collection of relevant documents is analysed and used as evidence for describing the process of policy change. Results Measures to reduce the negative consequences of continued use and to prevent the spread of AIDS were started mainly by private initiatives and soon taken up officially in the ,four-pillar' drug policy (including harm reduction, prevention, treatment and law enforcement). Medical prescription of heroin to chronic, treatment-resistant heroin addicts was one of the innovations, based on extensive scientific and political preparation. Detailed documentation and evaluation, ample communication of results, adaptations made on the basis of results and extensive public debate helped to consolidate the new policy and heroin-assisted treatment, in spite of its limitations as an observational cohort study. All necessary steps were taken to proceed from a scientific experiment to a routine procedure. Discussion Comparable policy changes have been observed in a few other countries, such as The Netherlands and Germany, based on the Swiss experience, with equally positive results of heroin-assisted treatment. These experiments were designed as randomised controlled trials, comparing intravenous heroin against oral methadone, thereby demonstrating the specific value of pharmaceutical diamorphine for maintenance treatment in opiate dependence. The positive impact of policy change and the positive outcomes of heroin-assisted treatment were acknowledged increasingly nationally and internationally, but made it difficult to continue the process of adapting policy to new challenges, due to the low visibility of present drug problems and to changing political priorities. Conclusion A major change in drug policy was effectively realised under typical conditions of a federalist country with a longstanding tradition of democratic consensus building. Facilitating factors were the size and visibility of the heroin problem, the rise of the Aids epidemic, and a pragmatic attitude of tolerating private initiatives opening the way to official policy change. [source] Ten years after the United Nations General Assembly Special Session (UNGASS): assessing drug problems, policies and reform proposalsADDICTION, Issue 4 2009Peter Reuter ABSTRACT In 1998 the United Nations General Assembly Special Session resolved that governments would reduce drug production and consumption greatly within 10 years. With that period now elapsed, there is an interest in reviewing how successful this was and considering how drug policy could be improved. The demand for drugs in the world has stabilized mainly as a result of the interaction of epidemic forces, culture and economic development. Supply has become more concentrated and the menu of drugs has changed surprisingly slowly. Drug policy is shifting to a more explicitly tolerant configuration in Europe and a few other countries, but retains its ferocity in most of the world. The most prominent innovations under discussion have limited potential effects (heroin maintenance), have as yet been unproductive of policy interventions (,addiction is a brain disease') or have no political appeal (legalization). The option with the most scope is increased effort at diverting arrested drug users out of criminal justice systems. No prevention, treatment or enforcement strategies have demonstrated an ability to substantially affect the extent of drug use and addiction. The best that government interventions can do is to reduce the damaging consequences of drug use and drug control. More attention should be given to reductions in the intensity of drug enforcement, which has many unintended adverse consequences and yields few of the claimed gains. [source] Dilemmas in harm minimizationADDICTION, Issue 3 2009Don Weatherburn ABSTRACT This paper discusses the dilemmas inherent in pursuing a philosophy of (drug) harm minimization. The dilemmas arise (i) because all drug control policies produce harms as well as benefits; (ii) because many of these harms and benefits cannot be measured; and (iii) because even when they can be measured, judgements about what harms matter the most are irreducibly political. The paper concludes by proposing that the interests of drug policy might be better served if we abandoned the idea of an overarching goal in favour of a set of goals dealing with specific identifiable problems. [source] The need for dynamic drug policyADDICTION, Issue 1 2007JONATHAN P. CAULKINS First page of article [source] Why does research have so little impact on American drug policy?ADDICTION, Issue 3 2001Peter Reuter First page of article [source] Access to essential drugs in Guyana: a public health challenge,,INTERNATIONAL JOURNAL OF HEALTH PLANNING AND MANAGEMENT, Issue 1 2010Enrique Seoane-Vazquez Abstract Guyana's pharmaceutical sector faces major challenges that limit access to essential drugs. This study analyzes Guyana's drug policy and regulation, public financing, and drug procurement and delivery. The study also identifies main barriers to drug access and proposes alternatives to strengthen the country's public health functions. Data were collected from the country's regulatory agencies, public procurement agency, pharmacies, wholesalers, and pharmaceutical companies. The information was supplemented with interviews with a convenient sample of Guyanese health authorities and stakeholders. Data were also compiled from scientific databases, and web pages of the country's Ministries of Health, Commerce and Finance, the Bureau of Statistics, and international organizations. Major barriers to drug access include: (1) lack of national drug policy and regulation, and limited role of the regulatory authority; (2) inefficient drug selection and irrational drug use; (3) insufficient financial resources and lack of drug pricing policy; (4) inefficient planning and managing public supply system; (5) deficient epidemiological and information systems; and (6) inadequate infrastructures and human resources shortage. Improving drug access in Guyana requires the strengthening of the country's public health functions and the implementation of a national drug policy and pricing policy, streamlining the drug financing, procurement, and planning and managing drug supply; and adequate infrastructures and human resources. Copyright © 2008 John Wiley & Sons, Ltd. [source] "New Governance" and Associative Pluralism: The Case of Drug Policy in Swiss CitiesPOLICY STUDIES JOURNAL, Issue 4 2003Sonja Wälti Throughout the 1990s, hierarchical administrative governance structures have been replaced by self-governing networks for various motives, one of which is to improve the authenticity and democratic quality of public decisions. Thus, "new governance" has been praised for its propensity to provide a plurality of civil society organizations with access to the decision process. This article explores these claims based on the case of drug policy in Swiss cities. We show that self-governing networks indeed seem to have increased the involvement of civil society organizations in the policy process. However, we also find evidence that self-governing networks may in the longer run induce state control over civil society organizations, thus ultimately reducing associative pluralism. They do so either by imposing a policy paradigm or by excluding actors who do not comply with the dominant paradigm from the networks. We conclude by arguing that self-organizing networks should not be dismissed, given that former hierarchical bureaucratic approaches to drug-related problems have failed even worse. Rather, their long-term effects should be subject to further examination aimed at developing adequate responses to their shortcomings. [source] | ||||||||||||||||