Research paper
Drug consumption rooms and the role of politics and governance in policy processes

https://doi.org/10.1016/j.drugpo.2014.01.008Get rights and content

Abstract

Background

In 2012 after more than 20 years of discussion Denmark introduced drug consumption facilities as part of its drug policy. This article investigates the processes that led to this new policy and its implementation in Copenhagen. The aim of the article is to analyze if the new policy and its implementation can be understood in terms of a shift from ‘government’ to ‘governance’ in drug policy. On this basis the aim is also to discuss the possibilities and limitations of ‘governance’ as an analytical perspective for understanding policy change in the field of drug policy.

Methods

Through the use of Kingdon's theory about policy change as following alignments of problem streams, policy streams and politics streams and deployment of Callon's concepts of ‘framing’ and ‘overflowing’ the article presents an analysis of recorded communication from the public debate and national and local policy processes.

Results

Politics and the authority of government played a key role in the policy change that led to the introduction of drug consumption facilities in Denmark. It was only after a change of government and a change of legislation that a new policy came about. Drug consumption facilities did exist on a small scale before this through acts of civil disobedience committed by civil society stakeholders.

Conclusion

The space for governance seems to be limited in a drug policy that is prohibitive, at least when it touches upon issues that concern law enforcement and the sovereign power of the state.

Introduction

Drug consumption rooms are professionally supervised healthcare facilities. These were established to provide a safer and more hygienic environment for drug users to take drugs but also to reduce public order problems associated with public drug use (Dolan et al., 2000, Hedrich et al., 2012, Stöver, 2002). According to Hedrich et al. (2012) the first legally sanctioned drug consumption room was established in Switzerland in the mid-1980s. Rooms were set up in other Swiss cities and in the Netherlands and Germany during the 1990s and from 2000 onwards these were available in countries including Norway, Spain, Luxembourg, Australia, and Canada (Hedrich et al., 2012). Research thus far has mainly focused on their effects on improving the health of drug users, including reducing risk behavior, their role as a gateway to other services, reducing public nuisance and preventing overdose deaths (e.g. Hedrich et al., 2012, Kimber et al., 2005, Salmon et al., 2008, Scherbaum et al., 2009, Small et al., 2007, Stöver, 2002, van der Poel et al., 2003, Watson et al., 2013, Zurhold et al., 2003). There has also been some examination of the characteristics of drug users who use these facilities (e.g. van der Poel et al., 2003, Tyndall et al., 2006, Watson et al., 2013). Much less research has examined the legal controversies between drug control and welfare services (e.g. Skretting, 2005, Skretting, 2006) or the policy processes leading to the establishment or continuity of drug consumption rooms (de Jong and Weber, 1999, Hathaway and Tousaw, 2008, Lloyd and Hunt, 2007, Small, 2007, Wood et al., 2008). This paper focuses on drug consumption facilities as a policy issue.

In 2012 an amendment to Danish drug legislation made it possible for municipalities to establish drug consumption facilities after authorization from the Minister of Health. In the same year the first municipal drug consumption facility opened in the area of Vesterbro in Copenhagen, the location of the largest open drug scene in Denmark. Since then, facilities have been set up in Aarhus and Odense in 2013 and more are planned in 2014.

Drug consumption facilities had been a contentious issue in Denmark for more than 20 years. We were interested in the processes that led to the policy change, making possible the establishment of drug consumption facilities. However, our aim was not merely to analyze how this policy change came about, but also to investigate the relationship between the institution of government and the practices of governance, in an area where legislation plays an important role. In this way our analysis will show both the possibilities and limitations of governance as an analytical perspective for understanding policy change within the field of drug policy.

Through an analysis of policy documents, newspaper articles and reports produced by different non-governmental organizations (NGOs) we consider how the policy process leading to the introduction of drug consumption rooms involved a variety of stakeholders from different levels of government and public, private and civil sectors of society. We present the concepts that underpin our analysis, and by using the Vesterbro area as an example, we examine how drug consumption rooms, at both national and local level, became a way to address problems linked to marginalized drug users and open drug scenes. Finally, we discuss our findings in relation to the notion of governance and the possibilities and limitations of this concept in the field of drug policy, where legal regulation plays a primary role.

Section snippets

Analytical framework

Our analytical interest was the extent to which we can understand the policy changes that made possible the introduction of drug consumption facilities in terms of a shift from ‘government’ to ‘governance’. This means a decentering of policy making and the focus of policy research away from the institutions of the state, formal decision making and implementation through public institutions and towards the enactment of governance via the negotiations between a multitude of public and private

Data and methods

The article is based on a textual analysis of a variety of sources: First, legislation (Law no. 185 of June 13th 2012 on drug consumption rooms) and documents relating to the legislative process, including transcripts from parliamentary debates; committee reports; documents produced by the state administration; expert input; and documents from public hearings. These were retrieved from the homepage of the Danish parliament (www.folketinget.dk) and the public homepage for information about

Findings

Our analysis focused on the period from the early 1990s to 2012. We examined the construction of policy problems, programs for action and politics in the continual framing and reframing of drug policy. We followed how policy making produces overflows of concerns and interests and the roles that different stakeholders have played. These stakeholders included: the national government, particularly the Minister of Health, national and local politicians, experts, NGOs and different civil society

Conclusion

We set out to investigate the policy change leading to the introduction of drug consumption facilities in Denmark and the extent to which this can be seen as a shift from government to governance. Our point of departure was Kingdon's theory of policy change and Callon's concept of framing and overflowing. We have looked at the streams of problematizations, policy proposals and politics over a 20 year period, where drug consumption facilities have been on the agenda and we have seen a continuous

Conflict of interest statement

We hereby certify that there has been no conflict of interest with any financial organization regarding the material discussed in this manuscript.

Acknowledgements

The research leading to these results has received funding from the European Community's Seventh Framework Programme (FP7/2007–2013), under Grant Agreement no. 266813 – Addictions and Lifestyles in Contemporary Europe – Reframing Addictions Project (ALICE RAP). Participant organizations in ALICE RAP can be seen at http://www.alicerap.eu/about-alicerap/partners.html. The research has been conducted in Work Package 2 which is focused on stakeholder analysis.

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