title: Partnerships and communities in English drug policy: the challenge of deprivation.
abstract: BACKGROUND
  From the mid-1990s, UK governments developed partnerships to tackle drugs nationally and locally. Over time, increased resources focused on communities and localities in greatest need. This reflected growing awareness of the concentration of problems in deprived areas, with social and spatial segregation being a feature of post-industrial urban areas.
  
  
  METHODS
  A review of English drug policy since the 1990s, drawing on:- analysis of documents; a review of sociological studies; an illustrative case-study of one northern town; interviews with local policy players; statistical analysis of key indicators with some of these data presented using Geographical Information System (GIS) mapping.
  
  
  RESULTS
  In-depth sociological studies demonstrate interconnections between historical patterns, socio-economic change, cultural complexity, deprivation, limited opportunities and illicit drugs. At local level, there are links between concentrated multiple deprivation, poor health, acquisitive crime and problematic drug use. Partnership policies, encouraged by the provision of ring-fenced funds, have been effective in containing problems. Underlying issues of inequality are however neglected in political debates. The article argues that post-industrial towns and cities are characterised by an increase in problems related to poverty and drugs. Both the real shape and perceptions of what is the problem change over time. In England, the profile of the problem drug user was described in a number of sociological studies conducted from the 1980s onwards. Key features were the concentration of problems in certain social groups (such as the poorly educated or unemployed) and in certain areas (inner cities or outer estates). Responding to rising public concern, national drug strategies developed and the New Labour Government after 1997 prioritised the issue of drugs, directing increased resources to drug treatment with tight control over the use of these new monies through target setting and measurement of performance. The emphasis was on the most dangerous drugs and most disadvantaged areas.
  
  
  CONCLUSIONS
  There is local variation in the pattern of problems and in implementation of national policies. In UK after 1997, New Labour policy aimed to promote a fair and cost-effective distribution of resources and improved availability and quality of treatment services and local policing. Tensions appeared between the drive to meet national targets and local perceptions of need. Ideas of localism, promoting market solutions and flexibility in provision, are now gaining ground in English social policy with the arrival of a Coalition (Conservative/Liberal Democrat) Government. These, together with an emphasis on abstinence and recovery, raise questions about the future adequacy of (a) attention to marginalised problems and stigmatised groups and (b) the distribution of resources in a context of severe fiscal restraint.
authors: Department of Social and Environmental Health Research, London School of Hygiene and Tropical Medicine, University of London, 15-17 Tavistock Place, London WC1H 9SH, United Kingdom. Susanne.MacGregor@lshtm.ac.uk
authors: Susanne
authors: S
authors: Macgregor
authors: Anthony
authors: A
authors: Thickett
mesh_terms: D000288:Administrative Personnel; D003159:Community-Institutional Relations; D003299:Cooperative Behavior; D003415:Crime / Q000331:legislation & jurisprudence / Q000517:prevention & control; D003466:Cultural Characteristics; D055030:Drug Users / Q000331:legislation & jurisprudence* / Q000523:psychology; D004335:Drug and Narcotic Control / Q000331:legislation & jurisprudence*; D004739:England / Q000453:epidemiology; D040362:Geographic Information Systems; D033161:Government Regulation; D006291:Health Policy / Q000331:legislation & jurisprudence*; D006801:Humans; D010465:Perception; D011050:Policy Making; D011203:Poverty / Q000331:legislation & jurisprudence*; D012111:Residence Characteristics; D057545:Social Stigma; D012946:Social Welfare / Q000331:legislation & jurisprudence*; D012959:Socioeconomic Factors; D013240:Stereotyping; D019966:Substance-Related Disorders / Q000453:epidemiology / Q000517:prevention & control / Q000523:psychology / Q000534:rehabilitation; D013997:Time Factors