(Demand-Side & Supply-Side Prevention)
Issue #38 August 2024
This issue is a modified and updated excerpt from “Buzz Kill: The Corporatization of Cannabis”.
In the previous issue of DPA, I shared a piece of my origin story in the drug policy field, and introduced the idea of demand- and supply-side prevention of drug problems.
Demand-side prevention strategies are aimed at the public and attempt to reduce the voluntary demand for, and harmful use of, drug products. Constructive initiatives can foster an evidence-based understanding of drugs and their actions, and facilitate personal awareness, responsibility, resiliency, and self-esteem. The fostering of these assets can be deployed to encourage and support any combination of abstinence, moderation, or otherwise safer drug use. The commonality among demand-side interventions is that the onus is placed upon individuals to regulate their personal drug use. Most people do this very well. But some do not.
All levels of government try to regulate drug use by people through the application of drug laws and enforcement. To say that this criminal law approach to the illegal use of drugs has become increasingly controversial over the last half-century would be an understatement. The criminalization of drug use has too often been justified by associating drug use with moral turpitude, sometimes as a guise for parochial economic or political gain. We have seen the construction of complex legislative provisions and expansive, unwieldy bureaucracies to punish those who use drugs that have not been approved by the state for commercial trade. Even for drugs that have been approved for commercial trade, there are restrictions on how they can be acquired, and where, or in what circumstances they can be used, and in what amounts. These restrictions also remain controversial.
Given the high levels of injury, illness, death, and economic costs associated with drug misuse, there is nothing wrong with placing reasonable restrictions on drug use for the overall protection of individuals and society. The problem often arises with discriminatory enforcement and with excessively harsh and counterproductive consequences for those who breach the restrictions. Apart from overly zealous and oppressive law enforcement, demand-side interventions are worthwhile. But even at their best, demand side approaches are insufficient for a comprehensive drug problem prevention strategy.
A comprehensive approach must also address how society supplies drugs to meet the public’s demand. This includes tobacco, alcohol, cannabis or pharmaceutical manufacturers. Supply-side interventions address a variety of considerations such as drug product integrity and safety during manufacturing, as well as clearly and accurately labelled packaging. Supply-side also addresses the availability of drug products through retail outlets. Measures can include restrictions on the appearance of retail outlets, as well as the maximum number in any area and their locations. There are restrictions on operating hours and on who can own or operate them. And finally, they can restrict who can be served and the amount sold to each customer on a single visit. The interventions hope to prevent bars from serving patrons to intoxication or retail stores from selling alcohol, tobacco or cannabis to minors.
The emergence of safe supply for legacy illegal drugs has become a contentious issue that also falls under supply-side interventions. Their implementation has been less than perfect, but safe supply and consumption remain important components of a harm reduction approach. And no, BARS ARE NOT SAFE CONSUMPTION SITES. Bars are associated with high levels of alcohol-infused rowdy behaviour at closing time including fights, injuries, and local property damage. They are also associated with impaired driving and its sometimes tragic consequences. And sexual harassment and assault. And domestic violence. BARS ARE NOT SAFE CONSUMPTION SITES. Yes, we need safe supply, but bars are not the shining example that some advocates claim they are. People should stop saying it.
Supply-side interventions also address the methods of drug product promotion through advertising and marketing or the depictions of drug use in pop culture. These practices can be regulated to control the degree to which normalization and the demand for the drug product is stimulated by drug, advertising, and entertainment industries – which may not always depict drug use and its effects within a realistic, accurate, or socially responsible context.
The important feature of supply-side prevention is that it extends responsibility beyond the individual person to include responsibilities for the suppliers in drug companies and the promotors in the entertainment and advertising industries. A supply-side approach must also address how well government regulates drug companies through law, regulations and enforcement. It must also include public expectations that government will communicate a public health priority to these industries, reinforcing those communications with laws and regulations, and consistently enforcing those laws with meaningful consequences for violations. Thus, there is clearly a role for the courts as well in managing the conduct of the suppliers. Increasing class action lawsuits against tobacco and pharma companies is the compelling example.
Industry and government often fail in their supply-side roles, and sometimes, the courts do as well. These failures are rooted in systemic neglect. That is a problem that requires political change. I am reminded of the United Kingdom’s advocate against child poverty, Sir Michael Marmot, who admonished us all with “…you live in a democracy. This must be the level of child poverty that you want. Otherwise, you’d elect a government that did something different.”
As nations waged the now-discredited war on drugs, young people were told to “just say no”. It was clearly unfair and unrealistic to place such an onus on young people. This is particularly true given that they were simultaneously encouraged to just say “let’s party!” by well-resourced, expertly advised, drug industries. Some pop culture icons have also promoted a kind of drug fetishism as a part of their image.
As a society, we need to do more to protect young people. Simply supplying a shield of knowledge, self esteem, and resiliency to help protect them from a perpetual stream of heat-seeking advertising and pop culture missiles is insufficient. Someone must also deal with the person launching those missiles. This is neither a new nor radical idea.
Over two decades ago, consumer advocate Ralph Nader, co-authored Children First ! A Parent’s Guide to Fighting Corporate Predators. Nader is a five-time candidate for the presidency of the United States, and was ranked, by Time Magazine, among the one hundred most influential Americans of the twentieth century. The corporate predators Nader challenges include not only drug industries but also purveyors of unhealthy food.
There are also acknowledgements of the enormous volume of advertising directed at children on the Canadian side of the border, On April 25 2015, the Canadian Broadcasting Corporation (CBC) broadcast of Under the Influence (hosted by Terry O’Reilly) noted that the entire production costs of the children’s movie, Smurfs 2 were paid for by product placement within the film. In the activist world, Vancouver-based Adbusters wields an edgy anti-corporate swagger. Adbusters was the creator of the anti-consumerism meme “the product is you”, and catalyst for the Occupy Wall Street and Buy Nothing Day movements. These can be unsettling ideas and tactics to those who would prefer not to confront the darker aspects of the determinants of health. A decade ago, I began asking what the determinants of the determinants of health were. We are now seeing the response in an emerging literature on the commercial and political determinants of health. These are daunting challenges but confront them we must. Much more on that in coming issues.
Mike DeVillaer
Hamilton Ontario Canada
August 27 2024
Order: “Buzz Kill: The Corporatization of Cannabis”
Canada / USA: University of Toronto Press utpbooks@utpress.utoronto.ca
UK / International: Central Books contactus@centralbooks.com
Or at your local bookstore. ISBN: 978-1-55164-795-1
They will appreciate your support.