Stakeholder influences on drug and alcohol policy processes

Vibeke Asmussen Frank (Centre for Alcohol and Drug Research, Aarhus University, Aarhus, Denmark)
Bagga Bjerge (Centre for Alcohol and Drug Research, Aarhus University, Aarhus, Denmark)
Karen Duke (Middlesex University, London, UK)
Axel Klein (University of Kent, Canterbury, UK)
Blaine Stothard (Independent Prevention Specialist, London, UK)

Drugs and Alcohol Today

ISSN: 1745-9265

Article publication date: 7 December 2015



Frank, V.A., Bjerge, B., Duke, K., Klein, A. and Stothard, B. (2015), "Stakeholder influences on drug and alcohol policy processes", Drugs and Alcohol Today, Vol. 15 No. 4.



Emerald Group Publishing Limited

Stakeholder influences on drug and alcohol policy processes

Article Type: Guest editorial From: Drugs and Alcohol Today, Volume 15, Issue 4.

The addictions field is populated by a wide range of stakeholder groups drawn from the public and private spheres and crossing disciplinary and occupational boundaries. Stakeholders have a key role in the formulation and delivery of policy and also in the production and dissemination of “evidence” that is used to inform policy and practice. Increasingly, stakeholders and stakeholder networks have emerged and developed locally and nationally, but they also operate beyond national boundaries. These different stakeholders and stakeholder groups now play an important part in knowledge and policy transfer. Understanding the dynamics of stakeholder involvement in the policy process, and its role in relation to evidence-based policy, is important in examining policy responses to substance use and addiction. The purpose of this special issue is to critically examine local, national and/or supranational stakeholders' influence on policy processes.

Policies to address issues of substance use, problem use and addiction have varied greatly across time and geographical location. Shifts in policy approaches have come about as the “problem” has been defined, framed and re-framed thereby altering the understandings of the issues and the necessary responses. Political imperatives, social and economic pressures and cultural changes have also influenced when, how and who uses any particular substance and the “rules” concerning acceptable and non-acceptable behaviours. Thus, the social actors and groups – or stakeholders – concerned with issues of substance use and addiction and with policies to manage the production, distribution and use of addictive substances have changed and, in the contemporary period, have grown in number and diversity.

Stakeholder analysis adopts primarily a qualitative and retrospective approach producing a picture of how a given issue shifts and develops over time, and the concept of stakeholder can broadly be defined as any actor who can affect and/or be affected by the activities of a policy making process (Freeman, 1984; Orts and Strudler, 2002). The many individuals and groups which can affect or may be affected by drug and alcohol policies include medical professionals, psychologists and social care workers, specialist treatment workers and treatment communities, officers and other staff in the criminal justice system, trade and industry groups, researchers, the media, a range of government departments and civil authorities, religious groups and institutions, philanthropists, and – of course – substance users themselves. Alcohol and drug policy has relevance for major state institutions – economic, health, leisure and criminal justice institutions, for example, and they, too, may be considered stakeholders. In any country, the structures and processes of governance also have significance for the range and nature of stakeholder groups, institutions and authorities. As governance is devolved in many countries to regional, municipal and local levels, stakeholder groups and networks become relevant at different levels of policy formation and implementation although some groups or individuals are likely to span the different levels. As Houborg and Frank (2014) have commented, a shift from “government” to “governance” means:

      Decentring policy 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 actors and institutions. While public institutions still play a role in governance, their authority is delegated and negotiated (Houborg and Frank, 2014, p. 973).

At the same time, the growing importance of international agreements, regulations and epistemic or knowledge communities may exert external influence, and at times pressure, on national policies. On the other hand, the authority of external stakeholders may be used by domestic actors to revise national policies or resist changes. Multi-level stakeholder structures are, therefore, a feature of the policy landscape. Consideration of multi-level interests is also a core aspect of stakeholder analyses.

Examination of the relationship between stakeholder groups and policy on substance use and addiction inevitably entails consideration of power, the material interests of professionals and institutions, influence and the dynamics of interaction between social actors striving to promote their preferred policy options. The production, use and dissemination of “evidence” become important tools and are often employed as a tactical strategy to gain legitimacy and credibility for a particular rationality of action. Thus, as patterns of substance use change and as policy designed to address the problems of drug or alcohol use in turn influences new behaviour patterns, the composition and influence of stakeholders varies and changes.

As we will see in the papers in this collection, the complexity of stakeholder activity illustrates the need to map out the stakeholders relevant to a specific policy issue and contextualise their activities within the different national cultures and the political, health, economic and social systems in force at any particular time. The five papers comprise a number of case studies from different parts of the world, including Australia, Denmark, Norway and the UK. They draw on a range of theoretical frameworks to examine stakeholder dynamics at national and local levels, and focus on stakeholders in local alcohol policy, opioid substitution treatment, heroin assisted treatment, policy responses to alcohol-related violence and responses to prevention at schools.

The four research papers in this issue were presented at the Nordic Alcohol and Drug Researchers' Assembly in August 2014 in Stockholm, Sweden. The conference is a biannual event where especially Nordic research within the alcohol and drug field is presented. One of the emerging themes at the conference was stakeholders' influence on policy processes. Two of the papers (Houborg and Andersen and Bjerge et al.) are outcomes of the EU seventh framework funded Addictions and Lifestyles in Contemporary Europe – Reframing Addictions Project research project, which contained a sub-project on stakeholder analyses in addictions fields in seven different countries. The fifth paper is a practitioner's paper, which provides an overview of school-based prevention work with young people in Denmark (Pedersen and Stothard).

Our aspiration with this special issue is that it will stimulate further discussion of the role of different stakeholders in country-specific contexts as well as in international fora. It is hoped that this will be debated both as a democratic issue in terms of examining whose interests and concerns get to be represented in policy processes and who has the opportunity to participate in such processes, as well as an epistemological issue in terms of exploring which kinds of knowledge and experiences are regarded as relevant and allowed to influence how society manages alcohol and drug-related issues.

Dr Vibeke Asmussen Frank is based at Centre for Alcohol and Drug Research, Aarhus University, Aarhus, Denmark.

Dr Bagga Bjerge is based at Centre for Alcohol and Drug Research, Aarhus University, Aarhus, Denmark.

Dr Karen Duke is based at Middlesex University, London, UK.

Dr Axel Klein is based at University of Kent, Canterbury, UK.

Blaine Stothard is an Independent Prevention Specialist, London, UK.


Freeman, R.E. (1984), Strategic Management: A Stakeholder Approach, Pitman Publishing, Boston, MA

Houborg, E. and Frank, V.A. (2014), “Drug consumption rooms and the role of politics and governance in policy processes”, International Journal of Drug Policy, Vol. 25 No. 5, pp. 972-77

Orts, E.W. and Strudler, A. (2002), “The ethical and environmental limits of stakeholder theory”, Business Ethics Quarterly, Vol. 12 No. 2, pp. 215-33