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The “public health” approach to illicit drugs: an eradicative drug discourse in a sanitorial disguise?

Steven Debbaut (Faculty of Law and Criminology, Ghent University, Ghent, Belgium and Faculty of Law and Criminology, Vrije Universiteit Brussel, Brussels, Belgium)
Tobias Kammersgaard (School for Business and Society, University of York, York, UK)

Drugs, Habits and Social Policy

ISSN: 2752-6739

Article publication date: 22 December 2022

Issue publication date: 1 March 2023




This study aims to problematize current calls for a “public health” approach to governing illicit drugs and the people who use them.


It draws on a range of historical sources to describe how drugs became a problem for governments, in order to critically diagnose the present and investigate the origins of current perspectives on drugs.


It is argued that there are currently two authoritative drug discourses. The first discourse is the dominant one and is eradicative, with blame and punishment as its primary responses. The second discourse is subauthoritative, but growing in importance, and is sanitorial, with care and cure as its primary responses.


While these two discourses have often been thought of as distinct, this historical exploration demonstrates that the eradicative and sanitorial discourses are both based on similar principles.



Funding: This work was supported by the Research Foundation – Flanders (FWO) [grant number FWOOPR2019008101].


Debbaut, S. and Kammersgaard, T. (2023), "The “public health” approach to illicit drugs: an eradicative drug discourse in a sanitorial disguise?", Drugs, Habits and Social Policy, Vol. 24 No. 1, pp. 1-13.



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