Chapter 13 surveys and assesses the different ways in which election laws and practices impact racial equality in the political process and the distribution of resources and power that stems from those elections. Topics include voter ID laws, felon disenfranchisement, and racial redistricting, as well as immigrant political incorporation and language access. Themed boxes include recent court cases on voter ID, specific voting rights cases, and noncitizen voting.

Methadone, a medication used to treat opioid use disorder (OUD), has resulted in decreased opioid overdose deaths, while increasing treatment retention and lowering the rates of infectious diseases associated with intravenous substance use. Access to methadone is limited in the United States due to federal laws and regulatory policies that are rooted in racist “criminal justice approaches” to substance use. Unlike other controlled prescription medications, methadone is subject to restrictions on the number of doses a person can receive at any given time, known as “take-home doses” (THDs). Federal regulations mandate that patients receiving methadone must travel to government-certified clinics known as opioid treatment programs (OTPs) almost daily to receive medication for at least the first 90 days of treatment. Due to the need to practice social distancing during COVID-19, the Substance Abuse and Mental Health Services Administration (SAMHSA) – the regulatory agency which sets the accreditation standards for OTPs – released a federal waiver in March 2020 granting significant exemptions to THD regulations. Thousands of patients have now received increased THDs, a historic and impactful shift in care for people with OUD. This chapter begins with an overview of the regulation of methadone for OUD before COVID-19. Next, it reviews the evidence for regulatory reform alongside our analysis of qualitative data we collected during COVID-19 that reflects patients’ experiences with increased access to THDs. Based on the findings of our qualitative study and the empirical literature, we conclude the chapter with recommendations for modifications of THD regulations.

Our response to the opioid epidemic has been reactionary, however preventing future addiction saves lives and money. Methods to prevent opioid misuse and addiction are frequently placed in one of three categories: universal, selective, or indicated. Universal prevention addresses an entire group of people without respect to any factors that might predispose someone to addiction. Most school-based curricula and education for prescribers fall under this category. Selective interventions are geared towards a subset of a population indentified as a higher risk for opioid use disorder, for example programs developed for children who have experienced traumatic events. Finally, indicated prevention focuses on individuals who are already using opioids but do not yet meet criteria for a clinical diagnosis of opioid use disorder. No matter the type, all strategies have the potential to postiively impact individuals and communities through reduced rates of addiction, overdose, and death.

In the late 1960s recreational drug use in the United States began to creep into the suburbs. As the children of white, middle-class Americans began to adopt this practice and the social stigmatization previously associated with recreational drug use began to fade as it became associated with protest and social rebellion in the era’s atmosphere of political unrest, these children’s parents began to demand that their government do something about it. In 1968 President Johnson formed the Bureau of Narcotics and Dangerous Drugs as the “War on Drugs” began. In the decades that followed groups like The Partnership for a Drug Free America and Drug Abuse Resistance Education sponsored media campaigns laced with anti-drug propaganda in a desperate attempt to protect the youth of America. Having had limited success parent’s organizations and government programs are now re-thinking how to create more effective drug education

The effect of individual governmental drug policies and regulations has, in many cases, been the main driving force behind the direction the opioid epidemic has taken in the United States and many countries around the world. Unfortunately these policies have sometimes had dramatically different effects than were initially intended. Changes in policy which allowed for increased availability of opioid medications had the unintended consequence of widespread opioid addiction and overdose deaths. Policies which aimed to crack down on the diversion of these medications from legitimate medical use resulted in the spike in heroin use as those people who were now addicted to opioids had to turn elsewhere. As demand for heroin surged, so too did manufacturing and sales, and as law enforcement targeted illicit heroin trafficking, cartels turned to the more potent and easier to hide synthetic opioids such as fentanyl and carfentanil. It seems that every governmental policy change or new regulation intended to stop the opioid epidemic is met with a creative solution by the people profiting to keep the opioid trade open.

After at least two decades of the proliferation of narconarratives mediated by the official discourse of “drug cartels,” an emerging current of writers, filmmakers, and journalists have renewed a critical approach to state violence and its implications beyond typical assumptions about organized crime. From the thousands of killings of the so-called war on drugs to the forced disappearance of forty-three students in the state of Guerrero in 2014, this counterhegemonic critique aims to rethink – and, more importantly, to reimagine – the most pressing events of violence as the result of social strategies of control and exploitation promoted by state structures and geopolitics. This essay proposes to analyze the politicized imagination intersecting state violence and drug trafficking that deliberately leaves behind the habitual hegemonic narconarratives to articulate instead a critical understanding of the criminal networks as by-products of official power. Along with the analysis of key works of fiction, film, and journalistic investigations, I will engage debates on state violence and neoliberalism in the age of permanent national security crises.

A perverse cycle defines the history of fear-based racial segregation in America. Step one in this cycle begins with the creation of inhumane and unsustainable conditions for a Black underclass by the dominant White social caste. Step two involves the natural and justified resistance to this treatment by the Black underclass. That resistance—whether it be expressed as escape from bondage, civil protest against Jim Crow, or assertion of constitutional rights in encounters with police—is then turned against the resistors. This reframing becomes step three: White social leaders mischaracterize resistance as evidence of lawless, violent, criminal behavior, using the lie to stoke racial fear and justify further oppression.

In this Chapter, I use American mass incarceration and the War on Drugs to draw conclusions about the increasing use of the criminal justice system to combat the abuse of non-human animals. I conclude that expanding criminal sanctions will result not just in increased incarceration, but in net-widening and deprivation of civil liberties. Furthermore, such negative effects are likely to be unequally distributed, falling most heavily on communities of color.

The Great Migration ended in 1970 as manufacturing was replaced with electronic goods. Wages stagnated, and income inequality increased rapidly. This led to a new Gilded Age. Nixon replaced Lyndon Johnson’s War on Poverty with his War on Drugs. Blacks were opposed to Nixon’s Vietnam War, and he penalized them by incarcerating them. This, helped by state laws and President Reagan, led to mass incarceration – which became known as the New Jim Crow. Public education was reserved for suburban whites, while urban Blacks were in prison or attended underfunded schools. The Flint, Michigan, water crisis demonstrates the difficulty of urban Blacks as jobs and urban facilities disappeared. President Obama was the first Black president, elected in the financial crisis of 2008. The Supreme Court nullified the 1965 Voting Act as it had done with amendments in the 1880s. Obamacare was the most enduring achievements of Obama’s presidency.

This introduces the topic of multilateral drug control, its contemporary relevance and the areas under examination within the book. It highlights the key themes grouped by three overarching focuses: historical, contemporary-legal and international relations theory. It examines the major debates under way in UN drug control and their direct relation to the historical-legal regulatory discussion encapsulated within the book. It outline existing historiography on international drug control and examines more recent developments. It points to continuing gaps in historiography, international relations, legal and policy literature which this book will fill. In particular it highlights the extensive literature on international legal fragmentation and its relevance for drug control debates. It offers an overview of regime theory and international relations approaches, suggesting a new and emerging framework based on evaluating drug control as a ‘regime complex’ in a similar lineage to climate change and intellectual property regimes, which will be covered in a more breadth in the Conclusion.

This chapter examines the legal legal of the Single Convention and its successor treaties. The passage of the Single Convention represented a high-water mark in the international regulatory system. While it contained little in terms of innovation, it streamlined the complex array of drug treaties, while moving the terrain of control forward marginally. It essentially solidified an economic regulatory framework for a global licit commodity market in certain essential medicines. To enforce this market it mandated certain action around controlling and prohibiting non-medical production and manufacturing. Key questions around dealing with ‘addiction’ and suppressing non-medical consumption were left largely unanswered. The US may have lost the battle around the Single Convention and control of the system in the 1960s but they would enter the 1970s ready to refight many of these battles, beginning with the declaration of the ‘war of drugs’ and an aggressive new round of bilateral drug diplomacy. Ultimately the ‘war on drugs’ was not an inevitable outgrowth of these documents, but instead represented a specific set of interpretations, bureaucratic and normative trajectories and member state implementations.

This chapter argues that whereas much of the past century was geared towards a legal and institutional homogenisation of international drug control, the coming decades appear underpinned by recourse to ‘policy pluralism’ as a mechanism to enable policy evolution. It is precisely these endogenous processes of pluralism, devolution and increasing diversity of global drug policies that provide the most promising avenues for various actors to influence policies at local, national, regional and international levels. It further argues that the international drug control system is undergoing a long-term process of fragmentation and evolution towards what international relations scholars in other spheres would term a ‘regime complex’. It concludes by suggesting that these endogenous regime changes likely provide the greatest opportunity to draw exogenous actors and regimes into the system’s orbit and thereby modernise and adapt drug policies to new global realities.

This chapter examines the role of the Opium Wars and great power conflict between Britain and China within the context of drug control. Within the Opium Wars, the foundational elements for the coming global drug control system were laid. These included straining bilateral relations between great powers as well as the emergence of nationalist and moralist coalitions of diplomats and missionaries driving ‘reformist’ agendas globally. The first international treaty, the 1912 International Opium Convention, aimed to create reciprocal state responsibilities for limiting the flow of mind-altering drugs. After World War I, the new multilateral drug control system was quickly absorbed by the League of Nations. However, the US’ simultaneous interest in the issue and unwillingness to join the League of Nations proved complicating. Throughout the 1920s and 1930s a whole series of treaties and institutional changes gave the system regulatory shape. The League Opium Advisory Committee, precursor to the UN Commission on Narcotic Drugs (CND) ultimately sank. The enforcement and monitoring bodies, survived and fled Geneva for the safety of Washington DC. The chapter concludes with a brief introduction to the main diplomats of the wartime era, most prominently, Harry J. Anslinger.