The 2021 National Drugs Forum focused on future needs and how we can anticipate changing patterns in drug use and supply to ensure our responses are robust and ready to meet new challenges. The forum was held online on 23 November 2021. The Department of Health in November 2021 published the midterm review of the national drugs strategy and has begun work on the six strategy priorities for 2021–2025.1 The forum provided an opportunity to reflect on the themes of preparation and foresight central to both national and European drug policies.

Strategic foresight

The forum introduced participants to the concept of strategic foresight and explained its relevance for anticipating trends in the drugs area. Strategic foresight is an approach to planning and policymaking that attempts to manage uncertainty by identifying a number of possibilities. Governments, institutions, non-governmental organisations, and other national and international collective entities can develop anticipatory capacity by making better use of what is known already.

The discipline of strategic foresight puts particular emphasis on harnessing existing knowledge. The session was led by Future Impacts, a consultancy that specialises in foresight capacity building, coaching, training, and research. Future Impacts has worked extensively on European Commission foresight projects and has advised the European Monitoring Centre for Drugs and Drug Addiction (EMCDDA) on a number of projects on drug-related futures.

Megatrends workshop

The workshop at the National Drugs Forum involved identifying and analysing megatrends to explore global changes and their implications for local policy. The overall objective of the workshop was to provide participants with an understanding of what foresight is and why it is important, as well as understanding wider changes in the environment that may have implications for drugs and drug monitoring in the future.

In the workshop, participants engaged with a number of groups and were asked to complete some simple exercises that provided them with hands-on experience of working with foresight and megatrends. Each group was tasked with prioritising megatrends according to their potential impact on the future of drugs, related policies, and development of services in response to the changing situation. They were then asked to identify the potential implications of the trends that could have an impact on drugs until 2030. The responses were imaginative and thoughtful, and each group gave consideration to possible developments for which we have, as yet, few early indicators.

Climate change and migration

The benefit of working with several megatrends together was clear from the groups’ recorded observations, as separate megatrends overlapped and reinforced the impact of one another. For instance, several groups considered climate change and environmental degradation, which has clear links to another megatrend, the increasing significance of migration. The needs of new communities will challenge the response capability of existing services. Climate change and migration will drive increasing urbanisation, with newer housing isolated from the centre and many people traumatised by dislocation and the loss of social networks. Climate change may facilitate drug production activities locally that are not feasible or economic at the moment and strain law enforcement resources.

On the positive side, the need to mitigate the harmful effects of climate change and Covid-19 may stimulate more cooperation between institutions and international cooperation.

Technological developments

One group highlighted increasing levels of self-medication as a result of both mental health challenges and changing consumer patterns facilitated by technological changes and consumer-oriented cultures in wealthier, but more unequal, societies. Participants were well aware of the preventative, early intervention, treatment, and harm reduction possibilities that technological innovations can bring. Remote access to services can increase availability and lessen the stigma associated with traditional treatment approaches.

While technological changes will provide new opportunities in service provision, differing digital literacy levels may compound existing inequalities and impede access for some. Services already facing challenges in staffing may struggle to provide new interventions and adapt to a rapidly changing drug environment. 

The Covid-19 pandemic has demonstrated the powerful impact of easily available misinformation and poor research. The traditional gatekeepers for public discourse are becoming less relevant. This multiplies the effect of a growing global marketplace for drugs, as consumers use non-scientific sources of information about potentially dangerous new products.

Technological change and hyperconnectivity also encourages more openness and curiosity among younger people, especially in social drugs that are increasingly seen as a normal part of the festival or event experience. This particular market is highly lucrative and likely to be exploited in increasingly sophisticated ways in the future. Easier transition to virtual spaces through accelerating technological change and hyperconnectivity may result in behavioural shifts similar to substance dependency and present a very different arena for treatment professionals to work in.

Global political and economic changes

Several groups considered the economic consequences of resource scarcity and the expanding influence of the East and the South. The increasing industrialisation of these regions will inevitably present opportunities for greater production of synthetic drugs, more easily transportable than traditional plant-based drugs along new and harder to detect trade routes. The political implications of global shifts in population, natural resources, and industrialisation may include a lowering of governmental commitment to human rights, leaving Europe isolated with regard to upholding individual freedoms and protections against coercion. There is a danger that, in this global environment, the gradual strengthening of progressive drugs policies may be reversed.

There is a connection here to the megatrend of shifting health challenges. A smaller population of working-age people will be asked to support healthcare for a growing older cohort. In an international political climate that may have less compassion for those who are seen to transgress social norms, will the next generation be prepared to support services for an ageing population of people who use drugs?

Working life

The changing nature of work may lead to an increase in early retirement and social isolation, which could result in greater alcohol and drug use among older people. For younger people, shifts in work patterns will expand social networks at home and abroad. This growth in professional relationships will also enable greater sharing of knowledge and insights from other countries. Of course, it will also increase awareness of new drugs and present opportunities to experiment. New work patterns may also blur the boundaries between home and work, placing more demands on people who consequently seek opportunities to relieve stress.

New modes of governing and consumer changes

New governing systems may also result in more participatory democracy through mechanisms like expanded citizens’ assemblies. Deliberations in these forums tend to have more liberal outcomes than parliamentary systems and could contribute to policies like legalisation of drugs. Any such legislative change must take into account the shifts in market dynamics and distribution patterns made possible by the internet. It is not clear what a legislative response to a quickly growing online drug market might be and there is concern that the response will be far slower than technological change.

Demographic changes and policy shifts in other European countries may increase pressure for the liberalisation of drug laws and increasing usage of a wider variety of drugs. While this will be challenging, regulation of substances that are currently illegal creates opportunities to regulate markets, educate users, and reduce criminal activity.

As conventional commercial enterprises seek new markets in a changing legal environment, regulators will face unforeseen challenges in managing very new, aggressive, and agile corporate entities. Consumption patterns will not be totally shaped by the increased availability of currently illegal drugs. Successful implementation of alcohol control measures may provoke a response from the industry to reclaim markets lost, amplifying the regulatory challenges that will follow the liberalisation of drug laws.
 

1  Drugs Policy and Social Inclusion Unit (2021) Mid-term review of the national drugs strategy, Reducing Harm, Supporting Recovery and strategic priorities 2021–2025. Dublin: Department of Health. https://www.drugsandalcohol.ie/35183/