The role of civil society and nongovernment organizations in preventing alcohol and drug problems

1
The role of civil society and nongovernment
organizations in preventing alcohol and drug
problems

• Robin Room
• School of Population Health, University of
  Melbourne
• AER Centre for Alcohol Policy Research, Turning
  Point Alcohol Drug Centre, Fitzroy, Victoria,
  Australia
• Centre for Social Research on Alcohol Drugs,
  Stockholm University
• Presented at a NordAN Conference, NGOs and
  Policy Making Role, Co-operation and
  Responsibility,
• Reykjavík, Iceland, 13 October, 2007

2
Between the state and the family or individual

• Social theory often used to be couched in terms
  of two levels
• the state or the society
• the family or the individual
• civil society as the collectivities or
  institutions that lie between
• Traditional institutional forms (often captured
  by the State)
• Church
• Economic enterprises
• Professions
• Voluntary organizations

3
Forms of voluntary organization

• Interest groups and social movements
• Pursuing change, traditionally in self-interest
• New social movements altruistic pursuit of
  change
• Professional societies and labour unions
• Furthering occupational interests and status
• Charitable, service and educational organizations
• Main emphasis on individual uplift, not social
  change
• Mutual-help and self-improvement organizations
• Main emphasis directed inward
• Recreational organizations and social clubs
• Main emphasis existential, not social change

4
In the alcohol field

• Temperance organizations
• as early voluntary organizations
• Mutual help but also altruistic action
• as a social movement pressing for change
• Mutual help organizations
• Alcoholics Anonymous, Länkarna
• Some also press for treatment policy (Laymens
  Organization)
• Professional and scholarly societies
• Interest
• Some also promote policies (e.g., British
  Swedish doctors)
• (Drinkers groups
• clubs, wine-tasting groups, etc.)

5
The alcohol policy arena

• The State as the policy fulcrum in developed
  societies
• its interests inherently split (Mäkelä
  Viikari, 1977)
• Fiscal (alcohol taxes as revenue)
• Economic development (alcohol production and sale
  as a contributor to the economy)
• Public health and order
• Reproduction (a productive new generation)
• Interests at play in the alcohol policy arena
• Economic interests producers, retailers,
  ancillary industries (advertising, hotels, etc.)
• Public health and order grassroots groups (MADD,
  MHF, etc.)
• Professional groups doctors, police, etc.
• Researchers
• (a century ago not only temperance, but also
  capitalists, unions, womens organizations)

6
Researchers in the policy arena an equivocal
force

• 1960s a wettening influence
• U.S. allergic to temperance, proponents of
  sociocultural model
• Finland Pekka Kuusis civilising project
  (Tigerstedt 2000)
• The 1970s turn-around the total consumption
  approach
• U.S. Alcohol and Public Policy Beyond the
  Shadow of Prohibition (National Academy of
  Sciences, 1980)
• Finland so far, the level of consumption is the
  best general indicator of harmful effects
  (Bruun, 1970)
• The researchers found an empty place at the
  policy table, formerly occupied by the temperance
  movement, and had to make the arguments to
  balance the discussion. -- Nils Christie in
  California, 1974
• But not reliable allies of any other interest

7
Beyond the policy arena wider cultural shifts

• (Other than in war and economic depression)
• Great reductions in alcohol problems tend to have
  occurred as a result of social movements, often
  in the form of a spiritual revival or awakening.
  Examples
• Temperance movements in the Nordic countries,
  allied with
• Religious renewal movements
• Workers movements
• Nationbuilding movements, in Iceland, Norway,
  Finland
• Temperance waves in the U.S. in the 1830s and
  later
• Father Mathew in Ireland in the early 1840s
• Movements such as the Ghost Dance and Native
  American Church in Native American history
• Gandhis advocacy of prohibition in the Indian
  national movement
• Sobriety in Ecuador after the earthquake in
  response to evangelical Protestant and reformist
  Catholic movements
• (B.Y. Butler, Holy Intoxication to Drunken
  Dissipation Alcohol among Quichua Speakers in
  Otavalo, Ecuador. University of New Mexico Press,
  2006)

8
Legislation/regulation ? shifts in opinion

• Even where the framing is rationalist and the
  methods legislative, purposive changes in
  alcohol/drug behaviour usually involve changes in
  popular sentiment. Examples
• The reduction of drink-driving casualty rates in
  Nordic countries, Australia
• Elimination of smoking in enclosed public places
• Womens anti-alcohol movement in Chuuk,
  Micronesia (Marshall Marshall, Silent Voices
  Speak, 1990)
• Change in sentiment may ? new law
• Discussion and implementation of the law may ?
  change in sentiment

9
Voluntary organizations, the state and the society

• Forms of relation between NGOs the state
• Insurgent
• Mutual neutrality
• Cooperation of independent parties
• Arms-length state support
• The NGO as subcontractor for the state
• The NGO as parastatal wholly subordinated
• The NGO and its base keeping a strong profile
  and ability to act
• Needs to be seen both inside and outside as
  responsible to its membership
• Needs to maintain a principled position (vs. the
  compromises of policymaking)
• NGOs seen as subordinated to the state tend to
  lose their constituency

10
The challenge for NGOs in the longer term

• The dilemma
• Funding support from and common interests with
  the State vs.
• Perception of the NGO as an independent actor
• There are good reasons to slide into a cosy
  relation with the state apparatus
• But it threatens the ability of the NGO to
  function as a genuinely bottom-up society and to
  retain a broad and committed membership
• For policy-oriented NGOs the challenge is how to
  both
• Influence the direction and strength of state
  action
• Influence developments in popular sentiment and
  culture