"Undisciplined" drinking, multi-sectoralism and political power: Examining problematisations in the Botswana alcohol policy

“Alcohol is life, it’s part of us”: Examining the Everyday Experiences of Alcohol Use in Botswana

Efforts to control and regulate alcohol has recently gained steam in Botswana. Inspired by a public health perspective, the government of Botswana has recently increased the alcohol tax levy, reduced the hours of operation for bars and increased penalties for alcohol-related offences to control alcohol-related harm. While these reforms have been central to policymaking, and caused some controversy, not much is known about the everyday experiences of alcohol consumers in Botswana. Drawing from semi-structured interviews (n = 40) collected amongst drinkers over a five-year period, this paper examines the everyday use of alcohol in Botswana. The analysis demonstrates that alcohol use constitutes an important part of leisure and night-time economy (NTE) activities in Botswana. It is a functional social activity that is used by people to take time away from the routines and pressures of daily life. More importantly, it is pleasurable to people, enhances sociability, and partaken as a form of transaction between men and women in bars. There is need for policy makers to consider the embodied experiences of alcohol use when designing alcohol interventions in Botswana.

'Keeping a lid on it': Exploring 'problematisations' of prescribed medication in prisons in the UK

BACKGROUND

The non-medical use of prescription medication and risk of diversion have become policy and practice concerns within prison settings in the UK. These issues have been highlighted by the Advisory Council on the Misuse of Drugs, Her Majesty's Inspectorate of Prisons and Her Majesty's Prison and Probation Service (2019) prison drugs strategy. In 2019, new prescribing guidance was issued by the Royal College of General Practitioners for clinicians working within prison settings.

METHODS

Informed by Bacchi's (2009) What's the problem represented to be? framework, the ways in which the 'problem' of prescribed medication in prisons have been represented is interrogated through an analysis of the prescribing guidance framework for clinicians working in prisons.

RESULTS

Restrictive prescribing practices are recommended as a solution to the 'problem' of diversion and misuse of prescribed medication. Prescribers are advised to consider de-prescribing, non-pharmacological treatments and alternative prescriptions with less diversionary potential. They are represented as responsible for the 'problems' that prescribed medication bring to prisons. The guidance is underpinned by the assumption that prescribers lack experience, knowledge and skills in prison settings. People serving prison sentences are assumed to be 'untrustworthy' and their symptoms treated with suspicion. This representation of the 'problem' has a number of effects including the possibility of increasing drug-related harm, damaging the patient-doctor relationship and disengagement from healthcare services.

CONCLUSION

The representation of prescribed medication as problems of diversion and prescribing practices inhibits alternative representations of the problem which would inform different policy directions including improvements to regime and healthcare provision and would include a range of practitioners in prison settings to address the 'problem' more holistically.