Prejudices and fears have long surrounded drugs, not always agreeing with facts and reality – yet validated by drug prohibition. The simplified fear-based thinking is rooted so deeply in minds and hearts that many believe misconceptions to be true, without questioning their evidence: all illegal drugs are seen as an evil, from which we need to be protected. These perceptions shape how we treat people affected by drugs, they influence policies and have major impacts on systems that are supposed to address drugs. Therefore, understanding the evolution, roots and impact of perceptions and misconceptions about drugs is critical.

This briefing seeks to outline exactly those aspects, and looks in greater detail at health issues, as one key area where perceptions have a significant impact.

Drugs have been present in the Eastern Europe and Central Asia (EECA) region over millennia. They have been consumed for food, medicinal purposes, rituals and/or recreationally. However, the 20th Century saw major transformations in drug use and the perception of drugs by the authorities and societies. At the beginning of that century, heroin and cocaine were legal in pharmacies, but that changed with prohibition. Many of today’s narratives about drug use – and the high levels of stigma experienced by people who use drugs – could be traced back to Soviet ideological constructs such as: the importance of eliminating ‘social evils’ like drug use; the social control approach to prevent ‘social evils’; changing cultures in the name of ‘enlightenment’; and defining drug use as a foreign, ‘Western’ issue, while positioning drugs as a taboo.

The dissolution of the Soviet Bloc saw increased drug use and more openness. By the late 1990s, drugs had become a major public concern. In turn, this came with public, moralistic and populistic proposals calling for stricter regulations and repressive solutions. From then-on, countries took different paths in drug policy. Russia and some others moved towards securitization, while much of Central and South-Eastern Europe and the Baltics have followed more complex, balanced, pragmatic and evidence-informed approaches, similar to those in the European Union.