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Purpose This study aims to problematize current calls for a “public health” approach to governing illicit drugs and the people who use them. Design/methodology/approach It draws on a range of historical sources to describe how drugs became a problem for governments, in order to critically diagnose the present and investigate the origins of current perspectives on drugs. Findings It is argued that there are currently two authoritative drug discourses. The first discourse is the dominant one and is eradicative, with blame and punishment as its primary responses. The second discourse is subauthoritative, but growing in importance, and is sanitorial, with care and cure as its primary responses. Originality/value While these two discourses have often been thought of as distinct, this historical exploration demonstrates that the eradicative and sanitorial discourses are both based on similar principles.

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