The Caribbean poses a significant drugs problem for the UK and the US, as the recent phenomenon of yardie gangs in British cities graphically illustrates. But in the islands themselves ganja, crack cocaine and the policies to control them have become, as this book demonstrates, a veritable social disaster. The authors, who are among the leading local researchers and engaged professionals in the region as well as the former regional head of the UN Drugs Control Programme, bring together new research investigations, insightful policy analysis and practical experience of on-the-ground interventions putting demand reduction into practice. The dimensions of the illicit drugs market in the Caribbean are made clear. The origins of the problem lie in part, it is argued, with the impact of neoliberal economic policies that have opened up the region's borders and gravely undermined its traditional sources of employment and exports, like bananas and sugar. The islands, in part under external US pressure, have adopted a region-wide policy of criminalization This has involved the creation of specialized drug courts and serious human and social consequences as a result of criminalizing traditional cultural practices around ganja consumption. Fascinating light is thrown on the difficulties facing drug abuse and rehabilitation centres and the dilemmas they throw up. Harm reduction as a fundamentally alternative approach to the drugs problem is also explored. This is the first book to examine the experiences of Caribbean countries since they adopted a coordinated approach to the drugs problem. There are valuable lessons to be learned at both policy and practical levels for other countries, and in particular those like the UK and US with large Caribbean populations.