SummaryThe formation of drug control policy in Britain in the first three decades of the twentieth century is reviewed. Pharmaceutical controls over sales, based on professional self‐regulation gave way to controls on possession and use during the First World War, These war‐time restrictions were the basis of the 1920 Dangerous Drugs Act which fulfilled Britain's international treaty obligations. During the 1920s, the Home Office attempted to establish a penal policy on the American model; the Rolleston Report of 1926 established the ‘British system’ of drug control. The ‘political’ significance of British drug control in this period, in particular its polemical use in the struggles to liberalise American drug policies in the 1960s, has inhibited a more developed analysis of policy. The tensions over policy and the 1926 Report were not simply battles between rival conceptions of control or a ‘victory’ for the ‘medical model’. This approach ignores the control aspects of both penal and medical views and the complexity of the interactions between them. The 1926 Report was not a ‘medical victory’ but the result of an accommodation and collaboration between medical and bureaucratic elites with sim