Cocaine and stimulants, the challenge of self-regulation in a harm reduction perspective
Categorie(s):
Health
Author(s):
Grazia Zuffa(1), Susanna Ronconi(2)
Keyword(s):
Drug related Harm Reduction, Controlled /uncontrolled use of illicit drugs, Users ‘ self regu-lationstrategies, Trajectories of drug use, Settings of drug use
DOI:
Abstract :
A significant body of research on cocaine users recruited outside the “captive” populations (i.e.
studies from samples of users who have not been enrolled through drug addiction services) has been
carried out in many European countries and outside Europe. These studies show a variety of patterns
and trajectories of use other than “addictive” use. The reason of most “controlled” use lies in a
wide set of self-regulation “rules” users “naturally” apply to keep drug use at bay and prevent the
disruption of everyday life. Not only is this perspective at odds with the “pathological” perspective of
professionals, focused as this is on “addiction” originated from the chemical properties of drugs and
individual psychological deficit; it also challenges the social representation of drugs as intrinsically
“out of control” substances and of drug users’ helplessness under the influence of drugs.
The paper describes the workstream Innovative cocaine and poly-drug abuse prevention programme,
developed in 2013 by the Italian NGO Forum Droghe within the European project New Approaches
in Drug Policy &Interventions (NADPI), aimed at linking findings from research on “controls” to
operational models in drug addiction services.
Through a critical overview of the disease model and taking cues from users’ self regulation strategies,
a new “self regulation” operational model has been developed, focused on users’ control abilities; and
on social context and setting of use, following the drug/set/setting paradigm.
The self regulation model may be seen as a development of the Harm Reduction approach to drug
policies, aimed at decreasing the negative consequences of drug use without necessarily reducing the
consumption of drugs.