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By taking cues from users’ self-regulation strategies, it is possible to design innovative operational models for drug services as well as drug policies, strengthening Harm Reduction as an alternative approach to the disease model.
Introduction
A significant body of research on cocaine users recruited outside captive populations – that is, studies based on 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.
Similar studies have been conducted on users of different drugs, such as amphetamines and cannabis, with analogous results. The reason for most controlled use lies in a wide set of self-regulation rules users tend to apply to keep drug use at bay and prevent the disruption of everyday life. This perspective is noticeably at odds with the point of view of drug addiction professionals, who tend to focus on addiction as a disease, resulting from the chemical properties of drugs combined with biological, psychological and social deficits of users. It also challenges the social representation of drugs as intrinsically out-of-control substances and of drug users as helpless under the influence of drugs.
By taking cues from users’ self-regulation strategies, it is possible to design innovative operational models for drug services as well as drug policies, strengthening Harm Reduction as an alternative approach to the disease model. This paper illustrates this paradigm shift of moving the main purpose away from elimination and towards regulation of drug use, with the aim of encouraging users’ informal controls while reducing the harm caused by punitive laws and policies.
Key Points
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