Explorations into the drug users’ perspectives

Drug users feature abundantly in the research literature. Their habits of consumption are being continuously and meticulously measured, their health condition scrutinized, their treatment evaluated, their criminal activities exposed and preventive measures outlined. In the majority of these writings, however, little or no room is left for the voices and views of the drug users themselves. Drug users are exhaustively written and spoken about, yet they are rarely allowed to speak for themselves.

Historically this is linked to the long tradition of considering vulnerable populations as too delusional to provide useful information about their own lives and situations (Gubrium & Holstein, 2009, p. 3). As with children, drug users are treated as the objects to be poked and prodded rather than subjects with potentially valid and valuable knowledge of themselves (Pole, Mitzen, & Bolton, 1999). Such an approach weakens their influence on how they are represented and, ultimately, treated by wider society.

This imbalance in the research literature is reflected in policy, prevention and treatment interventions. Only rarely are users approached as equals and asked for advice on how to prioritize and design interventions (Neale, 1998). As a consequence, many ill-informed and ill-prepared interventions are launched by decision makers eager to show initiative and social responsibility. Despite their best intentions, such interventions are likely to fail without an in-depth understanding of the people that they were meant to benefit (Hellman, 2012; Lovejoy et al., 1995; Montagne, 2002).

From academic studies to television and film, society typically portrays drug users through a prism of otherness. They are depicted as poor, criminal, child-like and in need of rescue, control or punishment (Singer & Page, 2014). Research literature, for example, often focuses one-sidedly on users’ excessive appetites, penchant for risk-taking, problems with the law, poor health, psychological deficiencies and other attributes that set “them” apart from “us.” In so doing, researchers partake in a practice of “making up people” (Hacking, 1986). We describe subjectivities – we diagnose, classify and label them – and then treat these portraits as having an objective reality (Stobart, 2008). In fact, our scholarly writings do not point to independent realities but are co-constitutive of these very realities (Keane, Moore, & Fraser, 2011). As researchers, we, therefore, have to think hard about what realities we want to focus on. As Law and Urry (2004, p. 404) put it “Which [realities] do we want to help to make more real, and which less real? How do we want to interfere (because interfere we will, one way or another)?” (see also Pienaar et al., 2015; Poulsen, 2015).

The often one-sided debate about drug users can be partly attributable to the many vested interests leading the debate. If a problem is systematically overestimated by researchers, prevention practitioners and therapists, these interested parties have an easier time winning recognition, funding and other benefits. Politicians and the media also profit from hyping up the alleged crises. The tendency to inflate problems is particularly strong concerning hidden behaviours with rather low prevalence, such as the use of heroin or cocaine. The general public, having little direct personal experience of these issues and situations, is unable to put such sensationalized statements into perspective. We also have to consider that prevention practitioners and therapists are primarily confronted with problematic users and rarely with non-problematic users. This further distorts the picture and makes the debate increasingly one-sided. Compounding the imbalance is the preoccupation with assessing problem prevalence before even understanding the nature of the problem. Pre-formulated, vague and equivocal survey questions constructed from a researcher’s perspective – often posed by commercial interviewers without giving the respondents a chance to address misconceptions or provide perspectives – do not help our understanding of complex behaviour and target populations, but instead foster myths and half-truths (Uhl, 2010).

This special issue seeks to turn the tables by giving voice to drug users themselves and their experiences, stories and points of view. The articles are divided in three thematic sections.

The first section investigates the benefits and problems of drug use as experienced and understood by drug users. As will be seen, no clear line can be drawn between the beneficial and the problematic. As the saying goes, “good and bad feed off each other”: blissful drug experiences often have destructive undertones, while even the most dreadful of drug experiences can provide pleasure or personal insights (Sandberg & Tutenges, 2015).

The second section focuses on local drug cultures and questions of morality, politics, and identity making. Policy makers often ignore what drug users, and especially marginalized drug users, think about policy issues (Stevens & Ritter, 2013). Drug policy researchers also often ignore the users’ perspectives (see Lancaster, Sutherland, & Ritter, 2014). Local drug cultures are often depicted as depraved, anarchic and without hope. In contrast, the articles presented here underline that drug users have important things to say about drug problems and drug policy; and they show that local drug cultures also have elements of hope, solidarity and social responsibility.

The final section focuses on drug users’ experiences of drug treatment. The articles analyse how drug users understand and talk about treatment, their level of satisfaction, how they relate to the subjectivities created in the treatment institutions, and how problems of stigmatization can emerge. As demonstrated, insights into these issues are crucial for designing successful and ethically sound services.

The contributions to the special issue come from countries as diverse as the United States, Canada, Australia, Britain, Norway, Denmark, Belgium and Ukraine. The reader can, therefore, compare the different issues at stake among drug users around the world and see how such issues are variously addressed by scholars from a diversity of national, methodological and theoretical backgrounds.

The result is a diverse mosaic, reminding us that drug users’ perspectives always have to be understood in the plural: perspectives. As Loic Wacquant (1995, p. 490) writes, it is questionable “whether one can pinpoint a single, generic “native” point of view, as opposed to a range of discrepant, competing, or warring viewpoints” (see also Auyero, 1999). Like all other aspects of existence, the lives of drug users form an ever-changing stream of becoming, and it is not all aspects of these lives that can be comprehended and transformed into written words (Sandberg, 2009). What we present in this issue, therefore, is by no means an exhaustive or definitive account of drug users and their innermost realities. Instead we offer a series of partial, positioned and political descriptions that hopefully will open up new interpretations and engagements with drug users.

Acknowledgements

The ideas in this editorial were discussed at a workshop in Vienna hosted by Sigmund Freud University and held at the Beethoven Hotel, Vienna, in December 2013, and we are grateful for comments from participants including Franca Beccaria, Wim van den Brink, Geoffrey Hunt, Gerry V. Stimson, Julian Strizek, Betsy Thom, and Laura Williamson.

Declaration of interest

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of this article.