– People who Use Drugs Heavily (PUDH)

Defining the Project’s target audience or end beneficiaries comes with considerable difficulties. The official project title, “New Psychoactive Substances among Problem Drug Users - Towards Effective and Comprehensive Health Responses in Europe” clearly points towards the goals and objectives of the project, to contribute to health, but is less clear about who is meant with “Problem Drug User.”

The EMCDDA defines problem drug use as “injecting drug use or long duration or regular use of opioids, cocaine and/or amphetamines” and notes that this definition specifically includes regular or long-term use of prescribed opioids such as methadone but does not include their rare or irregular use not the use of ecstasy or cannabis. This definition labels both drug injecting and specific (classes of) drugs, opioids, cocaine and amphetamines in particular, as problematic by and in themselves and, as Stallwitz notes (2012), has no regard for how drug, set and setting (Zinberg, 1984) interact in shaping the risk environment of drug use (Rhodes, 2009). Furthermore, the term problem drug use(r) is loaded with negative moral connotations. Language and medico-moral membership categories in particular, are instrumental in the stigmatization, and criminalization of people who use drugs (see e.g. White, 2007).

We acknowledge that for a significant minority of people engaging in drug use, the outcomes are not always favourable. But, unfavourable outcomes present themselves on a sliding scale and they may change over time, subject to the various risk and protective factors interacting in the risk environment of drug use. In this project, we focus at the emergence of new drug trends, NPS in particular, in populations where the outcome of drug use tends to go towards the more unfavourable end of the scale. The project aims to develop practical harm reduction interventions that may help individuals who use drugs habitually or heavily, and who seem more prone to their negative consequences, manage their drug use, reduce risks and improve their quality of life.

Finding a morally neutral term that describes their behaviours without moral connotations rather than defining the whole person, as with the term ‘PDU,’ is challenging. As Eliot Albers, director of INPUD notes, “we have to be very careful when dealing with the NPS phenomenon that we don't replicate the old demon drug narrative that we've seen before with crack, methamphetamine and with other drugs.”

For these reasons, we speak of people using drugs habitually or heavily (PUDH) (Cf. Cohen, 1990; Stallwitz, 2012). We realise that these terms are rather unspecific, but practically they also reflects the diversity of the issues and populations targeted in the five partner cities.


Download here the pdf:
Rehm et al - 2013-Defining Substance Use Disorders - Do We Really Need More Than Heavy Use


Jean-Paul Grund,
Principal Investigator
WS 1, 2 Leader












Defining NPS

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Defining Target Groups

Defining the Project’s target audience or end beneficiaries comes with considerable difficulties. The official project title... read more





Project News

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Addictology, the Czech based journal for research into addiction, published a special issue on NPS related articles, including those with the outcomes of the NPS in Europe project.

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The NPS staff presented project outcomes at the International Harm Reduction Conference in Kuala Lumpur, Malaysia.

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NPS Policy: Moving Forward
Leading European experts, including researchers, practitioners and policy makers will meet at a Seminar in Lisbon on the 26th of November to discuss the latest developments in the field of New Psychoactive Substances (NPS).

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The NPS in Europe project organises a training on new psychoactive substances (nps), 23 - 25 November 2015 in Lisbon, Portugal. The training is aimed at service provider and peers, supporting NPS users in Europe. The course will give an overview of relevant NPS substances, identify current patterns and develop effective harm reduction service responses.
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Practical information...

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NPS in Europe

is launching a questionnaire on NPS use in all European countries.