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This article aims to discuss the results on prevalence, patterns of use and motivations for the use of legal high products/new psychoactive substances (NPS) and possible consequences for drug policy.

The main results are derived from a non‐representative quantitative online survey in Germany, focused on persons with experience in legal highs use.

The general prevalence of legal highs varies considerably in different European countries; generally, it is much lower than the lifetime prevalence of illicit drugs. Almost every legal highs user has experience in the use of illicit drugs. Several types of (repeated) users can be identified. “Herbal incense” products are used by many persons in order to compensate for a limited availability of cannabis or to remain inconspicuous for law enforcement. Current research chemicals (RC) users are mainly experienced drug users who seek to expand the range of drugs being consumed with RCs. Repressive drug policy approaches seem to contribute to the use of legal highs as replacement drugs.

Given that many NPS show side effects that are at least as serious as those associated with illicit drugs, and that long‐time risks are unpredictable, repressive drug policy enforcement may lead to increased public health risks regarding drug users.

The survey is the first published quantitative survey focusing on legal highs users. The results have not been published in English yet.

The purpose of this paper is to explore the hidden social worlds of competent clandestine users of drugs controlled within the confines of the UK Misuse of Drugs Act 1971, which now includes NPS substances. The authors explore how and in what way socially competent drug users differ from others who are visible to the authorities as criminals by criminal justice bureaucracies and known to treatment agencies as defined problem drug users.

This qualitative research utilises a bricoleur ethnographic methodology considered as a critical, multi-perspectival, multi-theoretical and multi-methodological approach to inquiry.

This paper challenges addiction discourses and, drawing upon empirical evidence, argues the user of controlled drugs should not be homogenised. Using several key strategies of identity management, drug takers employ a range of risk awareness and risk neutralisation techniques to protect self-esteem, avoid social affronts and in maintaining untainted identities. The authors present illicit drug use as one activity amongst other social activities that (some) people, conventionally, pursue. The findings from this study suggest that punitive drug policy, which links drug use with addiction, crime and antisocial behaviour, is inconsistent with the experience of the participants.

Due to the small sample size (n=24) employed, the possibility that findings can be generalised is rendered difficult. However, generalisation was never an objective of the research; the experiences of this hidden population are deeply subjective and generalising findings and applying them to other populations would be an unproductive endeavour. While the research attempted to recruit an equal number of males and females to this research, gendered analysis was not a primary objective of this research. However, it is acknowledged that future research would greatly benefit from such a gendered focus.

The insights from the study may be useful in helping to inform future policy discourse on issues of drug use. In particular, the insights suggest that a more nuanced perspective should be adopted. This perspective should recognise the non-deviant identities of many drug users in the contemporary era, and challenge the use of a universally stigmatising discourse and dominance of prohibition narratives.

It is envisaged that this paper will contribute to knowledge on how socially competent users of controlled drugs identify and manage the risks of moral, medical and legal censure.

The evidence in this paper indicates that drug use is an activity often associated with non-deviant, productive members of the population. However, the continuing dominance of stigmatising policy discourses often leads to drug users engaging in identity concealment within the context of a deeply capitalist Western landscape.

Imprisonment is common among drug users. However, historically healthcare for injecting drug users in prison in England and Wales has not been equivalent to that offered in community settings. Fiftyone injecting drug users who had a history of imprisonment were interviewed. Interviews focused on the experiences of drug‐related care and treatment in prison. The interviews were analysed using the Framework method. Accounts of prison drug treatment experiences provided valuable insights into drug treatment in the English prison. The participants’ accounts provided a historical perspective, many of which reflected the different practices of different prisons and prison staff and the changes in policy and practice that have occurred in prison healthcare over recent decades. Positive and negative experiences of healthcare and drug treatment in prison were discussed. Issues that affected levels of drug use inside prisons and their receipt of care, support and treatment in prison included prescribing policies, illicit drug availability and prison staff and doctor attitudes. Whilst negative experiences of prison and drug treatment prevailed, users identified that recent policy and practice changes had positively influenced healthcare provision for drug users in prison, particularly the provision of opiate maintenance therapy. Drug users often saw prison as an opportunity to detoxify and contemplate their drug use. Further work needs to build on the positive experiences identified to ensure that prison drug treatment in England and Wales is consistent, effective and efficient in the future.

Semi‐structured interviews were undertaken with a random sample of 220 students from schools and youth training centres within a rural area of the south eastern region of Ireland. The results show that against the backdrop of rising drug use prevalence, the attitudes towards drug use of both adolescent users and abstainers have become more liberal and ‘normalised’.

For local law enforcement agencies, the subject of illicit drugs can appear all‐pervasive. Any multifaceted problem situated in an intrusive media and political environment raises difficult challenges concerning the allocation of resources. This article explores the process behind Lancashire Constabulary's decision to highlight Class A open drug markets as an operational priority, and looks at how a multi‐agency intelligence process, based on geographic mapping methodology (GIS), was initiated to direct enforcement and preventative activity.

This study aims to problematize current calls for a “public health” approach to governing illicit drugs and the people who use them.

It draws on a range of historical sources to describe how drugs became a problem for governments, in order to critically diagnose the present and investigate the origins of current perspectives on drugs.

It is argued that there are currently two authoritative drug discourses. The first discourse is the dominant one and is eradicative, with blame and punishment as its primary responses. The second discourse is subauthoritative, but growing in importance, and is sanitorial, with care and cure as its primary responses.

While these two discourses have often been thought of as distinct, this historical exploration demonstrates that the eradicative and sanitorial discourses are both based on similar principles.

The purpose of this study is to suggest how the Covid-19 lockdown may affect illicit drug users and vulnerable children and young people who become involved in County lines drug dealing.

This is an “opinion piece” based on data released by central and local government departments and voluntary sector sources concerning the impact of the Covid-19 restrictions on illicit drug users and vulnerable children and young people. The data is augmented with information from recent discussions with police officers, youth workers and social workers in a London borough.

It appears that the Covid-19 restrictions have had, and will continue to have, a deleterious impact upon both illicit drug users and the young people caught up in County lines drug distribution.

The study’s originality lies in its attempt to use a range of sources to anticipate the consequences of the Covid-19 restrictions on illicit drug users and vulnerable children and young people.

This article will explore many of the challenges facing the future of effective user involvement as we prepare ourselves for a new government drug strategy and National Treatment Agency era, which on first viewing appears to have turned its back on a movement that it has long paid lip service to as a valued and respected partner and component of effective drug treatment. The tone of this article is intentionally opinionated and provocative and is based on 10 years experience of being an illicit drug user (although admittedly never a service user) working in the harm reduction and user involvement field as a coalface worker, strategic co‐ordinator and presently, manager of a national charity. If this piece polarises opinion and stimulates debate then it has been successful; user involvement used to be dictated by personal politics and passion, not a pension, and in order to survive, it may need to rediscover that.

The purpose of this paper is to analyse the association between drug consumption and unemployment. This paper also studies the differential association between these variables in both the pre- and current-crisis periods. The results are compared in an attempt to verify that the population of users is more vulnerable in terms of how likely they are to get and hold down a job in the labour market.

Matching methods and microdata from the Survey on Alcohol and Drugs in Spain, EDADES are used. The use of these methods on the estimates carried out prove to be particularly effective in reducing treatment-selection bias. The authors’ interest is also to analyse the differential association between the interest variables in both the pre- and current-crisis periods. For this purpose, the authors also use the differences-in-differences (DID) estimation method between the two periods to check if the impact of drug use on unemployment depends on the economic context. The estimations are compared in an attempt to verify that the population of users is less likely to attain and hold down a job in the labour market than non-drug users.

The results obtained in the current study are consistent with the hypothesis that drug use decreases an individual’s capacity and availability when he or she is trying to enter the labour market. In both 2007 and 2013, drug users were more likely to be unemployed, regardless of the type of drug. Differences in the probability of being unemployed intensify during an economic crisis. In light of these results, it is possible to conclude that the negative effect of drug consumption on an individual’s employability is increased during periods of economic recession.

The study presented here has some limitations. Firstly, cross-sectional data were used to examine the causal relationship between consumption and employment. In this sense, the results are susceptible to bias. The unavailability of longitudinal data on the same individual made it impossible for the researchers to consider periods of abstinence, the duration of periods of consumption and how this consumption affected an individual’s productivity and his or her working situation. Another limitation is that certain relevant unemployment variables may have been omitted. Among the variables that affect an individual’s labour participation is the existence of sources of income as an alternative to market salaries. With state subsidies, income from illegal activities and money sent by family or friends, an individual may decide not to work. This problem could be mitigated if omitted variables operate in a similar way throughout both of the periods examined.

Given the results obtained in this paper, the authors believe that public policy conclusions should be mainly concerned with the importance of implementing proactive employment policies, along with family support programmes and a greater role for primary care among the people with the highest risks of exclusion. Health treatment should go jointly with measures that make it easier for individuals to enter the workforce. These steps would only be possible with an improved level of education and more complete professional profiles, to increase motivation when individuals seek employment.

This study could make various contributions to the existing body of evidence. In the authors’ knowledge, this is the first attempt to document the effect of the economic crisis on the employability of the drug-using population in contrast with the general population. Moreover, a methodology is presented that provides an alternative to those used in earlier studies, in terms of reducing treatment-selection bias. At the same time, the use of a DID estimation method between pre- and current-crisis periods allow us to check if the impact of drugs consumption on unemployment depends on the economic context.

The reasons why some people use illicit drugs recreationally and in a dependent, harmful, way are not clearly understood. Various factors have been put forward, each of which may play some part in affecting individual drug using outcomes. Rounsaville (1982), for example, analysed the life records of approximately 400 opiate users and identified two antecedents to drug use, childhood trauma and early antisocial or delinquent behaviour. Social background and deprivation have also been noted as possible preceding factors. Parker et al (1987) found correlations between heroin use and unemployment, overcrowding and other indices of deprivation. Other perspectives on use, cited by Johns (1990), include availability and peer influence. Sub‐culture has also been suggested as an important context to use (Becker, 1963; Williams, 1989). The Third Triennial Report to Congress (Department of Health and Public Service, 1991) focused on individual ‘risks’, which were categorised as biological (genetic), psychological, behavioural (anti‐social and delinquent activies), demographic (such as gender or ethnic factors), and environmental (arising from family or peer group influence). However, despite these and many other perspectives on pathways to illicit drug use and drug‐related harm, a comprehensive account which seeks to ground such practices in the complex interplay between the individual, their community and elements of social structure has yet to be achieved.