Self-support for drug users in the context of harm reduction policy: A lay expertise defined by drug users’ life skills and citizenship

Abstract This paper focuses on the way drug users (DUs) play an active role in implementing public health policies by their involvement in self-support groups, thus providing new forms of patients’ expertise. Expertise of this nature may seem paradoxical, in that it confers qualities to populations whose practices are unlawful and whose identity is stigmatised. A qualitative method including semi directive interviews (57) and ethnographic observations was used for this research. A thematic content analysis was done from empirical data following an inductive logic. This paper aims to show how a DUs’ organisation finds a place in the social arena in the political context of harm reduction, succeeds in building the French DUs’ health and welfare conditions as a legitimate cause, and elaborates a specific rhetoric centered around life skills and citizenship. The new forms of patients’ expertise, based on life experiences, contribute to enhancing the value of practical, emotional and subjective knowledge that sometimes questions specialist knowledge. This claim for citizenship is often used as a sort of magic incantation, and content may be lacking if public health policies are not accompanied by broader policies that attempt to take into account the political, legal, economical and social conditions of stigmatised social groups like DUs.