From Drug Problem to drug-related issue. For a coherent conceptualisation in the field of addictions

Abstract

This article analyses the need for a consistent conceptualisation of the drug use phenomenon, moving away from reductionist and deterministic views. It argues that hegemonic conceptions, both prohibitionist and medical, have biased the understanding of the phenomenon, leaving aside cultural and social factors, proposing a holistic approach based on risk reduction. For the study, a critical analysis of the explanatory models of addictions was carried out, reviewing their historical and conceptual evolution, contrasting biomedical and psychosocial perspectives, and highlighting the role of programmes such as Energy Control in the implementation of alternative strategies. The results relate to how traditional models (penal and medical) have stigmatised substance use, leading to ineffective policies. The importance of considering the person-substance-context triangle to understand the phenomenon was noted. It became evident that approaches such as harm reduction offer more inclusive and effective strategies. For this reason, we can conclude that it is necessary to overcome hegemonic paradigms and adopt integrative perspectives that enable a comprehensive understanding of drug use in its social, cultural, and economic complexity, where risk reduction is presented as a viable and humanised approach to address this reality.