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Between Recreation and Self-Medication: The Role of Stimulants in Mental Health Management

Fri, September 5, 6:30 to 7:45pm, Communications Building (CN), CN 3103

Abstract

This study represents the first qualitative exploration of stimulant drug use in Croatia, focusing on patterns of consumption, user characteristics, and the relationship between stimulant use and mental health. Data were collected in June 2024. from 24 adult participants (13 men and 11 women aged 21–55 years) who had used at least one stimulant drug (MDMA/ecstasy, amphetamine, methamphetamine, cocaine or synthetic cathinones) in the past 12 months. Participants were recruited through harm reduction programs, social networks, and snowball sampling to ensure diverse experiences. The sample included individuals from various socioeconomic backgrounds, different levels of drug use intensity, and distinct consumption settings. Semi-structured interviews and a focus group provided insights, analysed thematically.
One of key theme of the study is the complex, bidirectional relationship between stimulant use and mental health. Participants reported using stimulants to cope with psychological distress, including anxiety, depression, emotional numbness, and trauma-related symptoms. Some initially experienced increased energy, self-confidence, and temporary emotional relief. However, prolonged use exacerbated pre-existing mental health conditions, leading to paranoia, mood swings and impulsive behaviour. Findings suggest a cyclical pattern in which stimulants initially serve to self-medicate, but ultimately exacerbate distress and increase dependence. Many participants experienced internalized stigma that increased shame and self-blame, while external stigma further discouraged them from seeking professional help.
Keywords: Substance use behaviours, Stigma and mental health, Harm reduction

Widespread mistrust of the healthcare system was reported, with participants citing inadequate psychological support, judgmental medical staff, and the inaccessibility of mental health services as barriers to treatment. These findings underscore the urgent need for targeted interventions that integrate mental health and harm reduction strategies. Recommendations include implementing anonymous and free drug testing, expanding accessible mental health support tailored to stimulant users, and developing non-stigmatising treatment approaches that address the complex interplay between drug use and mental health problems.

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