“What goes up must go down”: An exploration of the relationship between drug-related pleasure and harm experienced by a sample of regular ‘party drug’ users

Aims: This paper explores the complex and dynamic relationship between pleasure and harm as experienced by a group of young people during and after "party drug" use. Methods: Fourteen months of ethnographic fieldwork was undertaken among regular recreational users of ecstasy and methamphetamine. Weekly participant observation took place in licensed venues and private homes. In-depth interviews were conducted with 25 core participants. Findings: There were four primary domains of both pleasure and harm experienced by participants that included: (a) elevated and lowered mood, (b) heightened and impaired cognition, (c) economic availability and unavailability and (d) enhanced and troubled friendships. This analysis suggests that it is unhelpful to discuss the harms of drug use without an appreciation of pleasure, as one is not typically experienced without the other. Conclusions: A more nuanced understanding of the relationship between pleasure and harm is needed, as the two concepts are not in opposition, as they are so commonly used. Appreciating the way in which individuals experience the dynamics between pleasure and harm will enable the development of more appropriate harm reduction measures that resonate with individuals.