Purpose -The prevalence of cocaine use has been increasing since the mid-1990s in many European countries, Italy included. There is a large variety of patterns of cocaine use in natural settings, but on the whole, the existence of different patterns of cocaine use remains widely unknown to drug professionals, as well as to public opinion. The purpose of this paper is to investigate patterns and trajectories of use, the meaning of use within the context of users' life styles, the perception of controlled/uncontrolled use, personal strategies to keep drug use "under control". Design/methodology/approach -This paper illustrates findings from a qualitative study among 115 cocaine users. Participants were recruited using the snow ball sampling (a minimum lifetime experience of 20 instances of cocaine use was required). Findings -The findings confirm the variability of cocaine use trajectories and the prevalent tendency towards more moderate patterns of use. Such variability is in patent contrast to the disease model of addiction and its assumed predetermined linear trajectories. Set, and particularly setting and all the environmental factors, such as life events, appear to be the variables that can better explain the dynamic course of patterns of use.Research limitations/implications -The main limit concerns the non-randomisation in the selection of the nominees. Participants were recruited in the night entertainment scene of the main Tuscan cities through personal contacts of staff from risk reduction facilities: in spite of the personal and confidential approach, the number of "non institutionalized" users willing to collaborate was too low, therefore the authors decided to omit the randomisation. Social implications -The findings bear social implications as they can contribute to a change in the social representation of users so as to reduce the stigma. They can also prompt innovation in the operational models of drug services. Originality/value -It is the first qualitative research from the "control" perspective ever led in Italy.

Highlights• Proximity between services and groups may influence the self-help methodology.• By means of a qualitative study we tried to highlight the deep meaning of self-help for members.• Through analyzing qualitative data and organizational characteristics of the groups, two sub-cultures emerged.• Suggestions emerged for services and professionals on how to support groups eliciting no distortion.

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This chapter will discuss action research conducted in Tuscany to fight stigma surrounding mental illness. Public mental health services (PMHS) in Italy are perceived as ascribing a mentally ill label to individuals who utilize these programs. Local associations, especially sports associations, can be used to fight this stigma. This chapter will present key aspects and results of a community social innovation intervention jointly performed by a PMHS and the University of Florence. The research will explore perceptions surrounding the role and value of the community sports association, participants' perceived improvements, effects of sports participation, and the role of the sports association as an instrument to promote mental health. Results will show that the sports association is perceived as an agent of social capital to reduce social barriers emerging from mental illness. In addition, stigma is deconstructed through improvements to individual and social wellbeing.

This article reviews empirical studies from 2008 to 2017 on the effects of participating in online communities. The review uses three databases: PubMed, Scopus and ScienceDirect. The criteria are: (1) online community aimed to provide support by and for people with a common problem; (2) the content of the sessions was determined by users; (3) members met via the Internet; (4) online community was available 24/7; (5) online community access was free and open to everyone with an Internet connection. Of the articles, 13 of 105 met the inclusion criteria. Seven studies reported positive changes: informational and emotional support, increased sense of belonging, less isolation, better medical understanding. Six articles also considered risks: the rise of the level of stress because of successes or failures of other users, the addiction to the forum and the consequent isolation from real relationships.