Fri från narkotika. Om kvinnor och män som har varit narkotikamissbrukare

Abstract

Aim of the study, background, theory and method



The two aims of this study are to describe and analyse: i) how drug abusers have transformed their lives from the time when they did not use drugs, to becoming drug abusers, and finally leaving drugs behind them; and ii) what it means to be socially integrated with one's experience of having been a drug abuser.

The women and men who participated in this study represent a group that has received limited attention in the public discourse about drug abuse. The dominant view on drug abuse opines that drug abusers are victims of drugs and/or other circumstances and that it is very difficult to cease drug abuse . It is difficult to reconcile this view with the fact that there are people with a history of drug abuse that are now living "normal lives". Even research on drug abuse has taken limited interest in the group that the interviewees in this study represent. Research has largely paid attention to people who have not succeeded in changing their lives, as this study's interviewees appear to have done.

A central theoretical source of inspiration for this study is symbolic interactionism. This approach sees the individual as a socially oriented and intentionally acting creature of society. An individual's actions, iden¬tity, and life-style are interlinked, and created and re-created in a social process where interaction with other human beings and the social and cultural context have crucial meaning. Life-style is a way for the individual to give expression to the meaning which she or he gives to her or his social position. However, even material conditions, such as socio-economic conditions, have a meaning. Another important condition is the status the individual's actions and life-style have in society. This theoretical perspec¬tive also focuses on differences between women and men, and views these differences in actions and positions in society, not as inherent in human nature, but as a result of social and cultural processes which lay the ground for how women and men are regarded .

This study builds on qualitative research interviews which focus first on the interviewees' life histories, and then on their present lives. Seven women and seven men were each interviewed three times. They all expe¬rienced several years of drug abuse; have been free from abuse for more than two years; and are all socially integrated. The interviews were made between September 1994 and February 1996. The interviewees are living in different parts of Sweden.





Life before, during and after drug abuse



Both Swedish and international studies show that, among drug abusers, there is an overrepresentation of people who have grown up under dis¬advantageous conditions . Several studies also show connections between advantageous conditions while growing up and the possibility to cease drug abuse . However, ten of the fourteen interviewees in this study described their conditions while growing up as disadvantageous. Thus, among the interviewees in this study, there is an overrepresentation of people who have grown up under disadvantageous conditions. Even when other conditions in their lives before the drug abuse are considered, there are no apparent factors that can separate them as a group from those who continue to abuse drugs.

As with many other people who have abused drugs, they began using drugs in adolescence . None of the interviewees tells of beginning drug use because of depression or other personal problems. They say they began using drugs because they were curious, thought it was exciting, and had friends with the same attitude. One can interpret these descriptions of their reasons for initial drug use above all as relations strengthening. Over time their drug use developed to a central activity in their lives. However, neither they defined themselves nor did others define them as drug abusers. Thus, their choice to begin using drugs cannot be equated with a choice to become drug abusers. Rather, the intention of interviewees' deepened invol¬vement in drug use was to reach social belonging. This contradicts the view that it is dependence on drugs that makes initial users continue to use drugs.

None of the interviewees' descriptions of how their lives developed during drug abuse is different from how the lives of drug abusers has been illustrated in other studies . All of them developed advanced and regu¬lar drug habits and, for several years, their thoughts and actions were focused on how to provide for and take drugs. To be able to maintain the drug abuse, they were involved in criminality. Men in particular became subject to different types of legal proceedings (for example imprisonment). Even if most of the interviewees were working or studying early on in the drug-abusing period, only two of them were employed at the end. Consequently, drug abuse damaged their relations to relatives and others who stood out of their drug-using circles. All of them also went through periods when they where mentally and/or physically low. In other words, their lives became very difficult to the point that they occasionally questio¬ned their lives as drug abusers.

There were several differences between the women and the men in their life conditions during drug abuse. It was obvious that the women were sub¬ordinate to men and that this subordination sometimes took brutal expression through the physical and psychic battering of the women by men in their lives. Women were not, however, passive appendages to men. On the contrary, the women's descriptions of their lives during the drug abuse show that they needed a great deal of power of initiative and action. For example, the women actively participated in drug dealing and other criminality to finance their drug use. Only two of the women speak of periods when they were prostitutes. Mainly, the women provided for their drug use the same way as the men. The women's power of initiative and action is also shown in how they acted against people outside the drug circles. A clear example is offered by the women who became mothers during the abuse and who expended a lot of energy and developed the capability to keep social workers and other persons in authority unaware of their drug abuse.

The picture of the drug abuse as a generator of social, psychic, physical and economic problems is the one that stands out clearest because it contrasts against what can be called a "normal life". However, there is one aspect of life as drug abuser that easily is hidden behind that picture. Namely, the interviewees also participated and interacted with the surroundings outside the drug circles. Even if their social lives became increasingly enmeshed with other drug abusers and can be described as a subculture or social world, the drug abusers also had important contact with the surrounding society. The "normal life" was in their consciousness, and is shown through most interviewees' attempts to live without drugs long before they finally succeeded.

The interviewees faced serious situations when they decided to leave the drug abuse life. No matter what motives they describe for beginning to change their lives, their decisions were influenced partly by negative social consequences generated by drug abuse, and partly by positive social changes which, together, helped them to begin to break away from drug abuse. An example of important negative social consequences is the con¬flict in their relations to people both inside and outside the drug circles. For some, recurrent prison sentences became increasingly unbearable. Some became evicted and homeless. Several felt surrounded by economic problems because of unpaid and accumulating debt. Some women lost custody of their children. Two examples demonstrate the positive social influences that promoted interviewees to change their lives. Several women ended relationships to men who also were drug abusers. For some of the men, an opposite social change was of great meaning. They formed rela¬tionships to women who were not drug abusers. Several of them also point out that, fairly soon after ceasing drug abuse, they obtained work and lodging. Several also said that it was important they met new friends. For the women who had children it was of great meaning that they could keep or get back custody of their children.

Most of the interviewees went through institutional treatment to cease drug abuse. Treatment was important in several ways not the least because it helped them to break away from their drug circles. After treatment, none moved back to the surroundings where they had lived during the abuse. In particular, the women said the treatment helped them to relieve feelings of shame and guilt. When the interviewees speak of the treatment, they touch on several of the factors which, according to different studies, are impor¬tant for successful treatments – confidence, community, respect, tolerance, engagement and positive expectations . However, nobody said she or he was "ready" upon leaving treatment. Treatment can be regarded as a part of a prolonged change process which is influenced by many other factors outside of the treatment context. This is shown by the fact that the conditions for a life without drugs were complicated when they left the secure environment of the treatment institutions. In fact, several of them relapsed after treatment.

When the interviewees speak of what has been most important for the change of their lives, all emphasise relationships to other people. Without relationships to people who gave them support in their striving to build up a life without drugs, it would not have been possible for them to stop abusing drugs. It was important for them to feel accepted by people who they met at work, in schools and organisations, where they lived, and in other contexts. They were looked upon as people who were free from drugs. They felt they were good enough and that there were people who gave them a place in ordinary society.

Today the interviewees live "normal lives". They are working or studying. All are living in family constellations where children are included. Three of the women are single with their children. The others are cohabiting or married. All give positive pictures of their relations to their children and the men and women with whom they live. The family is accordingly an important part of their lives, but all also speak of the importance of friends. Most of them are engaged in different organisations, for example sport clubs, political parties, or Narcotics Anonymous. For several of the women, their closest friends are women who also have been drug abusers. One important reason for this is the women, to a greater extent than the men, may still feel shame about their backgrounds as drug abusers.

The fact that they succeed in ceasing drug abuse and today are leaving "normal lives" can not be explained by the possibility that they as group were better equipped socially, by hereditary, or by acquired characteristics, than people who continue to use drugs. Rather, changes in their existential conditions which made it possible for them to cease drug abuse. Of deci¬sive meaning was that they took part in social contexts where they built relationships to people who gave them confidence and who were able to see and meet the interviewees during their initial fragile striving for change. The interviewees ambivalence and insecurity about building a life without drugs was reduced by the fact that they felt acceptance and respect from people who assumed the interviewees had resources and knowledge that were important for living "normal lives".





Drug abuse as a process of creating existential meanings of life



In the study, the interviewees' lives before, during, and after the drug abuse are discussed with help of the theoretical perspective that has been a guiding principle for the study. The interviewees' lives can be understood as existential, meaning-creating processes. Identity, as the basis for how individuals choose to act and shape their life-styles, is the point of depar¬ture for the discussion. Thus, the meaning an individual gives to one's life not only is an abstraction grounded in her or his interpretations of the rela¬tions to the social surroundings, but also has practical and concrete - existential - consequences for how she or he chooses to act. The interlinking between the individual's actions and the meaning she or he gives to her or his life is indissoluble. Meaning is a social product that is decisive for the individual's actions . To understand why an individual chooses to act in a certain way, one has to understand how she or he interprets her or his social position.

In the discussion, the interviewees' lives are described as processes characterised by modulations in the meaning they have given their lives. There are six essential phases in this process, each of which produces different content to the meaning of an individual's life. It is not an easy task to develop a phase-divided model of the interviewees' lives. It implies that one has to set limits which reduce processes which are fluid and overlap each other. This phase-model is grounded in how the interviewees in this study describe their lives and should be regarded as a theoretical model of how one can understand their lives as existential, meaning-crea¬ting processes. The implication is that other people who cease drug use and who become social integrated do not necessarily have to go through all the phases which stand out in the interviewees' life-stories. Briefly, the phase model looks as follows:

The first phase – Creating Meaning Becomes Problematic – comprises the interviewees' lives before they began using drugs. In this phase, they, as children, found meaning in their lives, but by early adolescence the creation of meaning became problematic.

The second phase – Drugs Give Meaning to Life – is comprised of initial drug use. It is characterised by the interviewees giving meaning to their lives with drugs and though social belonging to other teenagers whom also used drugs.

The third phase – Drugs are the Meaning of Life – refers to the period when drug use has developed to abuse. It is characterised by the interviewees as a time of being deeply involved in the drug world. A great part of their lives was centred on how to supply and take drugs, but at the same time drug use began to generate complications.

The fourth phase – Drugs are Questioned – is characterised by drug use causing complications, for example damaged relations to people in and outside the drug world, financial problems, illness, problems with public authorities. Therefore, the interviewees began increasingly to call their drug use into question. Several of them tried to break away from drugs, but their first attempts were not successful because they did not have an alternative meaning for their lives.

The fifth phase – Creating a New Meaning in Life – is comprised of the period when the interviewees began to break away from the drugs in diffe¬rent ways. It is characterised as a creation of new meanings in their lives. Of great importance was that they were involved in social circles that stood outside the drug circles and where they received social support and acceptance. However, also of importance was that they got a material base in the ordinary society with a place to live and something meaningful to do.

The sixth phase – Life has a New Meaning – refers to the interviewees' present lives. It is characterised by the interviewees being established in ordinary society, both in a social and material way. They have good family lives, friends, places to live, and stable economical situations. They are occupied by living "normal lives" with all that it can imply and they find meanings for their lives in that.

Abstract (Swedish)

Popular Abstract in Swedish

De personer som ingår i undersökningen har gemensamt att de har erfarenheter av flera års avancerat narkotikamissbruk, varit drogfria i minst två år samt att de idag är socialt integrerade. Det faktum att de lyckats sluta missbruka narkotika och idag lever "vanliga liv" innebär att de tillhör en grupp som hitintills fått mycket liten uppmärksamhet av missbruksforskningen. När det gäller intervjupersonernas uppväxtvillkor, bakgrunder till att de började använda narkotika eller livssituationer under missbruket så skiljer de sig inte som grupp från den bild som framkommer av tidigare forskning om narkotikamissbruk. Att de lyckades bryta sig loss från narkotikamissbruket och idag lever "vanliga liv" kan således inte förklaras med att de var bättre rustade, varken socialt eller egenskapsmässigt, än de människor som blir kvar i missbrukslivet. Det var istället positiva förändringar av deras sociala och materiella villkor som möjliggjorde för dem att lämna narkotikamissbruket bakom sig. Av avgörande betydelse var att de tog sig in i sociala sammanhang där de byggde upp relationer till personer som gav dem stöd och som de kände sig accepterade och respekterade av. De flesta av intervjupersonerna genomgick behandling i samband med att de lämnade missbruket, men ingen av dem menade att behandlingen var tillräcklig för att de skulle kunna leva drogfria, utan behandlingen kan i stället betraktas som en del i en långvarig förändringsprocess där en rad andra faktorer var betydelsefulla. Undersökningen visar i flera avseenden på viktiga skillnader mellan de kvinnliga och manliga intervjupersonerna och t.ex. visar undersökningen att det är betydligt mer stigmatiserande för en kvinna än för en man att vara eller ha varit narkotikamissbrukare.

• author: Kristiansen, Arne
• supervisor: Stefan Morén
• opponent: Segraeus, Vera, Statens institutionsstyrelse/Stockholms universitet
• alternative title: Free from drugs
• publishing date: 1999
• type: Thesis
• publication status: published
• subject: Social Work
• pages: 339 pages
• defense location: Samhällsvetarhuset, Umeå universitet
• defense date: 1999-11-26 10:15:00
• ISBN: 91-7191-713-6
• language: Swedish
• LU publication?: no
• id: b8c1af26-ca32-43ab-85c9-e4557c678c01 (old id 3218245)
• date added to LUP: 2016-04-01 16:06:28
• date last changed: 2020-04-14 14:34:06