The influence of institutional response on the individual's recovery from drug misuse
Abstract
This study explores the influence of institutional response on the individual's recovery from drug misuse.
It is integrated in the Drug Use Recovery, Social Environment and Social Subjectivy (D.U.R.E.S.S) project, an international study included within the European Research Area Network on Illicit Drugs (ERANID), cofunded by the General Directorate for Intervention on Addictive Behaviours and Dependencies (SICAD) and carried out by the Faculty of Psychology and Education Science of University of Porto (FPCEUP).
DURESS aims to set up the characterization of the role of social environment in pathways to the recovery and socioeconomic reintegration from drug abuse. Using a qualitative approach, the project is able to merge with the findings from previous predominant quantitative research on the topic, resulting in a more accurate and inclusive depiction of the illicit drug issues.
25 individuals with substance misuse history who were underoing opoid substitution treatment in Porto region were recruited to keep qualitative health diaries, in which they reported their subjective experiences before, during and after the treatment, thus providing a way to access their perspectives, backgrounds, meanings and thereafter their perceived needs. Of the initial 25, 14 participants documented their outlooks for an average of 6 months.
It was prevailingly acknowledged the crucial role that institutional response plays on recovery. Participants pointed out both positive and negative aspects concerning the formal support received. The rapport built with the practitioners, in addition to an empathetic, honest and motivational approach were particularly referred, being even considered complement or substitution of the informal care support. They also mentioned the positive relevance of opiate substitution programs, psychological aid and, logistically, the predominant readiness and availability of the services.
Nonetheless, the individuals addressed some issues in regard to the treatment provided: ineffectiveness to satisfy their needs consistently, the extreme conformity to a standard model of treatment , inadvertent to the singularity of each person, the failure to build a trusting relationship with the drug user, the judgmental approach, and the systematic tendency to withold power of choice from the users. The excessive reliance on bureaucracy and a disproportionate control were also indicated.
Some suggestions of improvement were actively conceived as well, regarding additional interventions, such as sensibilization and prevention actions, support to the individual's formal social network, and expansion of the harm reduction services.
Being a vehicle of active voice to the people who lived the experience of recovery in first hand, these findings are able to contribute to a redirection of institutional policy and might reshape the current therapeutic services, improving the treatment efficiency.