Proposed title:
‘Routes to recovery from drug addiction: An oral
history account of addicts in recovery on the KZN South Coast’
Personal Background:
As a result of my own personal history I have chosen
to do a dissertation that focuses on drug use and recovery instead. I have become
interested in this field of addiction recovery
through my own experience of addiction and realised that with my
experience I can make a contribution. I
have suffered a long term battle with
drug addiction and came into treatment early last year at a
rehabilitation centre in Scottburgh on the South Coast. On leaving treatment 18
months ago I decided to stay in Umdoni where there is a very strong fellowship
of recovering addicts and have immersed myself into the program and activities
of Narcotics Anonymous. I have also used
this time to do research, on my own volition, on addiction and recovery with a particular
interest in the Recovery Movement in the USA and other treatment and recovery
models around the world.
I am also a member of the Harm Reduction Advocacy
Group which is co-ordinated by the UFC@DUT. I believe that my meeting up with
Prof. Monique Marks has been very fortuitous. I am keen to combine my social
science training with my deep interest in health sciences. The project focus of
the UFC@DUT on street level drug addiction resonates with my personal and
academic interests.
While I have no formal training in the Health
Sciences, I do believe that this is the correct Faculty for me to conduct my doctoral
research on pathways to recovery for drug addiction, which I view as a chronic
illness. Not only do I hope that my doctoral work will assist in understandings
pathways to recovery further, but I am also keen to use this doctoral programme
to assist in establishing a community based organisation that centres on
community recovery and makes use of alternative models of therapy and
treatment. I have already began my research journey by reading extensively on the
recovery movement, but also through conducting in-depth oral histories of a
wide range of individuals who are currently in recovery.
It is my view that studying in the field of Health
Science will enable me to be able to work more effectively, and with greater
credibility, in the broad health sector. But most importantly, I view this
doctoral degree as an opportunity to learn more about drug addiction recovery,
and to contribute to this body of knowledge in significant ways, and within the
context of KwaZulu-Natal.
Background to the
dissertation:
As a recovering drug addict, and someone who has read
extensively about both addiction and recovery, I have come to believe that
existing models of addiction treatment are very limited. Addiction is by and
large treated as an acute illness that can and should be cured after a short
stay (one to three months) in a
treatment centre. Increasingly research is showing that that is not viable or
effective, and that simply weaning off or detoxifying users is inadequate in
the medium to long term. It is for this reason that most rehabilitation
programmes fail to ‘cure’ addicts of their illness in the longer term, and
instead what is most evident is repeat relapse and wasted expenditure.
Short term medical and even psychological
interventions are without doubt ineffective. What is required is a real
understanding not simply of the biological factors that contribute to
addiction, but the more deep level motivation for getting into drug use in the
first place. Much of this has to do with feelings of social disconnect and
dissociation, as well as ways of coping with traumatic and stress. While
providing short term therapy might
establish a structure for ongoing recovery, in and of itself it is inadequate. Staying
clean is a long term process and extended recovery requires finding ways in assisting drug users to feel connected and purposive. What is
evident from the latest research on recovery is that that long term addicts
often have little or no life-skills or resources to stay clean. What is
required, then, is sustained help with reintegrating into society, and developing
alternative ways to deal with the personal and social problems that led them
into addiction in the first place.
Another limitation with existing addiction treatment
models is that they are by and large focused on the individual. The community
context from which the individual comes and the social dynamics that feed
addiction habits are largely overlooked. What is required then is more community based approach that
addresses social dynamics in much the
same way as is now happening with other chronic illnesses such as diabetes and
obesity. If we are to truly understand addiction as a long term illness, it is
critical to understand the role that community plays in contributing to the
illness and in remedying it. William White and others have claimed that
communities where addiction levels are high have been victims of what they call
“historical trauma”. Such trauma erodes indigenous sources of cultural and
personal resilience leaving communities, community institutions,
neighbourhoods, families, and individuals particularly vulnerable to drug and
alcohol related problems. This, I believe is crucial to the rise in drug
addiction in the South African context where whole communities have experienced
and continue to experience collective trauma, and where individuals have become
disconnected and alienated from family and community. It is therefore important
in the South African context to gain a deeper understanding of how individual
vulnerability to drug addiction is mirrored with broader community
vulnerability and risk.
A third and critical problem with existing rehabilitation
treatment is that it is extremely costly. The majority of addicts are unable to
afford the cost of the existing treatment centres, even those that are short
term in their services. And in resource poor countries like South Africa, the
chances of having long term holistic intervention in the public sector is
unlikely in the short to medium term. In the meantime, addiction numbers are
rising and the longer this is left untreated, the more endemic this social and
public health problem is likely to become.
It is for this reason that it is important to gain a
deep understanding of how those who are in long term recovery came to the point
they are at. This dissertation therefore will focus on the pathways to recovery
of a group of addicts, some of whom have been clean for a sustained period of
time, some still struggling to find recovery , but with a strong desire to do
so. There are various possible paths to recovery and the point of this
dissertation is to uncover what they are and to see which ones are thought to
be most effective.
The thinking behind this
dissertation is largely based on literature on the recovery movement. The
recovery movement locates both addiction and recovery firmly within the
community. The focus of this movement is on involving recovering addicts, and
those affected by addiction (families and communities) in the healing process,
and the reintegration of addicts back into their communities. It is strongly
rooted in the ideas, drawn from the 12 step program of the Narcotics and
Alcoholics Anonymous movements, of one addict helping another and of recovery
being dependent on service to others. While the movement primarily started in
America where there is a strong network
of Community Recovery organisations has emerged, and is spreading around the
world. In South Africa though this movement is in its infancy.
These organisations are embedded in
communities through establishing Recovery Community Centres, which host a range
of activities from out-patient therapy, to life-skill and job training, to
providing a venue for creative and recreational activities. They also operate
as a resource centre for families and social and health care workers to learn
about addiction. The movement is also engaged in advocacy, education and
research and a strong body of academic writing is emerging. In places like the
US and Northern Ireland, the recovery movement is now gaining increasing
support from both those in the health care professions and from police who are
confronted with the back end of addiction consistently.
Johan Hari has also drawn
attention to the importance social
context plays in driving addiction through elaborating on the famous “Rat Park” experiment. For Hari the prime
drive of addiction is disconnection and the focus of recovery should be
reconnection.
Anne Wilson Schaeff argues
that our society is driven by addictive behaviour. The obsession with
extracting fossils fuels with no regard to the environmental damage and our fixation with material wealth and
possessions as a measure of success and happiness certainly mirror the behaviour of an addict..
My contention is that our
society suffers from a dis-ease of which the individual addict is but the
symptom and carries the burden of suffering. Perhaps through the healing and reintegration
of individuals a greater healing can begin and the lessons of addiction and
recovery at an individual level could hold some solutions for our broken
communities and for society at large.
Objectives of the study are:
·
To discover, through Oral histories the most effective routes out of drug
addiction
·
To
document the stories of users who are part of a recovery community on the KZN
South Coast
·
To
follow and assess the progress of a Community Recovery program which is being
introduced in this community as it unfolds
·
To
document the processes and the structure of the Umdoni Recovery Programme with
the intention of investigating new model for drug addiction treatment
·
To
understand the link between individual addiction and community trauma and
vulnerability.
·
To
critically engage with the various debates about addiction recovery in the
existing literature and to contribute to theoretical and evidential debates
·
To
ultimately contribute toward designing an effective model for treating drug
addiction that ‘fits’ with the localised South African context.
Key questions to be answered:
Given the above, the following questions are viewed as
central to this dissertation:
·
What
are the most effective and sustainable pathways out of long term drug addiction?
·
What
are the pathways into drug addiction?
·
In
what way do family and community factors contribute to individual addiction?
·
What
impact does addiction have on communities?
·
In
what ways can families and communities be involved in individual recovery?
·
In
what ways can individuals be involved in community recovery?
·
What
alternatives to the mainstream rehabilitation programmes should be developed in
a South African context?
Research methodology
This study will focus on a group of recovering addicts
that are living in the broad Umzinto district on the Natal South Coast. The
majority, but not all of these addicts are from Riverside Park, a poor
community particularly hard hit by drug addiction, especially whoonga. This
group has been chosen purposively as it comprises of addicts who are actively
seeking, and involved in recovery through participation in a Narcotics
Anonymous group of which I am a part. This group has grown from two regular
attendees at NA a year ago to a core of eight members now clean between 3 weeks
and 1 year, plus a growing group of between 6-10 addicts still in active who
regularly attend meetings expressing the desire to get and stay clean.
This study will mainly comprise of oral histories
which will allow those in recovery to tell their stories in a manner that is
not constrained nor overly directed. The oral histories will be taken over two
different periods of time allowing for some evaluation of the effectiveness of
the pathways that the recovering addicts that are part of the study have opted
for. The two points of conducting oral histories will be 12-18 months apart.
I plan to hold focus
groups with recovering addicts in Umzinto to deliberate various aspects of
addiction and recovery. I will also interview family members and other members
of the community as to the effect addiction has had in the community and, as
the study progresses the effect a group of recovering addicts has on the
community as they begin to reintegrate.
Further a number of
initiatives are being planned in this community. An NGO is being put
together to raise funding to start a community centre. This will obviously
be a long term process. In the meantime
creative and innovative ways of
implementing some of the ideas of community recovery will be
pursued. Throughout this research
process, I will be drawing on aspects of applied research through the describing
and evaluating of these initiatives as they develop.
