‘Pathways to recovery from heroin addiction: An oral history account of addicted heroin users in recovery.’

Thesis Proposal pt1: Context of the Research

This is the final version of my proposal as accepted by the Durban University of Technology, to undertake a research project leading to a PhD degree in Health Science.

The United Nations recently convened a special assembly recently in response to the growing criticism of present international drug policy. In particular the so-called “War on Drugs” is coming under increasing attack as, at its best,  a costly and futile exercise, (Gray 2001; Rolles et al. 2012) and, at its worst, a sinister machination of bio-political control (Bobo and Thompson 2006). Internationally and locally experts are baffled by the growth of what is perceived as a “drug problem”. An increasing number of countries, institutions and individuals are exploring and debating a range of alternatives in reducing the harm that drugs cause, from legalization to policies that are aimed at harm reduction rather than punishment (GCOD 2011; UKDPC 2012).  In South Africa the National Drug Master Plan commits to a multi-disciplinary and community-based oriented in what it refers to as a “bio-psycho-social” model (South Africa 2012: 30). However according to Howell and Couzyn (2015: 1) the plan is “riddled with internal inconsistencies and impractical resolutions” and will be extremely difficult to implement due to lack of government resources and co-ordination on one hand, and the lack of non-government facilities on the other. Furthermore content analysis by Geyer and Lombard (2014: 342) reveal that the master plan is still stuck with using the language of criminalisation and individual pathology, which, they conclude, has the result of absolving the government of any responsibility. There is a growing perception that present treatment and policy models in regard  to drug addiction are inadequate to deal with the multitude of psycho-social, family and community issues emanating from, and leading to, the ever-increasing abuse of drugs. They tend to pathologise the individual and overlook the structural and social aspects of the problem (Chetty 2015; Prinsloo and Ovens 2015) . Further there is little agreement as to what the outcome of the recovery process should be. Dos Santos claims too that “the pathways to recovery tend to be complicated and the variety of possible outcomes is extremely great”  (Dos Santos 2012: 54) .   Practically treatment is inaccessible to the majority of addicted user (Myers and Parry 2005; Dos Santos, Rataemane and Rataemane 2013). This is available either through private residential treatment centres, which are prohibitively expensive and inaccessible to the majority of addicted users, or available, largely as out-patient treatment centres through non-profit state or NGO organisations. Access to these centres is limited, due to lack of funding and resources, and there is usually a three to six month waiting list. In both private institutions and the NGO/state sector there is a poor record in achieving sustained recovery. (Jeewa and Kasiram 2008) . Largely missing from this debate is the voice of addicted user themselves. As a recovering addicted heroin user myself, I have come to believe that it is critical to have such voices heard if a decent model for dealing with drug use disorders is to be developed and implemented. Drug users are a highly stigmatised and marginalised community. Their voices are seldom heard when it comes to policy making and practice models that are directed at them. Yet their own experiences and journeys into and out of problematic drug use could provide invaluable insights into the development of more effective treatment models.