Hearing the voice of the addicted drug user

For me the crucial line between the addicted user and the non-addicted user, following Bill Wilson, the originator of the 12 step program, is the inability to stop. Wilson wrote: “If anyone questions whether he has entered this dangerous area, let him try leaving liquor alone for a year. If he is a real alcoholic, there is scant chance of success” “Some will be drunk the day after making their resolution; most of them within a few days.” ( Alcoholics Anonymous p 34). Wilson was writing of alcohol but it is equally true of drugs. This resonates with my own experience with heroin. I lived for in ten years of active addiction with the desperate desire to stop using, but found myself nevertheless using everyday. Over these years I found myself in and out of rehabs, temporarily getting off heroin, but always returned to using after a few days, weeks or months. In my experience and understanding this is the mark of a truly addicted drug user: wanting to stop but not knowing how.

My own  views about addiction and recovery have evolved since beginning this study. At the outset I was a fairly dogmatic believer in the 12 step model of total abstinence and the disease model of addiction. Through my extensive reading for this study and my personal experience with a methadone substitution program run by the Urban Futures Centre, I have discovered that there are many paths to recovery. Abstinence and the 12 step program is still my personal solution, but I have come to realise the value of harm reduction and other approaches. Harm reduction and recovery are often seen by their respective practitioners and supporters as mutually exclusive and antagonistic and they are often, in my experience, hostile to one another.  I believe that they are in fact different pieces of the same puzzle, and have far more in common than differences between them. This position is supported by, amongst others, William L. White, a prominent member of the recovery movement in America.  One of the goals of this study is to find mutual ground between the various approaches and to draw from each what works in practice.  

 My theoretical approach draws largely from the social recovery model as espoused by William White and others. It is also influenced by the writings Bruce Alexander who is famous for the so-called Rat Park experiments. More recently he has developed a socio-political understanding of addiction as resulting from the dislocation and alienation inherent in modern capitalist society.  Today I have come to believe that it is not the individual addicted user that is sick, but our society. Addicted drug users, like other stigmatized and marginalized groups, are the ones who carry the symptoms of the disease. They are despised because they are a constant reminder of the sickness of our society. I believe, however, they are also the ones who carry the cure, like the survivor of a rare virus who carries the antidote to the disease. By listening to them and learning from their life experience we can gain a greater understanding as to why so many people in modern society turn to drugs for their solution.

The voice of the addicted user is largely missing from the literature. An essential part of this study is to explore what addiction and recovery mean to the recovering addicted user, to begin to understand these from lived experiences. 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. Addicted drug users, especially those living on the streets, are a highly stigmatised and marginalised community. Their views are seldom heard when it comes to policy making and treatment models that are directed at them. Yet their own experiences and journeys into and out of addicted drug use could provide invaluable insights into the development of more effective treatment programs. The deficit in regards to the missing voices of drug users is even more stark in South African context.  Dos Santos, in her 2008 thesis, (amongst others) draws attention to the scarcity of research in the area of heroin use disorder intervention in South Africa and the desperate need for such research.