Older Former Prisoners’ Pathways to Sobriety

Abstract

This study explores how older age shapes processes of substance abuse cessation among male substance users recently released from prison. Semi-structured in-depth interviews and brief surveys were conducted with 15 men aged 49+, released from prison in a large, Eastern U.S. city. A follow-up interview was conducted with each participant (n=15). Conventional content analysis was used to analyze these data. Aging was central to the stories men told about attaining and maintaining sobriety. Men gained clarity after forced detoxification in prison, which was often followed by a period of reflection and evaluation of their lives. Older age seemed integral for this period of sobriety and reflection to catalyze cognitive change, a phenomenon I term Sober Aged Reflection. Further, men described a heightened awareness of mortality that had come with older age, and were deeply afraid of dying in prison. This fear helped inspire a new commitment to sobriety and concordant rejection of the crime that had been linked with their drug use in the past. Finally, men revealed identities and goals that had changed with time, changes incompatible with on-going drug use. Policy implications are discussed.

Ageing and older people who use illicit opioids, cocaine or methamphetamine: a scoping review and literature map

“…Most included frameworks were existing theories incorporated a priori and used to guide the investigation, with the exceptions of the MIMSAE [36] and sober aged reflection [37], which were new models of older adult drug use proposed by the included publications. Theoretical frameworks generally focused upon describing factors, processes and contexts related to drug use in order to support research regarding older adults who use drugs.…”

“…The mega-interactive model of substance abuse among the elderly (MIMSAE) was explicitly proposed to help medical professionals understand drug use behaviour and diagnose substance use disorder among older adults [36]. Sober aged reflection was developed among older former PWUD recently released from prison, who attributed their sobriety to the specific combination of externally imposed abstinence during their incarceration and the selfreflection prompted by growing older [37]. Longitudinal studies used the life-course perspective on drug use [13,[38][39][40][41] and the concept of drug use careers [13,38,42], two closely related frameworks that consider the trajectories, transitions and life events that occur during a long period of drug use.…”

“…Most included frameworks were existing theories incorporated a priori and used to guide the investigation, with the exceptions of the MIMSAE [36] and sober aged reflection [37], which were new models of older adult drug use proposed by the included publications.…”

“…Twenty-eight publications (17%) referred to the criminal legal system, including incarceration (n = 15), policing (n = 6) and driving under the influence (n = 2). While some papers reflected older adults' fear of or experiences with the criminal legal system [28,37], incarceration history was most often used to describe the study population or to distinguish between comparison groups [101,102].…”

“…In combination with a period of sobriety, this self-reflection can lead to cognitive change and cessation of drug use. Wyse (2018) developed this model in a study of ageing men recently released from prison Wyse (2018) [37] F I G U R E 2 Content areas in reviewed publications. Publication counts are not mutually exclusive, as publications could discuss multiple content areas.…”