Turning points toward drug addiction recovery: contextualizing underlying dynamics of change

Abstract

Background: A life course approach recognizes the role of turning points in adding twists and turns in individuals' addiction recovery processes. The notion of certain key life events that trigger turning point experiences offers a valuable theoretical construct for understanding processes of change. The current study aimed to identify turning points and assess the role of contextual dynamics in generating longterm changes, based on lived experiences of persons in drug addiction recovery. Method: A qualitative research design was applied using a Lifeline Interview Method (LIM), allowing a retrospective lens to elicit recovery narratives. Purposive sampling was utilized to compose a heterogeneous group of thirty persons in self-defined drug addiction recovery in Flanders (Belgium). An interpretative phenomenological approach was adopted during a thematic analysis, grounding the research claims in respondents' lived experiences. Results: Key moments of change that were reported by participants are: (1) adverse drug-induced experiences; (2) becoming a parent; (3) 'hitting rock bottom'; (4) (dis)engagement of social networks and environments; and (5) addiction treatment. The findings illustrate the role of contextual dynamics that can facilitate (or hamper) experiencing these life events as turning points toward change.Conclusions: This study contradicts the notion of a single event or turning point causing abrupt changes in individuals' addiction trajectories. Contextual dynamics and meaning-making processes simultaneously influence whether specific life events can facilitate change. Treatment providers, researchers, and policymakers should take into account the process-based, situational, and relational nature of recovery.

Women in mid-life and older age in recovery from illicit drug use: connecting and belonging

“…The study findings mirror findings from elsewhere ( 6 , 7 ) that show recovery is an ongoing process in which women set boundaries with others, assume more control over relationships and develop a recovered identity that others can view as authentic, honest, and genuine. Making connections and belonging to social networks unrelated to active drug use encourages women to develop identities and sense of self as women in their own right, rather than women defined by drug use.…”

“…For women in mid-life and older increasing isolation and marginalization within drug-using circles is exacerbated by disengagement from relationships through the death of drug-using friends, friends who use drugs and enter recovery and stop using, or age-segregation within the drug using environment ( 6 ). Nevertheless, a shrinking network of drug-using associates and significant others can be beneficial to reducing and abstaining from problematic drug use and shifting to a new social identity that engenders a sense of belonging ( 7 ). Bellaert et al’s qualitative study of 30 women revealed supportive social and structural factors were needed to create a positive separation from drug-using networks and to increase feelings of connectedness ( 7 : p. 298).…”

“…Nevertheless, a shrinking network of drug-using associates and significant others can be beneficial to reducing and abstaining from problematic drug use and shifting to a new social identity that engenders a sense of belonging ( 7 ). Bellaert et al’s qualitative study of 30 women revealed supportive social and structural factors were needed to create a positive separation from drug-using networks and to increase feelings of connectedness ( 7 : p. 298). However, network members can also provide support which can make it difficult to fully disconnect from relationships that might risk recovery ( 8 ).…”

Understanding the Process of Drug Addiction Recovery Through First-Hand Experiences: A Qualitative Study in the Netherlands Using Lifeline Interviews

“…Overall, the four themes support that addiction relates to various aspects of the individual and social environment, and thus, that recovery can take place in many life domains ( Laudet & White, 2010 ; Mellor et al, 2020 ; Moos & Moos, 2007 ). From the autobiographic data, we could distill how recovery was interwoven with the entire lives of participants ( Bellaert, 2022 ). In addition, we show that some (universal) recovery processes transcend the context of addiction.…”

“Watch out for the boogieman”: stigma and substance use recovery among migrants and ethnic minorities

“…Historically, the recovery literature has mainly started from a personal point of view, exploring how recovery can be promoted on a personal level. In recent years, critical voices have argued that this approach foregoes the context in which people recover (Bellaert, Van Steenberghe, De Maeyer, Vander Laenen, & Vanderplasschen, 2022; Davidson et al, 2021; Fomiatti, Moore, & Fraser, 2018). This study has shown that stigma and recovery experiences are relative to their contexts and take shape across time (pre‐ and post‐migration) and space (country of origin and country of residence).…”