Lived experience of NA in the cycle of recovery from addiction

Transcription

1 Lived experience of NA in the cycle of recovery from addiction Seyed Ali Hashemianfar 1, Reza Esmaeeli 2, Majid Rahimi 3, Bahadori Jahromi Samineh 4, Aghdas Aghababaian 5, Seyed Naser Hejazi 6, Karam Yaghoobi 7 1 Member of Faculty, University of Isfahan, Isfahan, Iran 2 Member of Faculty, Khorasgan Branch, Islamic Azad University, Khorasgan, Iran 3 Member of Faculty, Jahrom Branch, Islamic Azad University, Jahrom, Iran 4,5,6 Member of Faculty, Dahaghan Branch, Islamic Azad University, Dahaghan, Iran Abstract Narcotics Anonymous is an autonomous, non-profit association composed of women and men whose main problem is drug addiction. NA members regularly come together to support each other in their recovery from addiction. The purpose and focus of this study is to reveal the meaning of lived experience in the NA group in the cycle of addiction recovery. The Hermeneutic approach with emphasis on van Manen methods was used in the present study. Information was collected through semi-structured interviews with 8 NA.The obtained were analyzed data to determine the definition of NA and NA groups. 5 participants were male and others were female and had between 1 to 10 years of membership in the NA group. 15 following themes emerged from the data and were categorized into 4 main themes. The concept of NA was explained based on the themes and sub-themes. These findings support the concept of social workers in a better understanding of NA, a better understanding of the issues facing addicts, considering the needs of addicts, better communication with people and ultimately help to improve the performance of social workers. Keywords: the lived experience of NA, addiction, Group NA, Hermeneutic phenomenology Introduction Any addict, or anyone who has a tendency to addiction is suffering from an incurable physical, intellectual and spiritual disease. Addicts have been caught in an insoluble problem and its resort has a spiritual nature. So Narcotics Anonymous or NA is a nonprofit international association formed out for association of recovering from drug addicts in which the addicts regularly come together to help each other maintain their purity (of drugs). The spiritual issues and strategies discussed in the NA forums are examined in this paper. Narcotics Anonymous - NA NA, (NA) is a nonprofit international association of women and men whose major problem in their lives is addiction. The association includes the addicts recovering from drug who regularly come together to help each other maintain their purity (of drugs). (NA) is the abbreviation of Narcotics Anonymous following by the word [world] which states that it is a global issue. History Alcoholics Anonymous was the forum that Bill Wilson and his wife Lewis established to help family members of alcoholics. Following the success of the Association of Alcoholics Anonymous, 12 step programs have also been developed, the second of which was Narcotics Anonymous. Association of 51

2 Alcoholics Anonymous is marked with the initials AA in English but the association founded by Bill s wife to help families of alcoholics is known by initials Al-Anon. After 20 years since the founding of Alcoholics Anonymous forum, due to the attraction of more people to drug, drug addiction has become a major social problem and subsequently Narcotics Anonymous or NA was founded. 12-step is the basis and foundation of all programs is the same as the 12-step program in the Alcoholics Anonymous. The only significant difference between these associations is the first and twelfth step. The two steps required the members to determine and declare their main problem. And the association has set up and developed these two steps to be compatible with the destructive behavior that the drug addicts suffer from. The first step in the NA certain does not point to the specific consumer and instead uses the term addiction as a disease to show the addicts are helpless in the face of addiction and it is not a matter of consumer. The actions and principles that we need to do to recover are the same in 12- step programs. In addition, all 12-step programs follow a general guideline called twelve traditions, Alcoholics Anonymous meetings and community service structure (The World NA Forum (NA), 2006). Specifications The members of this forum as addicts knew their common feature called addiction disease. Addiction means using substance that take them out of their natural feelings and thoughts. Narcotics Anonymous believe that the remedy to get rid of addiction has a spiritual nature. Although the association is not a religious organization, however, the members have different religions around the world and the statement that "Narcotics Anonymous is not religious. in essence means that anyone from any religion can be a member and it is not related to any particular religion. There are no preconditions to join Narcotics Anonymous. It does not belong to any organization. Dues are not received; the members do not sign a letter of commitment and promise to anyone and has no relationship with any political organization, religion or law. It does not follow anyone and everyone regardless of age, with or without religion, race, and sexual identity can join them. Through voluntary donations NA members are entirely self-reliant and any financial assistance will not be accepted from those outside or other organizations. Users can even donate unusual and provide a great deal financial support (the World NA Forum (NA), 2006). Anonymity The basic principle of anonymity makes the addicts to participate in meetings without fear of social and legal prohibitions. Anonymity, all the spiritual traditions of the community and in their opinion, is reminiscent of the characters are always preferred. In addition, the anonymity of the service is a priority. Program The Twelve Steps of Narcotics Anonymous recovery program and get rid of the main pillars of drug addicts has been modeled from that of Alcoholics Anonymous (AA). Alcoholics Anonymous has recovered over a million people. This program is an avoidance of any drugs. The only requirement for membership is a desire to stop using drugs. The only important thing for members is the way of solving the problem and how others can help him. NA claim that group experience shows that those who regularly participate in meetings could remain clean (World NA Forum (NA), 2006). Meetings NA holds two types of meeting based on the anticipated program. Closed meetings are for the special addicts or those who think they may have a problem with drugs. Open or public meetings accept the members of anyone who wants to experience the community. 52

3 Structure of the NA sessions NA meetings have informal structure and are held in a place that is rented by the group and are led by members who take turns opening and closing sessions. Cost of meetings and other services is entirely supplied from voluntary contributions of the drug users and the sale of recovery. Most meetings are held on a weekly basis, usually in public places. Meetings have various forms: participation, speaker, question and answer or some combination of the above types. The most common type of organization is of the partnership and the leader allows a user to speak between one to three minutes in each session. Methods of NA Group Foundation of Narcotics Anonymous was to help other addicts to recover. Members regularly come together to talk about their experiences in recovery. The main method of healing in the community is the belief in the therapeutic value of one addict in helping another. Members talk about their experiences and recovery of drug use. The more experienced members (known as guides) work individually with newer members. The Twelve Steps of Narcotics Anonymous is considered the most basic program (NA World Forum (NA), 2006). Research Method Hermeneutic phenomenology or interpretation is a qualitative research approaches focused on the experiences of human life and has the philosophical roots (2002 Polit DF). The Hermeneutic phenomenological approach with emphasis on van Manen method was used to explore the concept of Addicts Anonymous. van Manen stated the following six activities as Hermeneutic phenomenological approach which is also followed in the present study (1990 van Manen, M). Six approaches consist of giving attention and orientation to the nature of life experience, describing the experience of life as it is considered, reflection (Reflectio) in the inherent themes, describing phenomena by using the art of writing and rewriting, establishing and maintaining a strong and conscious phenomena in view of the components and the corresponding context of the research and finally, orientation to the nature of the experience of life. The purposive sampling method (Purposeful sampling) was used to select participants. (Strubert H, 2011). This study sample size was determined based on the information saturation (Polit DF, 2007) and anonymous addicts participated in this study having the following characteristics: 1- they speak Farsi, 2. they grapple directly with their addiction.3. They participated in the research voluntary and informed. To saturation, 8 nurses participated in the study based on purposive sampling method phenomenological study. The instruments of data collection were a semi-structured interview and a demographic data Questionnaire. To collect data, the semi-structured interviews were used. The data analysis was based on the phenomenological method of van Manen. In order to explain the concept of Addicts Anonymous question and the semi-structured interviews were made by the opinions of experts and advisers and with the help of professors in the qualitative study. Then the researcher refer to the sites of research with the cooperation of the staff and administrators rehab centers and earn the trust of the selected participants, the interviews was conducted with their consent. Typically, a few days before the interview, it was informed to the participants to get ready to participate in the interview. In the interview session after its introduction, the objectives were stated and it was pointed to confidentiality so that the consent of the participant was attracted. Then semi-structured interviews were conducted with participants. The semi-structured interview was based on the form of the question. Interviews were conducted in an environment preferred by participants and were recorded using a digital voice recorder. Interview was done with 8 participants (8 NA) 5 men and 3 women between 21 and 46 years. Time of the interviews was between 32 minutes to 75 minutes, respectively. After each interview in the shortest 53

4 possible time after the interview, the information was recorded several times to listen carefully. he interviews were transcribed. Information transmitted on paper was reviewed while listening to a tape recorder. This was done so in order to increase the accuracy of the information transmitted on paper and researchers become more dominant on the information. From this point on, the information transmitted on paper became the source of data analysis. The researcher (Trustworthiness) did the following steps to confirm phenomenological findings: 1. The researcher acted carefully in the selection of participants and selected those who wish to express their experiences and they had full participation in the research. 2. Data and assumptions of the researchers have tried to be controlled to reduce its impact on the analysis and interpretation of the data. 3. Data were studied faculty supervisor, consultant and experts to implement and ensure consistent with the statements of the participants. 4. After modification, the interviews were returned to the participant and in another session, the participants were exposed to a final comment. Findings 8 NA were interviewed, 5 patients were male and between 21 and 46 years of age. 1 woman and 2 men were single and the rest were married. Time of the interviews ranged from 32 to 75 minutes. Van Manen method was used to analyze and separate the meaning of holistic approaches and choice. Based on a holistic analysis, 10 general descriptions were extracted from 10 interviews. The researcher described the selective analysis stage to extract themes. In the following analysis, the selection extraction themes and themes related to the drug was recognized. Accordingly, the first 53, then 23 and finally 15 sub-themes were identified. Then the 15 sub-themes were put in the 4 main themes. Then the experience of addiction was described based on the following themes. Derived Themes and sub-themes were as follows. A) The theme of the Addicts Anonymous, which has the following 4 themes 1. Effective communication with addicts in withdrawal, 2. The consent of the addicted person to improve the situation, 3. Belief in complete remission 4. More attention giving to the Families of Addicts B) The theme of trying to get rid of the opium has the following 4 themes 1. Effort so effectively, 2. Give hope to the families of addicts, 3. The exact following of the oppressive social workers and C) The theme of respect for human dignity included 2 sub-themes: 1 - Understanding the spiritual needs of the Addicts Anonymous and 2 - To achieve peace D) The theme of moral conscience and responsibility included 5 sub-themes 1. Complete Care of Addicts Anonymous 2. Returning of the Addicts Anonymous to the contaminated environment, 3. Frustration and disappointment of failing to stop addiction, 4. Feeling guilty about the failing to stop addiction and 5. The family members and social workers sympathy to Addicts Anonymous. The semantic units of some participants can be found below. Effective communication {a 28-year-old woman with a history of 3 years addiction} 54

5 "My addiction has caused many problems for me at the University... My addiction was causing problems for my family...addiction had caused insisting on my demands... it had a bad effect on my relations... " Respect for human dignity {a 23- year-old man with a history of 4 year drug addiction} "I did not consider the material needs of my family... I did not want to accept responsibility for life and my actions and I could not do my daily responsibilities I was being crushed under the burden of responsibility are and it hurt my conscience and my dignity was greatly overshadowed... " Getting rid of opium in ruinous and move towards recovery {A 40-year-old man with a history of addiction} "As soon as I realized that things do not go according to my plan, it mentally put me into trouble... Any protest was considered an insult to my personality... My life and I were exposed to a serious risk and i ignored it which was my due to mu addiction and I could not protect my life anymore. I had terrible thoughts and my tears finally had to get out of this fix ruinous... In addition to several meetings with university professors and advisors,the researcher also hold about 8 sessions with experts in the field of Qualitative Research and Hermeneutic phenomenology in Isfahan and Shiraz. The opinions of the experts were used to modify, delete, add or impose any other necessary changes, classification and extraction of 4 main themes. According to the experts opinions, Changes and improvements in the interviews, data analysis and mining were the themes. However the concept of Addicts Anonymous can be defined on the basis of findings. Fear and ignorance has led addicts who are grappling with the problem of addiction and self-deception due to their ignorance of the terms and conditions or marked as "addicted", those who suffer in silence. And those are not aware of their suffering to escape from a situation from which they can successfully improve by asking for help. Discussion: This study aimed to clarify the concept of Addicts Anonymous from addicts perspective and those around them and showed that the addicts anonymous concepts is composed of the themes of life, trying to get rid of opium, and themes of respect for human dignity and responsibility. Very few qualitative researches have been done in the field of Addicts Anonymous. The research study showed that no qualitative research has been done in this field in Iran. Further, the qualitative researches done in this field are very old and used the methods different from the phenomenological method. However, the phenomenological method considered in this study is the most specific concept. Conclusion As mentioned above, in this present study ٤ main themes were presented due to the difference between theory and phenomenology.phenomenological method is specific and most useful way for an open, rich, abstract, relevant and accurate definition. In this study, the most important factors on all of these themes are moral conscience and responsibility of social workers, friends and relatives of the Addicts Anonymous and Narcotics Anonymous themselves. These factors caused the Addicts Anonymous to try in all stages of the recovery, not to forget the effort, do everything to prevent returning to addiction and finally, in case of returning, comply with the human rights and the value of the addict. However, the concept of Addicts Anonymous was not defined. Any addict, or anyone who has a tendency to addiction is suffering from an incurable physical, intellectual and spiritual disease. The ultimate solution of these unresolved problems has a spiritual nature. The limitations of this study was the difficulty of entering a rehab center, unwillingness of some 55

6 institutions, confounding factors such as noise and lack of a well-ordered, decent and sincere environment for interviewing. On the other hand, it is not enough to only study the social workers and the family members who live with Addicts Anonymous. Therefore it is recommended to also consider the friends and peers of the Addicts Anonymous. Considering the fact that addicts anonymous as approved by all the participants and researchers are among the most important measures, it is better to extract the healing process of grounded theory method used in Iran. Acknowledgements Special thanks to all social workers, Addicts Anonymous and their families, researchers and Professors Ali Hashmianfar, Reza Ismaili, Majid Rahimi who helped us during conducting the present research. Reference 1. NA Basic Books, Publisher: NA World Association (NA), (2006) Tehran 2. Polit DF, Beck CT, Hungler BP. Essentials of nursing research: methods, appraisal, and utilization. 5th ed. 3. van Manen M. Researching lived experience: human science for an action sensitive pedagogy. Ontario, ON: 4. Polit DF, Beck CT. Nursing research: principles and methods. 6th ed. Philadelphia, PA: Lippincott Williams &Wilkins; Philadelphia, PA: Lippincott Williams & Wilkins;