VanDeMark Nancy R
Graduate School of Social Work, University of Denver, 2148 South High Street, Denver, CO 80208 USA.
Subst Abuse Treat Prev Policy. 2007 Sep 19;2:28. doi: 10.1186/1747-597X-2-28.
The predominant U.S. policy approach toward individuals with substance abuse problems has relied on stigma and punishment by withholding access to education, cash assistance, housing, social support, and normal social roles. In contrast to this approach, the theory of reintegrative shaming asserts that providing individuals with the opportunity to reconnect with society is more effective in reducing potential to relapse to crime and drug abuse. Strategies that promote such reconnection include expanding access to basic needs and supportive relationships along with increasing opportunities to fully participate in mainstream social roles.
The present cross-sectional study examined the predictors of relapse and the facilitators of recovery in a sample of 325 women with histories of substance abuse. Analysis of secondary data, collected as part of a national cross-site study, employed a mixed methods approach conducting (1) logistic regression to examine the predictors of relapse and (2) an inductive qualitative analysis of responses from open-ended items to explore the women's perceptions of barriers to and facilitators of recovery.
Results suggest that lower levels of instrumental support, affective support, and participation in normal roles (such as parent, employee, student, and citizen) are significant predictors of relapse to drug use and criminal behaviors. Qualitative findings support the quantitative results, revealing that participating women perceived the variables of support and role participation as critical in facilitating their recovery. They also noted the importance of individual characteristics such as optimism and strength and emphasized the significance of their relationship with their children in motivating them to avoid relapse. Findings suggest that punitive policies toward women with substance abuse histories may be ineffective.
The author concludes that current policies designed to withhold access to basic needs such as housing, education, cash assistance, and positive relationships may deprive women with histories of substance abuse of the means to reconnect with society. Policies that promote access to basic needs and offer avenues for women to participate in normal societal roles should be more fully explored.
美国针对有药物滥用问题的个人的主要政策方法一直依赖于污名化和惩罚手段，拒绝为他们提供教育、现金援助、住房、社会支持以及正常的社会角色。与这种方法形成对比的是，重新融入羞辱理论认为，为个人提供重新融入社会的机会，在减少其重新犯罪和药物滥用的可能性方面更有效。促进这种重新融入的策略包括扩大基本需求和支持性关系的获取途径，以及增加充分参与主流社会角色的机会。
本横断面研究在325名有药物滥用史的女性样本中，考察了复发的预测因素和康复的促进因素。作为一项全国性跨站点研究的一部分收集的二手数据分析，采用了混合方法，进行（1）逻辑回归以检验复发的预测因素，以及（2）对开放式问题的回答进行归纳定性分析，以探索这些女性对康复障碍和促进因素的看法。
结果表明，工具性支持、情感支持水平较低，以及参与正常角色（如父母、员工、学生和公民）的程度较低，是药物使用和犯罪行为复发的重要预测因素。定性研究结果支持了定量研究结果，表明参与研究的女性认为支持和角色参与变量对促进她们的康复至关重要。她们还指出了乐观和力量等个人特质的重要性，并强调了她们与孩子的关系在激励她们避免复发方面的重要性。研究结果表明，针对有药物滥用史女性的惩罚性政策可能无效。
作者得出结论，目前旨在拒绝提供住房、教育、现金援助和积极关系等基本需求的政策，可能会剥夺有药物滥用史女性重新融入社会的手段。应更全面地探索促进获取基本需求并为女性提供参与正常社会角色途径的政策。
