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Lamb R, Kougiali ZG. Women and shame: narratives of recovery from alcohol dependence. Psychol Health 2024:1-38. [PMID: 38736242 DOI: 10.1080/08870446.2024.2352191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Accepted: 04/27/2024] [Indexed: 05/14/2024]
Abstract
OBJECTIVE Existing literature indicates distinct pathways and the key role of shame and stigma into alcohol dependence (AD) and recovery for women. Internationally, there is a paucity of research exploring these factors from women's perspectives. METHODS AND MEASURES Taking a critical realist epistemological position, unstructured life story interviews were analysed via narrative analysis to explore how seven women from the UK, storied shame in their recovery from AD. RESULTS Shame followed a common trajectory across participants' stories, appearing as a reoccurring factor throughout AD and recovery. Participants narrated shame as gendered, contributing to a loss of personal control in defining a valued personal identity. Drinking began as a shame-management strategy but evolved into a source of shame, compounded by fears of being labelled an 'alcoholic woman'. Recovery involved reclaiming the self through de-shaming a shame-based identity and developing a positive, non-drinking identity. By evaluating 'shaming' recovery frameworks, sharing stories and reconstructing their own, participants were able to work through shame, resist pathologising identity labels and internalise esteemed 'sober' identities. CONCLUSION This research provides important insights into the intersection between shame, identity, gender and culture in women's recovery from AD. Implications for clinical practice, future research and policy are considered.
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Affiliation(s)
- Robin Lamb
- Department of Psychology, University of East London, London, UK
| | - Zetta G Kougiali
- School of Psychology, Liverpool John Moores University, Liverpool, UK
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Kersey K, Hutton F, Lyons AC. Women, alcohol consumption and health promotion: the value of a critical realist approach. Health Promot Int 2023; 38:6974794. [PMID: 36617295 DOI: 10.1093/heapro/daac177] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
Research on women's drinking occurs in largely disparate disciplines-including public health, health promotion, psychology, sociology, and cultural studies-and draws on differing philosophical understandings and theoretical frameworks. Tensions between the aims and paradigmatic underpinnings of this research (across and within disciplines) have meant that knowledge and insight can be frequently disciplinary-specific and somewhat siloed. However, in line with the social and economic determinants of the health model, alcohol research needs approaches that can explore how multiple gender-related factors-biological, psycho-social, material, and socio-cultural-combine to produce certain drinking behaviours, pleasures and potential harms. We argue that critical realism as a philosophical underpinning to research can accommodate this broader conceptualization, enabling researchers to draw on multiple perspectives to better understand women's drinking. We illustrate the benefit of this approach by presenting a critical realist theoretical framework for understanding women's drinking that outlines interrelationships between the psychoactive properties of alcohol, the role of embodied individual characteristics and the material, institutional and socio-cultural contexts in which women live. This approach can underpin and foster inter-disciplinary research collaboration to inform more nuanced health promotion practices and policies to reduce alcohol-related harm in a wide range of women across societies.
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Affiliation(s)
- Kate Kersey
- School of Health, Victoria University of Wellington, Kelburn Campus, Wellington, New Zealand
| | - Fiona Hutton
- Institute of Criminology, Victoria University of Wellington, Kelburn Campus, Wellington, New Zealand
| | - Antonia C Lyons
- Department of Social and Community Health; Centre for Addiction Research, University of Auckland, Auckland, New Zealand
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Pennay A, Duff C. Diversifying and enriching theoretical approaches to the interdisciplinary study of alcohol and other drug use. DRUGS: EDUCATION, PREVENTION AND POLICY 2022. [DOI: 10.1080/09687637.2022.2130176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
- Amy Pennay
- Centre for Alcohol Policy Research, La Trobe University, Melbourne, Australia
| | - Cameron Duff
- Centre for People, Organisation and Work, RMIT University, Melbourne, Australia
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Tse WC, Djordjevic F, Borja V, Picco L, Lam T, Olsen A, Larney S, Dietze P, Nielsen S. Does naloxone provision lead to increased substance use? A systematic review to assess if there is evidence of a 'moral hazard' associated with naloxone supply. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2021; 100:103513. [PMID: 34798434 DOI: 10.1016/j.drugpo.2021.103513] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Revised: 10/15/2021] [Accepted: 10/16/2021] [Indexed: 10/19/2022]
Abstract
BACKGROUND Take home naloxone (THN) programs have been rapidly upscaled in response to increasing opioid-related mortality. One often cited concern is that naloxone provision could be associated with increased opioid use, due to the availability of naloxone to reverse opioid overdose. We conducted a systematic review to determine whether THN provision is associated with changes in substance use by participants enrolled in THN programs. METHODS We conducted a systematic review of the literature to assess changes in heroin or other substance use by people who use opioids following THN provision. RESULTS Seven studies with 2578 participants were included. Of the seven studies, there were two quasi-experimental studies and five cohort studies. Based on the Joanna Briggs Institute quality assessment, four studies were of moderate quality and three studies were of high quality. Of the five studies that reported on the primary outcome of heroin use, no study found evidence of increased heroin use across the study population. Five studies reported on other substance use (benzodiazepines, alcohol, cocaine, amphetamine, cannabis, prescription opioids), none of which found evidence of an increase in other substance use associated with THN provision. Four studies reported on changes in overdose frequency following THN provision: three studies reporting no change, and one study of people prescribed opioids finding a reduction in opioid-related emergency department attendances for participants who received naloxone. CONCLUSION We found no evidence that THN provision was associated with increased opioid use or overdose. Concerns that THN supply may lead to increased substance use were not supported by data from reviewed studies.
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Affiliation(s)
- Wai Chung Tse
- Monash Addiction Research Centre and Eastern Health Clinical School, Monash University Peninsula Campus, Frankston, VIC 3199, Australia; Monash University School of Medicine, Clayton Campus, Clayton, VIC 3800, Australia
| | - Filip Djordjevic
- Burnet Institute Centre for Epidemiology and Population Health Research, Melbourne, VIC 3004, Australia
| | - Viandro Borja
- Alfred Mental and Addiction Health program, Alfred Health, Melbourne, VIC 3181, Australia
| | - Louisa Picco
- Monash Addiction Research Centre and Eastern Health Clinical School, Monash University Peninsula Campus, Frankston, VIC 3199, Australia
| | - Tina Lam
- Monash Addiction Research Centre and Eastern Health Clinical School, Monash University Peninsula Campus, Frankston, VIC 3199, Australia
| | - Anna Olsen
- Australian National University College of Health & Medicine, Australia
| | - Sarah Larney
- Université de Montréal and Centre de Recherche du CHUM, 2900 Edouard Montpetit Blvd, Montreal, Quebec H3T 1J4, Canada
| | - Paul Dietze
- Burnet Institute Centre for Epidemiology and Population Health Research, Melbourne, VIC 3004, Australia
| | - Suzanne Nielsen
- Monash Addiction Research Centre and Eastern Health Clinical School, Monash University Peninsula Campus, Frankston, VIC 3199, Australia.
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Ghiabi M. Ontological journeys: The lifeworld of opium across the Afghan-Iranian border in/out of the pharmacy. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2021; 89:103116. [PMID: 33485741 PMCID: PMC7611031 DOI: 10.1016/j.drugpo.2021.103116] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Revised: 12/28/2020] [Accepted: 12/31/2020] [Indexed: 02/06/2023]
Abstract
How can we conceive alternative policy models that embrace the empirical potentialities emerging from the lifeworld of drugs? The article reflects on this question, concluding that to reassess and to reinvent current policies on drugs, we need to think with a political ontology. Incidentally, the article also responds to the critique dismissing ontological inquiries as obstructing - or, at best, not informing - alternative drug policies. In an archaeological approach inspired by the work of Giorgio Agamben, the article unearths the case study of opium maintenance programme in Iran (1969-79), a forgotten policy experiment in an understudied and yet crucial geo-cultural environment for the global study of drugs. Mobilising the conceptual framework of ontological journeys, the article recomposes the lifeworld of opium within the horizons of transformative cultural practices, international borders, policy regimes and public ethics. Here, the materiality of drug consumption under the maintenance policy links with the changes in opium's transnational political economy and with shifting regimes of health and bioethical orthodoxy. Ontological journeys, hence, develop in a fluid space and time, making it possible to illuminate the lifeworld of drugs in places and times hitherto deserted by global policy studies. In building theoretical reflections upon a non-Western case, the article also incites the possibility of theory beyond Eurocentric knowledge and Euromerican cases. In this way, the article's purpose is to analyse the be-coming of opium beyond 'good' or 'evil', as a 'medicine' or a 'drug' and its real or perceived classification as 'licit' or 'illicit' across the Afghan-Iranian border. In conclusion, the article reflects upon the significance of this forgotten policy experiment, understood as an ontological journey, for contemporary drug policy and drug studies, but also for reinventing notions of care, welfare and health.
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Affiliation(s)
- Maziyar Ghiabi
- SOAS, University of London, Thornhaugh Street, London WC1H 0XG, UK; College of Social Sciences and International Studies, University of Exeter, UK.
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Duff C. A geology of drug morals. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2020; 88:103023. [PMID: 33202324 DOI: 10.1016/j.drugpo.2020.103023] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Accepted: 11/04/2020] [Indexed: 11/16/2022]
Affiliation(s)
- Cameron Duff
- Associate Professor, Centre for People, Organisation and Work, College of Business and Law, RMIT University, Melbourne, Victoria. 3000, Australia.
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Howarth D, Standring A, Huntly S. Contingent, contested and constructed: a poststructuralist response to Stevens' ontological politics of drug policy. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2020; 93:102965. [PMID: 33032870 DOI: 10.1016/j.drugpo.2020.102965] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Revised: 09/12/2020] [Accepted: 09/17/2020] [Indexed: 11/16/2022]
Affiliation(s)
| | - Adam Standring
- Environmental Sociology Section, Örebro University, Örebro, 702 81, Sweden.
| | - Scott Huntly
- Department of Politics, University of Suffolk, UK
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Lancaster K, Rhodes T. Towards an ontological politics of drug policy: Intervening through policy, evidence and method. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2020; 86:102932. [PMID: 32912826 DOI: 10.1016/j.drugpo.2020.102932] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2020] [Revised: 08/30/2020] [Accepted: 08/31/2020] [Indexed: 02/06/2023]
Abstract
Increasing attention has been paid to matters of ontology, and its accompanying politics, in the drug policy field. In this commentary, we consider what an 'ontological politics' might mean for how we think about what drug policy is and what it might become, as well as for how we think about (and do) research in drug policy. Thinking ontopolitically questions the tacitly accepted status of 'drug problems', calls into question the realist presumptions which underpin much drug policy analysis, and provokes thinking about what counts as 'evidence' and the 'evidence-based policy' paradigm itself. We call attention to the inventive possibilities of method when grappling with the challenges thrown forth by the ontological turn, with a renewed focus on practice and relations. An ontological politics disrupts consensual claims and draws critical attention to objects that might otherwise appear 'finished' or 'ready-made', not least the things we call 'drugs' and 'drug policy'. Working with 'drug policy multiples' invites new thinking and dialogue to provoke an ethico-political mode of intervention in the field of drug policy and drugs research.
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Affiliation(s)
| | - Tim Rhodes
- University of New South Wales, Sydney, Australia; London School of Hygiene and Tropical Medicine, UK
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Valentine K, Seear K. Commentary on Alex Stevens (2020) Critical realism and the 'ontological politics of drug policy'. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2020; 84:102879. [PMID: 32795879 DOI: 10.1016/j.drugpo.2020.102879] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Revised: 07/09/2020] [Accepted: 07/20/2020] [Indexed: 11/28/2022]
Affiliation(s)
- Kylie Valentine
- Social Policy Research Centre, Goodsell Building, UNSW Sydney, Kensington, NSW, 2052, Australia.
| | - Kate Seear
- Faculty of Law, Monash University, Clayton, Victoria, 3800, Australia; Australian Research Centre in Sex, Health and Society, La Trobe University
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Duff C. WITHDRAWN: A Geology of Drug Morals. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2020:102852. [PMID: 32709555 DOI: 10.1016/j.drugpo.2020.102852] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Revised: 07/02/2020] [Accepted: 07/06/2020] [Indexed: 01/28/2023]
Abstract
This article has been withdrawn at the request of the author(s) and/or editor. The Publisher apologizes for any inconvenience this may cause. The full Elsevier Policy on Article Withdrawal can be found at https://www.elsevier.com/about/our-business/policies/article-withdrawal.
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Affiliation(s)
- Cameron Duff
- Centre for Social Organisation and Work, RMIT University, Building 80, Level 9, 445 Swanston Street, Melbourne, Victoria 3000, Australia.
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