A Narrative Analysis on How Women Become Drug Addicts

Expended Abstract Introduction: Since the increase in the number of female drug addicts is one of the major social issues across the world, Iran has been no exception to this global trend. The present study aims at identifying the nature of the problem, defining and analyzing it, as well as describing women’s experience of addiction. Method: The present research is qualitative in type. Participants include 50 female drug addicts residing in the city of Esfahan, and have been selected through the targeted sampling method. Data were collected using the in-depth interview method. Conditions for participation included: being 15 years of age or older, informed consent for participating in the research, being addicted to drugs or being under drug rehabilitation treatment. The narrative analysis method has been used to analyze the data. Findings: Fifty women, all current or past drug abusers with an average age of 32±5, participated in the research. Forty-six participants had high school education or lower, and four had college or university education. Forty-three participants were jobless (housekeepers) and seven were employed in mainly unstable jobs without insurance or pension. Eighteen participants were single, 15 were divorced, two were widows, and 15 were married. The distribution of high-risk behavior among the participants suggest that prostitution (45 participants), cohabitation with the opposite sex (20 participants), alcohol use (nine participants), residence in hangouts (seven participants), and rough sleeping (five participants) have respectively been the most frequent high-risk behaviors among the participants. To better realize women’s narratives about addiction, their perspective about addiction history; lived experiences and the fundamentals of addiction in female users; the consequences of addiction, and the challenges and ups and downs of quitting drugs have been addressed. Women’s narratives in response to the first question of the study regarding lived experiences and the fundamentals of addiction can be categorized into four general classes of “relief and adventurism”, “personality”, “regular companions”, and “facilitators of drug use”. In their narratives, the subjects perceive drug use as comforting, and were emphasizing on their personal beliefs, self-adventure, and excitation-seeking qualities to justify their addiction. As a motive for their addiction, the subjects recounted factors, such as pleasure and relief, oblivion, despair after physical, emotional and sexual abuse, neglect during childhood and even adulthood, as well as curiosity and excitement. Excessive confidence, having a dependent personality, mother’s complex (or insufficient maturity to face the realities and problems of life), lack of logical thinking, and kindness-seeking are among the building components of the personality of the female drug users which have been derived from the narratives of the participants in the research. In their narratives about their addiction, the subjects have indicated and emphasized on the role of family and friends as people who have always been with them and have persuaded them to take drugs. Troubled childhood, parents’ inability, broken relations with family members, parents as a role model for drug use, patriarchy and acquaintance or friends have been among the factors pointing toward the role of regular companions in the process of women’s drug addiction. Mental and emotional issues, lack of knowledge and immaturity, unawareness about the consequences of drug use, inability to say no, meekness, life in contaminated environments, and the limitations imposed on women in the society have been among the concepts relating to the facilitators of drug use in the narratives of the subjects. Many women have indicated pre-existing factors such as bipolar disorder, anxiety, stress, and lack of confidence; and have voluntarily refused to take doctor’s prescribed medicines for mental and emotional disorders and have replaced them with drugs. The majority of participants were from uneducated, poor, and/or average backgrounds and have had the experience of early marriage; therefore, they have never had the opportunity for appropriate emotional growth. Most women were unaware about the progress of their addiction and have indicated this among the main influential factors for their addiction issues. A lack of knowledge about life skills, living in suburbs, and polluted environments were among the other factors recounted by the subjects. Husbands have been among the most influential people in women’s addiction. Most participants have recounted husband’s company and recreational use with the husband as inevitable motives for their addiction. Table 1. the main and sub-categories of participants’ narratives about the foundations of addiction in women main concepts    secondary concepts    primary codes relief and thrill ecstasy and oblivion ease of tensions curiousness and adventure    desirability    escaping from the undesirable facts of life, carelessness caused by drug abuse, relief     exultation and happiness after using drugs, forgetting problems after using drugs         relief from mental, physical, and sexual pressures; freedom from the feeling of isolation and guilt         family limitations, curiosity, the joy of new and forbidden experiences     feeling of weakness love and attachment desperation and inaction hatred and revenge seeking love    humiliation and revenge    self-conceit and being ignored, revenge, humiliation, vindication by using drugs     fondness, doubled joy from addiction and love, consumption with a male partner, emotional failure, betrayal         desperation, surrendering to difficulties, despair and stress         inappropriate care and feelings, pride and adamancy, cynicism, feeling of being deceived         looking for approval, expectation, lack of love     regular companions    family: a sand house     troubled childhood    poor self-respect and self-perception, troubled family background, lack of parental control, addiction of family members, divorce         parents’ lack of skills    poor upbringing skills, negligent parents, inconsiderate parents, parents’ weakness         troubled family relations    troubled families, poor inter-personal interaction within the family, lack of trust within the family, cheating, extramarital affairs         parents as role models    parents creating addiction, lifestyle with addiction, parents’ dependence on drugs         humility and overcoming masculine dominance    unprecedented love and attention from partner while using drugs, partaking and recreational use with partner, threatening with divorce     old friends    friendly companions    hanging out with drug-using friends, peer pressure facilitators of drug abuse loose hair lack of knowledge about the consequences of drug abuse a contaminated social environment overcoming limitations    mental health issues    stress, worry, lack of confidence, mental health issues, emotional disorders     an economically poor family, a culturally poor family, a socially poor family, an incomplete and insufficient emotional growth, early marriage, forced marriage, marriage to evade difficulties         lack of knowledge about addiction, misconception about self-control, medical use of drugs, unprescribed drug use, use of multiple drugs         living in suburbs, a contaminated social environment, ease of access to drugs in the neighborhood         marriage out of spite, drug abuse out of spite, feeling limited     Women’s narratives in response to the second question of the study, regarding the ramifications of drug addiction have fallen into the two general categories of “perceived inner feelings” and perceived outer feelings”. The perceived inner feelings include concepts, such as the role of the victim, isolation, vulnerability, prostitution, regret and despair. The perceived outer feelings also refer to concepts, such as the feeling of being blamed, lack of credibility and rejection. Women’s narratives show that the female addicts have, in many cases, fallen victim to the desires of men who have taken advantage of their need for drugs to abuse them. In addition, because of the physical and appearance-related issues resulting from excessive drug use, these women have mostly stayed at home and had no desire to go outside of their house. On the other hand, the lengthy rehabilitation process, the neglect about their mental and emotional issues during treatment as well as financial difficulties have made them tired and suppressed their motivation to continue and finish the treatment period. Female drug addicts have had to resort to prostitution and because of this, have experienced the stigma and pain of discredit, vulnerability, and loneliness. They express regret and feel guilty about their situation, feel sorry for the opportunities that they have lost in their lives, and wish to return to the past. Table 2. the main and sub-categories of participants’ narratives about the consequences of addictionmain concepts    secondary concepts    primary codes inner feelings    victim’s role    feeling victimised, being abused, feeling deceived, feeling discriminated against     isolation and reclusiveness    rejection, losing contact with the society, intolerance of the new situation, fatigue and abandonment, intolerance of rehabilitation conditions     prostitution    vulnerability, procuring drugs at any cost, lack of value, life in hangouts     regret and remorse    expressing guilt, regret and remorse, regret about the past     despair and hopelessness    feeling damaged, disappointed and uselessness outer feelings    feeling blamed    feeling shame and guilt from drug abuse     feeling valueless     losing face and credibility     feeling rejected    rejection, being branded, dishonour The women’s narratives in response to the last question of the research regarding the challenges and ups and downs of quitting drugs, point to the two factors of “the need for freedom” and the challenges of a change”. The need for freedom incorporates concepts such as being under threat, reaching a dead-end, tiredness, the urge to take drugs, building a better relationship with God, and the unreserved support of family. And the challenges of a change incorporate concepts, such as deprivation of a family, family members’ addiction, awareness about the existing support in the society, financial dependence and the ineffectiveness of rehabilitation camps. Table 3. the main and sub-categories of women’s narratives about the challenges and ups and downs of rehabilitation main concepts    secondary concepts    primary codes the need for freedom    being threatened    fear of change, fear of criticism, fear of quitting, fear of rejection, and more serious consequences of addiction     dead-end/the end    hitting the end of the line, feeling valueless, dissatisfaction with life     fatigue    social isolation, lack of self-confidence, inability to perform the most basic daily routines     being forced to use    fear of inability to procure drugs, fear of losing supply     reconciling with god    desperation and hope in a better being, the power of spirituality     family’s unreserved support    family’s support, family’s financial support, family’s emotional and mental support the challenges of change    lack of family support    lack of family support, non-acceptance by the family     addiction of family members    family’s hazardous conditions, unsuitable family environment     lack of knowledge about support services in the society    lack of knowledge about support centres, such as the Narcotics Anonymous, services from the welfare and health organisations, and women’s walk-in centres         financial dependence/women’s lack of authority    inability to afford, financial dependence     ineffectiveness of rehabilitation camps    limitations and shortcomings of the camp, unsuitable environment for the camp, inappropriate behaviours of the camp members, unsuitable atmosphere of the camps Discussion: the best and fastest method to prevent women from turning to addiction for a second time is to empower them. Providing educational services, professional courses, and the services required for finding employment in order to strengthen their skill set can surely be regarded as an effective strategy. Providing safe houses for homeless, addicted women who are rejected by their families is an important factor which needs consideration. Keywords: Addiction disorders, Drug abuse, Background, Addictive experience, Tendency addictive, Narrative analysis Ethical Considerations Funding This study was funded by the Islamic Republic of Iran’s Drug Control Headquarters. Authors’ contributions Both authors designed the research. Data collection was done by the first author. All authors contributed to the classification, analysis and critical review of the findings. Conflicts of interest The authors declare no competing Interests Acknowledgments The authors have adhered to all ethical considerations including informed consent and good behavior; and non-plagiarism, duplication, distortion, or fabrication of data in this article. The University of Kashan and the Islamic Republic of Iran’s Drug Control Headquarters have approved the research ethics-conformation of this study.