This blog post is in Slovakian*. For English version click here.
Vzťahy a drogy
Prečo je dôležité rozprávať sa o vzťach počas užívania drog
Poznámky a literatúra:
Culture shock is defined by Wikipedia as the “difficulty people have adjusting to a new culture that differs markedly from their own. A reverse culture shock a.k.a. “re-entry shock” or “own culture shock” is a state when returning to one’s home culture after growing accustomed to a new one produces the same effects.
Crossings changed me; how has the motel changed?
Edited March 4, 2020 by janklimas
… or women, men and non-binary folk who mentored me.
Career in addiction health services research can be daunting. There are moments when people in this career path struggle at work. Have you ever been in that situation yourself? Here’s my story.
Needle exchange movie at 16
The internet was still a toddler and I watched the TV rarely. But when I turned on the box on one of such occasions, a summer afternoon, I was brought into the streets of the Slovakian capital, Bratislava, which was a world far far away for me. Young social work students backpacked those streets with bags full with clean needles and distributed them to drug users and sex workers; they talked about what this exciting and controversial pastime meant for them. They worked for a needle exchange project – Odyseus – and I wanted to do it too. I was excited to help drug users in the same way these women did, but I had to wait a couple of years until I grew up.
At that time, they still called it ‘Street work’ which later became ‘Terrain Social Work’. In the following years, I learned from my future boss that the Slovakian public TV screened the film quite often, but mainly as a filler in the downtime hours.
Unanswered phone call at 20
After acceptance at the psychology degree, my world changed and the range of my interests expanded. Nevertheless, I never forgot about that documentary. It was in the second year when I saw a poster at our university board, at advertised Needle Exchange as a part time job for students. I picked up a public phone and dialled a number from the poster – following my teenage dream. Nobody picked it up, so I left a message which too remained unanswered, forever. The number on the advert wasn’t for the Needle Exchange which the documentary talked about, but I didn’t know it at that time. By chance, I ended up working for the agency from the documentary movie because they had an email address posted on the internet and were more responsive than the project which advertised on our student board.
Student project at 21
Part of my comprehensive exam in the 3rd year of my undergrad was a research project. As most of my friends, I struggled with access to patients. Because of that, almost everyone did a literature review – without having a clue what we were doing. I chose the role of family and drugs as my topic, but it wasn’t an easy choice. At that time, my interest in drugs was drifting away and I felt like researching something else, for example depression or disabilities. I don’t remember how I ended up with drugs again, but my review led to working with Dr Timulak, and eventually, to my MSc and PhD projects.
Dr Peter Halama, PhD and Hungarian trams at 25
Dr Halama, PhD was this new face at the Trnava University, when I wrapped up my comprehensive exam. They were good friends with Dr Timulak and when I asked him about ideas for my MSc research, he said that Dr Halama was doing some interviews with drug users. Two years later, I found myself co-presenting our findings with Peter at a psychotherapeutic conference in Slovakia. Read more about that research here. From there, it was easy to continue in my research with Peter at a doctoral level. I enrolled as a part time student in Social Psychology, which did not convince him that I would finish it. When I announced – after two years of studies – that I’m moving to Hungary for a year, I think Peter had a hard time suppressing his doubts that I would finish my PhD from Hungary. My Hungarian adventure was, however, a real turning point. I had to commute between offices and spent long hours in trams. Being too bored of watching cars and people pass by, I started to read open access articles which I downloaded from internet the previous day. Some were more interesting, others less, but when I found something really relevant to my work, I felt like a gold miner who just dug his jewel out of piles of dirt. My passion grew stronger with every new paper.
Irish job hunt at 28
When we arrived to Ireland in early Autumn 2008, all I had was a small EU grant with a budget of 3000 euros and an unclear host organization. We managed to survive for almost a year with a great help of my wife’s EVS stipend and occasional p/t jobs. The work on my PhD and the EU grant took most of my time, leaving only a couple of hours for finding a more stable position. When I eventually ran out of money, it was late winter and the job market had dried up. I submitted my resume to many advertisements, including a research job on men’s sexual health. I must say that research was not on my list of Top 5 jobs, but when this position came up after 8 hopeless months of job hunt it was a true God-send. The pictured ad initially offered a PhD post in drugs research, but at the interview, my current boss – Prof Walter Cullen – told me about a p/t place on the same project. That’s how I came to research drinking among methadone patients in primary care at UCD.
Dr Dennis McCarty, PhD at 31
OK, I know I said that there were 5 key decisions earlier, but there has been a lot going on recently. In July 2011, I have been to a summer school on drugs in Amsterdam, Netherlands – no one could imagine a better place for this adventure. Dr McCarty, lectured for several days on different policy models and evidence based treatments. Two years later, I’m sitting in an office down the hall from Dr McCarty’s office, writing my final report about the INVEST fellowship. Visit this post to read more about how I got here. I did not think that the summer school would lead to a fellowship in Portland, OR and I’m most grateful that it did.
Engage in not for profit organizations.
Two organizations jump started my work in non-profits, the University Pastoral Centre and a youth club. I learned the power of community building through youth activism with John Lesondak and taught team building for non-profits with Ivan Humenik. With Ivan and friends, we also had a musical band, JK& band. These activities inspired me to get involved in the community projects for people who use drugs.
Access mentors in voluntary service programs.
Petra a Ivan Sedliacik connected us to the world through the European Voluntary Service, which is a training program of the European Union. My youth exchange training took part in Budapest, Hungary, and a small suburban town called Goddollo with Zsuzsa Szabo. I was trained as European volunteer, improving soft skills and contributing to the common good. Petra and Ivan continued to support me throughout my training and shared their own experiences from living abroad and being European volunteers.
Be a life-long learner.
A Leonardo Da Vinci Scholarship, which was European Union’s Lifelong Learning Program, took me to Cork city on the south of Ireland. Geoff Dickson mentored me in the city’s YMCA. A few miles away, in Ballincolig, Ivan McMahon overlooked my evaluation of youth programs for early school leavers and single moms. It was great to see the practical application of science in Ireland while doing my part time doctoral degree. I got to evaluate training programs, develop program databases and identify best practice approaches for real life problems by searching the literature.
Write outside your comfort zone.
While writing scholarly articles is difficult itself, one can easily fall asleep their comfort zone. I stepped out of this zone in 2013 when I enrolled in a prompt-based creative writing workshop in Portland, OR, housed by the state’s largest bookstore, the Powell’s books on Burnside street (https://writearound.org/). This is when I began to take my writing interests seriously thanks to our volunteer instructor, Matt Blair. His workshop re-invigorated my passion for writing and taught me the value of daily writing practice.
Believe me, or not, trust is something that has been emphasized in addiction treatment for many years. One can hardly argue that it has become one of the usual suspects in the life stories of most recovering drug users.
This comes with no surprise – trust is key for building or restoring relationships of all people. No matter if they have drug problems, or not. In this way, my research confirmed what common sense tells us without any special knowledge of research. Re-prioritisation of relationships during treatment was facilitated by the experience of help, support and restoration of trust in relationships.
Saying that they are not bothered with relationships or that they’ve no interest in them is too simplistic, and as suggested by this research, not true. Other research showed that people with drug problems do engage in social relationships, pro-social activities, social relationships, raising children – they just don’t do it in a way that ‘we’ are willing to accept. The question that remains to be answered by future research is what would happen if the barriers of engaging in culturally-acceptable social activities were removed? Would ‘they’ be more like ‘us’? The first signals supporting this question come from the opioid agonist treatment. People maintained on pharmaceutical opioids, substituting their illicit drug use, lead more stable lives, commit less crime and have better chances of being employed than people without these substitutes.
Background: interpersonal problems among drug users (DU) are frequent, are related to other problems, and improve during the addiction treatment.
Aims: to better understand changes in relationships which occur in the course of drug use and drug treatment, as well as their subjective appraisal by ex-drug users, using retrospective methodology.
Method: semi-structured interviews with DUs in a therapeutic community (TC) were analysed with descriptive-interpretive method. The coding of interview transcripts into categories was performed in two phases using qualitative software NVivo 7. Five interviews were coded in the pilot phase, followed by an audit by an external psychologist and progressive coding of the rest of the transcripts, with data saturation being reached in the second phase.
Participants: nine male and one female client, aged 18-36 years (mean: 25.9), participated in the study and the length of their stay in the TC was 2-35 months (mean: 9.9). The approximate mean age of drug use onset was 15.6 years (12-28).
Results: the analysis provided 21 categories which were divided into three domains based on chronological order. Changes in relationship priority during active drug use occurred on the basis of barriers (such as the need to obtain drugs and stigma), which restrained active DUs from engaging in and maintaining their social relationships. Re-prioritisation of relationships during treatment was facilitated by the experience of help, support and the restoration of trust in relationships.
Conclusions: this study builds on the previous work exploring the broad issue of social consequences of drug use and offers clients’ perspective on this topic.
Cite as: Klimas, J. (2012) Interpersonal relationships during drug use and treatment from the perspective of clients in a therapeutic community. [Interpersonálne vzťahy v priebehu užívania drog a liečby závislosti z pohľadu klientov/iek v terapeutickej komunite.]. Adiktologie (12)1, 36-45
More at: www.adiktologie.cz
|Figure 1. Evolution of relationships during drug use, addiction and treatment|