Exploring psycho-social determinants of natural recovery process in substance dependency

Abstract

There is a growing recognition that natural recovery or self propelled change without professional support is an important pathway to recovery from drug addiction. Natural recovery in substance dependence is largely an unexplored domain. Only handful of studies has been conducted in this challenging area. Still many questions regarding its underlying process, contributing factors, and interrelations among these factors need to be explored. The present study was aimed to understand the core process of natural recovery in substance dependence with the major goal to contribute in designing and developing community based interventions to foster natural recovery. There is severe lack of knowledge on this significant issue worldwide especially in our country. In this context, grounded theory approach of qualitative research design was suitable to be used to explore the contributing psychosocial factors associated with natural recovery and to investigate the interrelations among those factors. In depth interviews were conducted with nine naturally recovered individuals who never sought formal treatment for their addictive behaviors. Average drug using and abstinent period of those adult respondents were 12 and 7 years respectively. Snowball sampling technique was used to find out these hard-to-reach populations. Verbatim transcripts from the recorded interviews were the main source of data for this study. The whole data collection process was guided by theoretical sampling. Using NVivo-8, data analysis was completed through open, axial, and selective coding which revealed three broad sections namely encouraging factors to natural recovery, strategies in natural recovery course and prolonging factors for sustenance of natural recovery, incorporating 20 emerged themes associated with natural recovery process. Nine factors were found to be causally linked where rest of the factors were revealed as associated with each other. To find out the exclusive factors for natural recovery, present findings were compared with the factors associated with treated recovery as suggested by the experts working in the drug field. Through this process five factors appeared to be the core contributors for natural recovery such as inaccessibility to formal treatment, high self respect, adaptive cognitive structures (normalization, non-stigmatized attitude towards self, internal attribution, and high self esteem), gradual goal approximation, and supplementary drug use. The present study does not suggest any notion against professional treatment; rather it simply promotes the idea that it is possible to overpower drugs without formal treatment through the significant route of natural recovery. Apart from gaining knowledge about the process, this study will also break the silence regarding natural recovery of drug addiction in our country as this is the first study in Bangladesh. The findings may facilitate the enhancement of current treatment practices through evaluation of the existing interventions and treatment programs for drug addiction. The present study may be a milestone of future works on natural recovery in Bangladesh that may be helpful for people to overcome their drug problems who does not have access to formal treatment.