Explanations & Expectations: Drug Narratives among Young Marijuana Users In Treatment

This article analyses how young people enrolled in drug addiction treatment in Copenhagen, Denmark, explain their cannabis careers and how they view their possibilities for quitting drug use again. Inspired by Mead and narrative studies of health and illness, the article identifies four different drug use ‘aetiologies’ drawn upon by the interviewees. These cover childhood experiences, self-medication, the influence of friends and cannabis use as a specific lifestyle.

A central argument of the article is that these explanations not only concern the past but also point towards the future by assigning the interviewee a more or less agential position in relation to drugs. 

Further, the drug narratives are viewed as interactional achievements, related to the social context in which they were produced, namely, the institutional setting of the treatment centres. 

The article is based on 30 qualitative interviews with young people in drug addiction treatment.

...Participants’ expectations regarding the future were also related to their drug use patterns at the time of the interview, but in complex ways. For instance, some of the interviewees who said they could easily stop described an intense current use, sometimes with severe consequences for their quality of life, which made it difficult for them to explain why they continued. Also, some of the interviewees who said they were unable to stop using cannabis reported that they had not smoked it for months. There was a pattern though, tying explanations of drug use development to participants’ present smoking practice. By and large, current cannabis use was more common among interviewees drawing on the self-medication and lifestyle explanations than in the two other narrative categories. While for the former category this was because of a perceived medical ‘need’ for the drug, for the latter it was presented as a personal preference for continued smoking.

The interviewees’ explanations were not produced in a social vacuum; rather they should be seen in relation to specific contexts. First, the interview setting in itself may have influenced the drug use aetiologies depicted in the accounts. An interview is, as we stated earlier, a specific type of interaction (an ‘elicited context’, cf. Hydén ¹⁹⁹⁷: 62) where the interviewee is supposed to produce a coherent narrative. The interactional dynamic of an interview may contribute to the development of ‘dominant’ explanations. Interviewers typically respond to the statements of interviewees by accepting them, showing empathy and understanding, asking the interviewees to elaborate on certain themes (and not others), etc. – and all this may be conductive to the creation of specific causal patterns in the interviewees’ accounts. In this sense, the interviews in themselves may have contributed to the shaping, and sharpening, of certain explanations at the expense of others, explanations that we later identified as ‘dominant’.

Second, the interviewees’ explanations may be related to the treatment contexts in which the interviewees were enrolled. As mentioned in the methods section, participants were recruited from three small treatment centres (Centre A: 14 interviewees; Centre B: 12 interviewees and Centre C: four interviewees). These three centres have a lot in common: they are out-patient units working with a combination of therapeutic approaches (systems therapy, cognitive therapy and narrative therapy) and they have young people under 25 as their primary target group. But there are also differences. Centre A is more oriented towards psychiatry and more focused on using tests (ADHD-tests, intelligence tests, addiction severity tests) than the two other centres. Centre B is more narratively oriented, and at least some of the staff members are sceptical towards tests. This centre is explicitly concerned with not defining their clients as drug abusers and with reducing the stigma often associated with illicit drug use. Cannabis smoking in itself is not necessarily a problem, according to this centre, and ‘controlled’ use is just as good a treatment goal as abstinence. Centre B is also preoccupied with ‘unravelling’ the clients’ family backgrounds. Drug use is often seen as an indication that something is wrong in the families, not with the young drug user…

Full article at:   http://goo.gl/xysJuE

By:  Margaretha Järvinen¹ and Signe Ravn²

¹Department of Sociology, University of Copenhagen and SFI – The Danish National Centre for Social Research, Copenhagen, Denmark

²SFI – The Danish National Centre for Social Research, Copenhagen, Denmark

Address for correspondence: Margaretha Jarvinen, University of Copenhagen - Department of Sociology, Øster Farimagsgade 5, Copenhagen K 1014 K, Denmark. E-mail: kd.uk.cos@jma

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