It came and went in the blink of an eye and what seemed like a brilliant future for Marxist Anthropology in the mid‐1970s now lies in a grave of dead‐ended approaches bearing the epitaph 'Political Economy'—the sign which for Marx summed up all that was critically in error in capitalist and capitalizing analysis, hence his sub‐title to Capital, "A Critique of Political Economy."
The study uses qualitative interviews conducted with 19 crack using women to explore their experiences of stress and their views regarding the relationship between stress and drug use. Fifteen of the women participated in follow-up interviews conducted 5–7 years after the baseline. Life history interviews unveiled a pattern of close connection between the intensity of women's drug use and the level of stress they experienced in relation to their past adversities and current life circumstances. The majority of the women viewed stress as an important causal explanation of their drug use. Tensions related to romantic relationships, traumatic childhood, motherhood failures, unabated grief, and humiliating experiences of "crack life" were discussed as the most common sources of psychosocial stress. Most women had very limited positive coping resources and skills. Crack use was perceived as a very common, although highly maladaptive, way to deal with stress. Implications for interventions are discussed.
This qualitative paper describes different pathways substance users experience as they decide whether to link to treatment or not after being assessed in a centralized intake unit in a Midwestern city. The narratives of 16 participants who did not link with treatment were compared with the narratives of 20 participants who did. Narratives from both groups described similar themes that were experienced differently. Nonlinkers were characterized by pretreatment abstinence, a negative experience with previous treatment, little previous engagement in a treatment career, and meaningful social support coming from AA. Linkers were more likely to continue using drugs before treatment entry, yet they described more readiness for treatment and were more engaged in a treatment career. The treatment careers approach provides a broader framework for understanding linkage versus nonlinkage to treatment.
Pharmaceutical opioid misuse has been recognized as a growing public health problem across the nation. To develop appropriate treatment and prevention programs, the population of pharmaceutical opioid abusers has to be well understood. This exploratory study is based on qualitative interviews with 24 people in the Dayton/Columbus, Ohio, area. Interviews were conducted for the Ohio Substance Abuse Monitoring Network, a statewide epidemiological surveillance system. Participants ranged in age from 18 to 48 years; the majority was White and male. To explain initiation and continued use of pharmaceutical opioids, participants discussed a number of different reasons, including self-medication of emotional and physical pain, legitimate medical prescriptions related to chronic pain management, social influences, recreation, and easy access to pharmaceutical opioids. On the basis of participant age and lifetime experiences with pharmaceutical opioid and other drug misuse, six user groups were identified that faced unique risks and prevention/treatment challenges. Research implications are discussed.
Many substance users report that they experience multiple barriers that produce significant challenges to linking with treatment services. Being on a waiting list is frequently mentioned as a barrier, leading some people to give up on treatment and to continue using, while prompting others to view sobriety during the waiting period as proof they do not need treatment. This ethnographic study examines the views that 52 substance users have of the waiting time before treatment and the strategies they created to overcome it. Understanding how substance users react to waiting time itself and in relation to other barriers can lead to services that are effective in encouraging treatment linkage.
The goal of the present study was to identify the dimensions present in items representing internal barriers to substance abuse treatment and to test their invariance across gender, ethnic, and age groups. Twenty items from the Barriers to Treatment Inventory (BTI) were used to assess the structure and nature of the internal treatment barriers of 518 clients presenting to a central intake unit for a substance abuse assessment. Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) revealed that a five factor model provided the best fit to the data. Internal treatment barriers were best described by five dimensions: absence of problem, negative social support, fear of treatment, privacy concerns, and committed lifestyle. Extending the confirmatory factor analysis to test multi-group invariance, there were some differences in measurement and structural relations among the internal barrier dimensions across gender, ethnic, and age groups. However, the lack of invariance was small and practically insubstantial. The findings led to the conclusion that the theoretical constructs measured by the five internal barrier dimensions are equivalent across important characteristics in this population.