Introduction and Aim. Further gains in the prevention of drug abuse disorders require in-depth and holistic understanding of the risk factors of addiction from different perspectives. Lay persons and experts have different concepts of risk which could complement each other. The purpose of this study was to elaborate drug abuse risk factors through the story of individuals who had become drug dependent. Design and Methods. In this qualitative research, 33 individuals attending treatment centres for drug abuse were interviewed about the story of their addiction in Kerman, Iran. Interview questions were around the story of the participants. Results. All participants were male and in the age range of 18–40 years. Narrative analysis identified five themes as the main risk factors: family factors, peer pressure, the effect of gateway drugs (especially waterpipe), individual characteristics, and the community factors. More emphasis was placed upon the role of family factors, peer influence, and gateway effect. Discussion and Conclusion. This study elicited information from drug dependent subjects regarding the risk factors of drug abuse. According to drug dependent individuals’ views, more attention should be devoted to family and peer influences by policy makers, in developing culture-based preventive strategies. 1. Introduction According to the UNODC report, approximately 5% of the world adult population have used illegal drugs at least once in 2010 and 0.6% of people are considered “problem drug users” [1]. Drug abuse will impact various aspects of one’s life including physical, mental, and social aspects. In addition to more than 200,000 deaths per annum due to heroin and cocaine abuse, drug abuse could lead to delinquency, early sexual activity, family disintegration, and increased risk of HIV [1, 2]. Although the rate of drug abuse is reported to be steady in some countries, it has shown an increasing trend in many developing societies [1]. Iran is facing an increasing number of drug abusers that have negative social and health impacts [3]. Over the past century, many theories have been proposed to describe the aetiology of drug abuse [2, 3]. These theories are categorised in 3 main subgroups of social, psychological, and biological subgroups [4]. Although multiple theories would help in better understanding of the aetiology of addiction, this multiplicity could convey the lack of consensus around aetiology of drug abuse [2] and, according to Spooner, scientific evidence in this area is inadequate [5]. The majority of studies in drug dependency have a
References
[1]
UNODC, World Drug Report, United Nations Office on Drugs and Crime, Vienna, Austria, 2012.
[2]
C. M. Kodjo and J. D. Klein, “Prevention and risk of adolescent substance abuse. The role of adolescents, families, and communities,” Pediatric Clinics of North America, vol. 49, no. 2, pp. 257–268, 2002.
[3]
N. Nakhaee and N. Jadidi, “Why do some teens turn to drugs a focus group study of drug users' experiences,” Journal of Addictions Nursing, vol. 20, no. 4, pp. 203–208, 2009.
[4]
E. Goode, “Theories of drug use,” in Drugs in American Society, chapter 3, McGraw Hill, Boston, Mass, USA, 7th edition, 2007.
[5]
C. Spooner, “Causes and correlates of adolescent drug abuse and implications for treatment,” Drug and Alcohol Review, vol. 18, no. 4, pp. 453–475, 1999.
[6]
M. Frisher, I. Crome, J. Macleod, R. Bloor, and M. Hickman, “Predictive factors for illicit drug use among young people: a literature review,” Home Office Online Report 05/07, 2007, http://dera.ioe.ac.uk/6903/1/rdsolr0507.pdf.
[7]
T. Rhodes, R. Lilly, C. Fernández et al., “Risk factors associated with drug use: the importance of 'risk environment',” Drugs: Education, Prevention and Policy, vol. 10, no. 4, pp. 303–329, 2003.
[8]
J. Neale, D. Allen, and L. Coombes, “Qualitative research methods within the addictions,” Addiction, vol. 100, no. 11, pp. 1584–1593, 2005.
[9]
D. J. Clandinin, “Narrative inquiry: a methodology for studying lived experience,” Research Studies in Music Education, vol. 27, no. 1, pp. 44–54, 2006.
[10]
B. Shabani Varaki, “Narrative inquiry in educational research,” Forum: Qualitative Social Research, vol. 8, no. 1, 2007, http://www.ibrarian.net/navon/paper/Narrative_Inquiry_in_Educational_Research.pdf?paperid=5648273.
[11]
L. H. Pellico and P. L. Chinn, “Narrative criticism: a systematic approach to the analysis of story,” Journal of Holistic Nursing, vol. 25, no. 1, pp. 58–65, 2007.
[12]
M. Murray, “A narrative approach to health psychology. Background and potential,” Journal of Health Psychology, vol. 2, no. 1, pp. 9–20, 1997.
[13]
A. Williamson, A.-M. Feyer, N. Stout, T. Driscoll, and H. Usher, “Use of narrative analysis for comparisons of the causes of fatal accidents in three countries: New Zealand, Australia, and the United States,” Injury Prevention, vol. 7, supplement I, pp. i15–i20, 2001.
[14]
P. Slovic, “Perception of risk,” Science, vol. 236, no. 4799, pp. 280–285, 1987.
[15]
J. Petraitis, B. R. Flay, and T. Q. Miller, “Reviewing theories of adolescent substance use: organizing pieces in the puzzle,” Psychological Bulletin, vol. 117, no. 1, pp. 67–86, 1995.
[16]
T. Kelly and L. Howie, “Working with stories in nursing research: procedures used in narrative analysis: feature article,” International Journal of Mental Health Nursing, vol. 16, no. 2, pp. 136–144, 2007.
[17]
R. Clayton, “Transitions in drug use: risk and protective factors,” in Vulnerability to Drug Abuse, M. D. Glanz and R. W. Pickens, Eds., pp. 15–52, American Psychological Association, Washington, DC, USA.
[18]
A. C. Sparkes, “Narrative analysis: exploring the whats and hows of personal stories,” in Qualitative Research in Health Care, I. Holloway, Ed., pp. 191–209, Open University Press, 2005.
[19]
C. K. Riessman, “Analysis of personal narratives,” in Handbook of Interviewing, J. F. Gubrium and J. A. Holstein, Eds., Sage, London, UK, 2001.
[20]
R. T. Brown, “Risk factors for substance abuse in adolescents,” Pediatric Clinics of North America, vol. 49, no. 2, pp. 247–255, 2002.
[21]
H. G. Levine, “Global drug prohibition: its uses and crises,” International Journal of Drug Policy, vol. 14, no. 2, pp. 145–153, 2003.
[22]
D. M. Morrison, S. Golder, T. E. Keller, and M. R. Gillmore, “The theory of reasoned action as a model of marijuana use: tests of implicit assumptions and applicability to high-risk young women,” Psychology of Addictive Behaviors, vol. 16, no. 3, pp. 212–224, 2002.
[23]
M. Enoch, “The role of early life stress as a predictor for alcohol and drug dependence,” Psychopharmacology, vol. 214, no. 1, pp. 17–31, 2011.
[24]
M. R. Naqavi, M. Mohammadi, V. Salari, and N. Nakhaee, “The relationship between childhood maltreatment and opiate dependency in adolescence and middle age,” Addiction and Health, vol. 3, pp. 92–96, 2011.
[25]
T. Korhonen, A. C. Huizink, D. M. Dick, L. Pulkkinen, R. J. Rose, and J. Kaprio, “Role of individual, peer and family factors in the use of cannabis and other illicit drugs: a longitudinal analysis among Finnish adolescent twins,” Drug and Alcohol Dependence, vol. 97, no. 1-2, pp. 33–43, 2008.
[26]
J. F. Scherrer, H. Xian, H. Pan et al., “Parent, sibling and peer influences on smoking initiation, regular smoking and nicotine dependence. Results from a genetically informative design,” Addictive Behaviors, vol. 37, no. 3, pp. 240–247, 2012.
[27]
D. B. Kandel, “On processes of peer influences in adolescent drug use: a development perspective,” Advances in Alcohol and Substance Abuse, vol. 4, no. 3-4, pp. 139–163, 1985.
[28]
R. D. B. Velleman, L. J. Templeton, and A. G. Copello, “The role of the family in preventing and intervening with substance use and misuse: a comprehensive review of family interventions, with a focus on young people,” Drug and Alcohol Review, vol. 24, no. 2, pp. 93–109, 2005.
[29]
A. R. Sabahy, K. Divsalar, S. Bahreinifar, M. Marzban, and N. Nakhaee, “Waterpipe tobacco use among Iranian university students: correlates and perceived reasons for use,” International Journal of Tuberculosis and Lung Disease, vol. 15, no. 6, pp. 844–847, 2011.
[30]
A. Markwood, “Comprehensive theory of drug abuse prevention,” http://www.jointcommission.org/assets/1/6/comprehensive_theory_bhc.pdf.
[31]
K. R. Merikangas and S. Avenevoli, “Implications of genetic epidemiology for the prevention of substance use disorders,” Addictive Behaviors, vol. 25, no. 6, pp. 807–820, 2000.
[32]
A. B. Brenner, J. A. Bauermeister, and M. A. Zimmerman, “Neighborhood variation in adolescent alcohol use: examination of socioecological and social disorganization theories,” Journal of Studies on Alcohol and Drugs, vol. 72, no. 4, pp. 651–659, 2011.
[33]
R. F. Catalano, R. Kosterman, J. D. Hawkins, M. D. Newcomb, and R. D. Abbott, “Modeling the etiology of adolescent substance use: a test of the social development model,” Journal of Drug Issues, vol. 26, no. 2, pp. 429–455, 1996.
