Addiction treatment services usually prioritize the recovery of the user, despite the fact that problematic consumption often leads to distress among families that requires attention. The purpose of this study is to identify types of narratives constructed by relatives of people with substance dependence disorders regarding their condition and recovery process. Additionally, we seek to understand the conditions that facilitate or hinder the recovery process from the perspective of family members. Seven in-depth interviews were conducted with a narrative approach. Progressive, stable, and regressive narratives were identified, corresponding to various stages in the addiction and recovery processes. These narratives revealed different forms of distress, obstacles to treatment, and critical junctures with respect to attending care services. Families represent a valuable resource for user recovery, and therefore must be included in the treatment process.
1. Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, Instituto Nacional de Salud Pública, Comisión Nacional contra las Adicciones, Secretaría de Salud. Encuesta Nacional de Consumo de Drogas, Alcohol y Tabaco 2016-2017: Reporte de Alcohol [Internet]. México: INPRFM; 2017 [citado 26 ago 2019]. Disponible en: https://tinyurl.com/y9zzygv3
2. Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, Instituto Nacional de Salud Pública, Comisión Nacional contra las Adicciones, Secretaría de Salud. Encuesta Nacional de Consumo de Drogas, Alcohol y Tabaco 2016-2017: Reporte de Drogas [Internet]. México: INPRFM; 2017 [citado 26 ago 2019]. Disponible en: https://tinyurl.com/y7vbylru
3. Berenzon S, Medina-Mora ME, Lara MA. Servicios de salud mental: veinticinco años de investigación. Salud Mental. 2003;26(5):61-72.
4. Marín-Navarrete R, Medina-Mora ME, Tena-Suck A. Addiction care in Mexico: a challenge for non-specialized health professionals. Salud Mental. 2016;39(5):241-242.
5. Schwartzman J. Addict abstinence and the illusion of alternatives. Ethos. 1977;5(2):138-150.
6. Stanton MD, Todd TC, Heard DB, Kirschner S, Kleinman JI, Mowatt DT, Riley P, Scott SM, Van Deusen JM. Un modelo conceptual. En: Stanton MD, Todd TC. Terapia familiar del abuso y adicción a las drogas. Barcelona: Gedisa; 1985. p. 25-42.
7. Cirillo S, Berrini R, Cambiaso G, Mazza R. La familia del toxicodependiente. Barcelona: Paidós; 1999.
8. Selbekk AS, Sagvaag H, Fauske H. Addiction, families and treatment: a critical realist search for theories that can improve practice. Addiction Research & Theory. 2014;23(3): 196-204.
9. Orford J, Velleman R, Copello A, Templeton L, Ibanga A. The experiences of affected family members: a summary of two decades of qualitative research. Drugs: Education, Prevention and Policy. 2010;17(Suppl 1):44-62.
10. Orford J, Velleman R, Natera G, Templeton L, Copello A. Addiction in the family is a major but neglected contributor to the global burden of adult ill-health. Social Science & Medicine. 2013;78(2):70-77.
11. Natera G, Tiburcio M. Tailoring an intervention model to help indigenous families cope with excesive drinking in central Mexico. Salud Mental. 2007;30(6):32-42.
12. Madsen P, Marsden-Hughes H. Exploring the processes involved in long-term recovery from chronic alcohol addiction within an abstinence-based model: implications for practice. Counselling and Psychotherapy Research. 2013;13(3):201-209.
13. Wagner V, Bertrand K, Flores-Aranda J, Acier D, Brunelle N, Landry M, Brochu S. Initiation of addiction treatment and access to services: young adults’ accounts of their help-seeking experiences. Qualitative Health Research. 2016;27(11):1614-1627.
14. Wisely C. The logic of recovery and injection drug use. Journal of Substance Use. 2013;18(1):56-64.
15. Candil A. Acompañar a usuarios intensivos de drogas: el papel de las redes de proximidad en los tratamientos ambulatorios. Antípoda, Revista de Antropología y Arqueología. 2016;26:179-196.
16. Brown S, Tracy EM, Jun M, Park H, Min M. Personal network recovery enablers and relapse risks for women with substance dependence. Qualitative Health Research. 2015;25(3):371-385.
17. Edwards ME, Steinglass P. Family therapy treatment outcomes for alcoholism. Journal of Marital and Family Therapy. 1995;21(4):475-509.
18. Epstein EE, McCrady BS. Behavioral couples treatment of alcohol and drug use disorders: current status and innovations. Clinical Psychology Review. 1998;18(6):689-711.
19. Meads C, Ting S, Dretzke J, Bayliss S. A systematic review of the clinical and cost-effectiveness of psychological therapy involving family and friends in alcohol misuse or dependence. Birmingham: University of Birmingham, Department of Public Health and Epidemiology; 2007.
20. Copello A, Velleman R, Templeton L. Family interventions in the treatment of alcohol and drug problems. Drug and Alcohol Review. 2005;24(4):369-385.
21. Lucksted A, McFarlane W, Downing D, Dixon L. Recent developments in family psychoeducation as an evidence-based practice. Journal of Marital and Family Therapy. 2012;38(1):101-121.
22. Liddle HA, (ed.). Multidimensional family therapy for adolescent cannabis users, Cannabis Youth Treatment Series, Volume 5. Rockville: Center for Substance Abuse Treatment, Substance Abuse and Mental Health Service Administration; 2002.
23. Fernández C, González J, Barrera, G. Modelo de terapia familiar multidimensional con perspectiva de género. México: Centros de Integración Juvenil; 2006.
24. Orford J, Copello A, Velleman R, Templeton L. Family members affected by a close relative’s addiction: the stress-strain-coping-support model. Drugs: Education, Prevention and Policy. 2010;17(Suppl 1):S36-S43.
25. Natera G, Tiburcio M, Mora J, Orford J. Apoyando a familias que enfrentan problemas por el consumo de alcohol y drogas. México: INPRFM-Pax; 2009.
26. Natera G, Mora-Ríos J, Tiburcio M, Medina P. An international perspective: constructing intervention strategies for families in Mexico. Drugs: Education, Prevention and Policy. 2010;17(Suppl 1):S193-S202.
27. Nuño-Gutiérrez BL, Álvarez-Nemegyei J, González-Forteza C, Madrigal-de León E. La adicción ¿vicio o enfermedad? Imágenes y uso de servicios de salud en adolescentes usuarios y sus padres. Salud Mental. 2006;29(4):47-54.
28. Raikhel E, Garriot W. Addiction trajectories. London: Duke University Press; 2013.
29. Almanza AM. Narrativas acerca del VIH: la mirada del paciente y de su red social. Riga: Publicia; 2015.
30. Kleinman A. The illness narratives. Nueva York: Basic Books; 1988.
31. Hydén L. Illness and narrative. Sociology of Health & Illness. 1997;19(1):48-69.
32. Good B. Medicina, racionalidad y experiencia: Una perspectiva antropológica. Barcelona: Bellaterra; 2003.
33. Gergen K. Realidades y relaciones: Aproximaciones a la construcción social. Barcelona: Paidós; 1996.
34. Frank A. The wounded storyteller: Body, illness and ethics. Chicago: The University of Chicago Press; 1995.
35. García B. El modelo Minnesota: Un método de tratamiento para las adicciones. [Tesis de maestría]. Bilbao: Universidad de Deusto; 2011.
36. Gómez-San Luis AH, Almanza-Avendaño AM. Barriers to addiction prevention and treatment in communities with organized crime: the perspective of health providers. Salud Mental. 2018;41(2):73-80.
37. Lieblich A, Tuval R, Zilber T. Narrative research. Reading, analysis and interpretation. California: Sage; 1998.
38. Marín-Navarrete R, Eliosa-Hernández A, Lozano-Verduzco I, Fernández-De la Fuente C, Turnbull B, Tena-Suck A. Estudio sobre la experiencia de hombres atendidos en centros residenciales de ayuda mutua para la atención de las adicciones. Salud Mental. 2013;36(5):393-402.
39. Harkness D, Cotrell G. The social construction of co-dependency in the treatment of substance abuse. Journal of Substance Abuse Treatment. 1997;14(5):473-479.
40. Hänninen V, Koski-Jännes A. Narratives of recovery from addictive behaviours. Addiction. 1999;94(12):1837-1848.
41. Lozano-Verduzco I, Romero-Mendoza M, Marín-Navarrete R. Violence narratives of Mexican women treated in mutual-aid residential centers for addiction treatment. Substance Abuse Treatment, Prevention and Policy. 2016;11(1):39-49.
42. O´Grady C, Skinner W. Journey as destination: a recovery model for families affected by concurrent disorders. Qualitative Health Research. 2012;22(8):1047-1062.
43. Burke AC, Clapp JD. Ideology and social work practice in substance abuse settings. Social Work. 1997;42(6):552-562.
44. Klingemann J. Lay and professional concepts of alcohol dependence in the process of recovery from addiction among treated and non-treated individuals in Poland: a qualitative study. Addiction Research & Theory. 2011;19(3):266-275.
45. Kougiali Z, Fasulo A, Needs A, Van Laar D. Planting the seeds of change: directionality in the narrative construction of recovery from addiction. Psychology & Health. 2017;32(6):639-664.