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Int J Drug Policy. 2016 Jan;27:89-96. doi: 10.1016/j.drugpo.2015.08.003. Epub 2015 Aug 19.

In their own words: Content analysis of pathways to recovery among individuals with the lived experience of homelessness and alcohol use disorders.

Author information

1
Department of Psychiatry and Behavioral Sciences, University of Washington - Harborview Medical Center, 325 Ninth Ave, Box 359911, Seattle, WA 98104, USA. Electronic address: collinss@uw.edu.
2
Department of Psychiatry and Behavioral Sciences, University of Washington - Harborview Medical Center, 325 Ninth Ave, Box 359911, Seattle, WA 98104, USA. Electronic address: cbj5@uw.edu.
3
Department of Psychiatry and Behavioral Sciences, University of Washington - Harborview Medical Center, 325 Ninth Ave, Box 359911, Seattle, WA 98104, USA. Electronic address: gaileh2@uw.edu.
4
Department of Health Services, University of Washington School of Public Health, 1100 Olive Way, Suite 1200, Seattle, WA 98101, USA. Electronic address: lonnin@uw.edu.
5
Department of Psychiatry and Behavioral Sciences, University of Washington - Harborview Medical Center, 325 Ninth Ave, Box 359911, Seattle, WA 98104, USA. Electronic address: hawess@uw.edu.
6
Department of Psychiatry and Behavioral Sciences, University of Washington - Harborview Medical Center, 325 Ninth Ave, Box 359911, Seattle, WA 98104, USA. Electronic address: graziv@uw.edu.
7
Department of Psychiatry and Behavioral Sciences, University of Washington - Harborview Medical Center, 325 Ninth Ave, Box 359911, Seattle, WA 98104, USA. Electronic address: jlmack11uw@gmail.com.
8
Department of Psychiatry and Behavioral Sciences, University of Washington - Harborview Medical Center, 325 Ninth Ave, Box 359911, Seattle, WA 98104, USA. Electronic address: jkholttum@gmail.com.
9
Department of Psychiatry and Behavioral Sciences, University of Washington - Harborview Medical Center, 325 Ninth Ave, Box 359911, Seattle, WA 98104, USA. Electronic address: gmkaese@uw.edu.
10
Department of Psychiatry and Behavioral Sciences, University of Washington - Harborview Medical Center, 325 Ninth Ave, Box 359911, Seattle, WA 98104, USA. Electronic address: jamesml@uw.edu.
11
Department of Psychiatry and Behavioral Sciences, University of Washington - Harborview Medical Center, 325 Ninth Ave, Box 359911, Seattle, WA 98104, USA. Electronic address: herndp@uw.edu.
12
Department of Psychiatry and Behavioral Sciences, University of Washington - Harborview Medical Center, 325 Ninth Ave, Box 359911, Seattle, WA 98104, USA. Electronic address: seemac@uw.edu.

Abstract

BACKGROUND:

Alcohol use disorders (AUDs) are more prevalent among homeless individuals than in the general population, and homeless individuals are disproportionately affected by alcohol-related morbidity and mortality. Unfortunately, abstinence-based approaches are neither desirable to nor highly effective for most members of this population. Recent research has indicated that homeless people aspire to clinically significant recovery goals beyond alcohol abstinence, including alcohol harm reduction and quality-of-life improvement. However, no research has documented this population's preferred pathways toward self-defined recovery. Considering principles of patient-centred care, a richer understanding of this population's desired pathways to recovery may help providers better engage and support them.

METHODS:

Participants (N=50) had lived experience of homelessness and AUDs and participated in semi-structured interviews regarding histories of homelessness, alcohol use, and abstinence-based treatment as well as suggestions for improving alcohol treatment. Conventional content analysis was used to ascertain participants' perceptions of abstinence-based treatment and mutual-help modalities, while it additionally revealed alternative pathways to recovery.

RESULTS:

Most participants reported involvement in abstinence-based modalities for reasons other than the goal of achieving long-term abstinence from alcohol (e.g., having shelter in winter months, "taking a break" from alcohol use, being among "like-minded people"). In contrast, most participants preferred alternative pathways to recovery, including fulfilling basic needs (e.g., obtaining housing), using harm reduction approaches (e.g., switching from higher to lower alcohol content beverages), engaging in meaningful activities (e.g., art, outings, spiritual/cultural activities), and making positive social connections.

CONCLUSIONS:

Most people with the lived experience of homelessness and AUDs we interviewed were uninterested in abstinence-based modalities as a means of attaining long-term alcohol abstinence. These individuals do, however, have creative ideas about alternative pathways to recovery that treatment providers may support to reduce alcohol-related harm and enhance quality of life.

KEYWORDS:

Alcohol use; Content analysis; Drinking; Homelessness; Pathways to recovery; Qualitative analysis

PMID:
26364078
PMCID:
PMC4715940
DOI:
10.1016/j.drugpo.2015.08.003
[Indexed for MEDLINE]
Free PMC Article

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