A qualitative study investigating the association between social exclusion, stigma and long term problem drug use in a New Zealand town
Background: The aim of this study is to investigate the association between problematic drug use (PDU) and social exclusion and stigma in a deindustrialised New Zealand town (DNZT). The purpose of this research is to capture the perceptions; experiences and life course journey of individuals with long term problematic drug use (IPDUs) and contribute new knowledge and understanding of this lived experience. Method: A review of national and international literature related to the phenomena of social exclusion, stigmatisation and problematic drug use was conducted to theoretically inform the study. The small-scale study employed a qualitative approach that involved a non-probability sample that met the criteria for long-term problematic drug use. This allowed respondents to share their perceptions and experiences of social exclusion, stigma and PDU in their own words and by their own frames of reference. The researcher occupied a position of insider. Following transcription of the interviews a six stage thematic analysis was conducted on the data. Findings: The downward social and psychological trajectory of this respondent group began before the respondents encountered long-term unemployment and before the onset of problematic drug use, initiated at an early age by common experiences of trauma, exclusion and damaged home environments. For this cohort it appears problematic drug use may have become a coping mechanism or relief from the reverberating impact of stigma, exclusion and marginalisation. Conclusion: The cohort interviewed show significant experiences of stigma, trauma and a disrupted life journey. These experiences became considerably exacerbated by problematic drug use and it appears most of the respondents have internalised and embraced a permanent status as ‘addicts’ with limited expectation of change. Respondents spoke of being ‘parked’ on methadone in respect of their drug problem and excluded from employment. This research suggests there is a need to look beyond the presented problem of addiction and its apparent solution of methadone maintenance treatment (MMT) and explore a more holistic strength-based approach that addresses issues of inequality, social care and discrimination.