Traditional and Other Drug Use(r) Intervention: Necessary Critical Parameters

Abstract

The presentation consisted of a number of pages listing major area topic headings and subheadings, some of which were further delineated. Its purpose was to serve as a framework and a guide for the exhibit's planning in order to help the visitor to actively consider:

• The complexity and multi-dimensionality of substance use and its interventions, past, present and future (both more immediate and more distant) in terms of areas, processes, models, stakeholders, and unresolved critical issues.

• That the traditional view that considering and understanding (a) types of drugs and their actions, (b) types of users and their focused-on characteristics and behaviors (and not their actual as well as potential strengths and limitations), and (c) some of the semantics of the field are sufficient for effective intervention, has resulted and will continue to result in built-in failures and unnecessary frustrations for a range of individuals (substance users and non-users) and systems.

• The dimensions of what is being focused on, their “demands,” and the critical necessary conditions (endogenous and exogenous) for a posited concept, process, model, policy, etc., to operate (begin, continue, become integrated and anchored, change as realities change, etc.) or not to operate.

• What interests and whose interests have been served and which need to be served with and through substance use(r) intervention and/or non-intervention; who and what are the facilitators-promoters; barriers-preventers, as well as irrelevant foci that can and do use up limited intervention resources (human and non-human resources).

Participants were invited to critically analyze the “list”; to delete, change, and add.

Keywords:

• chronic relapse ritual
• complexity
• critical intervention parameters
• interests
• multi-dimensionality
• relapse
• stakeholders

Notes

Notes

1. The reader is asked to consider the possible paradox of the posited dimensions of temporality for pathologizing a substance use disorder person by a profession that has institutionalized its inflexible hours of treatment, by and large, based on ideologies and “principles of faith” and not on the needs of the planned change process or the person in need (Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) American Psychiatric Association, 1994). If time is essentially existence, as Heidegger has posited, then “relapse” can be an opportunity for … and not a stigma to be used against those who may be doing the best that they can at that time and place in their lives.

2. “The Poets Obligation,” Pablo Neruda, in Fully Empowered, Farrar, Strauss and Giroux, 1975.

3. Can traditional “normed” services, particularly publicly funded ones, which traditionally have been permitted to deprive a relatively powerless, stereotyped, stigmatized, and feared, often minority, “homogenized” but evidence-based heterogeneous population, from entitled health care and opportunities for well-being, for a variety of maleficent reasons, continue to do so?

4. Reactions, responses, and interventions to “drugs”—however defined by stakeholders in the United States and elsewhere since the nineteenth century—have progressed-regressed from moralization to criminalization to the more modern, “liberal” medicalization; from sinners to criminals and now to less than bonafide drug use disorder “sickees” … who continue to sin and commit crimes in order to support their “addictions” and states of clinical dependency.