“Itʼs time for a change. I need to. I have to”: Substance misuse recovery turning points of unhoused Alaskans

Abstract

Substance misuse is a pernicious health concern for many unhoused people. A deep understanding of turning points – what propels someone to take concrete action toward addressing substance misuse – is needed to inform recovery policies and practices. This study sought to identify common elements in turning points among unhoused people vis-à-vis a phenomenological qualitative approach. Twenty people (Mage = 47.47, SD = 9.75; 50% female) who self-identified as being in recovery while unhoused participated in semi-structured interviews in Anchorage, Alaska, a community with high rates of both houselessness and substance misuse. Survival (life- and health-sustaining), individual (intrapersonal), and relational (interpersonal) motivations all shaped turning points. Limitations include the possible underrepresentation of individuals using a harm-reduction approach or capturing differences by housing type. Programs to address substance misuse should consider these motivations. Future research should identify and refine turning points and work to understand how they interact with change processes.

Keywords:

• Homelessness
• houselessness
• motivation
• qualitative
• recovery
• substance misuse
• turning points

Acknowledgement

We thank the members of the Community Advisory Board for graciously sharing their expertise and guidance. Special thanks to each research team member for their dedication and excellence in this work. This work was possible due to the financial support of the Northwest Native American Research Center, Society for Community Research and Action, and Alaska Native Community Advancement in Psychology. Most importantly, we thank each participant for so generously sharing their story.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Notes

1 Age data from one participant is missing, as the interview was shortened due to signs of fatigue and he was unavailable for follow-up.

2 This and all other names are pseudonyms chosen by the participants.

Additional information

Funding

This research was supported through the Northwest Native American Research Center, the Society for Research and Action in the Community, and Alaska Native Community Advancement in Psychology.