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ABSTRACT
Background: Research examining substance users' recovery has focused on individual-level outcomes while paying limited attention to the contexts within which individuals are embedded, and the social processes involved in recovery. Objectives: This paper examines factors underlying African American cocaine users' decisions to reduce or quit cocaine use and uses practice theory to understand how lifestyle changes and shifts in social networks facilitate access to the capital needed to change cocaine use patterns. Methods: The study, an in-depth analysis of substance-use life history interviews carried out from 2010 to 2012, included 51 currently not-in-treatment African American cocaine users in the Arkansas Mississippi Delta region. A blended inductive and deductive approach to data analysis was used to examine the socio-cultural and economic processes shaping cocaine use and recovery. Results: The majority of participants reported at least one lifetime attempt to reduce or quit cocaine use; motivations to reduce use or quit included desires to meet social role expectations, being tired of using, and incarceration. Abstinence-supporting networks, participation in conventional activities, and religious and spiritual practices afforded access to capital, facilitating cocaine use reduction and sobriety. Conclusions: Interventions designed to increase connection to and support from nondrug using family and friends with access to recovery capital (e.g., employment, faith community, and education) might be ideal methods to reduce substance use among minorities in low-income, resource-poor communities.
Declaration of interest
The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the article.
Funding
Research reported in this publication was supported by the National Institute on Drug Abuse of the National Institutes of Health under Award Number R01DA026837 to Dr. Tyrone Borders. At the time of the work Ann Cheney was a Scholar with the HIV/AIDS, Substance Abuse, and Trauma Training Program (HA-STTP), at the University of California, Los Angeles; supported through an award from the National Institute on Drug Abuse (R25 DA035692).
Additional information
Notes on contributors
Ann M. Cheney
Ann M. Cheney, Ph.D., is an assistant professor in the Department of Social Medicine and Population Health in the Center for Healthy Communities at the University of California, Riverside School of Medicine. She is a medical anthropologist and health services research with interests in mental health and substance use services. Her work focuses on trauma and substance use among women and minorities.
Brenda M. Booth
Brenda M. Booth, Ph.D., has served as Professor of Psychiatry in the DHSR at UAMS and core investigator in Health Services Research & Development at the Central Arkansas Veterans Healthcare System for over 25 years. Dr. Booth has been continuously funded by NIAAA and NIDA. She is a biostatistician and conducts mental health and substance abuse health services research and has published widely on issues of substance use among rural populations.
Tyrone F. Borders
Geoffrey M. Curran, Ph.D., is a core investigator at the Central Arkansas Veterans Healthcare System and a Professor of Pharmacy Practice and Psychiatry at the University of Arkansas for Medical Sciences. He is a medical sociologist with research foci in health services research and implementation science.
Geoffrey M. Curran
Tyrone F. Borders, Ph.D., is the Foundation for a Healthy Kentucky Endowed Chair in Rural Health Policy and Professor and Chair of the Department of Health Management and Policy at The University of Kentucky. His research focuses on the conduct of population-based studies to investigate rural/urban disparities in health and health services, including substance use and treatment.