Lay and professional concepts of alcohol dependence in the process of recovery from addiction among treated and non-treated individuals in Poland: A qualitative study

Abstract

The study identifies and categorizes concepts of addiction among treated and non-treated former alcohol dependents, and their function in the process of recovery from addiction within the post-communist treatment system dominated by the Minnesota model. This qualitative study is based on a media recruited sample of 29 former alcohol dependents (ICD-10) in Warsaw/Poland 2006/2007. They reported a recovery time of at least 2 years (M_recovery= 11, SD = 9). In-depth interviews were analysed according to the Problem-Centred Interview method using Atlas.ti software. The applied triangulation procedures ensure reliability and validity of the data collected and the analysis of the narrative accounts. The results of the study show that professional concepts of addiction reconstructed on the basis of narratives from treated respondents resemble the disease model of addiction. A first category of lay concepts of self-changers adopt a medical–moral model of dependence including strong will as a key element of the successful recovery. A second category describes dependence as a symptom of maladaptive social functioning and recovery as a process of understanding one's role in society and fulfilling social expectations. While self-changers relied on one of these lay concepts, treated respondents were confronted with a conflict between lay and professional definition of dependence. It is argued that lack of recognition of lay concepts of addiction by treatment providers may weaken help-seeking and increase drop-out rates. The disease model implies the stability of the status of the alcoholic – which potentially weakens the individual's chance to reach the stage of stable recovery.

• Disease model of alcoholism, lay knowledge, self-change, Problem-Centred Interview

Acknowledgements

The study was financed by Polish Ministry of Science and Higher Education as a research grant ‘Ways of overcoming alcohol dependence’ (grant no. 1H02E03630). The author would like to thank Professor Antonina Ostrowska from the Institute of Philosophy and Sociology at the Polish Academy of Sciences, whose work in sociology of medicine was the inspiring framework to issues connected to alcohol dependence and recovery. The author is also very grateful to Harald Klingemann for critical comments to earlier versions of this article.

Declaration of interest: The author reports no conflicts of interest. The author alone is responsible for the content and writing of the article.

Notes

Notes

1. Calls to participate in the study read as follows: Can you win the battle with alcohol on your own? Yes you can! Many people who have had problems with alcohol have managed to cope with it by themselves – without professional help. Some have switched to complete abstinence, others drink only small amounts of alcohol. How did they manage? A workgroup headed by professor Antonina Ostrowska (Polish Academy of Sciences) is conducting a study of ways of quitting excessive drinking. We would like to learn about the experiences of people who have overcome their problems with alcohol. If you are such a person or are very familiar with such a history, get in touch with us. Simply call 0 22 458 25 39. This contact is completely anonymous and in no way obligates you to co-operate any further. By sharing your experience you will help others.

2. ‘A total institution may be defined as a place of residence and work where a large number of like-situated individuals, cut off from the wider society for an appreciable period of time, together lead an enclosed, formally administered round of life’ (Goffman, 1961, p. 13).

3. Symbols in parentheses: gender (M: male, F: female), age, type of recovery strategy (SC: self-changer, CR: consumer, AA: Alcoholic Anonymous believer, OP: outpatient, IP: inpatient), present alcohol consumption pattern (A: abstinence, M: moderation).