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“I know if I drink I won’t feel anything”: substance use relapse among depressed women leaving prison

2013; Emerald Publishing Limited; Volume: 9; Issue: 4 Linguagem: Inglês

10.1108/ijph-02-2013-0009

1744-9219

Jennifer E. Johnson, Yael Chatav Schonbrun, Jessica E. Nargiso, Caroline Kuo, Ruth Shefner, Collette A. Williams, Caron Zlotnick,

Substance Abuse Treatment and Outcomes

Purpose – The purpose of this paper is to explore treatment needs and factors contributing to engagement in substance use and sobriety among women with co-occurring substance use and major depressive disorders (MDDs) as they return to the community from prison. Design/methodology/approach – The paper used qualitative methods to evaluate the perspectives of 15 women with co-occurring substance use and MDDs on the circumstances surrounding their relapse and recovery episodes following release from a US prison. Women were recruited in prison; qualitative data were collected using semi-structured interviews conducted after prison release and were analyzed using grounded theory analysis. Survey data from 39 participants supplemented qualitative findings. Findings – Results indicated that relationship, emotion, and mental health factors influenced women's first post-prison substance use. Women attributed episodes of recovery to sober and social support, treatment, and building on recovery work done in prison. However, they described a need for comprehensive pre-release planning and post-release treatment that would address mental health, family, and housing/employment and more actively assist them in overcoming barriers to care. Practical implications – In-prison and aftercare treatment should help depressed, substance using women prisoners reduce or manage negative affect, improve relationships, and obtain active and comprehensive transitional support. Originality/value – Women with co-occurring mental health and substance use disorders are a high-risk population for negative post-release outcomes, but limited information exists regarding the processes by which they relapse or retain recovery after release from prison. Findings inform treatment and aftercare development efforts.