Journal of Qualitative Research in Health Sciences

Document Type : Original Article

Authors

1 Ph.D. Candidate in Nursing, Nursing Research Center, Kerman University of Medical Sciences, Kerman, Iran

2 2. Associate Professor, Department of Psychology Nursing ,Razi School of Nursing and Midwifery, Kerman University of Medical Sciences, Kerman, Iran

3 Assistant Professor, Department of Critical Care Nursing, Razi School of Nursing and Midwifery, Kerman University of Medical Sciences, Kerman, Iran

4 Associate Professor, Department of Medical Surgical Nursing, Razi Faculty of Nursing and Midwifery, Kerman University of Medical Sciences, Kerman, Iran

Abstract

Introduction: The 12-step Narcotics Anonymous (NA) program can provide support for the recovery of people with substance use disorder. This organization considers spirituality as the most important factor in fighting temptations and finding ways for long-term improvement through personal change and spiritual awakening. Thus, this study was conducted in southeast Iran to explore the lived experiences of the members of Narcotics Anonymous and to clarify what spiritual awakening means to them.
Methods: This is a hermeneutic phenomenological study inspired by Ricoeur’s philosophy and explained by Lindseth and Norberg. The participants were asked to narrate their experiences of spiritual awakening via in-depth semi-structured interviews. Interpretation of transcribed interviews was performed in three stages: naïve understanding, structural analysis, and comprehensive understanding.
Results: The present study showed spiritual awakening in the NA members can be considered as opening the doors of perception to a higher reality. This theme consists of seven subthemes, including (1) Being accepted and embraced by fellow pain sufferers through their very presence, (2) Being connected to a higher power and freedom from self-centeredness, (3) Self-reorganization and acceptance through self-reflective practice, (4) Taking responsibility by stopping making excuses and starting making changes, (5) Cultivating a culture of continuous care, (6) Connecting with the true self and spreading unconditional love, and (7) Living in the flow of life and learning from nature.
Conclusion: Following the principles of the 12-step program, the NA members managed to recover from addiction, fill their existential voids, and become loving people who have accepted guidance and have surrendered. Conducting qualitative studies and reflecting on the experiences of people who have recovered from addiction is a source of knowledge that can be a guide to implementing preventive measures and medical interventions for other addicts, the general public, and healthcare providers.

Keywords

  1.  

    1. Akhondzadeh S, Shabrang M, Rezaei O, Rezaei F. Personality patterns in narcotics anonymous members versus individuals with addiction receiving methadone maintenance therapy. Iran J Psychiatry. 2014; 9(3):158-62. PMID: 25561957.
    2. Lucchetti G, Granero Lucchetti A. Spirituality, religiosity and substance use: Evidence and proposed mechanisms. J Subst Abuse Alcohol 2(2): 1016.
    3. UNODC (United Nations Office on Drugs and Crime). Global overview of drug demand and supply latest trends, cross-cutting issues. United Nations: United Nations publication; 2018.
    4. Khan Ahmady F. 2 million and 808 thousand addicts in the country. Iran newspaper; 2017. Available from: magiran.com/n3582313. [In Persian].
    5. Galanter M, Dermatis H, Post S, Sampson C. Spirituality-based recovery from drug addiction in the twelve-step fellowship of narcotics anonymous. J Addict Med. 2013; 7(3):189-95. doi: 10.1097/ADM.0b013e31828a0265.
    6. Galanter M. Combining medically assisted treatment and Twelve-Step programming: A perspective and review. Am J Drug Alcohol Abuse. 2018; 44(2):151-9. doi: 10.1080/00952990.2017.1306747.
    7. Delucia C, Bergman BG, Beitra D, Howrey HL, Seibert S, Ellis AE, et al. Beyond abstinence: An examination of psychological well-being in members of narcotics anonymous. J Happiness Stud. 2015; 17(2):817-32. doi:10.1007/s10902-014-9609-1.
    8. Galanter M, White WL, Hunter BD. Cross-cultural applicability of the 12-step model: A comparison of narcotics anonymous in the USA and Iran. J Addict Med. 2019; 13(6):493-9. doi: 10.1097/ADM.0000000000000526.
    9. Snyder JK, Fessler DM. Narcotics anonymous: Anonymity, admiration, and prestige in an egalitarian community. Journal of the Society for Sychological Anthropology. 2014; 42(4):440-59. doi: 10.1111/etho.12063.
    10. Beygi A. Piritual development, socio-religious performance and quality of life in narcotic anonymous. Knowledge and Health. 2011; 6(2):6-12.
    11. Walton Moss B, Ray EM, Woodruff K. Relationship of spirituality or religion to recovery from substance abuse: A systematic review. J Addict Nurs. 2013; 24(4):217-26. doi: 10.1097/JAN.0000000000000001.
    12. Feigenbaum JC. A historical review of perceptions of key aspects of spirituality and religion within alcoholics anonymous. J Addict Nurs. 2013; 24(4):229-36. doi: 10.1097/JAN.0000000000000004.
    13. Allen JP, Nieuwsma J, Pollitt M, Blazer D. Recovery on higher ground: Spirituality in the treatment of substance abuse. Current Psychiatry. 2014;13(2):24-40.
    14. Brown AE, Tonigan JS, Pavlik VN, Kosten TR, Volk RJ. Spirituality and confidence to resist substance use among celebrate recovery participants. J Relig Health. 2013; 52(1):107-13. doi: 10.1007/s10943-011-9456-x.
    15. Lyovin A. A mixed-methods exploration of spiritual awakening and corresponding levels of executive functioning in participants of 12-step programs for methamphetamine recovery. California: Palo Alto; 2012.
    16. Strobbe S, Cranford JA, Wojnar M, Brower KJ. Spiritual awakening predicts improved drinking outcomes in a Polish treatment sample. J Addict Nurs. 2013; 24(4):209-16. doi: 10.1097/JAN.0000000000000002.
    17. Lyons GC. Spirituality, forgiveness and purpose in life in faith-based substance abuse treatment programs. Australia: University of Wollongong; 2012.
    18. Shamsalinia A, Norouzi K, Khoshknab MF, Farhoudian A. Recovery based on spirituality in substance abusers in Iran. Glob J Health Sci. 2014; 6(6):154-62. doi: 10.5539/gjhs.v6n6p154.
    19. Dermatis H, Galanter M. The role of twelve-step-related spirituality in addiction recovery. J Relig Health. 2016; 55(2):510-21. doi: 10.1007/s10943-015-0019-4.
    20. DeLucia C, Bergman BG, Formoso D, Weinberg LB. Recovery in Narcotics Anonymous from the perspectives of long-term members: A qualitative study. J Groups Addict Recover. 2015; 10(1):3-22. doi: 10.1080/1556035X.2014.969064.
    21. Berridge V. The rise, fall, and revival of recovery in drug policy. Lancet. 2012; 379(9810):22-3. doi: 10.1016/s0140-6736(12)60011-7.
    22. Flaherty MT, Kurtz E, White WL, Larson A. An interpretive phenomenological analysis of secular, spiritual, and religious pathways of long-term addiction recovery. Alcohol Treat Q. 2014; 32(4):337-56. doi:10.1080/07347324.2014.949098.
    23. Laudet AB, Humphreys K. Promoting recovery in an evolving policy context: What do we know and what do we need to know about recovery support services? J Subst Abuse Treat. 2013; 45(1):126-33. doi: 10.1016/j.jsat.2013.01.009.
    24. Izzard LM. The influence of narcotics anonymous on long term recovery, family relationships, and career development: A qualitative study. Sarasota: Argosy University; 2014.
    25. Rodriguez L, Smith JA. ‘Finding your own place’: An interpretative phenomenological analysis of young men’s experience of early recovery from addiction. Int J Ment Health Addiction. 2014; 12(4):477-90. doi: 10.1007/s11469-014-9479-0.
    26. Embree L, Behnke EA, Carr D, Evans JC, Huertas-Jourda J, Kockelmans JJ, et al. Encyclopedia of phenomenology. Netherlands: Springer Netherlands; 2013.
    27. De Chesnay M. Nursing research using phenomenology: Qualitative designs and methods in nursing. New York: Springer Publishing Company; 2014.
    28. Emami Sigaroodi AH, Dehghan Nayeri N, Rahnavard Z, Nori Saeed A. Qualitative research methodology: Phenomenology. J Holist Nurs Midwifery. 2012; 22(2):56-63.
    29. Van Manen M. Researching lived experience: Human science for an action sensitive pedagogy. London: Routledge; 2016.
    30. Polit DF, Beck CT. Nursing research: generating and assessing evidence for nursing practice. United States: Lippincott Williams & Wilkins; 2011.
    31. Foster J. Life without a centre: Awakening from the dream of separation. United Kingdom: Non-Duality Press; 2006.
    32. Ford D. The dark side of the light chasers: Reclaiming your power, creativity, brilliance, and dreams. New York: Riverhead Books; 2010.
    33. Chen G. Social support, spiritual program, and addiction recovery. Int J Offender Ther Comp Criminol. 2006; 50(3):306-23. doi: 10.1177/0306624X05279038.
    34. Shamsalinia A, Norouzi K, Khoshknab MF, Farhoudian A. Recovery based on spirituality in substance abusers in Iran. J Glob Health Sci. 2014; 6(6):154-62. doi: 10.5539/gjhs.v6n6p154.
    35. Green LL, Fullilove MT, Fullilove RE. Stories of spiritual awakening: The nature of spirituality in recovery. J Subst Abuse Treat. 1998; 15(4):325-31. doi: 10.1016/s0740-5472(97)00211-0.
    36. Zia Hashemi, Shaban M. T anonymous addictives association and the effectiveness of morality-based approaches in recovering addictives. Journal of Social Problems of Iran. 2017; 7(2):219-49. doi: 10.22059/ijsp.2016.63797.
    37. Best D, Beckwith M, Haslam C, Alexander Haslam S, Jetten J, Mawson E, et al. Overcoming alcohol and other drug addiction as a process of social identity transition: the social identity model of recovery (SIMOR). Addiction Research & Theory. 2016; 24(2):111-23. doi: 10.3109/16066359.2015.1075980.
    38. Razeghi N, Firozjaeian AA, Ghasemzadeh H. Social capital among the narcotics anonymous members and their continuation of quitting drugs (a case study of addicts participating in the na association of mazandaran province). Quarterly of Social Studies and Research in Iran. 2018; 6(4):571-93. doi: 10.22059/jisr.2018.215674.417.
    39. Dossett W. A daily reprieve contingent on the maintenance of our spiritual condition. Addiction. 2017; 112(6):942-3. doi: 10.1111/add.13731.
    40. White W, Galanter M, Humphreys K, Kelly J. The paucity of attention to narcotics anonymous in current public, professional, and policy responses to rising opioid addiction. Alcohol Treat Q. 2016; 34(4):437-62. doi: 10.1080/07347324.2016.1217712.