初探女性藥癮者之復元歷程─以中途之家至復歸社會者為例

Abstract

物質成癮是一個複雜的疾病總稱，其中「藥癮」更對各國社會治安、政策走向帶來極大難題。新興毒品的快速崛起帶來一種不同的濫用趨勢，加劇各國政府在防毒、緝毒上的困難，亦導致民間普遍對於公部門的防毒策略產生不信任。據此聯合國毒品犯罪部門建議在毒品處遇策略上應以穩定復歸社會為目標，並促進個體在健康、家庭、社區、工作等面向上功能及關係的蛻變。顯然過往以「醫療」為主體的服務典範已無法回應成癮者、其家庭、社區等各層面之多元需求與問題，因此「復元」的觀點便是在這樣的氛圍中逐漸受到重視，是強調各發揮其內、外在的資源與優勢來面對毒品及生活上的種種問題已促使個人的全人成長。此外，隨著「性別」意識的抬頭，「性別」亦成為政策與學術上的重要議題，檢視我國當前之毒品防制之討論仍以男性為主軸，對女性之相關政策、處遇策略與執行成效評估上鮮少加入性別議題的分析。因此本研究期望藉由女性藥癮者之主觀論述，以期達到以下之目的： 一、 梳理女性藥癮者由中途之家至復歸社會歷程的經驗與詮釋。 二、 探討女性藥癮者之復元面向，並分析相關影響因素。 三、 探究中途之家對女性藥癮者之意義。 四、 提供女性藥癮者相關政策、處遇之建議。 本研究設計上採質性研究方法，以深度訪談的方式，輔以訪談大綱與基本資訊問卷收集資料，並於2018年12月至2019年5月間藉由更生保護會宜蘭分會、花蓮主愛之家推薦合適之對象，最後共邀請5位符合資格者參與本研究，探討女性藥癮者復元歷程中的整體樣貌。 本研究有三個主要發現，首先復元是始於關鍵情境的觸發，是研究參與者經歷各種挫敗或評估後而有的相關行動與動機；再者女性藥癮者由中途之家至復歸社會之歷程中，所展現之復元面向來自四個層面，分別為：（1）個人層面：內在力量、外在功能；（2）人際關係：人際網絡、家庭關係、互動技巧；（3）社會參與：社會連結與融入、公民角色；（4）生活品質：生活意義、自我充實、自我現；最後，復元歷程中的影響因子則可分為（1）個人因素；（2）人際互動因素；（3）系統因素，各類別亦有其影響途徑，為研究參與者帶來不同的助力與阻力。 本研究結論為（1）復元是個人持續的、非線性的動態發展歷程；（2）由中途之家至復歸社會之歷程中，依序呈現調適期、個人功能重建期、社會功能重建期、過渡期、功能再造期；（3）中途之家之於女性藥癮者的復元歷程扮演多元的角色，是家、是社會的縮影、是銜接社會的橋樑亦是復元的催化劑。並依此研究結論提出對公部門、實務工作與未來研究之建議。

Substance addiction is a general term for a complex disease, among which 'drug addiction' has brought great problems to the social security and policy trends of various countries. The rapid rise of emerging drugs has brought about a different trend of abuse, aggravating the difficulties of governments in anti-drug and anti-drugs, and has also led to widespread distrust of the public sector's anti-drug strategies among the people. Based on this, the UNODC recommends that drug treating strategies should aim at stabilizing the return to society, and promote the transformation of individual functions and relationships in health, family, community, and work. Obviously, the past service model with 'medical' has been unable to respond to the diverse needs and problems of addicts, their families, and communities. Therefore, the view of 'recovery' is gradually being emphasized in such an atmosphere. Each exerting its internal and external resources and advantages to face the various problems of drugs and life has promoted the whole person growth of the individual. In addition, with the rise of 'gender' awareness, 'gender' has also become an important policy and academic issue. Reviewing the current discussion of drug control in Taiwan is still focused on men, and related policies, treatment strategies and implementation of women Analysis of gender issues is rarely included in effectiveness evaluation. Therefore, this study hopes to achieve the following goals through the subjective discussion of female drug addicts: 1. Review the experience and interpretation of the process of female drug addicts from halfway house to community return. 2. Discuss the recovery aspect of female drug addicts and analyze related influencing factors. 3. Explore the significance of the Halfway House for female drug addicts. 4. Provide advices on policies and treatment of female drug addicts. The design of this study adopts qualitative research methods, in-depth interviews, supplemented by interview outlines and basic information questionnaires to collect data, and from December 2018 to May 2019 through the Yilan Affter-Care Association and the Hualien Agape House recommends suitable objects, and finally invites 5 qualified persons to participate in this study to explore the overall appearance of female drug addicts in their recovery process. There are three main findings in this study. First, recovery begins with the triggering of key situations, which are related actions and motivations that the Research participants experience after various frustrations or evaluations; second, the journey of female drug addicts from a halfway house to a return to community In this chapter, the recovery aspects shown in this chapter come from four levels, namely: (1) personal level: inner strength, outer function; (2) interpersonal relationship: interpersonal network, family relationship, interactive skills; (3) social participation: society Connection and integration, civic role; (4) quality of life: meaning of life, self-fulfillment, self-reality; finally, the influencing factors in the recovery process can be divided into (1) personal factors; (2) interpersonal interaction factors; (3) System factors, each category also has its own way of influence, which brings different help and resistance to research participants. The conclusions of this study are (1) Recovery is a continued, non-linear and dynamic development process for individuals; (2) From a halfway house to reintegration into the community, the adjustment period, personal function reconstruction period, social function reconstruction period, Transition period and functional reconstruction period; (3) The recovery process of the halfway house for female drug addicts plays multiple roles. It is a home, a microcosm of society, a bridge connecting society and a catalyst for recovery. And based on this research conclusion, put forward suggestions for public sector, practical work and future research.