少年時期藥物濫用者的復元之路：改變如何開始與持續？

Abstract

藥物濫用的問題長久以來存在於我們的社會中，且隨著快速攀升的少年藥物使用人數，犯罪、教育、社會等問題接踵而至，少年藥物濫用問題已是我們不得不積極面對的現況。儘管過去研究有不少討論，但仍多聚焦於藥物使用與預防，而少有對於復元的探討。本研究試圖透過另一個角度看待少年藥物濫用議題，以藥物濫用復元者自身的經驗，了解曾經的毒品使用者一路走來所經歷的轉變與轉折。本研究採質性研究取向，深度訪談5位曾於少年時期長期使用非法藥物、現已復元者，探討他們的藥物使用經驗、決定改變的原因，以及持續復元的歷程。 研究發現引發受訪者改變藥物濫用行為的動機在於遭遇到重大生命事件，也就是轉捩點，例如車禍、入獄等。而改變歷程有5個共同階段，包括：轉捩點、身癮戒除（過渡期）、下定決心、心理與社會復元，以及穩定期。除了自身的努力外，宗教、家人、學校或工作則是復元歷程重要的助力。阻礙持續復元的風險則可分為前期與後期，前期主要是脫離原有環境的孤獨與茫然感受，以及對他人眼光的擔憂，隨著生活逐漸穩定，復元中後期的阻礙則是生活中的挫折及壓力事件。除了此之外，本研究也看到了幾個復元特性：一、改變動機可能早在藥物濫用前期產生；二、環境與整個少年藥物濫用與復元歷程息息相關；三、年輕與復元經驗作為一種復元資本。另外，也針對少年時期藥物濫用問題的性別差異有所討論。 依照本研究結果，建議助人工作者以朋友的角色與藥物濫用少年建立關係，並透過多方合作，建立能夠留住少年的環境。對於政策層面則提出三點建議：一、將資源投入協助家庭等非正式支持系統；二、建構能留住孩子的校園與社區，落實專業輔導工作；三、務實地建構藥物濫用安全網，進行服務體系的整合與串聯。

In the past few years, the number of adolescent drug abusers has increased sharply and became a serious problem in our society. Although there are many researches and exploration, most of them focus on drug use and prevention rather than recovery. To better understand the process of recovery, this study examined the experience of using drug, the motivation of behavior change and the facilitators and barriers to drug abstinence from the perspective of former adolescent drug abusers.

The study employed qualitative research design and conducted in-depth interview with 5 individuals who has a history of drugs use during adolescence and has recovered with a new lifestyle for 6 or more months. According to participants, the motivation of change were crucial events, such as prison and traffic accident, which defined as turning point in the study. There are 5 stages in recovery process: turning point, abstinence of physical addition (the transitional period), determination, psychological and social recovery, and maintained sustained abstinence. The study also examined the facilitators and barriers during the recovery process. Besides self-efforts, the facilitators during recovery process are religion, family and friends, school attendance or employment. While participants might encounter different barriers during their process of recovery. In the early stage of recovery, the barriers were the negative feelings and emotions, such as loneliness and isolation, which arisen by severing all ties with drug-using friends and environment. After adapting to the new live and environment, barriers became the frustrations or pressures in daily life. To sum up, findings show the following characteristics of recovery: a) The motivation to change might not coming with turning point, instead it appears in the early stage of drug-using process; b) Environment plays an important part in adolescent drug abuse; c) The relatively young age and the experience of recovery are the advantages to sustained abstinence.

Based on the results, the study suggests that to work with adolescent drug abusers, social workers should build up a friend-like relationship with them. Moreover, social workers should continue working with other professionals to create a supportive environment for these young drug users. On policy planning, the current study suggests that public service should also focus on helping the informal support of adolescent drug abusers. Furthermore, from school, community to family, a pragmatic and integrated drug abuse service system should be established.