Navigating desistance from heroin careers : an evolved grounded theory study

Abstract

Using an evolved grounded theory approach, this research explores the navigation of desistance from heroin careers characterised by problematic heroin use in the Maltese context. Evidence suggests that many individuals affected by such use manage to attain desistance at some point in their heroin career. This research attempts to develop an explanatory framework for the process of change from high-risk drug use to desistance by examining the main motivators that draw people towards desistance, the process of desistance, and strategies utilised to sustain continued long-term desistance within the Maltese context. The research adopts an evolved grounded theory methodology rooted in the interpretation of narrative data from interviews. Twenty-two participants, fourteen identifying as male and eight as female, who had desisted from using heroin for a minimum of five years, sat for a semi-structured interview. The theory conceptualises how a series of losses suffered following commitment to the heroin career fosters ambivalence towards the lifestyle and culminates in reckoning moments that nudge participants to change. Hope that desistance is an attainable goal emerges as instrumental in the eventual action taken to desist. Though pathways to desistance varied across participants, the theory identifies strategies adopted in the navigation of the journey towards desistance and identifies identity change as a key explanatory contingency in initiating, working towards, and maintaining desistance. Belonging to the community through the adoption of role such as parent or employee secures commitment to desistance and fosters the solidification of a conventional identity. The substantive theory illustrates that valuable insights can be acquired by examining the experiences of heroin users and makes a number of recommendations for policy, practice, and further research.