ORIGINAL ARTICLE
DOI:10.11606/issn.1806-6976.v12i2p65-74

 

Legal and work-related impacts in the life of chemically dependent individuals

 

Impactos legales y en el trabajo en la vida del dependiente químico

 

 

Miriam Aparecida Nimtz^I; Anna Maria Fornalski Tavares^II; Mariluci Alves Maftum^III; Aline Cristina Zerwes Ferreira^IV; Fernanda Carolina Capistrano^V

^IPhD, Professor, Departamento de Enfermagem, Universidade Federal do Paraná, Curitiba, PR, Brazil
^IIRN
^IIIPhD, Professor, Departamento de Enfermagem, Universidade Federal do Paraná, Curitiba, PR, Brazil
^IVRN, MSc
^VRN, MSc, Secretaria Municipal de Saúde de Curitiba, Curitiba, PR, Brazil

 

 

---

ABSTRACT

The purpose of this study is to identify the impact of drug use in the lives of chemically dependent individuals, in the contexts of criminality and employment. It is a qualitative exploratory study with data collected between August and September 2012 at a rehabilitation unit for the chemically dependent in Paraná. A total of 20 dependent individuals were interviewed. The data were treated with a thematic categorical analysis. Of the results found, we highlight the work-related and social vulnerabilities of the interviewees. It was concluded that the use of illicit chemical substances negatively impacts the functional work life of the user, and also subjects the individual to penalties in the criminal sphere.

Descriptors: Street Drugs; Substance-Related Disorders; Crime; Nursing.

---

RESUMEN

El objetivo de ese estudio es identificar el impacto del uso de drogas en la vida del dependiente químico en situaciones de criminalidad y de trabajo. Se trata de una investigación cualitativa exploratoria, cuyos dados fueron colectados entre agosto y septiembre de 2012, en una unidad de rehabilitación para dependientes químicos de Paraná. Fueron entrevistados 20 dependientes químicos. Los datos fueron tratados con el análisis categorial temático. De los resultados encontrados, se resalta la vulnerabilidad laboral y social de los entrevistados. Se concluye que el uso de substancias químicas ilícitas lleva el usuario a perjuicios de la vida funcional de trabajo, además de someterlo a las penalizaciones en la esfera criminal.

Descriptores: Drogas Ilícitas; Trastornos Relacionados con Substancias; Crimen; Enfermería.

---

 

 

Introduction

It is known that the deliberate use of psychoactive substances is a public health problem, especially in light of the epidemiologic rise in the number of drug users since the 1980’s. This situation causes concern not only for health professionals, but also for all of society. One can surmise that, given the growing consumption of drugs, chemical dependency may contribute to the criminal relationships in society. It is, therefore, a complex, dynamic phenomenon, which is also considered a legal, social, and sanitary issue^(1-2).

In the post-war period, there was a decline in criminality rates, especially in European countries and in the United States. However, since the 80’s, criminality has increased, including the number of drug-related infractions (trafficking – related to work – and use), and crimes against heritage, as well as violent crimes such as theft, kidnapping, and homicide. At the end of the 1980’s, drug trafficking and use were responsible for tripling the number of convictions in comparison to two decades earlier. This occurred in almost all states and major Brazilian cities, mainly in the metropolitan regions. In the 1990’s, this phenomenon spread nearer to the inland areas, especially those situated on trafficking routes⁽³⁾.

Given this alarming situation, in 2009, the federal government invested around R$ 200 million toward preventing and treating users of alcohol and other drugs, as well as treating individuals with mental disorders, enabling 73 new Psychosocial Care Centers. Brief hospitalizations of up to 20 days for patients in crisis were encouraged, with a 31.85% rise in the daily price per patient in general psychiatric hospitals⁽⁴⁾.

International estimates coincide with the context outlined above, such that approximately 10% of the population of urban centers worldwide abuse some psychoactive substance independently of sex, age, social level, and education. There are around 76.3 million people dependent on alcohol, adding to this percentage the 65% of individuals with a life expectancy lower than 60 years, as well as the 15.3 million people who have mental and behavioral disorders due to the use of other drugs⁽¹⁾.

Thus, it can also be stated that disorders originating from the use of psychoactive substances have a relevant impact on individuals, their work environment, and their families and community, resulting in damage to physical and mental health, compromising relationships, causing financial loss, and, as mentioned earlier, leading to legal problems⁽³⁾.

The strong desire to ingest a drug, the difficulty of controlling consumption, frequent use (even though it results in severe consequences), the priority given to the drug (even though other activities must be accomplished), the increase of tolerance for the drug, and the state of physical abstinence may result in psychiatric disorders related to relevant rates of aggressiveness, detention for illegal actions, suicide, relapses, treatment expenses, lack of housing, re-hospitalizations, and sequential hospitalization periods^(3,5-7).

Regarding treatment for users of illicit chemical substances, and, consequently, adherence to this treatment, it can be seen that in developed and developing countries there are various problems concerning adequate treatment and rehabilitation for these abusive users, considering the lack of treatment itself and the other priorities for allocating the public and/or private budget available^(8-10).

In light of the above, the purpose of this study is to identify the impact of drug use in the lives of chemically dependent individuals in the contexts of criminality and employment.

 

Methods

This is a qualitative exploratory study, undertaken in the period from August to September 2012, in a rehabilitation unit for chemically dependent males over 18 years of age in the state of Paraná.

The inclusion criteria for the study participants were: being 18 years old or older, being under treatment at the rehabilitation unit, and not being in a detoxification period.

The total population of patients in treatment during the collection of data was 30 chemically dependent individuals, 20 of which participated in this study, defined by the theoretical saturation of the data.

The data were collected through semi-structured recorded interviews, with the open question: "Describe if you have experienced consequences related to work and to the law due to drug use". The study was conducted in accordance with the ethical standards required, and the participants were asked to sign the term of informed consent after explicitly agreeing to participate in the survey, following a detailed explanation of the objectives of the study.

To analyze the information obtained in the interviews, the categorical thematic analysis technique was used, which is operationally organized into three phases: pre-analysis, exploration of material, and treatment and interpretation of the results obtained⁽¹¹⁾. Thus, the interviews were fully transcribed, and later the data were systemized so as to maintain the basic thought content and meaning of the message presented by the chemically dependent individual.

The themes emerging from the transcribed reports were grouped into units of context, forming thematic categories that, confronted with the literature, are presented in a thematic category and two subcategories.

The study participants were indicated by the letter "P", along with a numeral with no correlation to the order of the interviews. This study is part of the "Re-internment of chemically dependent individuals in a rehabilitation unit: causes and motives for relapse" project, approved by the Research Ethics Committee of the Department of Health Sciences (UFPR – Federal University of Paraná), under registration code CEP/SD: 904.029.10.03; CAAE 0825.0000091.10, according to the rules in resolution number 196/96.

 

Results

The study participants were between 21 and 66 years of age, 12 of which were between 20 and 40 years old. Of these, 17 participants began using drugs between the ages of 10 and 19. The legal drug with the highest use rate was alcohol (20), followed by tobacco (18), crack (11), and cocaine (8), though the participants used more than one substance.

Thus, the theme of this article is "the impact of the use of drugs in the lives of chemically dependent individuals in the contexts of criminality and employment" and "impact caused by work-related and financial problems".

Impact Caused by Criminality Problems

Drugs can have bio-psychosocial consequences in social living, related to crime and financial losses. Such consequences are: disrespect for rules and values, and the development of antisocial personality and conduct, such as, for example, theft as a means of obtaining drugs. Notably, most of the reports include theft or mishandling of objects and money within the family environment:

I never stole to use drugs. I just removed a device for cable television from the house, a decoder. [...] It had been left in a corner and no one used it. That’s all. (P.11)

I stole money from my father to buy drugs. [...] He would store money in a specific place, so I would go there and take it. (P.15)

I stole things from my house to use drugs. I would steal things like my brother’s watch and tennis shoes. Things of mine, also. (P.17)

I would take my things from the house, like a television and DVD device, but I’ve also stolen things from my father and mother. (P.18)

I was arrested twice for robbery. Once I was drunk downtown and we decided to do an express kidnapping. We robbed two couples first, and when we were going to rob the third couple, we were arrested. Even the victims were arrested because they were carrying 10 or 15 grams of cocaine. My other incarceration was also for robbery, but at a bakery. (P.13)

Chemically dependent individuals take things of others to sustain drug use, but on the other hand, in vulnerable situations, they are also expropriated of money and belongings by others:

When I took to sleeping in the streets, I started to have heavier consequences in my life: police roundups, fights, and also rats – people who steal from you while you’re asleep. (P.14)

     The person’s family, having a chemically dependent member in their midst, seeks to help them not get involved in crime, providing funding for maintaining the vice, and the user tries to obtain the drug through services to other users:

I never thought of stealing to get drugs. I would always ask my father for money, and if he didn’t give me any, I’d go get the drug for someone and would earn a little. (P.19)

 Impacts Caused by Work-Related and Financial Problems

The habitual, abusive, and constant use of drugs harms social, family, and work relationships of the individual, affecting their quality of life, including financially. This situation causes a condition of disorganization in life, leading the person to skip work and not be able to complete tasks, resulting in job loss, financial disengagement, undervaluing of self-image, and the cultivation of negative feelings due to financial losses:

I’ve worked in a lot of professions, the last profession I had was as a driver. [...] I’ve been unemployed for a few years. [...] Alcohol affected my job because when you’re dependent you don’t feel like going to work. How will people who are dependent on alcohol go to work? There’s no way. (P.2)

At my job, drugs affected my income. I worked well, but with relapses I wouldn’t work properly. On Monday I wouldn’t go to work because I’d use drugs over the weekend and become very tired. (P.3)

Every day, at midday, I liked to drink alcohol. Sometimes my boss would notice because of the smell and ask if I had been drinking, but I’d always deny it. I ended up getting fired. I got another job and was fired; and so on. It’s is one of the consequences of alcohol, unemployment. (P.14)

My finances dwindled to zero, even though I used to earn a lot. [...] I’ve also sold my things, such as: television, video games, computer, DVD device, and clothes. (P.13)

I lost a lot of things: clothes, money, and a bank account. Drugs take everything. (P.1)

My financial condition was leveled. To this day I try to get on my feet financially and I can’t. (P. 20)

When I was working, I would think of going to the bar as soon as possible so I could start drinking. Sometimes, in the morning, I would go to work and would get nauseous on the street; I’d arrive at the bus terminal and run to the bathroom to vomit. At work, until around 10 AM I’d work with my body very sore, but after that it would get better. [...] Despite all that, I never missed work and never lost a job because of alcohol. (P.7)

 

Discussion

It can be noted that the participants are adults and, as a consequence of the use/abuse of drugs, end up being let go from their employment activities, becoming deprived of their social and family functions, and frequently becoming involved in criminal situations.

The theme that alludes to drugs and the debate generated have been developed around scientific discussions that tend to configure the question sometimes as a public security issue (related to trafficking and repression), and other times as a public health issue (related to repression of demand on one hand and damage reduction on the other)⁽¹²⁾.

Currently, drug consumption is stimulated as a product, with an established market and marketing, and with yields that reach 500 billion dollars per year. The literature has demonstrated how the position of illegality (attributed to a set of drugs) has incremented other criminal activities, such as arms trafficking, contraband, terrorism, wars and guerrillas, coups d’état, and also illicit activities⁽¹²⁾.

It should be noted that, despite there not being enough studies in the health sector concerning the predisposition of people for ingesting drugs, there are multiple factors that can be considered for the increase of the vulnerability of the individual to chemical dependency, such as: biological, psychological, and personality factors (antisocial personality, for example)^(5,9,13).

The literature indicates that there is a connection between behavioral problems and the profile of users of chemical substances, among them the illicit ones. However, delinquent behavior seems to be a factor more relevant to exposure to marijuana than to the use of alcohol or tobacco^(10,13).

In this context, among the population groups available, there are some that are considered more vulnerable than others in the initiation to the world of drugs, such as: low education, poverty, and unemployment. It should be noted that the type of drug consumed also differs in the layers of social spheres and regions of the country. In a recent study of homes, the literature showed that alcohol remains the most consumed and most frequently considered "risky" by the interviewees⁽¹⁴⁾.

In Brazil, the term "delinquency" is vulgarly treated with certain repulse in society, as in the media it is associated with any group of young people that undertakes different infractions. The legal definition considers "delinquent" an individual that commits a crime – that is, one who is guilty of an infraction to penal law by offense or crime, which can be in the form of robbery, homicide, or another violent act ⁽¹⁰⁾.

One in every five individuals uses psychoactive substances for experiences other than habitual use, however, constant abusive use of the same drug provokes changes and dislocates the relationships that this individual has, denigrating and impoverishing their quality of life in all dimensions: organic, family, work, and social⁽¹⁴⁾.

The literature highlights four relevant factors that reinforce the social exclusion of drug users when they begin to use/abuse⁽¹⁴⁾, which are: the association of the use of alcohol and other drugs with delinquency; the stigma attributed to users, promoting their social segregation; the inclusion of trafficking as a work and income alternative for poorer populations; the illegalness of use that prevents organized social participation.

Such associated phenomena generate a state of disorganization with different levels of commitment, perceived symptomatically as: increase of absenteeism at work, incapacity of fulfilling stipulated tasks/goals, loss of employment, negligence of social roles, interruption of studies, weakening of family relationships, financial disengagement, subordination to sub-jobs, devaluation of self-image, depressive traits, and more frequent negative feelings. In addition, the time spent to obtain and consume the drug and the time under its effect reorganize the habits of daily life, where the priority becomes the drug itself and the marginalized social circle that surrounds it⁽¹⁴⁾.

According to epidemiologic data, the profile of crack users remains young males with low income, evidencing the relevant speed of this situation, which culminates in the deterioration of the mental, organic, and social life of the individual^(15-16).

Thus, among the objectives of the Integrated Plan for Facing Crack and Other Drugs, the competent agencies believe that it may be plausible to continuously capacitate government and non-government actors involved in actions toward prevention of use, treatment, and social reinsertion of users of crack and other drugs, and towards facing trafficking of illicit drugs⁽¹⁷⁾.

It can be stated, however, that the moderate use of certain psychoactive substances is even stimulated in society, such as caffeine, tobacco, and alcohol. Nevertheless, it is known that although use may begin licitly and without being characterized as chemical dependency, it may become illicit when the person begins to use other illegal chemical substances to satisfy their needs^(5,13).

National epidemiologic data show that 12% of individuals above 12 years of age who consume alcohol and other drugs – except tobacco – concomitantly present severe mental disorders. In this population, the impact of alcohol is ten times higher than the combination of illicit drugs ⁽¹⁸⁾.

There is a wide gamma of directives in use in Latin America, most of which follow principles of treatment forerun by developed countries, with the purpose of knowing and eradicating the needs of the dependent. These directives are mainly present in the matter of drug abuse, where the problem is not the drug itself, but the user. This, therefore, is the main agent in its rehabilitation ⁽⁴⁾.

In this scenario, it becomes evident that the use of legal and/or illegal drugs leads to damages and harm to the family, work, and social lives of the users, often causing repercussions of criminality – a fact that is increasingly frequent in the daily lives of these people.

 

Conclusion

According to the data exposed and discussed, it can be considered that drugs affect the social and work lives of people, since the losses surround the daily life of the individual dependent on psychoactive substances.

Thus, drugs and violence as a consequence of consumption should be the subjects of further studies, with the aim of greater knowledge and practices that can contribute to the health of the population and prevention of violence.

In this manner, the use/abuse of drugs consists of a public health problem, considering that their effects radically influence the health and quality of life of the users, in the social, work, and family dimensions, and for all of society. It should be highlighted that the stimulation propagated in media resources congruent with the use of legal drugs can promote the beginning of delinquent behavior when associated with the path to success, also often being synonymous with youth and happiness.

 

References

1. Vargas D, Bittencourt MN, Rocha FM, Oliveira MAF. Representação social de enfermeiros de centros de atenção psicossocial em álcool e drogas (CAPS AD) sobre o dependente químico. Esc Anna Nery. 2013 Abr-Jun;17(2):242-8.         [ Links ]

2. Ferreira ACZ, Capistrano FC, Maftum MA, Kalinke LP, Kirchhof ALC. Caracterização de internações em uma unidade de reabilitação. Cogitare enferm. 2012 Jul-Set;17(3): 444-51.         [ Links ]

3. Chalub M, Telles LEB. Álcool, drogas e crime. Rev Bras Psiquiatria. 2006;28 Suppl 2:69-73.         [ Links ]

4. Vargens OMC, Brands B, Adlaf E, Giesbrecht N, Simich L, Wright MGM. Uso de drogas ilícitas e perspectivas críticas de familiares e pessoas próximas, na cidade do Rio de Janeiro, Zona Norte, Brasil. Rev. Latino-Am. Enfermagem. 2009;17(n.espec):776-82.         [ Links ]

5. Oliveira VC. Perfil sociodemográfico, clínico e familiar de dependentes químicos em tratamento em um Centro de Atenção Psicossocial- Álcool e Outras Drogas da região metropolitana de Curitiba. [Dissertação de Mestrado em Enfermagem]. Curitiba: Pós Graduação em Enfermagem da Universidade Federal do Paraná; 2011. 110 p.         [ Links ]

6. Álvarez AMA. Fatores de risco que favorecem a recaída no alcoolismo. J Bras Psiquiatr. [Internet]. 2007 [Acesso 14 ago 2013]; 56(3):337-49. Disponível em: http://www.scielo.br/scielo.php?pid=S0047-20852007000300006&script=sci_arttext.

7. Fonseca AM, Galduróz JCF, Tondowski CS, Noto AR. Padrões de violência domiciliar associada ao uso de álcool no Brasil. Rev Saúde Pública. 2009;43(5):734-49.         [ Links ]

8. Scaduto AA, Barbieri V. O discurso sobre a adesão de adolescentes ao tratamento da dependência química em uma instituição de saúde pública. Cienc Saúde Coletiva. 2009;14(2): 605-14.         [ Links ]

9. Kaplan BJ, Sadock V. A. Compêndio de psiquiatria: ciência do comportamento e psiquiatria clínica. 9 ed. Porto Alegre: Artmed; 2007. 1584 p.         [ Links ]

10. Martins MC, Pillon SC. A relação entre a iniciação do uso de drogas e o primeiro ato infracional entre os adolescentes em conflito com a lei. Cad Saúde Pública. 2008;24(5):1112-20.         [ Links ]

11. Bardin L. Análise de Conteúdo. 6ed. Lisboa: Edições 70; 2011. 280 p.         [ Links ]

12. Garcia MLT, Leal FX, Abreu CC. A política antidrogas brasileira: velhos dilemas. Psicologia & Sociedade [Internet]. 2008 [Acesso 2 dez 2013]; 20(2):267-76. Disponível em: www.scielo.br/pdf/psoc/v20n2/a14v20n

13. Silva LHP, Borba LO, Paes MR, Guimarães AN, Mantovani MF, Maftum MA. Perfil dos dependentes químicos atendidos em uma unidade de reabilitação de um hospital psiquiátrico. Esc Anna Nery. 2010;14(3):585-90.         [ Links ]

14. Beck LM, David HMSL. O abuso de drogas e o mundo do trabalho: possibilidades de atuação para o enfermeiro. Esc Anna Nery. 2007;11(4):706-11.         [ Links ]

15. Gabatz RIB, Schmidt AL, Terra MG, Padoin SMM, Silva AA, Lacchini AJB. Percepção dos usuários de crack em relação ao uso e tratamento. Rev Gaúcha Enferm. 2013;34(1):140-6.         [ Links ]

16. Kessler F, Pechansky F. Uma visão psiquiátrica sobre o fenômeno do crack na atualidade. Rev Psiquiatr Rio Grande do Sul. 2008;30(2):9698.         [ Links ]

17. Decreto n.7.179, de 20 de maio de 2010 (BR). Institui o Plano Integrado de Enfrentamento ao Crack e Outras Drogas, cria o seu Comitê Gestor, e dá outras providências. Diário Oficial da República Federativa do Brasil, Brasília (DF), 21 maio 2010: Seção 1: 43.         [ Links ]

18. Azevedo DM, Miranda FAN. Práticas profissionais e tratamento ofertado no CAPSad do município de Natal-RN: com a palavra a família. Esc Anna Nery. 2010;14(1):56-63.         [ Links ]

 

 

Received: Apr. 27^th 2014
Accepted: Oct. 21^st 2015

Corresponding Author:
Miriam Aparecida Nimtz
Universidade Federal do Paraná. Departamento de Enfermagem
Av. Lothário Meissner, 632, Bloco Didático II
Jardim Botânico
CEP: 80210-170, Curitiba, PR, Brasil
E-mail: miriamnimtz@uol.com.br