Exiting the Drug-Addict Role: Variations by Race and Gender

Tammy L. Anderson University of Illinois at Chicago

Lynn Bondi

San Francisco, California


Our paper explores race and gender variations in the processes of exiting a "drug-addict role" and in creating a "recovering-addict role" within the ideological constraints of 12-Step programs. Our method is qualitative and features in-depth interviewing with 45 currently abstinent drug addicts from the 12-Step programs of Alcoholics Anonymous (A.A.) and Narcotics Anonymous (N.A.) in the Washington, D.C., Metropolitan Area as well as a residential and out-patient treatment program in mid-Michigan. Our respondents' exit processes typically began with doubts about the drug addict role followed by an often long and dynamic period of seeking alternatives to it without giving up drugs and alcohol completely. In some cases, however, participation in a new role initiated doubts about an existing one. Contrary to extant research, turning points or epiphanic moments in existing roles were riot always identified. Most importantly, however, we found many differences by race and gender in what comprised the exit process. Gender socialization, ( cultural diversity, and the history of race relation; in the United States help to explain this diversity.

INTRODUCTION

Beginning in the 1960s, students of social interaction (Goffman 1961 a; Turner 1962, 1978, 1985) began to criticize the premises of role theory, especially the functionalist version that was formulated by Linton (1937) and extended by Parsons (1951) and Merton (1957). The interactionists argued that this account of role theory was too static and deterministic in its description of interpersonal relations and social organization.

More recently. feminist scholars have shown that role theory has misjudged the scope of gender socialization on lived experience (O'Leary, Unger, and Wallston 1985; Lopata

Direct all correspondence to Tammv L. Anderson, Prevention Research Center, University of Illinois @ Chi­t ago, 850 W. Jackson Blvd, Suite #400, Chicago, IL 60607; e-mail: TAMMYA@UJIC.EDU.


 

 

 

 

 

 

 

 

 

 

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1987). These scholars have criticized the "gender roles" concept because it refuses to acknowledge gender as a fundamental organizing principle of human affairs which cannot be compartmentalized into a particular "role." Their work has resulted in the decreased presence of the term in sociology, but it has not inspired role theorists to reconsider their claims. In addition, role theorists have neglected insights from critical race scholars (Hill­Collins 1991: hooks 1984: Dill 1983; Davis 1981) concerning how race and gender inter­

sect to produce different realities (e.g., role relations, tasks, and performances) across social groups.

Wacquant (1990, p. 401) recently asked, "Can we assume that role exit is a process homogeneous across institutional arenas and unaffected by the cultural frames of interpre­tation specific to each?" We think not and set out in this study to explore race and gender diversity in the processes of exiting the drug-addict role and in creating one type of ex ­addict role (i.e., the recovering-addict role).' We employ a qualitative approach to our research with four separate groups: Black females, White females, Black males, and White males.

In addition, we believe that our project makes a contribution to the substance abuse lit­erature. Extant theoretical models of addiction and drug career exit (i.e., drug use termina­tion) also pay inadequate attention to race or gender diversity (Biernacki 1990, 1986: Gomberg 1982: Henderson and Boyd 1992; Pohl and Boyd 1992; Maglin 1974: van den Bergh 1991). Extending the scope of such work to explain sub-group variations promises to improve efforts to reduce drug addiction and related social problems.

ROLE EXIT & DRUG ABUSE
The Drug-Addict Role

To facilitate a clearer understanding of the subject matter, we begin with a brief descrip­tion of the drug-addict role--the one our respondents were attempting to exit when we interviewed them. Stephens (1991) has described it as a master role in the heroin subcul­ture, where "role" is assumed to be a set of behaviors and relations associated with a par­ticular status.'- The latter include little social concern or guilt for one's actions, the adoption of "deviant" values, a commitment to a street language, manipulative relationships with those who both use and do not use drugs (especially in financial affairs), and an anti-soci­ety viewpoint that privileges interaction with fellow addicts. Stephens proposed that the greater the role strain felt by the street addict, the greater the likelihood of drug use cessa­tion, or what we would call "exit" from the drug-addict role. However, proposed no varia­tions by race and gender.

The 12-Step Recovering-Addict Role

It is important to note the influence of 12-step ideology on the social construction of the various roles considered here. Contemporary drug treatment is dominated by 12-step pro­grams, such as Alcoholics Anonymous (A.A.), Narcotics Anonymous (N.A.), and Cocaine


 


Exiting the Drug Addict Role

157

-anonymous (C.A.). Affiliation with these groups is one of the few ways to identify an addict subject pool for study. Each of our respondents had some exposure to 12-step ideol­ogy prior to being interviewed. Such programs furnish members with a script for getting oft drugs (Room 1992). This script covers how the individual who desires abstinence should re-construct the drug-addict role. Mutt we study, therefore, is the transition from a drug-addict role to the 12-,step-influenced recovering-addict role.

Role Exit

Discourse about role exit is part of a larger sociological literature on life transitions. Interactionists such as Berger and Luckmann (1966). Becker (1953 ), Glaser and Strauss ( 1971 ). Goffman 11959, 1961 b). and Hughes (1971) were among the first to discuss iden­tity and role changes in various types of life transitions. Later. Blau ( 1973) and Allen and van de Vlierts ( 1984) introduced the concept of role exit to the role theory and life transi­tions debate.

Helen Rose Ebaugh's (1988) role exit theory is a recent and significant contribution to this literature. Her insightful analysis of ex-doctors, ex-nuns, ex-lawyers, and ex-alcoholics has identified a useful framework for understanding the processes involved in departing from a role by creating an ex-role. For Ebaugh, role exit is "the process of disengagement from a role that is central to one's self-identity and the reestablishment of an identity in a new role that takes into account one's ex-role" (1988, p. 1). Her framework consists of four stages/factors, including first doubts (beginning to question or doubt one's role commit­ment and a redefining of one's situation). seeking alternatire.s (an evaluation of the costs and benefits associated with an alternative role), turning points (events, usually negative in quality, that force one to consider doing something different), and creating the ex role (becoming emotionally removed from a previous role while experiencing social expecta­tions based on a new one).'

Our respondents' descriptions of how they attempted to get off drugs hinted at Ebaugh's framework and we found her work useful for our purposes here. This is notable since, in our interviews, we asked nothing about roles per se or her theory. Therefore, our analysis is structured to reflect our respondents' role exit stories as well as their similarities and dif­ferences with Ebaugh's model. This approach will help us contribute to the debate concern­ing life transitions, role changes, and the process of getting off drugs.

METHODS

We used in-depth, face-to-face interviews because this procedure gives respondents the opportunity to provide authentic and comprehensive accounts (Denzin 1974; Glaser and Strauss 1971). During the winter and fall of 1990, and the summer of 1993, the first author interviewed a total of 45 respondents on one occasion each for approximately two hours. Some respondents were recruited at 12-step meetings in the Washington. D.C., metropoli­tan area, as while others were recruited at a residential treatment program in mid-Michigan that relied on I2-step meetings as part of its effort.


 


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The interviews featured questions about identity and the respondent's life prior to drugs, during drug use, and in abstinence. These interviews were free-flowing; respondents were not forced to stick to a specific period in time. Indeed, they frequently vacillated between the past, present, and future, which is typical of everyday discourse.

We used Miles and Huberman's (1984) twelve tactics to uncover patterns in the responses. We began by separating the respondents into four sub-groups: Black females, Black males. White females, and White males. We uncovered patterns by sub-group first and then compared the stories from each sub-group to note similarities in the role-exit pro­cess for all of our respondents. The paragraphs below describe the general or shared pat­terns first and then patterns that are specific to each race and gender sub-group. Moreover, we have selected quotes that best represented each pattern.

The Respondent Pool

The respondent pool consisted of 10 Black females, 9 Black males, 13 White females, and 13 White males (n = 45). Some were new to 12-step programs, while others were avid and seasoned members. Another portion were abstinent from drugs and alcohol and had stopped attending 12-step meetings a long time ago. `t Attachment to 12-step ideology var­ied greatly within the pool. Thus, our respondents' theoretical statements are more than simple 12-step recitations. There were also differences among the respondents concerning the length of time they had been active in creating the recovering-addict role (i.e., abstain­ing from drugs) and had been experiencing the role exit process.5 Therefore, some accounts are more "retrospective" than others.

Our ten Black females had an average age of 36 and they were single when we inter­viewed them. Nine were parents of 3-4 children. Four were employed and earning between $25,000 and $35,000 per year. They had completed 10- 17 years of education, with an aver­age of 11 years. Our Black males were, on average. 35 years of age. Seven were single, and two were married. Seven were parents of 1-3 children. Seven of our Black males were employed at the time of the interview and earning between $16.000 and $63,000 a year (with an average of $25,000). They had completed 9-16 years of education, with an aver­age of 11.5. The average age of our White females was 34 years old, and nine were single when we interviewed them. Six had 1-3 children. Two were married, and two others were living in committed relationships with female partners. All of our White females were employed at the time of the interview and earning between $10,000 and $35,000 a year (with an average of $26,500). They had completed 10-18 years of education, with an aver­age of 14 years. Finally, our White males were, on average, 34 years of age when inter­viewed and, like their female counterparts, all were single. However, four were parents of 1-3 children. Twelve of our 13 White males were employed and earning an average of $20,250 per year (with a range of $5,000 to $75,000).

It may appear that our Black female pool is of a lower socioeconomic status than the other three. A difference of this kind could affect the patterns we report on here. However, there are two reasons why this is not the case. First, the income disparities between Black females and the other three groups had more to do with being employed at the time of the


Exiting the Drug-Addict Role                                                                                                                 159

interview than about real class differences in the role exit process. Three of the six unem­ployed Black females had been recently laid off from $30,000-$35,000 a year jobs in the auto industry. Had the interviews taken place a few months sooner, the average income among Black females would have been more consistent with that of the other three groups. Second, Black females were no more likely to come from poor families than were members of the other three groups.

Also, racial differences in average years of education completed might suggest other social class differences between Blacks and Whites. The range in years of education com­pleted per group shows that this is not the case. Nevertheless, we suspect that social class affects the role exit process, and this may be a fruitful direction for future research. Our respondent pool is simply not diverse enough on this variable to include analysis of it here.

HAVING DOUBTS ABOUT THE DRUG-ADDICT ROLE

For all of our respondents, the role exit process began with a doubting period. Over time, evidence and questions arose that challenged one's commitment to and participation in the drug-addict role. Our finding that having doubts comprised the first discernable stage in the role exit process supports Ebaugh's model. However, we also found that these doubts and questions varied by race and gender. This finding distinguishes our work from hers.

Doubting and questioning drug-related roles often concerns such things as organiza­tional changes (e.g., changes in drug markets, subcultures, or lifestyles), burnout (i.e., growing tired of drugging and the deviant lifestyle-see Shover 1983 and Biernacki 1986 for similar work in this area), significant changes in relationships (e.g., the loss of loved ones because of drugs), and other specific events (e.g., arrest). Still other types of doubts stem from the loss of control over one's life or self, depression, personal crisis or decline, and a felt sense of narrowing life options (Rosenbaum 1981). Stephens (1991) added ques­tioning the values and lifestyle of the drug user/addict, feeling guilty about manipulating (financially, emotionally, or psychologically) significant others for drugs or worrying about how one's drug-related activities affect them, and questioning one's relationships with other drug users and their social outcast viewpoints.

Our analysis revealed many types of doubts that were consistent with the literature. Two types of first doubts with the drug-addict role were shared among our four groups. These included burnout or frustration with the drug-addict lifestyle or "world" and personal (i.e., emotional and/or financial) decline because of drug use. Vicki, a White female, states:

 

It was that type of feeling. Disgust. Disgust at what I was doing. I was disgusted with

what these people were doing and just not wanting to be like that. But I didn't know how to turn my life around either. I was like stuck. I was very stuck at that point. Like I

didn't know how to do this, yet I knew that I didn't want to be like that.

Keith, a Black male, reports:

The only thing I can remember is I know when I really started smoking love boat, that's

when I started saying I got to stop smoking love boat. I can remember tripping out and not feeling okay about it. I was depressed about myself, and I wasn't successful playing


160                                                                Symbolic Interaction Volume 21, Number 2, 1998

music. I wanted to do something for it, but I couldn't do it because I was smoking reefer and feeling empty.

We also found important race and gender differences here. Three of our four groups (i.e., Black females, White females, and Black males) reported gendered versions of personal decline as a type of doubt about their drug-addict roles. White males, on the other hand, more often reported burnout and frustration with the drug world and "lifestyle." In other words, Black females and males and White females began to question their commitment to the drug-addict role when drugs and related behaviors threatened their sense of self and personal well-being. White males questioned their commitment to the drug-addict role when the context which defined the role (i.e., the drug world) became too difficult for them to negotiate. This finding suggests that White males are more externally-oriented, while the other three groups are more introspective and emotionally-oriented. Research on gender socialization supports this interpretation (see Andersen 1988; Lopata 1987; Hill-Collins 1991). The difference is, however, less expected between White and Black males. Cultural diversity (e.g., African holistic values about personal/spiritual well-being versus Eurocen­tric concerns with individuaUmaterial success-see Hill-Collins 1991; hooks 1984) and the history of race relations in the United States (i.e., inequalities between Whites and Blacks in resource distribution and acquisition) might explain the difference between White and Black males on doubting the drug-addict role.

Black Females

Our Black females reported initially questioning or doubting their involvement with drugs and the so-called "drug world" because of their perceived "failure" with gender ­related roles (e.g., in their roles as mother). Problems with meeting their parental responsi­bilities and fearing that their children would become drug users or be taken away from them were the primary sources of personal dissatisfaction that produced first doubts. Car­olyn states:

 

Oh, well my oldest daughter, my mother practically raised her because of my drug

usage. What sort of made my mind up is it was killing me to look at my youngest daugh­ter, looking so sad at me, saying, "Mama, you're not on drugs are you, Mama?" And I'd say,  "No, I'm not on drugs." And her handing me candy boxes and I'm saying, `There's no candy in here." And she said, "No. Mama. Read it." And I look and it would say, "Say no to drugs."

 

Although more women work outside of the home today than ever before, women still have primary and often sole responsibility for the "private sphere" of life, especially child care (Andersen 1988). Men remain less obligated in this area. We would expect both Black and White women to report that their questioning of the drug addict role is more often related to motherhood or to significant changes in their relationships (e.g., losing custody of children or failing at spousal roles-see Rosenbaum and Murphy 1990) than their male counterparts. Our finding that Black females' primary reason for doubting their drug ­addict roles was due to parental obligations is consistent with previous work (Rosenbaum


Exiting the Drug-Addict Role                                                                                                                161

1981; Rosenbaum and Murphy 1990) and departs from Ebaugh's model (i.e., gender is an important source of doubting one's commitment to a given role).

White Females

 

Our White female respondents also reported gendered versions of doubting their drug ­addict roles, thereby underlining the significance of gender socialization for the role exit process. Fewer of our White females reported being mothers at the time of the interview, and those who were mothers had fewer children. However, their personal decline and loss of control was also "gendered." It concerned interpersonal relationships (i.e., with family, friends or intimate others) and not their performance at work or a diminished career, like their male counterparts (see below).6 Two forms emerged. First, drug use was perceived as causing problems in significant relationships with non-drug-using family members and friends. Billie provides an example:

I felt tired. I was tired. I was so exhausted. I couldn't get the drugs into me anymore. I had no veins. I couldn't do anything. My brother was getting married in California, and

I hadn't been home in eight years. I had moved here and got attached to the dope here. And I had felt, like I said before, beaten down and really worn out.

A second type featured their relationships with intimate others or friends who were, them­selves, attempting to terminate drug use by attending 12-step meetings. Participation in another's attempts at abstinence subsequently influenced some of our respondents to ques­tion their own drug-addict roles. Linda states:

A woman I was working with went to a rehab, and she had been shooting dope, and we were really good friends. And she started going to meetings, and she was feeling

better and looking better. She picked me up one day, she and this other guy that she was in rehab with. It was the Sunday after my 21st birthday. I kind of wanted to see

what she was doing. I mean, I didn't really see that I had a problem until a couple months later.

This second pattern of personal decline as a source of doubt challenges Ebaugh's assumptions about the linearity of and definitive stages in the role exit process. Both the components and structure of the role exit process might vary by dimensions of social orga­nization. In other words, we cannot assume that all groups will pass through a certain num­ber of stages in a pre-specified and orderly fashion or that they will reconstruct it as such in an interview situation. For example, many of our White females participated in a 12-step program with a significant other, who was using it as an alternative to his or her drug-addict role. This participation provided a mechanism for exit before these females had doubts about their own drug-addict roles. This is especially common in 12-step programs such as Al-Anon (a support group for the significant others of addicts and alcoholics), which often influences one to question one's own drug or alcohol consumption. The sequencing here would include alternative chosen by other, creating the ex role by other, then doubting one's own role commitment.


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Black Males

 

Gender socialization also emerged as a significant influence on doubts among our Black males and pertained to traditional aspects of masculinity. Our Black males reported that their primary reason for questioning their drug use was that drugs were blocking their opportunities for professional growth, something they especially valued as central to their masculinity. They also believed that drugs were causing their life options to narrow. Michael C. stated:

I'll tell you what really made me realize that something was really seriously wrong. I had just gotten a promotion that year, after going through my divorce, and everything was final in July. I remember one pay day getting my check at lunch time, leaving my job. going and buying some rocks, and never going back. And that, I think about that today. I left at lunch time and went and cashed my check and went and bought some rocks and just got high. Didn't go back that day. I didn't go back the next day, or the next day. I didn't call, I didn't do nothing.

White Males

 

Our White male respondents reported that burnout from the drug world was what ini­tially and primarily caused them to doubt their commitment to the drug-addict role and to terminate drug use. This burnout included a frustration with complications surrounding drug use, including a loss of control over money for the purchase of drugs or over drug use and a related loss of control over themselves. Burnout among White males also referred to their reported inability to achieve euphoria (i.e., the drugs stopped working) and having too

much financial debt. Ron offers the following statement:

Ron: I realized I was budgeting my entire income on drugs no matter where it came from. I was taking the amount of money, dividing it by so many days, until I knew there was another income. If there wasn't a check coming in two weeks, it was divided by 14. If my next check was seven days, it was divided by seven.

Interviewer:  That was your daily drug allowance?

Ron:  Right

Interviewer:  Did you always stay within it?

Ron: No. Usually, the more money I had, I drank and got reckless and would resort to doing things like buying street drugs that I couldn't afford. Then after I would get up the following day, or days, I would say, "Oh." And it would scare me because I would find that now I'm really in a bind. Being on a budget scared me. It was like I got to go get help.

 

Of slightly less concern, and like their Black male counterparts, White males reported having doubts because drugs were blocking their opportunity for future professional growth and were decreasing their life options. Finally, parental concerns did not surface as

a source of doubts for White males, despite several reporting being fathers.


Exiting the Drug-Addict Role                                                                                                                                                                           163

ALTERNATIVES TO THE DRUG-ADDICT ROLE

This section reports on our respondents' journeys to A.A. and N.A., since they were creat­ing a recovering-addict role through 12-step programs at the time of the interview. In gen­eral, our respondents told us that they experimented with various alternatives to the drug­ addict role off and on for several years. This process featured vacillation between drug use and abstinence (i.e., they did not give up drugs and alcohol first and then seek an alternative to them). More often, they kept using them, or abusing alcohol, during their search for something better. This is similar to Ebaugh's (1988) finding that most people remained in their current role, performing its tasks, until they found an alternative that worked.

Our respondents' efforts often began with a desire and an attempt to regain control over their drug use or to reduce their dependence on drugs without giving them up completely. Efforts to control their drug use were successful for some, but not for any significant period of time. Eventually, doubts set in about being able to control one's drug use at all. Those who reported giving up illicit and/or licit drug use by consuming alcohol only, experienced the same pattern. Nearly all reported attending at least one privately- or publicly-funded drug treatment program, staffed by paid professionals, in still other failed attempts to quit or control drug use.

These patterns demonstrate a more free-flowing vacillation between a series of doubts and alternatives than Ebaugh described (e.g., trying one alternative, experiencing doubts about it, and then repeating the same sequence with another alternative). Our respondents' experience with relapse underscores this point. Later, our respondents reported reaching some personal decision that pinpointed 12-step programs as the chosen alternative. Jim, a White male, tells a common story:

I was going to see some counselor and he said, "Why are you here?" And I said, "Maybe I drink a little bit too much." And then he asked, "Do you think that you have a problem with drugs?" And I said, "I don't think so." So then he said, "Well, what are you doing here?" And I said, "I don't know." And that was the last time that I dealt with any 12-step programs at that point. And a couple days later, I started drinking again. I had two drinks and then I put it down and that proved to me that I wasn't an alcoholic. And so after chopping wood one day, I had a couple beers and got high and said, "This is great!" You see. I just had two beers and so I must be cured. I'm fine. I can drink like a normal person. About a week later, I was back to drinking two or three six packs a day, and I started doing coke again.

Johnny, a Black male, adds the following story:

I had went on a binge ... this was a point where I had gotten to in my using where I wasn't shooting dope every day. I was shooting dope like once a month. You know. Trying to control it. But I was hitting the pipe. I was into crack. Crack was what really ... I went on a binge. I owed a lot of people money, was trying to duck out on the debt, plus I miserable and was looking for someone to teach me how to use socially. So I was looking, when I reached out for help, I thought I needed maybe four or five days of rest, you know, from off this binge, so I could go back and I'd just use maybe once a month. That's what I was looking for. So what led me to looking for a rehab was a cocaine hinge, smoking crack, smoking free-base, whatever you want to call it, it's all the same. And I ended up talking to a lot of rehabs and I ended up at Suburban and that's how I got into rehab and A.A.


 

 

 

 

 

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Our analysis of this part of the exit process revealed stronger differences by race than by gender. This is in contrast to the earlier discovery of both race and gender differences in the doubting period and illustrates the complicated ways that race, culture, and gender may impact social phenomena like roles, role-relations, and related behaviors. We found two major variations. First, our Black respondents reported a tendency to favor N.A. over A.A. as an alternative to their drug-addict roles, while our White respondents reported the reverse (i.e.. A.A. over N.A.). Second, our White respondents reported seeking assistance from mental health "experts" (e.g., psychiatrists, therapists/counselors, licensed social workers) as an alternative. None of our Black respondents reported doing so.

 

Black Females and Males

We can think of three reasons that might explain Blacks' preference for N.A. instead of A.A. First, there is a greater proportion of Blacks and minorities at N.A. meetings. Second, there may be extra stigma problems for Black drug abusers (Anderson and Ripullo 1996). White addicts are less stigmatized. Many of our Black respondents were recovering from crack addiction, which was heavily stigmatized in the 1980s (Lusane 1991). N.A. could be a place where Blacks feel protected from this stigma and can connect with others who are combating the same issues. Sharon W. states:

 

I like the N.A. and C.A. meetings better, because I can get more out of them. Most  of the N.A. meetings, they are a lot of people who use crack cocaine. You never really found out how much. But there will be a lot of people talking more so about crack cocaine than they do the alcohol.

 

Debbie, a Black female, adds:

I go to N.A. because I tend to agree with N.A. in terms of a drug is a drug is a drug, whether it's alcohol or not. They don't discriminate either drug. Okay, A.A. is specifi­cally a alcoholic [sic]. N.A., you could call it a balance because it deals with all drugs,okay? A.A. just alcohol. C.A. just cocaine. That's all they want to hear you say. "Well, I'm a alcoholic, you know." In N.A., you can say, "I'm an addict," you know, because it's better to say "I'm an addict" than "I'm cross-addicted." That sort of like voids that out. I prefer to go with N.A.

 

Third, our Black respondents did not report as extensive experience with alcohol as did our Whites. Research indicates that there is less consumption of alcohol among Blacks

(Rebach 1992). Also, our Black respondents were less likely to have the kind of jobs that provided the mental health access that Whites had.

White Females and Males

Our White females and males reported attending A.A. meetings and seeking help from various mental health experts as alternatives to their drug-addict roles. Michael F., a White female, states:

I would walk around Manhattan and would want to jump off a bridge, and I didn't understand why. 1 had never been suicidal before in my life. So, I went to see a therapist


Exiting the Drug-Addict Role                                                                                                                165

in New York. I talked about leaving my husband, where I'd lived, and my lack of career, and this and that. And I happened to mention that I smoked dope every day and didn't seem to be able to quit. And she told me that I couldn't make any other decisions in my life until I quit smoking pot. So, a few months later I tried, but couldn't.

TURNING POINTS OR EPIPHANIC MOMENTS

Research on the termination of drug and alcohol careers (Denzin 1987), 12-step literature (Alcoholics Anonymous 1976), and Ebaugh's (1988) model all propose that the process of exiting the drug addict role contains an epiphanic moment, a "hitting bottom" experience, or a turning point. Such events serve as the end point of one role and the beginning of a new one. Denzin (1992, p.x) states:

Recovery begins with an epiphanic moment-a turning point experience where the per­son surrenders to his or her addiction. This moment is often grounded in a mundane

event, yet it often carries great symbolism.

For Ebaugh, turning points are a necessary third step in the role exit process. She defined them as events, often negative in quality, that force one to consider doing something differ­ent or to realize that old lines of action are complete or have failed. She noted four types:

specific events, last straws, time-related factors, and either/or alternatives. More impor­tantly, perhaps, 12-step ideology constructs such events as "hitting bottom" and a neces­sary experience to getting sober.

Given this literature, we find it noteworthy that our respondents did not always report such an event or experience in their exit process. We could not discern a turning point in our interviews with six of our Black females, who were new to 12-step programs. Other "new" respondents did, however, report turning points. Moreover, the turning points we found varied so greatly that it is difficult to offer general patterns that describe each group. Again, this underscores our earlier point about the problematic assumptions of imputing linearity and definitive stages to everyday life.

The types of turning points we found fit Ebaugh's descriptions of either/or alternatives, last-straw factors, and specific events. Either/or alternatives were of three kinds: (1) choices between drug treatment or incarceration following an arrest for drugs or alcohol or drug treatment as a way to shorten a prison sentence, (2) a perception that one more episode with drugs and/or alcohol could threaten one's life (e.g., an overdose), and (3) an ultima­tum or intervention from a significant other. Last straws came in two forms: (1) gradual personal (emotional and physical) decline and (2) job-related decline. Attendance at 12­step meetings with friends, arguments with friends, being fired from a job or expelled from school, and stealing from a loved one were five types of specific events that acted as turn­ing points for our respondents.

Black and White Females

 

The turning points reported by our Black and White females centered on two issues: health-related factors and attendance at 12-step meetings with a friend. Ruby, a Black female, describes health-related, either/or alternatives that acted as her turning point.


 

 

 

 

 

 

166                                                                Symbolic Interaction Volume 21, Number 2, 1998

Interviewer: Why did you go to treatment'?

Ruby:   Because June 1st I was drinking some alcohol and doing some cocaine

                       and I drank some liquor straight down and it sped up my heart rate. I couldn't 

                          breathe and everything, so, I went to the hospital that night and they told me that the 

                      alcohol and the cocaine, when they was mixed together, did something to my

                        breathing. Plus I had an infection in my lung, and come to find out that I had  

                           pneumonia.

             Interviewer: Did the hospital recommend treatment?

              Ruby: No. They just told me that if I wanted to kill myself, to keep drinking

 

                        alcohol and doing cocaine. Then I decided to do it on my own.

 

Health-related either/or alternatives, health-related last straws, and attending 12-step meet­ings with friends or acquaintances (as specific events) are three areas of common ground between Black and White females. However, our Black females also reported a threatened loss of children as an either/or alternative, while a few of our White females reported being threatened with time in prison if they did not attend a drug treatment program. The latter either/or alternative was reported even more frequently by both Black and White males (see below).

Daly (1987a, 1987b, 1994) has claimed that the courts may impose less severe punish­ment on women because of their greater involvement in child-rearing. Such leniency, she reminds us, is far less costly to the State than incarceration of the caretaker and foster care for the child. In our sample, the greater involvement of Black females in parenting may account for the lower frequency with which they report legal either/or alternatives as turn­ing points in the role exit process.

Black and White Males

 

The turning points reported by our Black and White males pertained most frequently to either/or alternatives following an arrest or drug treatment to shorten a stay in prison. The relationship between male drug use and formal social control reflects the nature of race relations in the United States. First, our Black males more frequently reported this kind of either/or alternative than did our White males. Second, most of our Black males were already incarcerated when the drug treatment option was presented as a way to shorten their stay in prison. Mark, a Black male, states:

 

Oh yeah, I wanted to go. I wanted to make the road to abstinence. I was in Lorton doing 45 months. And this guy told me, he said if you go to school and go to meetings at night, those meetings he called it, you'll make parole. And I did.

 

In contrast, our White males reported that judges or lawyers offered drug treatment pro­grams as a condition of probation and an alternative to prison terms. Baird-, a White male, describes this either/or alternative:

 

When I was 18, I was arrested for armed robbery and I didn't go to jail. When I was 23, I was on probation for armed robbery and was arrested again, twice in one month. The

lawyer said the only way I'd ever not go to jail was to state recovery on the paper, through the hospital. Then my lawyer told me to go to the hospital. The shrink had


Exiting the Drug-Addict Role                                                                                                               167

already been telling me to do it (i.e., to go to the hospital). And the hospital introduced me to the 12-step program.

These differences appear despite the relative similarities between Black and White males' drug using careers. Moreover, these differences provide evidence of racism in the War on

Drugs (Lusane 1991) as well as the criminal justice system (Richey-Mann 1993).

Still other turning points, which were far more often reported by White males (1 I of 13 vs. 3 of 9 Black males), concerned job/professional decline or termination (last straws,

either/or alternatives, and specific events), financial loss (specific events), health-related decline (either/or alternatives and last straws), and significant other (i.e., ultimatums from

girlfriends as either/or alternatives). Males reported health-related and significant other either/or alternatives less than both female groups. Stan, a white male, describes the work­

related either/or alternatives:

I went back in the pharmacy in 1984, and I was using drugs in about 3 or 4 months. I had bounced back to addiction. And I got apprehended. I got discovered very fast because they [drug security at place of employment] were at that particular time, they were keeping close contact with their narcotic inventories and everything. And they found out that I was stealing drugs, and they apprehended me in the store one day. And the head of security of drugs there said, "You need help. Call these people up when you get home. And I want you to do everything they tell you to do. And if you don't, I'm going

to press charges. I won't put anything on your file that has anything to do with what happened unless you don't do everything they tell you to do." And at that particular time. I knew it was time to change, that I had to do this to continue being able to prac­tice so I  did like he told me. I went home and I called a guy to make sure I got into treatment.

THE RECOVERING-ADDICT ROLE

For our respondents, exiting the drug-addict role meant learning the tasks, relations, and behaviors that would promote continued abstinence from drugs and alcohol. And because our respondents were attempting to achieve this objective through 12-step programs, they were also considering self-change and adherence to the disease model of addiction, which denies a return to casual drug or alcohol consumption permanently (Anderson 1994; Den­zin 1987; Room 1992). Therefore, our respondents will likely be "recovering addicts" for a long time.

They cited many ways of achieving this objective. Some were 12-step suggestions or variations on program principles. We found differences by race and discuss them below. However, the members of all four groups told us that they would make abstaining from drugs (and usually alcohol, too) a top priority in their lives. They also planned to continue attending 12-step meetings and stressed the importance of changing their friends (i.e., from people who use drugs to those who do not). There was a notable preference for interaction with other former drug users who were trying to create the recovering-addict role. Peggy, a Black female, states:

How does a person who don't do that, drink and drug, going to tell another person that

do? They don't know nothing about it themselves. All they know is not to drink because they ain't never drunk, but they don't know how it is. They don't know how it hap-


 


 

168                                                                Symbolic Interaction Volume 21, Number 2, 1998

 

 

pened. So, no, it's not good for a person that don't do nothing, that don't do what I do, to tell me nothing.

Finally, they felt that continued understanding and acceptance of the disease concept of addiction would also help them to create the recovering-addict role. Chance, a Black male,

illustrates these patterns:

Interviewer:     How do you stay oil drugs?

Chance: I still hang around with recovering people. I'm still going to meetings. I still won't go to places where there's alcohol or drugs. You know what I'm saying? So, sometimes they have a party downstairs, and I come

home at night and I smell alcohol. So, I still don't go around places where there's drinking or where I suspect there's drugs.

Dawn, a White female, further elaborates on these points:

Interviewer:     Do you think there is anything wrong with all of your friends being in A. A.?

Dawn:            No. Maybe some people will think I'm isolating from the world? I'm

hiding in a cocoon?

Interviewer:      Yeah, some people might think that.

Dawn: Fine, if it works and keeps me from drugs and alcohol, who gives a shit?

It's not your life. It's mine. That's how I feel about it. I'm not out there

robbing anybody any more. I was harmful, not only to myself but to oth­ers. And whatever works, why stop it? That's just how I believe, and if

I have to stay in a cocoon, then so be it.

Our respondents also reported having to do other things to stay off drugs, and these strat­egies differed by race. For instance, we found that our Whites took a more individualistic (i.e., self-fulfillment and personal growth) approach to creating the recovering-addict role, while our Black respondents took a broader, family and community-oriented one (cf. Hill­Collins 1991). Whites told us about conforming to specific 12-step suggestions, while Blacks recited a looser application of 12-step themes to secure a "normal" life.

White Males and Females

When discussing how they would remain abstinent from drugs, and alcohol, Whites talked about following the basic suggestions of 12-step programs (e.g., attending many meetings on a regular basis, getting a sponsor, finding a "higher power," etc.) to initiate personal growth and self-fulfillment. Many were also planning to start or were actively engaged in some sort of mental health counseling to achieve this goal. In addition, Whites mentioned restoring relationships with members of their families of origin as part of their efforts to create the recovering-addict role.

Finally, our White respondents reported that avoiding drug-involved situations (e.g., work-related or family parties and other social events) would also enable them to success­fully create the recovering-addict role. This last point represents a significant difference between our White and Black respondents. Our Whites told us that they could "pick and choose" when and where they would be exposed to drugs. For instance, Oliver describes


Exiting the Drug-Addict Role 169

the control many Whites reported having over their exposure to drug use and its relevance in creating the recovering-addict role.

I have to deal with like living in a using world, being clean, and learning how to do that. If somebody asks me if I want a drink, I say I'm allergic to alcohol. It's really difficult socially, in a lot of ways. not to drink or use, because so much of like social activity canhe centered around drinking and using outside of the program. So learning that it's okay for me just to say no, and I don't need to feel guilty about that or less than, as a person but that I could feel good about that choice. I mean I wish I could use on one level, youknow, but I know that I don't want to. And I feel pissed because it's like it's still out there and it's waiting and I can go back to it at any point that I choose.

In contrast, our Black respondents reported having very little control over exposure to drug use.

Black Males and Females

Our Black respondents discussed securing a "normal" life as the best way to create the recovering-addict role. Securing such a life featured meeting basic human needs (i.e., food, clothing, and shelter), getting back together with one's family (children and significant oth­ers-especially among Black females), finding an intimate other if single, church atten­dance, resuming work or getting a job, pursuing additional education, and developing some personal goals. Unlike their White counterparts, Blacks viewed 12-step meetings, espe­cially N.A., as a means to help them obtain this normal life. They did not simply focus on following 12-step suggestions.

A second pattern had to do with neighborhood and community concerns about drug exposure. This pattern diverges from that reported by Whites. Our Black respondents told us that successful creation of the recovering-addict role would entail dealing with aspects of their neighborhoods (i.e., the people who live there and the activities that take place) that would likely threaten their abstinence from drugs. Our White respondents reported that staying away from "slippery places" (i.e., parties, bars, social functions) where drugs were used or the "slippery people" (old acquaintances or coworkers) who used them was also important. What makes this pattern a significant race-related difference is the frequency with which the threat is encountered and the respondents' perceived ability to control it. The "neighborhood" threat reported by most of our Black respondents was a daily part of life over which they had little control. Such was not the case for Whites. Marjorie, a Black female, states:

There just ain't no peace because I know everybody. And when you know everybody then you got to know what they up to. If they up to any good, you got to know that. Around here it's just too small and too easy to be doing the same things, which is nothing.

Efforts to construct socially desirable roles can be subject to negative reactions because of the stigma that previous roles carry. Goffman (1963) has described the lingering effects of stigma, and Anderson and Ripullo (1996) have applied his work to strategies of stigma management among recovering addicts. We found two additional patterns among our Black respondents that pertained to stigma management as part of their efforts to create the


170 Symbolic Interaction Volume 21, Number 2, 1998 recovering-addict role. First, our Black respondents reported that they would have to asser­tively instruct others who offered them drugs that they were not involved in drug use any

longer and were creating the recovering-addict role. This management strategy is unlike those previously discussed (Anspach 1979; Herman 1993), since it features a direct con­frontation between two former in group members who now stand in opposition to each other. Daniel explains the assertive-instruction strategy and the "neighborhood" challenge to sobriety.

Interviewer: What might prevent you from staying sober?

Daniel: Ain't nothing going to prevent me from staying sober, you know. I sit here, I can look right out there in that street right now and sit there and watch them smoke dope. That's a hard thing to do, you know what I'm saying? Smell the smell of crack coming in the air. But this right here ... if somebody says, "Here's a hit." We going to get to fighting. We going to fight over it.

Interviewer: You want to challenge yourself like that?

Daniel: As long as you ain't tasting it. See, that's the difference. See, it's like this. Tasting and seeing is two different things. You know what I'm say­ing? I can't keep on hiding. You know what I'm saying? One day I might be in a place, and it's ninety-four below zero outside.... You know what I'm saying? And they're smoking crack. They got all this crack around. What do you think I'm going to do? Go outside and wait until they are done? What do you think I'm going to do, huh? That I'm going to the bathroom and lock myself up? Be for real.

And Ruby, a Black female, tells about the instruction strategy and getting a normal life as part of her recovering-addict role:

There's a lot of things that I promised my kids, and we're going shopping on the first of the month. I'm supposed to get myself a little something, too. I'm going to buy me some clothes for once. So, that's my first step. On the first, it's going to be me and my kids. Go buy them a Nintendo, and I want to try to get my two young ones a bike. It might not be a brand-new one, but I know I'm going to get them one. Because I've been promising these things for a long time, and I just put it off, put it off, just for that drug, you know. So, now it's in my mind. So. like the first, whoever come over and thinks they are going to get high off me or bring drugs in my house, they might as well stay home because I'm not doing no drugs. I don't want to see that.

Second, all of our respondents believed that Blacks would have a harder time creating the

recovering-addict role because of the powerful stigma attached to their drug and alcohol use, which all respondents (both Black and White) thought far outweighed that encoun­tered by Whites.

DISCUSSION

Our study of race and gender differences in the role exit process challenges existing models in two major ways. First, we found that the often implicit assumptions that such models make about the sequencing and linearity of processes in everyday life are problematic. Our respondents' role exit stories often did not conform, for instance, to Ebaugh's four-stage


 

 



Exiting the Drug-Addict Role                                                                                                               171

 

 

model of the role exit process. They reported vacillating between doubts and alternatives to the drug-addict role over several years. Often, alternative ways of controlling their drug use ended in doubts about the chosen alternative, but not in renewed commitment to the drug­addict role. Moreover, our work also showed that the process of seeking alternatives some­times preceded doubts about a particular role altogether, especially among White females. Another sequencing challenge comes from our failure to find a discernable turning point for some respondents, especially Black females. We can only speculate that divergent race­ related commitments to 12-step ideology might account for this. In other words, it may be that the preference among Blacks for N.A. and the preference for A.A. among Whites affects their ability to specify a turning point in the process of getting sober. Whether there are significant differences between N.A. and A.A. in constructing the "hitting bottom" phe­nomena remains an empirical question.

Second, and perhaps of greater importance, we found considerable race and gender dif­ferences in each part of the role exit process. For instance, our inquiry revealed race and gender interactions with having doubts about the drug-addict role, race variations in seek­ing alternatives to it, mostly gender differences with epiphanic moments or turning points, and still other race interactions in creating the recovering-addict role.

Gender and the Drug-Addict Role Exit Process

Differences between women and men in the drug-addict role exit process closely parallel cultural norms and socialization experiences regarding femininity and masculinity. Women's exit processes centered more on the personal and emotional aspects of drug­ related experiences (e.g., crises or concerns with interpersonal relationships), while men's focused more on external and financial ones (e.g., concerns about professional growth, jobs/careers, money, and arrest). The dichotomous classification of men's and women's lives into public and private spheres has, of course, been blurred over the years, but our research shows that the bifurcation still has some validity. However, we found grey area on this point, most often having to do with race.

Race and the Drug-Addict Role Exit Process

Race also plays an important part in the drug-addict role exit process. We found that Whites experience the exit process on a much more individualistic level than Blacks. The Black experience is far more family and community-oriented. This difference becomes most apparent when the abstinence process gets underway or when new roles are being negotiated. This difference has been previously documented in studies of the eurocentric and afrocentric cultural experiences.

More critically, our research indicates that certain structural inequalities (concerning stigma and social control policies) constrained the exit and abstinence process more for Blacks than for Whites. We hope that both grass-roots and government efforts can remedy this situation. Additional research on these matters, including social class differences, would also be a wise course of action. Our findings help illustrate the complex ways in which basic forms of social organization structure life experiences. An increased under-


172                                               Symbolic Interaction Volume 21, Number 2, 1998

standing of the structural and cultural constraints on role transitions would be of great value to both the academic and applied communities.

Acknowledgment: This study was funded by the National Science Foundation and the American Sociological Association's Small Grants Program, by Central Michigan University's Summer Fellowship and Faculty Research and Creative Endeavors Pro­grams, and by the National Institute on Drug Abuse Substance Abuse Prevention Post­

doctoral Training Program. Findings reported here do not necessarily reflect the official position of the sponsors.

NOTES

I . This term refers to the type of ex-addict role that is experienced by individuals involved in 12­ Step programs. Other versions of the ex-addict role exist, but they are not considered here.

2.    Although Stephens studied heroin addicts, his socio-cultural theory of drug addiction and his description of the drug addict role are useful for the discussion of addictions to other substances as well (e.g., see Goode 1994).

3.  Ebaugh's (1988, p. 123) definition of turning points-events that mobilize and focus awareness that old lines of action are complete, have failed, have been disrupted, or are no longer personally satisfying-suggests that they are most often perceived or constructed as negative, although they might also be positive. Recently, both Turner (1991) and Fearns (1990) have noted the impor­tance of considering  emotions when studying the role exit process. Depressed or anxious states, commonly experienced during abstinence efforts, may have shaped our finding that these turning points are usually negative. In addition, the stigma associated with addiction might also have influenced this finding.

4. On average, our Black female respondents began using drugs later in life (at about 17 years of age) than the other three groups. Barnes and Welte (1986), Welte and Barnes (1987), and Thompson and Wilsnack ( 1987) have documented the same tendency. The predominant drug among our Black females was cocaine, in both powder and crack forms. They used their drug of choice for an average of nine years, starting with powder cocaine. On average, our White females reported starting drug use at 13 years of age. The drugs of choice were alcohol and marijuana, which White females reported using for an average of 13 years. Our Black male respondents began using drugs earlier in life ( I 1 years old on average) than the other three groups. Their drugs of choice were the same as for Black females: powder cocaine first, followed, for many, by crack cocaine. On average, Black males used these drugs (13 years) longer than their Black female counterparts. White male drug use began later (around 13 years of age). The common drugs of choice for White males were more varied than for any other group and included cocaine, alcohol, marijuana, and heroin. White males also used their drugs of choice longer (14 years) than any other group studied.

5. This was also the case in Ebaugh's study.

6. This was an opportunity for class-related (i.e., employment and subsequent yearly income) issues to affect the role exit process. White females' employment and income status at the time of the interview was somewhat higher than the other three groups. However, gender socialization explained their first doubts. Again, we caution readers about conclusions based on demographic characteristics, which were taken at the time of the interview and not over the course of the role exit process.

7. Not with one's family of origin as reported by our White respondents.


 

 

Exiting the Drug-Addict Role                                                                                                                 173
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