How Heroin-Addicted Offenders Experience Sobriety Upon Release From Jail

338 Pages·2017·1.83 MB·English

Walden University
ScholarWorks
Walden Dissertations and Doctoral Studies
Walden Dissertations and Doctoral Studies
Collection
2017
How Heroin-Addicted Offenders Experience
Sobriety Upon Release From Jail
Rebecca Lynn Foster
Walden University
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Walden University

College of Health Sciences

This is to certify that the doctoral dissertation by

Rebecca Foster

has been found to be complete and satisfactory in all respects,
and that any and all revisions required by
the review committee have been made.

Review Committee
Dr. Aimee Ferraro, Committee Chairperson, Health Services Faculty
Dr. Kimberly Dixon-Lawson, Committee Member, Health Services Faculty
Dr. Richard Palmer, University Reviewer, Health Services Faculty

Chief Academic Officer
Eric Riedel, Ph.D.

Walden University
2017
Abstract
How Heroin-Addicted Offenders Experience Sobriety Upon Release From Jail
by
Rebecca Foster

MBA, Columbia Southern University, 2013
BS, Columbia Southern University 2012

Dissertation Submitted in Partial Fulfillment
of the Requirements for the Degree of
Doctor of Philosophy
Health Services, Health Care Administration

Walden University
December 2017
Abstract
Heroin addiction is a growing epidemic in the United States. The need for proper
treatment programs accessible by heroin users who wish to or are mandated to participate
in recovery programs is a growing need, and pathways to sobriety for ex-offenders have
presented in literature as understudied. The purpose of this study was to examine heroin-
addicted offenders' experiences prior to and after release on their paths to sobriety. This
study followed a qualitative phenomenological approach based on the theory of personal
causation, which posits that individuals see events in life as either driven by themselves
or caused by others, both of which affect internal motivation. An empirical
phenomenological approach was used to explore how this group of individuals perceived
or experienced heroin addiction and their subsequent attempts at sobriety A purposeful
sample of 15 heroin-addicted offenders were interviewed in a jail in a rural county of
Wisconsin. Upon re-entry, 4 participants completed follow- up interviews. The results
showed that external motivators such as social and treatment factors were separate from
internal factors, although external motivators could influence the way a person makes
internal choices. Results were obtained by performing coding on the semi-structured
interviews both by hand and within the Atlas-ti analysis program. The theory of personal
causation supports and is supported by the findings of this study. Implications for positive
social change include a better understanding of the needs of heroin-addicted offenders
moving from incarceration to release in treatment program development, thereby
reducing harm to the heroin user, family members, and communities by decreasing
relapse, recidivism, and chances of overdose and death.
How Heroin-Addicted Offenders Experience Sobriety Upon Release From Jail
by
Rebecca Foster

MBA, Columbia Southern University, 2013
BS, Columbia Southern University, 2012

Dissertation Submitted in Partial Fulfillment
of the Requirements for the Degree of
Doctor of Philosophy
Health Services Health Care Administration

Walden University
December 2017
Dedication
This dissertation is dedicated to all those who live with heroin addiction.
Acknowledgements
I am so very grateful to my professors and instructors at Walden University. The
lessons I have learned stretched beyond the classroom into my private and social lives. I
was tested academically and personally, and pushed beyond my own perceived ceilings
of achievement.
I want to thank my chair, Dr. Aimee Ferraro, for being such an able-bodied
leader, capable of reaching me on several levels, and able to push me when I was ready to
walk away. I thank her for her blunt, real, words.
I want to thank Dr. Kimberly Dixon-Lawson for her input and support throughout
my class work, which inspired me to track her down for my dissertation, and through to
my final study.
I want to thank my URR, Dr. Richard Palmer Jr., for keeping me on track and
using his objective vision to find areas I needed to fix in a timely manner.
I would like to thank Kim Mueller for her help and support for the past few years,
as well as her energy in completing this study. I thank Michelle Robbins for her help and
support, e-mail after e-mail as we figured out how to coordinate interviews. And I would
like to thank the entire jail staff for being so accommodating and helpful while I
completed interviews. Amazing helpers!
I want to thank my husband and children for putting up with me all these years
while I pursued a personal goal, that none seemed to understand. The hours I spent
staring at articles and computer screens, freaking out about the noise or distractions…I
love you all so much, and I share this achievement with you. Thank you for helping me
and allowing me to complete this difficult journey through to the end.
Lastly, I want to thank God. His inspiration and support kept me going when I
wanted to give up. I heard His voice pushing me to find more, write more, complete
more, listen more, and do more. I would never have attempted this degree and
dissertation without His spiritual motivation. Thanks to all of these wonderful people, I
am here.
Table of Contents
List of Tables .................................................................................................................... vii
Chapter 1: Introduction to the Study ....................................................................................1
Introduction ....................................................................................................................1
Background of the Study ...............................................................................................2
Social Perspectives and Health Care Costs ............................................................. 3
Issues with Obtaining Health Care ......................................................................... 4
Overview of Heroin in the United States .......................................................................5
Overview of Heroin Use and Incarceration in the United States ...................................6
Overview of Drug Treatment Therapy ..........................................................................6
Statement of the Problem ...............................................................................................7
Purpose of the Study ......................................................................................................9
Nature of the Study ........................................................................................................9
Phenomenological Research ................................................................................. 10
Research Questions ......................................................................................................10
Theoretical Framework ................................................................................................11
Theory Guiding This Study .................................................................................. 12
Theory Informing Interview Questions ................................................................ 12
Personal Choice and deCharms' Theory of Personal Causation ........................... 13
Data Analysis Informed by Theory....................................................................... 13
Definition of Terms......................................................................................................14
Significance of the Study .............................................................................................15
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Assumptions .................................................................................................................17
Scope 17
Delimitations ................................................................................................................18
Limitations ...................................................................................................................19
Bias in Research .................................................................................................... 19
Self-Reporting Bias ............................................................................................... 20
Recall Bias ............................................................................................................ 20
Interviewer Bias .................................................................................................... 21
Generalizability ..................................................................................................... 22
Implications for Social Change ....................................................................................23
Summary ......................................................................................................................25
Chapter 2: Literature Review .............................................................................................28
Introduction ..................................................................................................................28
Literature Search ..........................................................................................................28
Theory of Personal Causation ......................................................................................30
Positive Options and Choices ......................................................................................34
Review of Literature Related to Methodology ............................................................38
Qualitative Versus Quantitative Method .............................................................. 38
Qualitative ............................................................................................................. 40
Phenomenology..................................................................................................... 40
Heroin Addicts and Crime ...........................................................................................44
Recidivism and Heroin Addicts ...................................................................................48
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