With God's Help I Can Do It: Crack Users’ Formal and Informal Recovery Experiences in El Salvador

Abstract

Crack use has increased dramatically in El Salvador in the last few decades. As with other developing countries with sudden onsets of drug problems, El Salvador has few medical staff trained in addictions treatment. Little research has examined drug users' attempts to reduce or abstain from drug use in countries where government-regulated formal medical treatment for drug addiction is scarce. This paper uses qualitative and quantitative data gathered from active crack users to explore their formal and informal strategies to reduce or abstain from drugs, and compares these with components of informal and formal treatment in developed countries.

The Religious and Spiritual Dimensions of Cutting Down and Stopping Cocaine Use

“…Others have noted that African American cocaine users in the rural South perceived Black leaders and Black churches as integral to the prevention and treatment of substance use, but local programs were often tailored to the needs of the White majority, making some feel alienated and discouraged in their recovery process (Brown, Hill, & Giroux, 2004). Many of the participants in our study found that the local church provided them with social resources to re-structure their lives and emotional support to cut down or stop substance use (van der Meer Sanchez, de Oliveria, & Nappo, 2008; Dickson-Gomez et al, 2011). The local Black church was a place where they could go to seek advice from individuals in recovery who gave themselves up to God and had assumed positions of authority as members of the clergy (e.g., preacher, deacon), mentoring those struggling with substance abuse.…”

“…Faith in God and reliance on the church may play an especially critical role in communities where illicit drugs are becoming increasingly available and there are barriers (e.g., stigma, lack of available resources) to accessing formal treatment services (Dickson-Gomez et al, 2011). Recent work among rural illicit stimulant users in Arkansas identified that the need for treatment utilization is high, but treatment seeking is low (Carlson et al, 2010).…”

Using Peer-Referral Chains with Incentives to Promote HIV Testing and Identify Undiagnosed HIV Infections Among Crack Users in San Salvador

“…Unfortunately, in El Salvador, crack users seldom access healthcare and outreach services, the entry points to HIV diagnosis [16, 17]. First, despite their evident HIV risk, crack users are rarely the target of HIV prevention efforts [8].…”

“…First, despite their evident HIV risk, crack users are rarely the target of HIV prevention efforts [8]. Moreover, crack users are often afraid of disclosing their substance use to healthcare staff, do not have contact with service organizations, and are reluctant to respond to outreach efforts that target stigmatized populations with whom they do not identify (e.g., commercial sex workers, men who have sex with men, injection drug users) [8, 16, 17]. …”

Shifting from Village-Based Networks to Locally Generated Networks: Undocumented Mexican Agricultural Workers Who Use/Used Hard Drugs

“…I focus on men from Mexico without papers, describe habitual drug use not previously included in discourse on undocumented workers in the United States, and discuss the effects of a cultural shift from village-oriented to locally generated networks. The latter is a major component of social processes that lead to new use of illicit drugs (primarily, crack-cocaine) with which most immigrant men, whether farm workers or not, rarely have prior experience in home countries [23][24][25]. By transmigrant, I refer to men who have left a former place to arrive in a new one, whereas undocumented, also known as "without papers" (sin papeles), refers to construction of identity that leads to vulnerability as "cheap labor" [26] and, for this analysis, vulnerability to the availability of drugs and alcohol in agricultural settings.…”