This article allowed drug users to talk about the perceived reasons for their use and to identify the role of socio-economic and political factors in the emergence of this problem. Our analysis revealed the confusing and contradictory nature of participants` discourse on triggering and treating substance dependence; This discourse oscillated between personal responsibility and socio-structural responsibility, the former leading to feelings of guilt and shame. Given the invisibility of structural violence, we are led to conclude that there is an urgent need to change the political, legal and institutional levels. Many studies and reports document the harmful effects of substance use disorders (SUDs) on the family system and individual members, including children [1–8]. These disorders clearly affect many people in addition to the person with the problem and often represent a burden on the family and its members. These effects on the family may include: In Daniel`s case, we find a direct link between drug abuse and the great economic crisis that hit Portugal in 2008. The negative effects of this crisis were amplified after 2011, when the troika imposed several austerity measures to restore the country`s economy. Austerity measures have caused, among other things, “the dismantling of the welfare state, the privatization of public goods, the individualization of social risks and the commercialization of social life” (Soeiro, 2014SOEIRO, J. Da Geração à Rasca ao Que se Lixe a Troika: Portugal no novo ciclo internacional de protesto. Sociologia, Lisboa, v.
28, pp. 55-79, 2014., p.10), which leads to higher taxes, wages and unemployment rates (Ferreira, 2011FERREIRA, A. C. A sociedade de austeridade: poder, medo e direito do trabalho de exceção. Revista Crítica de Ciências Sociais, Coimbra, v. 95, pp. 119-136, 2011.). This situation has had a dramatic impact on public health, especially mental health (loss of self-esteem, anxiety, depression) and has increased the prevalence of risky behaviours such as drug and alcohol abuse. The concept of structural violence, introduced by Galtung (1969GALTUNG, J.
Violence, Peace and Peace Research. Journal of Peace Research, London, v. 6, n. 3, pp. 167-191, 1969.), is important for drug addiction because it highlights the impact of power differences between different social groups on the lives of individuals and this power imbalance leads to a persistent lack of opportunities for those who are among the most vulnerable groups. Structural violence is therefore characterized by persistence and can be overt or latent, intentional or unintentional, physical or psychological. It undermines basic needs such as survival, well-being, identity and freedom (Galtung, 1969GALTUNG, J. Violence, Peace and Peace Research. Journal of Peace Research, London, v. 6, n. 3, pp.
167-191, 1969.). As we will argue, for many of our respondents, poverty and gender discrimination were important causes of substance abuse. It`s guilt, the first thing that weighed on me was guilt. I don`t know if it was just in my head, but I think my daughter, my mother and my brothers were ashamed of me now. They didn`t really demonstrate it, but I noticed something else about them. (Louise) In Table 2, we can see that the reasons given are generally varied, except in four cases where personal problems appear to be the sole cause of the abuse. For Paul, whose parents lived abroad while living with other relatives in unstable conditions, one of these personal problems was family isolation; For Dianne, it was the death of her boyfriend in a car accident that made her drink. (Notably, these participants have a higher level of education than the majority.) In all other cases, the reasons given are described as external forces emanating from the social structure.
As described above, these forces act invisibly but persistently on people`s lives (Galtung, 1969GALTUNG, J. Violence, peace, and peace research. Journal of Peace Research, London, v. 6, n. 3, p. 3. 167-191, 1969), which ultimately produced dramatic effects in fundamental areas. This is the case for gender discrimination, alone or related to poverty, and social exclusion due to long-term poverty or sudden personal bankruptcy following a severe economic recession. Legal – because drug addicts still have human rights, they have the right to a lawyer and a fair trial. Instead of focusing on bigger issues, they need to spend some of their time advocating for addicts.
The reason I came here was not the work, but the treatment. But they made me work, so I have to work like everyone else! We pay for treatment, and we run out of money at the end of the month. I think a person undergoing treatment should be treated like in a hospital. If you`re in the hospital, you don`t have to work. We can therefore assume that participants internalized the traditional view of addiction, including the idea of moral failure. By comparing the claims made regarding the first question – where the strength of socio-structural factors is acknowledged – and their beliefs of personal responsibility – in relation to the second question – one can easily imagine the latent confusion and conflict in their minds and their lack of reliable information about their own condition. Given the life histories of these participants, at the intersection of substance abuse, crime, and economic and socio-cultural poverty, we believe that the concepts of structural violence and social suffering are particularly useful for analyzing and discussing the data obtained. These concepts have been used to interpret and discuss countless forms of social discrimination and exclusion (Galtung, 1969GALTUNG, J. Violence, Peace and Peace Studies. Journal of Peace Research, London, v. 6, n.
3, pp. 167-191, 1969; Kleinman; That; Lock, 1997KLEINMAN, A.; DAS, V.; LOCK, M. M. (Ed.). Social suffering. California: University of California Press, 1997.), but to our knowledge, they have never been applied to the problem of drug abuse. However, when families are struggling to live with substance abuse (e.g., Incerti; Henderson-Wilson; Dunn, 2015INCERTI, L.; HENDERSON-WILSON, C.; DUNN, M. Challenges in the Family: Problematic Substance Use and Sibling Relationships.