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A framework for compassionate clinical responses to addiction
Thesis (MPhil)--Stellenbosch University, 2023.
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| Format: | Thesis |
| Language: | en_ZA en_ZA |
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Stellenbosch : Stellenbosch University
2023
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| _version_ | 1867613951522504704 |
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| access_status_str | Open Access |
| author | Walter, Sheridan |
| author2 | Palk, Andrea |
| author_browse | Palk, Andrea Walter, Sheridan |
| author_facet | Palk, Andrea Walter, Sheridan |
| author_sort | Walter, Sheridan |
| collection | Thesis |
| dc_rights_str_mv | Stellenbosch University |
| description | Thesis (MPhil)--Stellenbosch University, 2023. |
| format | Thesis |
| id | oai:scholar.sun.ac.za:10019.1/127002 |
| institution | Stellenbosch University (South Africa) |
| language | en_ZA en_ZA |
| last_indexed | 2026-06-10T12:44:18.274Z |
| license_str | Other — see source repository |
| provenance_str_mv | Harvested via OAI-PMH from SUNScholar — Stellenbosch University Repository |
| publishDate | 2023 |
| publishDateRange | 2023 |
| publishDateSort | 2023 |
| publisher | Stellenbosch : Stellenbosch University |
| publisherStr | Stellenbosch : Stellenbosch University |
| record_format | dspace |
| source_str | SUNScholar — Stellenbosch University Repository |
| spelling | oai:scholar.sun.ac.za:10019.1/127002 A framework for compassionate clinical responses to addiction Walter, Sheridan Palk, Andrea Stellenbosch University. Faculty of Arts and Social Sciences. Dept. of Philosophy. Applied ethics Compulsive behavior Addicts -- Rehabilitation Social norms Thesis (MPhil)--Stellenbosch University, 2023. ENGLISH ABSTRACT: Addiction is a particularly contentious issue, with discourses regarding, not only its definition but also the appropriate way of responding to and treating it, often framed in an uncompromising manner. This might come from the tendency to view drug use through a purely moral lens. This perspective, however, contributes substantially to addiction stigma, discrimination, and common misconceptions about addicts in society. It is also not uncommon for healthcare practitioners and institutions to espouse dominant social-moral norms of addiction, which add to the social exclusion, ostracization, and marginalisation of addicted people. As a result, addicts face significant obstacles in accessing health and social services, particularly if they are not yet ready to quit their substance use. This often leads to a denial of health care, or limited access to health care, based on certain preconditions. This is important as drug use can have adverse health and social consequences. For example, people who inject drugs are at significant risk of contracting blood-borne infections such as HIV and hepatitis C virus. In addition, deaths due to overdose have become increasingly alarming. Harm reduction strategies and programs that seek to minimise the harmful consequences of drug use do not require one to abstain from drug use. Abstinence often acts as a high threshold precondition to accessing essential treatment programs such as mental health care, TB care, and emergency services. Harm reduction proves to be a pragmatic, unbiased, more feasible and compelling response to addiction than abstinence-based treatment programs. Drawing from a South African, low-threshold opioid agonist therapy project, which is informed by salient features of the Southern African notion of ubuntu, I argue that social cohesion or group solidarity significantly improves retention in harm reduction programmes such as methadone maintenance treatment programmes. From this, I formulate my argument and I contend that ubuntu-related insights can serve as a framework informing clinical responses to addiction, in general. Specifically, this framework might augment harm reduction strategies, aid in providing non-punitive compassionate care, address the fundamental problem of social exclusion, isolation, and loneliness, and restore much-needed dignity and justice in responses to addiction. AFRIKAANS OPSOMMING: Verslawing is 'n besonder omstrede kwessie, met diskoerse wat dikwels hardhandig is oor hoe om dit te definieer en hoe om dit toepaslik te hanteer. Dit kan wees as gevolg van 'n neiging om dwelmgebruik deur 'n suiwer morele lens te beskou. Hierdie perspektief dra egter aansienlik by tot die stigma van verslawing, diskriminasie en algemene wanopvattings oor verslaafdes in die samelewing. Dit is ook nie ongewoon dat gesondheidspraktisyns en -instellings dominante sosiomorele norme van verslawing voorstaan wat bydra tot die sosiale uitsluiting en marginalisering van verslaafdes nie. Gevolglik staar verslaafdes beduidende struikelblokke in die gesig om toegang tot gesondheids- en maatskaplike dienste te kry, veral wanneer hulle nog nie gereed is om op te hou om dwelms te gebruik nie. Dit lei dikwels tot ontkenning van gesondheidsorg of beperkte toegang tot gesondheidsorg op grond van sekere toestande. Dit is belangrik omdat dwelmgebruik nadelige gesondheids- en sosiale gevolge kan hê. Byvoorbeeld, mense wat dwelms inspuit, loop 'n beduidende risiko om bloedgedraagde infeksies soos MIV en die hepatitis C-virus op te doen. Boonop word oordosissterftes al hoe meer kommerwekkend. Skadeverminderingstrategieë en -programme wat daarop gemik is om die skadelike gevolge van dwelmgebruik te minimaliseer, vereis nie dat daar van dwelmgebruik moet onthou word nie. Onthouding of weerhouding dien dikwels as 'n hoë drempelvoorwaarde vir toegang tot noodsaaklike behandelingsprogramme soos geestesgesondheidsorg, TB-sorg en nooddienste. Skadevermindering blyk 'n pragmatiese, onbevooroordeelde, meer haalbare en meer oortuigende reaksie op verslawing te wees as onthoudingsgebaseerde behandelingsprogramme. Na aanleiding van 'n Suid-Afrikaanse lae-drempel opioïed agonis terapie projek gebaseer op die belangrikste kenmerke van die SuidAfrikaanse begrip van Ubuntu, argumenteer ek dat sosiale kohesie, of groepsolidariteit, deelname aan skadeverminderingsprogramme soos metadoon-onderhoudsbehandelingsprogramme grootliks verhoog. Hieruit formuleer ek my argument en ek voer aan dat ubuntu-verwante insigte as 'n raamwerk kan dien wat kliniese reaksies op verslawing in die algemeen inlig. Hierdie raamwerk kan skadeverminderingstrategieë aanvul, help met die verskaffing van nie-bestraffende deernissorg, die fundamentele probleem van sosiale uitsluiting, isolasie en eensaamheid aanspreek, en broodnodige waardigheid en geregtigheid herstel in reaksie op verslawing. Masters 2023-01-31T19:17:28Z 2023-05-18T06:59:37Z 2023-01-31T19:17:28Z 2023-05-18T06:59:37Z 2023-01 Thesis http://hdl.handle.net/10019.1/127002 en_ZA en_ZA Stellenbosch University xi, 78 pages application/pdf Stellenbosch : Stellenbosch University |
| spellingShingle | Applied ethics Compulsive behavior Addicts -- Rehabilitation Social norms Walter, Sheridan A framework for compassionate clinical responses to addiction |
| title | A framework for compassionate clinical responses to addiction |
| title_full | A framework for compassionate clinical responses to addiction |
| title_fullStr | A framework for compassionate clinical responses to addiction |
| title_full_unstemmed | A framework for compassionate clinical responses to addiction |
| title_short | A framework for compassionate clinical responses to addiction |
| title_sort | framework for compassionate clinical responses to addiction |
| topic | Applied ethics Compulsive behavior Addicts -- Rehabilitation Social norms |
| url | http://hdl.handle.net/10019.1/127002 |
| work_keys_str_mv | AT waltersheridan aframeworkforcompassionateclinicalresponsestoaddiction AT waltersheridan frameworkforcompassionateclinicalresponsestoaddiction |