Aim: Know the meanings and family coping of adolescents who consume drugs in rehabilitation.

Method: Qualitative research with a phenomenological design sought to know the life stories of the families of adolescents who consume drugs in a rehabilitation center in the city of Chihuahua. Participant observation, field diary and in-depth interview were used, content analysis was carried out in three moments: discovery, coding and construction of units of meaning.

Results: The consumption of addictive substances in an adolescent causes changes and feelings in family dynamics, generating helplessness, and anger and at the same time stress and fear. From the perspective of the coping experienced by the family of the adolescent who uses drugs, there are four categories: poor family communication; to us as a family who takes care of us; mother's intuition, an awakening to reality and finally defeat as a family.

Conclusion: It is not easy to structure a form of care, it was necessary to reach the most sensitive fibers of the human being in order to understand the processes in which he is immersed, establishing an intimate and intentional dialogue with him, since he is surrounded by a whirlwind of pain and suffering.

Keywords: family coping, teenagers, consumption of drugs

The complexity of the drug phenomenon in its broad contextualization continues to be a family, social and public health problem throughout the world. Far from being minimized, it has worsened alarmingly in recent years like a cancer that, despite the efforts of the various associations and institutions continue to advance. The consumption of psychoactive substances has been an issue that has reached a critical point in which the State has fallen short with the management, control of trafficking and manipulation of narcotics, understanding that in recent years, the blow to drug trafficking has caused the psychoactive substances that were intended to be taken to other countries to remain circulating within the country, thus generating a notable growth in the number of people who are immersing themselves every day in the world of drugs and in the network of psychoactive substances.

The problem of addictions in the family is related to its structure coined by historical, social, cultural and economic aspects, which consider addictions as a problem that requires being hidden and kept as a family secret.¹ Hence the problem of addictions in the family becomes even more complex, since the person with addiction coexists between denial and concealment.²

In today's world it is evident that there are multiple perceptions that have arisen regarding the problems that emerge from the consumption of psychoactive substances, therefore it could not be established as a univocal situation since in this case both what you think and what you think are taken into account families that have young users of psychoactive substances, such as the user of said substances.

Therefore, the question that guided this research was: What are the meanings and family coping of adolescents who use drugs in rehabilitation?

A qualitative study with a phenomenological design was carried out to obtain the life stories, perceptions and meanings of the experience of families of adolescents who consume drugs.³

The selection criterion was being parents who were in a rehabilitation center in the city of Chihuahua with a teenage son with addiction problems. Prior to collecting the information, it was reviewed and authorized by the Ethics and Research Committee of the Faculty of Nursing and Nutrition of the Autonomous University of Chihuahua. The parents were approached at the rehabilitation center and a place, date and time were agreed upon to obtain the information. The interview, observation and data recording were used as a technique and a semi-structured guide was used as an instrument. The interview was recorded, with prior authorization and signing of the informed consent and then transcribed as expressed by the parents.

The number of participants was determined by the saturation of the information, that is, when the analysis of the interviews no longer generated new units of meaning, this was achieved with 12 participants, who were identified with the letter “P” for participant followed by consecutive numbering. The research adhered at all times to the ethical principles of beneficence and non-maleficence, seeking to protect life, dignity, integrity and privacy.^4,5 The confidentiality of the personal information of each of the participants was guaranteed.

The analysis of the information was carried out according to Husserl's phenomenology,³ the transcribed sections were read line by line to gain insight into the history and essence of the phenomenon under study, which made it possible to identify units of meaning that were coded to create the results.

To achieve methodological rigor in the research, the credibility criterion was applied, which consisted of returning the descriptions made to the participating parents, in order to verify if the content was a reflection of the information provided; Likewise, confirmation, auditability through the substantiation of each unit of meaning constructed from the information and finally the transfer of the results obtained through presentation at scientific events and in library spaces of the Autonomous University of Chihuahua.

The units of meaning and the stories are described below from the perspective of coping experienced by eleven families of adolescents who use drugs. Firstly, “Poor family communication”; followed by the unit “To us as a family who takes care of us”; in third place “Intuition of mother an awakening to reality” and finally “Defeat as a family”.

Poor family communication

The family is what teaches the individual to see and interpret reality inside and outside of it. Family conflicts, family disintegration, poor or inadequate communication, among many other behaviors, cause inadequate development that makes it difficult to solve problems and make decisions, turning its members into defenseless beings in the face of any problem.⁶

(…)         “It was very evident to see when my son was using that we lost communication, he became quiet, if we asked him something he simply did not answer, silence was his response and when he said something it was just excuses and lies”(Q.1).

(…)         “we stopped seeing our son, he lived more on the street and on his cell phone, he stopped talking to us, we went out to look for him on the street and when he found him it was just fighting because he didn't obey, it was going to look for him again and again time. It was simply impossible to communicate with him"(Q.3).

(…)         “When we arrived here with our son, there was talk of not having communication as a factor for our son to be addicted, I think they are partly right, but as a mother I tried every way to get closer to my son and I couldn't. "For him it was more important to be on the street with his so-called friends"(Q.7).

(…)         ”I don't know when I lost communication with my daughter, I believed that she needed her space because she was in that complicated stage of adolescence, I didn't understand how to talk to her and I let time pass without imagining what was happening, the “Social networks and following strange friends were an alarm for us as parents and we did not see it until it was too late”(P.11).

To us as a family who takes care of us

The care of parents for their children is a clear act of selfless love and when a member of the family is sick, especially the children, a clear and very precise action of care is created until recovery is achieved; However, when this disease is related to drug consumption, the action and intervention of other actors is necessary, such as institutions or rehabilitation centers creating efforts to recover the sick family member.

The above leads one to think that the family nucleus is fragmented, due to having a member in a situation of drug consumption and the family requires care and not only the member with drug consumption problems, as expressed in the following reports from the parents.

(...) “no one cares for us, we were alone with the addicts, no one loves them, and society thinks that you as a mother are to blame, there is the idea that only parents should tolerate their children”(Q.3).

(…)         ”There is the idea that only adolescents with these problems are the ones who should be cared for, but for us parents, who takes care of us, sometimes it is only scolding and rules that we must comply with as parents, an orientation on how to care for our children our children"(Q.4).

(…)         ”As if one as a mother is always healthy and eternal to take care of others, but no one takes care of me, as parents we also have needs and one of them is to be cared for and not because we are sick with something is sometimes a Sorrow of the soul"( Q.9).

(…)         “When a child enters rehabilitation, the efforts and attention are only for them because it is assumed that they are the only ones who need the care, but as parents we also need to be cared for, but care based on our need and not only to know how to care of the other"(P.10).

(…)         Here in the rehabilitation center there are people prepared to take care of our children, of course prepared in life or in their own experience, I think that it is necessary to always have a 24-hour health professional, but that is not the case, They evaluate them when they enter and that's it, then a follow-up after a few days and so on. “This care is only for the inmates, not for the parents, for us only the orientation as a family.”(P.12).

Mother's intuition an awakening to reality

The so-called blindfold on the parents' eyes in the face of a reality that exists and shouts at the top of their voice: "Here I am!" to their own parents or expulsion from school, the loss of a job, an important affection or other painful situations, that is, something that makes them go into crisis and feel the need to finally open their eyes, to realize of this sad reality that is consuming them all as a family and that unfortunately grows day by day without wanting to recognize this reality. This is how parents express it:

(…)         “The pain of a mother when she recognizes that she has an addicted child is something completely inexplicable, first the denial, pretending that everything is fine, until she simply has to accept reality”(Q.2).

(…)         “It is suffering, you suffer because your child is addicted and you also suffer for the entire family, because this affects everyone, not just the one who is addicted”(Q.5).

(…)         ”Denying reality is something that every parent does, comments begin between neighbors among the people around you and you as a mother pretend that you don't listen, you close your eyes to convince yourself that it is not true, and in the end you don't. "You have more to accept than accepting that your son is addicted."(Q.9).

(…) “Knowing reality as a mother is not easy, at first I denied it, then I knew it but I did nothing, I pretended that I didn't know it, then you turn it around thinking that it is not a problem, until you face a monster that called addiction (P.14).

Defeat as a family

It is considered that the family system is a changing structure that goes through different evolutionary periods. These changes are reflected in the expectations or forms of interaction and in the coping strategies of the individual who, throughout his or her existence, acquires skills to cope with the various situations that appear daily or new ones as well. When a situation arises where control is lost, such as the case of drug use by the adolescent, a feeling of defeat takes over the family system, then the expectations they had before awakening to reality are modified, appreciating very distant and even unattainable, as well as the following stories:

(…)         “As a family we feel like we are in the dark, it is something that cannot be explained, it is a very frustrating feeling, you feel that you failed as parents, you feel guilty because your child is addicted”(Q.1).

(…)         “It is impossible not to think that you fail as a parent, you think that you did not do things well as parents, you did not know how to educate your child well, the fact that your child is an addict is like a reminder of your defeat as a parent. Here at the center they teach us to remove that guilt, and we are working on that”(Q.6).

(…)         “Here we have been taught that it is not your fault as parents that your child is addicted, but it is difficult not to think about it and you begin to imagine that if you had done this or that but unfortunately he would not exist”(P.13).

The results of this study are placed below in the context of scientific knowledge of knowledge. Deficient family communication as the first unit of meaning found regains great relevance in current times. The results of this research show how the family relationships of adolescents who are in rehabilitation are seriously fragmented, on the one hand poor communication as a visible expression of the breakdown of the relationship between parents and children, but at the same time as a symptom of the root of the problem called addiction. In this regard, Morales,⁷ states that assertive family communication favors cohesion and adaptability within the family nucleus; Contrary to functioning problems, poor communication between parents and adolescent children and the lack of affection for them, it constitutes a risk factor closely linked to the consumption of alcohol and other drugs.

The family is usually expected to strengthen and encourage good behavior in children through the process of socialization of ethical and moral principles and values. However, the modern family is questioned because of some values that have been distorted, which has caused new behaviors in children and young people today.⁸

A determining factor today is the use of technologies, the results showed how social networks and friendships played a negative role in these families, it was evident how communication between friends influenced drug consumption. In this sense Cruz,⁹ refer that the relationships established in social networks are a valuable tool to understand the beginning and evolution of drug use over time, due to their potential to influence patterns of use, referring to mechanisms of persuasion and imitation of peers, which becomes a risk factor for consumption.

Given this unstructured reality that adolescents have and the serious problem of drug consumption, they arrived at the admission of a rehabilitation institution for their care, surveillance and monitoring. For the family, this situation is not at all gratifying, on the one hand the joy of finding help in their child's rehabilitation but at the same time the worry, the time invested and the financial resources that must be allocated for their child's recovery. This is where the home, the other members of the family, work become the new problem to address, in addition to the emotional burden generated by the situation.

This is where the second unit of meaning arose named “To us as a family who takes care of us.” It is naturally understood how the family should be involved in the recovery of adolescents with addiction, however this research allowed us to recognize the need that the family has to be cared for and valued outside of their child's recovery process. This is where Torres¹⁰ mentions that the recovery of the addict's family is necessary to be able to comprehensively heal all the damage caused by addiction in the family system.

The expression of the parents interviewed is one of help, desperation and anguish, it is a constant cry for help, not for their son in rehabilitation, it is a call to care for them as a family, as people. They report that the attention is focused on the rehabilitation of their children, the entire staff looking towards their children, which they appreciate, but the need also arises to be the object of care. The literature only refers to the participation of the family in the recovery and treatment of the person with addictions, there are workshops for family integration, on protective factors so that there is no relapse, in short, a series of measures that facilitate the life of the person rehabilitated person, however little exists about individual family care.

The above leads to the third unit of meaning that emerged in this research, called the “intuition of mother a desertion to reality.” This reality forced the parents, especially the mother, to forget her need and awaken her to reality even when the problem of child addition was evident your son.¹¹ The family of the addicted person often suffers from a condition known as “codependency.” In many cases the thoughts and feelings of wives, children and siblings are controlled by the behavior and emotions of the addict and this causes the destruction of the family unit. Family members may feel responsible for the problem, as it may give them mistaken hope that they can “cure” their loved one.

The feeling expressed by the parents is just as the last unit of meaning was named “Defeat as a family.” such as feelings of guilt for neglecting their children, believing that they did not dedicate enough time to their good upbringing, feeling that they dedicated more time to work and economic contribution, neglecting the ethical and moral side; both physical and psychological aggression, which occurs between spouses due to the reproach of one of them because they did not know how to raise their children; feelings of frustration when not obtaining the expected results when trying to solve the addiction problem of the affected child eleven.

It is not easy to structure a form of care, it was necessary to reach the most sensitive fibers of the human being in order to understand the processes in which finds himself immersed, establishing an intimate and intentional dialogue with him, since a whirlwind of pain and suffering surrounds him.

Without a doubt, the family is an elemental part in the history of substance use and abuse, in its detection, acceptance, orientation, channeling, treatment, rehabilitation and maintenance of abstinence, as well as reducing or causing relapses; It is therefore a key element in the generation and recovery of drug dependence.

This is where the support of health professionals towards the family system in crisis lies, emerging the need for nursing care, understanding it as the way in which said care is given, being a conjunction between the caregiver and the being cared for, Regarding this conjunction, Torralba¹² mentions “In the action of caring for a human being there is an encounter between two personal universes, between two free worlds, between two consciences, between two singular destinies in history.”

None.

The authors declare that there is no conflict of interest.

None.

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