Aside from journalistic accounts detailing the pitfalls of drug treatment (Shavelson 2001), little research has been done on the recovery process as it actually proceeds within particular programs. Research is not always well incorporated into treatment settings, which may resist innovations due to internal organizational factors (Hilton et al. 2002). Conducting research in criminal justice settings, including drug courts or programs administered through drug courts, is also problematic (Belenko 2002;Castellano 2007). Nonetheless, more such research is needed as treatment and recovery services become central features of the national response to substance abuse, especially in an era of prison downsizing. This will also require research that actively engages with communities and institutions (Sterk 1999). The proposed research will work collaboratively with multiple agencies to investigate the process of treatment and recovery as it occurs in women who participate in Fresh Start. Fresh Start is a substance abuse intervention program for female street sex workers who have come into repeated contact with law enforcement. Fresh Start is a coercive recovery-based program that serves as a direct contrast to voluntary, traditional, treatment-based programs. The program serves as an alternative to jail time for these women, who are arrested in periodic sweeps of neighborhoods where street prostitution is common. We predict that, prior to entering residential treatment through Fresh Start, women will have daily routines dominated by """"""""street"""""""" networks that are relatively constricted and immersed in drug use and drug- using contexts. For those that enter residential treatment and stay in the program for a year, we predict that networks will remain relatively constricted, but will instead be largely immersed in treatment-dominated contexts. In the recovery stage, women will be engaging with the larger community, that is, interacting with more people who are not in treatment or recovery. In this stage, we predict that networks may grow more extensive and variable, as women begin to explore new avenues of social interaction and opportunity. Using interdisciplinary methods, we will seek evidence of desired change in social networks, sociospatial contexts, and economic behaviors, resources and outcomes.

Public Health Relevance

Treatment professionals and substance abuse researchers agree that both successful drug abuse recovery and exiting street prostitution require changes in social networks and accompanying economic independence (Hansen, Lopez-Iftikhar, and Alegria 2002;Oggins, Guydish, Delucchi 2001;Benson and Mathews 1995;Rosenthal 1984). These changes can be both quantitatively and qualitatively described by studying street prostitutes who are engaged in the treatment and recovery process through the application of ethnographic and economic instruments and an accompanying mapping of changing social networks. The proposed work has implications for women's health and welfare and the prevention and treatment of sexually transmitted disease.

National Institute of Health (NIH)
National Institute on Drug Abuse (NIDA)
Exploratory/Developmental Grants (R21)
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Study Section
Community Influences on Health Behavior (CIHB)
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Duffy, Sarah Q
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University of Michigan at Dearborn
Social Sciences
Schools of Arts and Sciences
United States
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Draus, Paul; Roddy, Juliette; Asabigi, Kanzoni (2015) Making sense of the transition from the Detroit streets to drug treatment. Qual Health Res 25:228-40