Contributing factors to relapse of drug addiction among clients attending rehabilitation centres of Dharan, Nepal

Abstract

Relapse is the resumption of substance after a period of abstinence. It is frustrating but frequent part of recovery process. Several substance including opiates, cocaine and alcohol have particularly has high relapse rate with majority of client relapsing within 1 year following treatment. The first 90 days after treatment are very vulnerable time. Hence, the objective of the study is to assess the contributing factors to relapse of drug addiction since the aftercare services, the psycho-social aspect of the treatment has been ignored and high relapse is prevalent among the treated clients. A descriptive cross-sectional study was carried out among clients attending three rehabilitation centres of Dharan using lottery method of simple random sampling among 72 respondents using structured questionnaires from 20th September to 4th October, 2015. Findings of the study showed that majority (63.9%) of the respondents had started taking drugs again due to lack of self confidence. In addition to this another contributing factor to relapse was peer pressure (50%) followed by inability to give old habits (44.4%), easy accessibility of drugs (30.6%). The finding also indicated that there was significant relationship (p value = 0.054) between peer pressure and employment status. Lack of self-confidence, peer pressure, easy accessibility of drugs, lack of acceptance in society and family, adjustment problems had increased the chance of relapse after treatment. So, the treatment centres of Dharan should develop program that incorporate the overall development and treatment of client to prevent from relapse of drug addiction.

Factors Associated with Relapse in Men with Alcohol Dependence Versus Opioid Dependence: A Comparative Study From Western Nepal

“…Peer pressure, social or family problems, craving, negative mood state and concentration difficulties were other factors commonly found to be contributing to relapse in both groups. Similar results were 9,15,16 observed in some previous studies .…”

Determinants and prevalence of relapse among patients with substance use disorders: case of Icyizere Psychotherapeutic Centre

“…It was indicated that the social context can serve either as a resource or an obstacle for behavior change by the patient post treatment. For example, “negative peer influences have been noted in the development of substance use behavior and the promotion of relapse [ 9 , 33 ]. Similar authors found that patients were unable to resist either direct or indirect attempts by others to engage them in drinking.…”

“…Substance use dependence are episodic, with periods of abstinence, reduction of use, and relapse the prevailing pattern, often with the course of events being influenced by external factors such as availability of drugs and societal pressures [ 9 , 15 ]. Moreover, various factors are associated with relapse to SUD.…”

“…More than 50 % of person with SUD relapsed after treatment [4,6]. Other studies have documented that the relapse rates following treatments are high [4,7] and typically reaches 40-75 % in 3 weeks to 6 months period following treatment [6,[8][9][10].…”

“…Those factors are classified into individual, socio-demographic, psychiatric, medical conditions, and socio-cultural influences that may be controlled [16][17][18]. For instance, preceding studies found that young age at initiation, sex, unemployment, singular status, peer group influence, family history of substance use, conflict and poor family support, environmental factors like availability and accessibility of drugs are contributing factors of relapse [2,7,9,[19][20][21][22]. Physical factors can also increase the risk of relapse including physical illnesses, physical dependence on drugs, withdrawal from drugs and being in negative physical state [20,23,24].…”