Psycho-social factors associated with relapse in patients with substance use disorder " A comparative study "

Abstract

Drug addiction exacts an enormous medical, financial, and emotional toll on society in the form of overdose and health complications, family disintegration, loss of employment, and crime. Substance use disorder represents a serious national problem in Egypt. Substance use disorder is a chronically relapsing disorder characterized by; compulsion to seek and take the drug, loss of control in limiting intake, and emergence of a negative emotional state (e.g., dysphoria, anxiety, irritability), reflecting a motivational withdrawal syndrome when access to the drug is prevented. relapse occurs when the addict resumes his or her addictive behavior after a period of abstinence for people trying to control their behavior rather than trying to quit entirely, a relapse is a period of uncontrolled behavior, relapse is a hallmark of addiction, it is common even expected, that people who are attempting to overcome an addiction will go through one or even several relapses before successfully quitting. There are many risk factors for relapse & they vary from person to person a powerful need to stimulate reward centres within the brain can be the trigger point for an addict who is used to getting a certain drug, both external & internal factors can create the urge to use drugs again. Internal risk factors include a persistently negative mood, feeling stressed or depressed, a genetic predisposition or family history of addiction & coexisting psychiatric problems, while significant external psychological or social stressor can play apart in bringing on a relapse. Psycho-social factors, such as mental health, social functioning and significant life events, may also influence relapse rates and substance use among substance use patient It is important for relapse prevention management to identify the social and psychological predictors of relapse. Aim of the work: This study was conducted aiming to study psycho-social factors (predictors), affecting relapse among an Egyptian sample of patients with substance use disorder. The review of literatures included 3 chapters: Chapter (1): It represents epidemiology of substance use problem worldwide & in Egypt and risk factors of substance use. The biological basis of substance use, definitions and explaining relapse process and its precipitins and warning signs, then the stages of relapse and some tools to measure relapse of substance use. Chapter (2): It was concerned with psycho-social risk factors and determinants of relapse, (Social determinants of relapse, the role of stress in relapse and psychological factors affecting relapse; intrapersonal factors, explaining craving and its models and also interpersonal factors). Chapter (3): This chapter discussed relapse prevention in details including:  The different models of relapse prevention, (cognitive behavioral model, dynamic model, matrix model, twelve-step, psychotherapeutic and skills training approach and mindfulness-based relapse prevention).  Role of pharmacotherapy in relapse prevention.  Relapse prevention strategies or coping skills, (intrapersonal skills and interpersonal skills).