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

Abstract

Background: Relapse to substance use after successful detoxication and rehabilitation is a public health concern worldwide. Forty to sixty percent of persons in general relapsed after completing detoxication and rehabilitation treatments. Although substance use remains a burden in Rwanda, very little is known about relapse among people with substance use disorder (SUD). Hence, this study aimed to examine prevalence and the factors associated with relapse to substance use at Icyizere Psychotherapeutic Centre (IPC), Rwanda.

Methods: Retrospective, cross-sectional survey was conducted among 391 patients with SUD at IPC. Multiple logistic regression models using STATA version 13 were used to determine the factors associated with relapse among the patients with SUD.

Results: Majority (84.1 %) of the participants were males. More than half (54.1 %) of them were aged between 18 and 30 years with the age average of 33 years (SD = 11.9 years). The results showed a higher prevalence of relapse among patients with SUD (59.9 %). The multivariate analyses indicated that people with SUD living only with their mothers had a greater risk of relapse compared to those with both biological parents [OR = 1.9, 95 % CI (1.02-3.6), p = 0.04]. Patients that were hospitalized between one to three months were more likely (11.2 times) to relapse after treatments compared to those who spent more than three months in hospitalization [OR = 9.2, 95 % CI (1.1-77.6), p = 0.02]. Furthermore, people that used more than two substances had 1.5 greater risk to relapse than those who consumed one substance. Participants were more likely to relapse if they lived with their peers [OR = 2.4, 95 % CI: (1.2-7.8), p = 0.01] or if they lived in a family with conflicts [OR = 2.1, 95 % CI (1.05-9.7), p = 0.02].

Conclusions: This study is conducted at one institution caring for patients with SUD. The prevalence was 59.9 %. Future studies are recommended to investigate the effectiveness of the existing relapse prevention programs in order to adjust prevention strategies.

Keywords: Detoxification‐rehabilitation; Rehabilitation centre; Relapse; Substance use disorder.

Fig. 1

Conceptual framework. Based on the prior studies, this figure shows that the relapse is associated with various determinants that are classified into environmental factors, interpersonal or social factors, socio-demographic factors, intrapersonal factors and physical factors. Environmental included the factors such as availability and accessibility to drugs, interpersonal or social factors include peer influence, social category, conflict, employment status. But socio-demographic characteristics include the factors such as age, sex, residence, education, marital status, parental status of the participants. For intrapersonal factors, prior studies reported negative emotion whereas phsyicla factors included chronic or acute diseases, physical dependence, withdrawal, illness, post-surgical distress and injury