Drug abuse is not a new concept and there is no doubt that it is a public health problem as it has reached epidemic proportions both nationally and internationally. With the increase in drug abuse, treatment demands are also proven to be increasing. Even more so, the rate of re-admissions into treatment centres following relapse after previous in-patient treatment for drug abuse, is also on the increase. “Drug addiction is a chronic, relapsing disorder in which compulsive drug-taking behaviour persists despite serious negative consequences” (Cami & Farrè, 2003:975). Relapse refers to the return of drug use, after detoxification and in-patient treatment for at least six- to twelve weeks; together with the marked return of behaviours associated with drug use. Relapse rates have been found to be high both nationally and internationally. Considering South African statistics, in 2013, 22% of admissions into treatment centres were re-admissions (SACENDU, 2014:15). The problem of relapse is undoubtedly one of the most important challenges facing the field of addictions. In line with literature, it has become apparent that young African adults are being re-admitted on a frequent basis and the need for research amongst this target group was thus confirmed. The goal of this study was to determine the causes of relapse amongst young African adults following in-patient treatment for drug abuse in the Gauteng Province.
The theoretical frameworks that guided and informed this study was the adaptation model and the eco-systems perspective. The importance of being able to adapt to the environment at all levels of functioning (micro, meso and macro level) following in-patient treatment for drug abuse was regarded as important in determining the causes of relapse amongst young African adults.
This study used a quantitative approach with a non-experimental research design. The implementation of this study fell within the applied research category and was furthermore exploratory in nature. In this study a survey was undertaken to collect quantitative data from the respondents. The replicated randomised cross-sectional survey design was applicable as the survey was conducted with different samples randomly drawn from the population and was conducted with each sample. The study was conducted by applying stratified random sampling in combination with purposive sampling in the selection of respondents. The population was divided in terms of different strata, which included four in-patient treatment centres within the Gauteng Province that was part of this study. Within each of the strata, purposive sampling was employed to recruit prospective respondents. A total of 44 respondents took part in this study. All the respondents gave voluntary informed consent to partake in the study and completed a group-administered questionnaire. The data were analysed by making use of descriptive statistics, more specifically association statistics.
From the findings, the following causes of relapse amongst young African adults were identified: (1) Environmental risk factors, which included availability and accessibility of drugs and environmental cues; (2) interpersonal/ social risk factors including peer group influence, limited access to services in the community, lack of recreational activities, stigmatisation by community members, lack of support needed after treatment, conflict management, and difficulty finding employment; (3) intrapersonal risk factors including emotions and dealing with emotions, loneliness, lack of effective coping mechanisms and stress management, lack of assertiveness and easily influenced by others, cravings, losing motivation and commitment towards maintaining abstinence, controlled drug use, and the decision not to attend aftercare support services and (4) physical risk factors which included experiencing physical pain.
The conclusions of this study reflect that young African adults‟ communities (environments) are not conducive to recovery. This together with intrapersonal differences makes maintaining abstinence difficult for the young African adult. Rehabilitation of people with drug abuse problems must therefore be holistic and address both psychological developmental issues and environmental challenges as experienced by the young African adult.
Recommendations from this study can be used by in-patient treatment centres to improve their existing treatment programmes. By dividing service users in accordance to their gender and ages (developmental phase) treatment can be more specific to include specific challenges faced by them. It is recommended that a structured aftercare programme based on the causes of relapse amongst young African adults be implemented. Professionals should be educated with regard to aftercare services in an attempt to improve the utilisation and referral to such services. Future research that can contribute to relapse prevention include exploring the ignorance and barriers to effective aftercare being rendered; the effect of including skills development in a treatment programme; and the factors hindering efficient family support.