Factors influencing relapse after successful detoxification or rehabilitation among patients with substance use disorders

Abstract

This study investigated the biological, social, clinical and psychological factors influencing relapse after successful detoxification or rehabilitation among patients with substance use disorders. Employing a retrospective study design, the study analyzed secondary data from 852 patients admitted to Butabika National Referral Hospital with alcohol and drug use disorders between January 2022 and June 2022. Data extracted from patient files, retrieved from the records department, constituted the dataset for examination. Frequency distributions were conducted for each independent variable, followed by Chi-square test and t-test statistics to explore associations with relapse. Logistic regression was applied to investigate potential factors associated with relapse. The findings showed that 79.1% (95%CI: 60.2, 80.4) of the patients relapsed. Noteworthy factors associated with relapse included; family history of drug abuse, administration of antidepressants and the type of patient management (inpatient or outpatient). Patients with a family history of drug use disorder had about twice the odds of relapse than those without such a history (OR= 1.74; 95%CI: 1.11, 2.71). Outpatients had 50% higher odds of relapsing as compared to inpatients (OR= 1.55; 95%CI: 1.09, 2.21). Further, patients who did not receive antidepressants had about twice the odds of relapse than those given the antidepressants (OR= 2.45; 95%CI: 1.12, 5.14). Results showed significant interactions between receiving antidepressants and type of patient management (outpatient vs. inpatient), receiving antidepressants and family history of substance use, and type of patient management and family history of drug use. Patients managed as outpatients and not given antidepressants had 2.9 higher odds of relapse compared to in-patients managed with antidepressants (OR= 2.90; 95%CI: 1.56, 5.36). Similarly, outpatients with a family history of drug abuse had 2.5 times the odds of relapse as compared to in-patients without family history of drug use (OR= 2.50; 95%CI: 1.33, 4.70). Furthermore, patients who were not given antidepressants and had a family history of drug abuse had almost three times odds of relapse compared to patients given antidepressants and had no family history of drug abuse (OR= 2.75; 95%CI: 1.45, 5.21). The study recommends intensified attention to patients with a family history of drug use, advocates for inpatient care for individuals with substance use disorders, and suggests judicious administration of antidepressants for effective drug use disorder management.