|Year : 2016 | Volume
| Issue : 1 | Page : 46-49
Relapse coping strategies in young adults addicts: a quantitative study in Iran
Ebrahim Shafiei1, Agha Fatemeh Hoseini2, Farnaz Parsaeian3, Ali Heidarinejad4, Mohammad Azmal4
1 Department of Cardiac Surgery, Bushehr University of Medical Sciences, Bushehr, Iran
2 Department of Biostatistics, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
3 Department of ICU, Rasoul-E-Akram Hospital Complex, Iran University of Medical Sciences, Tehran, Iran
4 Department of Treatment Affairs, Bushehr University of Medical Sciences, Bushehr, Iran
|Date of Web Publication||28-Jan-2016|
Department of Treatment Affairs, Bushehr University of Medical Sciences, Bushehr
Source of Support: None, Conflict of Interest: None
| Abstract|| |
Background: Cognitive-behavioral coping approach is known as an effective strategy to preventing relapse. Its goal is to forget incompatible behaviors and replaces them with the compatible answers. Objectives: This study examines relapse coping strategies in young adults in selected substance abuse treatment centers in Iran. Patients and Methods: The present is a descriptive cross-sectional study. The sample consisted of 70 self-referred young addicts (18-24 years). Adolescence Relapse Coping Questionnaire was used to assess relapse coping strategies. Descriptive statistics was used to analyze the data. Results: The findings revealed that 71.2% have experienced a relapse totally. It was hard to control the hypothetical high risk situation and they greatly wanted to use the substance (mean 7.39 of 10). Addicts have used of all three coping skills in "definitely would do" level. Conclusion: Enhancing self-efficacy through training coping skills, especially abstinence - focused coping skills to react properly in high risk situation can be useful.
Keywords: Coping strategies, relapse, substance abuse treatment centers, young adult addicts
|How to cite this article:|
Shafiei E, Hoseini AF, Parsaeian F, Heidarinejad A, Azmal M. Relapse coping strategies in young adults addicts: a quantitative study in Iran. Indian J Psychol Med 2016;38:46-9
|How to cite this URL:|
Shafiei E, Hoseini AF, Parsaeian F, Heidarinejad A, Azmal M. Relapse coping strategies in young adults addicts: a quantitative study in Iran. Indian J Psychol Med [serial online] 2016 [cited 2019 Aug 20];38:46-9. Available from: http://www.ijpm.info/text.asp?2016/38/1/46/175111
| Introduction|| |
Given to a long history of substance abuse disorders in the world, it also has remained as a serious problem in recent years.  Because of some incorrect beliefs and specific geographical conditions, Iran has favorable conditions for youth to crave toward substance abuse.  Drug abuse is considered as a social problem in the country.  Based on a study which has conducted in Iran, the subjects experienced the drug use before they were 14 years of age in the 1 st time.  It seems that drug abuse among youth is spending a progressive trend in the country.  Hence, finding new ways to deal with this problem is one of the main priorities of Iranian government. In many countries, young adults aged 18-24 years have become a critical population who need to be addressed. This stage of life is assigned with intense psychological and mental disorder. ,
Drug abuse is known as a chronic repetitive process for a long time. Unfortunately, less attention has been paid to it until now. , Anderson (2007) noted that the majority (85%) of relapse occurs among young people when they join together with their peers. 
Research evidences indicate that many psychological factors are involved in drug addiction and subsequent relapse. Coping skills is one of these factors has been confirmed their effectiveness in many studies. The studies reminded these skills reduce drug use and relapse. , Research has shown that relapse prevention can be some extent predicted by increased the types of cognitive coping responses and coping behaviors.  Addiction treatment is a complex process that can be handled through addicts' desire to quit, family involvement and physical and psychological treatments.  Coping cognitive behavioral therapy helps individuals to recognize the difficult situation, avoid them in the right time and apply effective coping mechanisms. Teaching coping skills, changing reinforcement contingencies, and fostering motivation are the some of the basic tasks in this approach. 
Numerous studies indicate that learning coping skills is associated with a high degree of ability to prevent relapse among addicts. , Unfortunately, the relapse rates are high among who are not capable to use effectively coping skills in stressful events (family conflict, peer pressure, financial difficulties or temptations). 
This study aimed to study relapse coping strategies in young adults self-referred to Substance Abuse Treatment Centers in the South Iran.
| Patients And Methods|| |
A cross-sectional descriptive study was conducted to examine relapse coping strategies in young adult addicts to Bushehr public and private substance abuse treatment centers in summer 2013. All of young adult addicts aged 18 to 24 who were treated at these centers were voluntarily recruited. Finally, 70 people (total response rate 75%) of them accepted to participate in the study. Ethical considerations were approved by BPUMS Ethical Committee.
Adolescent Relapse Coping Questionnaire (ARCQ) was used for data collection. The questionnaire was developed by Myers a 34-item self-report measure to evaluate substance abuser coping skills.  The questionnaire introduces a hypothetical situation "you arrive at a friend's house in the evening. There are a few other people; everyone is sitting around talking, drinking, and using drugs. When you sit down, you are offered drugs and something to drink." The questionnaire consisted of two parts: The first, assess appraisal and how he/she response to this hypothetical situation by 10 points scale in six items and the second, evaluates the relapse coping strategies in seven points with 28 items. This part assesses scales of relapse coping strategies including cognitive and behavioral problem solving (12 items), self-critical thinking (7 items), and abstinence focused coping (9 items).
The validity of this survey has been confirmed by expert's views, and the reliability was calculated using Cronbach's alpha coefficient as 0.84. The questionnaire was distributed among addicts. SPSS version 16 and descriptive statistics were used for analyzing data. Results were reported as a mean ± standard deviation for the quantitative variables and percentages for the categorical variables.
| Results|| |
Seventy young adult addicts' aged 18-24 (mean 21.7) who were treated at public and private substance abuse centers participated. All participants were male. The highest level of education was diploma, and the lowest was bachelor's degree. 42% were unemployed. 3/24% single, 4/71% married, and 3/4% was divorced. 29% of them experimented prison. The most substance people taking were opium (37.7%) and heroin (29%), respectively. Participants mentioned their age at the onset of addiction about 17-year-old.
Regarding individuals experience in the hypothetical situation mentioned above, 14.7% of them mentioned they have never been in the situation, 42.6% of them 1-2 times, 22.1% 3-4 times, and 20.6% of them are more than 5 times were facing to this situation. [Table 1] shows that how individuals are dealing with this situation.
As shown in table, this situation has been difficult for participants to cope with (7.39 out of 10) and, furthermore, it was important for them not to use drug (mean 8.03). However, they thought it was something that they could be able to keep themselves from using (7.51).
[Table 2] shows findings from the ARCQ questionnaire and priority items to action by identified response pattern.
According to the findings from [Table 2], the total mean score of coping skills was 5.19. In this regards the highest mean score is related to "self-critical thinking" subscale (5.45). In self-critical thinking subscale the item "wish that you could change what had happened" was the highest and finally, "think that using is bad, you do not want to be part of it" was the highest in the abstinence focused coping subscale.
By prioritizing items based on response pattern to identify interventional areas for action and improvement, we found that the top items are in the subscales are: "Let your feelings out somehow," "try to forget the whole thing," and "use the support of a higher power," respectively.
| Discussion|| |
In this study, 85.3 % of addicts have experienced the hypothetical high-risk situation at least once. It can be said that this situation which individuals is tempted and return to drug use are easily provided in the community. In this regard, it is recommended actions by the families and related institutions to control and prevent the establishment of such circles occur. Based on the findings, it is important for addicts to avoid substances use but it was hard for them and they tend to reuse. These people were listed relapse risk rate and assistance from them in average level. By evaluating individuals responses along with appropriate measures encountering these conditions and cognitive-behavioral coping skills training and upgrading can be helped to prevent recurrence.
In this study, participants have used coping skills in average level (5.19 out of 10) while they could take advantage of these skills at a higher level. It is recommended that authorities especially psychologists working in substance abuse treatment centers should strive to improve addict's skills to be able to avoid substance use if they faced to the similar situations. Given the importance of the third factor-abstinence focused coping-as the best predictor of current and future substance use in individuals, more attention needs to be paid to the training, and improving the skills. This study identified areas that it need to improve. In this regard, it suggested that decision-makers develop an action plan to strengthen these skills. In addition, establishing continuous training programs and develop coping skills by an expert especially, a Psychologist can empower addicts to maintain themselves against any temptation and craving.
| Conclusion|| |
This study examines relapse coping strategies in young addicts in Substance Abuse Treatment Centers in Iran. Based on the findings, addicts desire to reuse substance in a hypothetical high risk situation and it was hard to handle this situation. They used coping skills to avoid this situation at an average level. Improving self-efficacy skills through teaching coping skills can help them in this way.
We sincerely grateful for all physicians, psychologists, managers, and employees of public and private Substance Abuse Treatment Centers in Bushehr province that helped us to conduct the study.
Financial support and sponsorship
This study was conducted by authors' expenses.
Conflicts of interest
There are no conflicts of interest.
| References|| |
Koob GF, Le Moal M. Plasticity of reward neurocircuitry and the 'dark side' of drug addiction. Nat Neurosci 2005;8:1442-4.
Pringle JL, Edmondston LA, Holland CL, Kirisci L, Emptage NP, Balavage VK, et al
. The role of wrap around services in retention and outcome in substance abuse treatment: Findings from the Wrap Around Services Impact Study. Addict Disord Their Treat 2002;1:109-18.
Ziaaddini H, Ziaaddini MR. The household survey of drug abuse in Kerman, Iran. J Appl Sci 2005;5:380-2.
Agahi C, Spencer C. Patterns of drug use among secondary school children in post-revolutionary Iran. Drug Alcohol Depend 1982;9:235-42.
Kelly JF, Hoeppner BB, Urbanoski KA, Slaymaker V. Predicting relapse among young adults: Psychometric validation of the Advanced WArning of RElapse (AWARE) scale. Addict Behav 2011;36:987-93.
Chan YF, Dennis ML, Funk RR. Prevalence and comorbidity of major internalizing and externalizing problems among adolescents and adults presenting to substance abuse treatment. J Subst Abuse Treat 2008;34:14-24.
Ibrahim F, Kumar N. The influence of community on relapse addiction to drug use: Evidence from Malaysia. Eur J Soc Sci 2009;11:471-6.
Marlatt GA. Taxonomy of high-risk situations for alcohol relapse: Evolution and development of a cognitive-behavioral model. Addiction 1996;91(Suppl):S37-49.
Marlatt GA, Donovan DM. Relapse Prevention: Maintenance Strategies in the Treatment of Addictive Behaviors. New York: Guilford Press; 2005.
Anderson KG, Frissell KC, Brown SA. Relapse contexts for substance abusing adolescents with comorbid psychopathology. J Child Adolesc Subst Abuse 2007;17:65-82.
El-Sheikh Sel-G, Bashir TZ. High-risk relapse situations and self-efficacy: Comparison between alcoholics and heroin addicts. Addict Behav 2004;29:753-8.
Litt MD, Kadden RM, Kabela-Cormier E. Individualized assessment and treatment program for alcohol dependence: Results of an initial study to train coping skills. Addiction 2009;104:1837-8.
Deas D, Riggs P, Langenbucher J, Goldman M, Brown S. Adolescents are not adults: Developmental considerations in alcohol users. Alcohol Clin Exp Res 2000;24:232-7.
Shafiei E, Hoseini AF, Bibak A, Azmal M. High Risk Situations Predicting Relapse in Self-Referred Addicts to Bushehr Province Substance Abuse Treatment Centers. International journal of high risk behaviors & addiction 2014;3.
Longabaugh R, Morgenstern J. Cognitive-behavioral coping-skills therapy for alcohol dependence. Current status and future directions. Alcohol Res Health 1999;23:78-85.
Witkiewitz K, Marlatt GA. Relapse prevention for alcohol and drug problems: That was Zen, this is Tao. Am Psychol 2004;59:224-35.
Tapert SF, Ozyurt SS, Myers MG, Brown SA. Neurocognitive ability in adults coping with alcohol and drug relapse temptations. Am J Drug Alcohol Abuse 2004;30:445-w60.
Myers MG, Brown SA. The adolescent relapse coping questionnaire: Psychometric validation. J Stud Alcohol 1996;57:40-6.
[Table 1], [Table 2]