Document Type : Original Article

Authors

1 Department of Public Health, School of Health, Social Determinants of Health Research Center, Hamadan University of Medical Sciences, Hamadan, Iran

2 Department of Epidemiology, School of Health, Modeling of Noncommunicable Diseases Research Center, Hamadan University of Medical Sciences, Hamadan, Iran

3 Department of Psychiatry, School of Medicine, Research Center for Behavioral Disorders and Substance Abuse, Hamadan University of Medical Sciences, Hamadan, Iran, 4

4 Department of Behavioral and Environmental Health, School of Public Health, Jackson State University, Jackson, MS, USA

Abstract

BACKGROUND: Substance use relapse after treatment is one of the most important aspects of
addiction. The present study aimed to investigate the factors affecting the substance use relapse
among Iranian addicts.
MATERIALS AND METHODS: This cross‑sectional study was conducted in 2019 on 396 addicts
referring to the addiction treatment centers in Hamadan, who were selected using a cluster random
sampling method. The data were collected by a two‑section questionnaire (demographic variables
and risk factors for substance abuse recurrence). The collected data were analyzed using descriptive
statistics and logistic regression analysis.
RESULTS: The participants’ mean (standard deviation) age was 36.56 (8.8) years, and 84.6%
of the participants had a history of relapse. The logistic regression analysis revealed that
marital status (odds ratio [OR] = 2.594; 95% confidence interval [CI]: 1.472–4.570), personal
willingness (OR = 8.186; 95% CI: 1.875–35.738), pleasure (OR = 2.738; 95% CI: 1.122–6.679), drug
availability (OR = 3.392; 95% CI: 1.023–11.247), family disputes (OR = 4.583; 95% CI: 1.345–15.609),
an addicted friend (OR = 2.693; 95% CI: 1.014–7.157), and close addicted relatives (OR = 3.513;95%
CI: 1.193–10.348) were the main predictors of addiction relapse (P < 0.05).
CONCLUSION: The present study confirmed the effect of several factors (namely demographic,
individual, interpersonal, environmental, and behavioral) on the substance use relapse. Accordingly,
designing and implementing some interventions based on the findings of the present study may
contribute to preventing substance use relapse.

Keywords

1. Shahraki G, SedaghatZ, Fararouei M. Family and social predictors
of substance use disorder in Iran: A case‑control study. Subst
Abuse Treat Prev Policy 2019;14:17.
2. Emcdda E. EU Drug Markets Report 2019. Luxembourg:
Publications Office of the European Union; 2019.
3. Akbari H, Roshanpajouh M, Nourijelyani K, Mansournia MA,
Rahimi‑Movaghar A, Yazdani K. Profile of drug users in the
residential treatment centers of Tehran, Iran. Health Promot
Perspect 2019;9:248‑54.
4. Simpson DD, Joe GW, Knight K, Rowan‑Szal GA, Gray JS. Texas
Christian University (TCU) short forms for assessing client
needs and functioning in addiction treatment. J Offender Rehabil
2012;51:34‑56.
5. Haghighi M, Alizadeh F, Rezaei T, Rezakhani Moghaddam H,
Sodaei Zenoozagh H, Mohammadpoorasl A. Environmental
and personal factors associated with addiction relapse in referral
patients to Marand treatment centers. J Community Health Rese
2018;7:63‑73.
6. Laudet AB. The road to recovery: Where are we going and how
do we get there? Empirically driven conclusions and future
directions for service development and research. Subst Use Misuse
2008;43:2001‑20.
7. Hao SQ, Zhao M, Zhang RW, Zhang JC, Zhang J, Feng XS. The
effectiveness comparison of Jitai tablets versus methadone in
community‑based drug treatment: A 1‑year follow‑up study.
Addict Behav 2013;38:2596‑600.
8. Shafiei E, Hoseini AF, Bibak A, Azmal M. High risk situations
predicting relapse in self‑referred addicts to bushehr province
substance abuse treatment centers. Int J High Risk Behav Addict
2014; 3: e16381.
9. Nunes EV, Gordon M, Friedmann PD, Fishman MJ, Lee JD,
Chen DT, et al. Relapse to opioid use disorder after inpatient
treatment: Protective effect of injection naltrexone. J Subst Abuse
Treat 2018;85:49‑55.
10. Fallahzadeh H, Hosseini N. The study of the causes of relapse
in addicts referring to Behzisti of Yazd. Tolooe Behdasht
2000;06:67‑73.
11. Deepti SS, Kaur S, Kaur J. A study of drug relapse and its
associated factors among cases admitted in Swami Vivekananda
Drug De‑addiction Centre, GMC, Amritsar. Int J Interdiscip
Multidiscip Stud 2014;2100‑5.
12. Afkar A, Rezvani SM, Sigaroudi AE. Measurement of factors
influencing the relapse of addiction: A factor analysis. Int J High
Risk Behav Addict 2017;6:e32141.
13. Barati M, Hidarnia A, Niknami S, Allahverdipour H. Factors
Associated With Tobacco Smoking Among Male Adolescents: The
Role of Psychologic, Behavioral, and Demographic Risk Factors.
Avicenna Journal of Neuropsychophysiology 2015;2:18‑24.
14. Kikhavandi S, Menati R, Kassani A, Menati W. Associated
factors with addiction relapse in patients of referring to addiction
treatment centers in Ilam: A case‑control study. Sci J Ilam Univ
Med Sci 2015;22:165‑73.
15. Ahmadi K, Maleki M, Alipour M. Addiction relapse in Iranian
veterans: Determination of etiologies and solutions. Iran J War
Public Health 2010;2:40‑4.
16. Allahverdipour H, Farhadinasab A, Bashirian S, Mahjub H.
Pattern of drug abuse among younger adults. J Yazd Univ Med
Sci 2007;15:35‑42.
17. Mansouri A. Prevalence and attitude about using drugs and
tobaccos in male students. Zahedan Journal of Research in Medical
Sciences 2012; 13.
18. Amini K, Amini D, Afsharmoghaddam F, Mahyar A. Social and
environmental factors related to recurrent drug abuse in addicts
referred to addiction treatment centers in Hamadan, 2000. J Adv
Med Biomed Res 2003;11:41‑7.
19. Moradi S, Ghorbani R, Radbakhsh N. Attitudes toward drugs
abuse and some related factors among Iranian high school
students. Koomesh 2018;20:325‑35.
20. Seraji A, Momeni H, Salehi A. The investigation of factors affecting
dependence on narcotics and reappearance of drug usage in
narcotics anonymous population in Khomein. Arak Med Univ J
2010;13:68‑75.
21. Ashrafi Hafez A, Kazemeini T, Shayan S. The relationship of
social support and religious orientation with relapse rates in
opioid dependent patients under methadone maintenance
therapy. J Nurs Midwifery Faculty Shaheed Beheshti Univ Med
Sci 2015;24:72‑38.
22. Karami‑Matin B, Barati M, Rahimi S, Zolghadr R, Fattahi M,
Mahboubi M . Mental health status: A cross sectional study among
male addicts in the West of Iran. Res J Med Sci 2016;10:159‑63.
23. Sharg A, Shakibi A, Neisari R, Aliloo L. Survey of factors related
to the relapse of addiction from view of addict patients attending
to drug abuse treatment clinics in West Azerbaijan. Urmia Med J
2011;22:129‑36.
24. Safari M, Mousavi‑Zade S. Factor influences on return to
substance abuse in clients referred to addiction treatment centers
in Maragheh City in 1390. J Shahid Beheshti Schl Nurs Midwifery
2014;24:57‑64.
25. Din Mohammadi M, Amini K, Yazdan Khah M. Survey of social
and environmental factors related to the relapse of addiction in
volunteer addicted individuals in welfare organization of Zanjan.
J Adv Med Biomed Res 2007;15:85‑94.
26. Nastizayi N, Hezareh Moghadam M, Mollazehi A. The study of
factors for recurred addiction from the view of self‑introduced
addicts to the addiction abandonment centers of zahedan. J Urmia
Nurs Midwifery Faculty 2010;8:0‑0.
27. Mirzaei T, Ravary A, Hanifi N, Miri S, Oskouie F,
Mirzaei Khalil Abadi S. Addicts’ perspectives about factors
associated with substance abuse relapse. Iran J Nurs 2010;23:49‑58.
28. Abasi H. The role of interventions in reduction of smoking in
high school adole