Psychosocial factors associated with relapse in men with alcohol or opioid dependence

Relapse is a common and distressing aspect of substance dependence mediated by several biological and psychosocial factors. This study examined the association between demographic variables, clinical parameters and certain psychosocial factors and relapse among patients with either alcohol or opioid dependence.

Structured assessments of clinical/demographic parameters, relapse precipitants, coping strategies, self-efficacy, stressful life events and perceived social support were carried out among patients with alcohol/opoid dependence (n=30) who had relapsed and compared with those (n=30) who had managed to remain abstinent. Similar comparisons were also carried out between relapsed and abstinent patients in the individual subgroups of alcohol and opioid dependence.

Patients who had relapsed were significantly more likely (i) to have a positive family history of substance use and higher number of previous relapses; (ii) to be using maladaptive coping strategies; (iii) to have been exposed to a higher total number of 'high risk' situations; and (iv) have experienced a higher number of undesirable life events. Those who had remained abstinent tended to use significantly more number of coping strategies, principally adaptive ones and scored significantly higher on all measures of self-efficacy. Factors influencing relapse appeared to be largely similar among patients with alcohol and opioid dependence.

This study provided further evidence in support of the importance of certain clinical/psychosocial factors in relapse in substance dependence. It extended these results to substances other than alcohol and provides the basis for investigating correlates of relapse in a wide range of behavioural and substance use problems.