IJCRR

IJCRR - 13(18), September, 2021

Pages: 40-43

Date of Publication: 26-Sep-2021

Relationship between Drug Craving and High-Risk Situations for Relapse Among Inmates with Substance Abuse Issues

Author: Nurulatiqah Yunos, Fauziah Ibrahim, Ezarina Zakaria, Wan Shahrazad Wan Sulaiman, Nazirah Hassan, Mohammad Rahim Kamaluddin, N.K. Tharshini

Category: Healthcare

Abstract:Introduction: Relapse occurs when there is a strong desire for repeating drug-seeking behaviour due to high-risk situations such as social environment, interpersonal conflict, and negative emotions. Objective: This article aims to analyse the relationship between drug craving and high-risk situations for relapse among inmates with substance abuse issues serving in Malaysian prisons. Material and Methods: This study was conducted using a quantitative approach. A total number of 407 inmates with substance abuse issues were randomly selected as respondents of the study. The data were analysed using descriptive and inferential analysis via SPSS software. Results: The result indicates that there is a positive and significant moderate relationship between drug craving and high-risk situations for relapse (r=0.452, p?0.01). Therefore, it can be concluded that drug craving is associated with high-risk situations for relapse among inmates with substance abuse issues. Conclusion: The findings of this study is expected to provide implications to the stakeholders such as counsellors and drug rehabilitation officers to improvise the existing rehabilitation modules and programs to address relapse issues among inmates in Malaysia.

Keywords: Drug craving, High-risk situation, Inmates, Relapse

Full Text:

INTRODUCTION

Relapse is defined as a repeated drug-seeking behaviour faced by the former drug addicts even after completing the rehabilitation process.¹Statistics obtained from the National Anti-Drugs Agency (AADK) show that around 7,867 drug addicts were involved in prison’s drug treatment and rehabilitation programs in 2010.²AADK also reported that around 4,800 drug addicts’ relapses in the year 2012. The figure sharply increases every year where a total number of 7,793 relapse cases were recorded in the year 2018.³ Due to the high escalation in drug relapse rate, the government of Malaysia has taken various steps to create a drug-free community especially by allocating a large sum of money every year for drug treatment and prevention programs. ^4,5.

Drug craving is a major risk factor contributing to relapse among inmates with substance abuse issues.⁶ In fact, drug craving has been identified as a key characteristic to predict future relapse among former drug addicts.⁷ The inability to control craving and managing stressful situations might increase the risk of relapse.⁸ A substantial body of literature indicates that the challenges to secure employment opportunity leads the majority of the former inmate to commit street crimes such as stealing and snatch theft to cover the costs of buying drugs. ^9,10,11Moreover, lack of access to advanced rehabilitation care is also one of the reasons that contribute to drug addicts’ relapse.⁸ Admittedly, if this situation is left unaddressed it may cause a negative effect on the mental well-being of the inmates¹² and bring harm towards public safety.¹³

Craving for drugs is driven by high-risk situations.¹⁴Individuals who experience high-risk situations usually encounter issues such as negative emotions, interpersonal conflict and social pressures from their surroundings.¹⁵ Correspondingly, there is a significant relationship between individuals with negative emotions, interpersonal conflicts and social pressure with drug relapse.¹⁶ In fact, a study shows that drug addicts who relapsed display negative emotions such as feeling depressed, sad, easily gets irritated and bored.¹⁴Moreover, intense pressure from the social environment and interpersonal conflicts such as misunderstandings with family members/partners/spouses/co-workers, or community members further increase the probability of relapse. Since individuals with a drug addiction history encounter various obstacles throughout the rehabilitation process thus this study is conducted to analyse the relationship between drug craving and high-risk situations for relapse among inmates with substance abuse issues who are currently serving in Malaysian prisons. Therefore, this study is conducted to (1) ensure the level of drug craving and high-risk situations for relapse among inmates with substance abuse issues and (2) to analyse the relationship between drug craving and high-risk situations for relapse among inmates with substance abuse issues.

METHODOLOGY

Research Design

The study employed a quantitative research design and a cross-sectional approach to collect data. According to ¹⁶quantitative research, the design uses numerical data to interpret the finding of a study.

Population, Sample and Survey Locations

In this study, the population is referred to all the inmates with substance abuse issues who are currently serving in the Malaysian prisons. A total number of 407 inmates with substance abuse issues from five prisons in Malaysia were selected as the sample of the study. Data were collected at various zones in Malaysia including the Southern Zone (Melaka Prison), Central Zone (Selangor Prison), Northern Zone (Perak Prison), Eastern Zone (Pahang Prison), and East Malaysia (Sabah Prison).

The inclusion criteria for this research include (1) Inmates with substance abuse issues who are currently serving for at least six months and (2) Malaysian male inmates with substance abuse issues.

Data Analysis

The data were analysed using the Statistical Package for the Social Science (SPSS). The research instrument used in this survey are as follows:

1. Drug Craving Scale: This instrument comprises 10 item questions measuring drug craving among inmates with substance abuse issues with the reliability score of 0.94.¹⁸ The instrument uses 4-point Likert scale scoring; (1) strongly disagree, (2) disagree, (3) agree, and (4) strongly agree.

2. The High-Risk Situations for Relapse Scale: This instrument is divided into three sections including; (i) social environment pressure (9 items), (ii) interpersonal conflicts (10 items), and (iii) negative emotions (10 items) to measure high-risk situations for relapse among inmates with substance abuse issue. The reliability score of 0.88.¹⁸ The instrument uses 4-point Likert scale scoring; (1) strongly disagree, (2) disagree, (3) agree, and (4) strongly agree.

In terms of scoring, the minimum score is 1 and the maximum score is 4. The level of drug craving among inmates with substance abuse issues is divided into three categories namely; (i) low level, (ii) intermediate level, and (iii) high level as shown in Table 1:

A descriptive analysis was employed to illustrate the results of the study. Frequency and percentage were used to present the first objective of the research whereas inference analysis (correlation test) was used to display the second objective of the research. The interpretation of the correlation is based on table 2 below¹⁹:

Procedure

Upon getting permission from the Director-General of the Malaysian Prison Department the researcher’s contacted the Prison administration to fix a suitable date for data collection. On the day of data collection, the researchers brief the Prison Officer on duty and the respondents involved in this study regarding the procedure to answer the survey form. To ease the data collection process, the respondents were divided into two main groups namely; (i) inmates who can read and write and (ii) inmates who are unable to read and write. The respondents who could read were monitored by the Prison Officer whereas respondents who are unable to read were monitored by the researchers. Researchers guided the respondents who are illiterate by verbally reading to them each question to help them to fill up the survey form. All the returned survey form was checked thoroughly by the researchers. The incomplete questionnaire was given back to the respondent to re-answer again.

RESULTS AND DISCUSSION

The Level of Drug Craving and High-Risk Situations for Relapse

Drug craving refers to the factors that initiate longing among inmates with substance abuse issues. Table 3 show the results of the survey related to the level of drug craving among inmates with substance abuse issues who are currently serving in Malaysian prisons. The survey results disclosed that the majority of the inmates exhibited a moderate level (55.8%) to a high level (23.1) of drug craving. Findings also unveiled that only 21.1% of inmates with substance abuse issues displayed a low level of drug craving. It can be fairly concluded that the level of drug craving among inmates with substance abuse issues is at an alarming stage. Therefore, stakeholders such as counsellors, social workers, and drug rehabilitation officers who are working in the prison setting need to revamp the existing drug rehabilitation module to help the inmates to handle the drug craving issues effectively.

High-risk situations for relapse refer to a condition such as pressure from the social environment, interpersonal conflict, and emotional disorder that influences inmates with substance abuse issues to relapse. The result indicates that high-risk situations for relapse among inmates who are currently serving at the Malaysian prisons are at a moderate (74.9%) to the low level (19.2%). Only 5.9% of inmates with substance abuse issues displayed high-risk situations for relapse (Table 4). The finding also shows that the majority of the inmates with substance abuse issues are still able to control the high-risk situations for relapse. To further reduce the relapse rate, new feasible programs/approaches to control drug craving should be created in no time.  It is suggested that the new programs/approaches should place more emphasis on the risks of relapse and strategies for coping with the drug craving. In addition, former drug addicts should also be educated to seek treatment if they begin to show relapse signs.

The Relation between Drug Craving and High-Risk Situations for Relapse

Table 5 shows the correlation result pertaining to the relationship between drug craving and high-risk situations for relapse among inmates with substance abuse issues.

H₁: There is a significant relationship between drug craving and high-risk situations for relapse.

The result shows that there is a positive and significant moderate relationship between drug craving and high-risk situations (r = 0.452, p ? 0.01) for relapse among inmates who are currently serving at the Malaysian prisons. The alternative hypothesis of this study is accepted. The positive relationship indicates that the greater the high-risk situations, the higher the craving for drugs and tendency to relapse among inmates with substance abuse issues. The results of this study are in line with a study conducted with another researcher that the drug craving is positively associated with the risk of addiction relapse (r = 0.509, p <0.01).¹⁹ Besides,²¹found that drug craving is also influenced by various risk factors such as emotional disturbances, family conflict, and social environment pressures experienced by the former drug addicts during the rehabilitation phase.

      CONCLUSION

In summary, the result of the study shows that the majority of inmates with substance abuse issues display moderate to high levels of drug craving. Indirectly, this indicates that the majority of the inmates have a higher tendency to relapse even after completing their rehabilitation program in the prison. The study also found that there is a significant moderate relationship between drug craving and high-risk situations for relapse. Thus, it can be fairly concluded that the drug craving is difficult to control if the inmates are highly exposed to high-risk situations such as extensive pressure from the social environment, interpersonal conflicts and negative emotions.

It is recommended that the stakeholders such as counsellors, social workers, treatment program administrators, and drug rehabilitation officers in prisons re-evaluate the current programs and rehabilitation modules to address the drug craving issues more holistically. It is also suggested that Cognitive and Behavioural Therapy (CBT) through counselling sessions should be practised intensively in a prison setting. In general, CBT is a form of psychotherapy to bring changes in an individual’s thinking and behaviour. Besides, stakeholders should emphasize the reintegration program to assist the inmates upon being released from the prison to reduce the recidivism rate. Moreover, the supervision should also be tightened up especially for inmates with substance abuse issues who have completed their sentences period to prevent the repeating drug-seeking behaviour.

ACKNOWLEDGEMENT

The researchers would like to acknowledge the Malaysian Prison Department, Faculty of Social Sciences and Humanities, UKM, and everyone who has contributed to the completion of this study.

Sources of Funding: The researchers would like to acknowledge the Ministry of Higher Education (MOHE) (FRGS/1/2018/SS06/UKM/02/2) for funding this research.

Conflict of interest: The authors declare that there is no conflict of interests.

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