Biopsychosocial Determinants of Relapse Among Patients Diagnosed With Substance Related Disorders at Mathari National Teaching and Referral Hospital, Kenya

Abstract

Studies show that relapse or uncontrolled return to drugs among patients diagnosed with substance related disorders following competent treatment has been on the rise. This has remained a major challenge to substance abusers and their counselors. The objective of this research aimed at identifying the social, psychological and biological determinants that promote and, or prevent relapse among substance abuse patients at Mathari National Teaching and Referral Hospital, Kenya. This study is a descriptive cross-sectional study design targeting care givers or guardians of patients seeking both outpatient and inpatients services for relapse due to substance abuse at Mathari Referral and National Hospital. Quantitative research approach was used to identify the causes of relapse among patients diagnosed with substance related disorders. In order to minimize bias during selection of respondents, multistage sampling was adopted. Pre-testing of the study tools was done in the Outpatient department, MNTRH. The responses were coded for analysis and put on an excel sheet. Data collected was then analyzed by statistical software (SPSS version 25). Both regression and chi-square were used to show association and comparisons between the variables respectively. Descriptive statistics were presented by use of the mean, percentages and standard deviation. Chi-square was used determine statistical significance of the differences in proportions and logistic regression used to identify the association between the variables The findings showed that, majority, 72.6 %( n=82) of the patients on substance abuse were between age 20 and 39 years with most 69.9% (n=79) of them from Nairobi county. Determinants of relapse among substance abuse patients were: the accessibility of specific drug(s) of addiction that patient was taking (p<0.011), Age of the patient in years (p<0.003), frequent conflicts within the family (p<0.014), and having financial or unemployment problems (p<0.010). All these could predict the likelihood of relapse among patients at the Mathari National Referral Hospital. Study concluded that Biological factors have a major role in determining relapse among patients with relapse in substance abuse in MNTRH compared to social and psychological factors. There is need for reduced access to drugs of addiction by instituting and implementing appropriate legislation by both National and County governments in Kenya. All leaders should come together to address the rising unemployment problem among the youth.