Between abstinence and relapse: The role of “pre-relapse abstinence” in drug rehabilitation in Hong Kong

Abstract

This study examined the relationship between the amount of drug-free time achieved before relapse (prerelapse abstinence) and the amount of drug-free time achieved in the next posttreatment period after relapse, a neglected issue in relapse studies. It was hypothesised that the former would have a significant, causal and positive effect on the latter. Data were extracted from the three-year Longitudinal Study of Chronic Drug Abusers in Hong Kong conducted from 2000 to 2003. The survey of the study involved three interviews, yielding two 12-month intervals and one retrospective six-month interval. Altogether 178 subjects who were in treatment at the time of the 1st and 2nd interviews were selected for analysis. Pre-relapse abstinence in the first and second intervals were each examined to see if it could affect the total drug-free time in the next interval. Pre-relapse abstinence and total drug-free time were measured by the percentage of drug-free weeks in an interval in which the subject was not in treatment. In order to test the spuriousness of the relationship between pre-relapse abstinence in an interval and total drug-free time achieved in the next interval, which was the new posttreatment period, two psychological variables (self-efficacy and life satisfaction), three social capital variables (family support, support of non-drug-using friends, and association with drugusing friends), and one treatment variable (number of treatments after relapse) were introduced as independent variables. Multiple regression results confirmed that, even after controlling for these other independent variables, pre-relapse abstinence in an interval was still significantly related to total drug-free time in the next interval. Findings of this study suggest that the conventional “failure” view of relapse should be replaced with a more constructive view that attaches importance to the amount of drug-free time achieved before relapse. The emphasis on pre-relapse abstinence also has relevance to the popular harm reduction approach in the drug field.