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Heroin Addiction and Related Clinical Problems: 2022, 24, N2 (pages: 27 - 34)

Relapse rate following institutionalized rehabilitation of male heroin addicts: A Sri Lankan experience

Darshana N., Wijesinghe C., and De Silva V.

Summary: Background. Relapses following rehabilitation are identified as a major drawback in the rehabilitation process of drug addicts in many countries, including Sri Lanka. The present study was conducted to assess the relapse rate following institutionalized rehabilitation programmes among male heroin addicts in selected rehabilitation centres in Sri Lanka. Methods A descriptive cross-sectional study with a follow-up was conducted among a randomly selected sample of 189 male heroin addicts in five selected rehabilitation centres in Sri Lanka. Study participants were followed up for six months with two follow-up interviews at 3 months and 6 months after discharge from the respective rehabilitation centre. A ‘relapse' was defined as a return to heroin use after a period of abstinence often accompanied by reinstatement of dependence symptoms. Results At the end of three months, the relapse rate was 48.7% (n=92), while after six months it was 59.6% (n=109), excluding cases where patients failed to attend follow-ups (n=6, 3.17%). The easy availability and accessibility of heroin within the living community was identified as the main reason for relapse in as many as 82.6% (n=90) of heroin users who had relapsed. A majority (66.1%, n=72) of those who relapsed did so within the first six weeks (mean (SD) 5.7 (5.3) weeks) after discharge. Conclusions. Relapse was identified as a common problem in the drug rehabilitation process in Sri Lanka. This calls for the attention of policy makers who are responsible for planning and implementing follow-up programmes for drug addicts, including heroin addicts, especially during the initial period after discharge from rehabilitation centres to minimize the number of relapses.