A STUDY OF FACTORS CONTRIBUTING RELAPSE IN ALCOHOL DEPENDENCE AND INTRA GROUP COMPARISON FOR FACTORS INFLUENCING DELAY IN TREATMENT SEEKING AFTER RELAPSE

Abstract

Background: Alcoholism is one of the major health issues in India characterized by much significant psychological, physiological and social dysfunctions associated with excessive and persistent use of alcohol. One study states that relapse following treatment reaches 75% in first 3 – 6 months period. Many studies found that adults with alcohol related problems postpone their treatment and they underutilize the resources. It is very important to understand the factors contributing to relapse and delay in seeking treatment in alcohol dependence. Objectives :To study various factors contributing relapse in alcohol dependence and intra- group comparison for factors influencing delay in treatment seeking after relapse.To compare those factors among early and late treatment seekers. Methodology: This is a cross sectional study conducted at the Institute of mental health, Chennai, a tertiary care hospital of Madras Medical College in 2017.100 alcohol dependent patients who relapsed after treatment were included with informed consent and after approval by the institutional ethics committee. The participants after clinical diagnosis by consultants were assessed using semi-structured pro-forma for socio demographic details, Severity of alcohol dependence questionnaire(SADQ), Alcohol relapse risk scale(ARRS) and Duke’s social support and stress scale(DUSOCS) Results: 49% people presented for the treatment with 6 – 12 months delay. 84% presented for the treatment within a year. 16% presented only after 1year. 75% report social influence especially other social networks as reason for the delay. 56% report psychological influence especially not decided to stop drinking yet as a factor for their delay. 20% and 40% report situational influence and access barriers for the delay in treatment. Conclusions: The following were the first 3 reasons for relapse elicited in our study- Family problems (57%), Peer pressure (39%), Craving (19%). While delaying treatment after relapse, only 27% reported within 3 months of relapse; nearly half of the people report by 3 – 6 months. Nearly 50% delay their treatment for more than 6 months after relapse. Person related factors like doubting the need for treatment, public stigma were the important factors delaying the treatment rather than treatment related factors. Those who seek treatment within 6 months of relapse have more social support and less stress.