Ramsewak Shalina, Putteeraj Manish, Somanah Jhoti
Psychiatry Department, Dr A.G. Jeetoo Hospital, Port-Louis, Mauritius.
School of Health Sciences, La Tour Koeing, Point aux Sables, 11108, University of Technology, Mauritius.
Heliyon. 2020 Aug 18;6(8):e04731. doi: 10.1016/j.heliyon.2020.e04731. eCollection 2020 Aug.
Substance Use Disorder (SUD) places a heavy burden on societal and health systems given its association with high mortality and morbidity rates worldwide, including Mauritius. Illicit substances act as a positive reinforcement and stimulate addiction through its pleasure-seeking attributes.
This study focused on identifying the risk factors leading to SUD among Mauritian male addicts as well as examining the potency of those factors in SUD development. The study also aimed at determining the prevalence of relapse and its causation.
A cross-sectional study was conducted over a period of six months using a sample of 180 male addicts registered in a public hospital. A questionnaire investigating dimensions such as risk factors, self-esteem and peer pressure was administered.
A high percentage of relapse was noted amongst users within the first year of abstinence. Majority of respondents originated from nuclear or single parents' family and were deprived of adequate social supports given their marital status. 57.5% of participants had a positive family history of SUD. Cannabis was the most commonly abused substance and 76.2% of the addicts were introduced to drugs through curiosity. Transposing the results against the Gateway Drug Theory showed a constant progression from soft to hard drugs for male addicts, a trend which was consistent with literature. Lastly, a theoretical model was developed based on the strong statistical association found between impulsivity and reduced thought processes prior to relapse; data revealing increased impulsivity which is a common trait in antisocial personality disorder and borderline personality disorder as being largely responsible for relapse.
The study was successful in bringing out the most common risk factors of SUDs which are linked to low socioeconomic status. The inability of addicts to progress with their rehabilitation given the alarming 92% of relapse was related to social pressure as prime deterrent to successful remission. Programmes involving relapse prevention must implemented in the first year of abstinence to facilitate rehabilitation.
物质使用障碍(SUD)给社会和卫生系统带来了沉重负担,因为它在全球范围内,包括毛里求斯,都与高死亡率和发病率相关。非法物质具有正强化作用,并通过其寻求快感的特性刺激成瘾。
本研究着重于确定毛里求斯男性成瘾者中导致物质使用障碍的风险因素,并检验这些因素在物质使用障碍发展过程中的影响力。该研究还旨在确定复发的发生率及其成因。
采用横断面研究方法,在六个月的时间里,对一家公立医院登记的180名男性成瘾者进行了抽样调查。使用了一份调查问卷,调查风险因素、自尊和同伴压力等方面。
在禁欲的第一年,使用者中复发率很高。大多数受访者来自核心家庭或单亲家庭,鉴于其婚姻状况,他们缺乏足够的社会支持。57.5%的参与者有物质使用障碍的家族病史。大麻是最常被滥用的物质,76.2%的成瘾者因好奇而接触毒品。将结果与“毒品网关理论”相对照,发现男性成瘾者从软性毒品到硬性毒品有一个持续的发展过程,这一趋势与文献一致。最后,基于在复发前冲动性与思维过程减少之间发现的强烈统计关联,建立了一个理论模型;数据显示冲动性增加是反社会人格障碍和边缘性人格障碍的常见特征,在很大程度上导致了复发。
该研究成功地找出了与社会经济地位低下相关的物质使用障碍最常见风险因素。鉴于高达92%的复发率令人担忧,成瘾者无法在康复过程中取得进展,这与社会压力作为成功戒毒的主要阻碍有关。必须在禁欲的第一年实施预防复发的方案,以促进康复。