Psychosocial Factors Associated with Relapse in Men with Alcohol Or Opioid Dependence (Report)
Substance dependence is a major problem worldwide, India being no exception. Although short-term treatment of this condition is quite effective, preventing relapse often proves to be far more challenging. A majority of such patients relapse within a year of starting treatment, with the first three months being the most vulnerable period (1). Relapse can be a frustrating experience and usually has several adverse consequences for patients, caregivers and therapists. Relapse is a complex and dynamic phenomenon that appears to be determined by both neurobiological and psychosocial processes. In the recent past, there has been an increasing focus on gene-environment interactions in the genesis of relapse (2). Studies on humans and animal models have also indicated the role of dysfunctional brain areas and circuits, changes in neurotransmitters such as dopamine or gamma aminobutyric acid, disturbances in hypothalamo-pituitary-adrenal axis, and the enduring biological effects of chronic drug exposure as key mediators of relapse. Altered neural responsiveness is proposed to impair the central nervous system’s ability to mount an appropriate response to environmental stressors, heightening the probability of relapse. These theories thus place particular emphasis on biological changes and their interactions with psychosocial factors in perpetuating the vulnerability to relapse (3-5).