A comparative analysis of the impact of voluntary and involuntary attendance in rehabilitation centers on substance use disorder relapse rates in Gilgil Sub-County, Nakuru County

Abstract

The problem of drug abuse has become a major source of concern to both the government and society in Kenya. Substances abused include alcohol which is the substance that is most abused and other legal and illegal substances. Inpatient rehabilitation programs for patients with substance use disorder have been the accepted method of treating the disorder. However, efforts aimed at rehabilitating addicts using the ninety-day residential treatment regime often fail as those who go through the program often go on to relapse. In many of the cases relapse had occurred more than once following the three months program. The purpose of the study was to find out the effect of voluntary and involuntary attendance to rehabilitation centers on relapse rates in Gilgil Sub-County of Nakuru County. The objectives of the study are to examine the effect of voluntary treatment in rehabilitation centers on relapse rates in Gilgil sub-County; to assess the effect of enforced treatment in rehabilitation centers on relapse in Gilgil Sub-County. Enforced treatment can include coercion from family members, the government or the employer to ensure patients attended treatment in rehabilitation centers in Gilgil sub-County. The study was based on the Self Determination Theory which lays emphasis on human motivation as a factor in the decisions people make in their lives. The target population was estimated at 600 comprising male clients who had undergone the ninety day program in the last five years within Gilgil Sub-county by the time of the study and had stayed for at least three months since the completion of the program. A sample size of 86 former clients of rehabilitation centers was obtained using simple random and purposive sampling techniques. Data was collected using structured questionnaires and in-depth interview schedules. The data generated by questionnaires was analyzed descriptively by use of frequencies, percentages and means and inferentially by use of Pearson correlation and regression analysis. The researcher made use of electronic means to reach out to the respondents, including electronic mail and messaging. Qualitative data from interviews was subjected to content analysis. The findings indicated that of the 42 (48.84%) of the respondents who attended treatment voluntarily 17 (40.70%) remained sober for over a year, 11 (26.74%) were sober for 8-12 months, 5 (11.90%) remained sober for up to 7 months and 9 (21.40%) remained sober for 3 months. Of the 44 respondents whose attendance was involuntary, 11(25%) relapsed within three months of leaving the treatment facility, 26(59.09%) relapsed after three months, 4 (9.09%) have been on and off treatment, while 3 (6.81%) are under psychiatric care. The research concluded that voluntary attendance has a higher rate of success and should be encouraged, while the use of coercion should be avoided unless there is possibility of harm to the client and others. The beneficiaries of this study are the victims of substance abuse who have had to undergo forceful addiction treatment, families with members suffering from substance abuse, rehab administrators, therapists and the government of Kenya, all of whom have been grappling with the issues of relapse following addiction treatment for substance abusers and the social, economic implications of failed substance addiction treatment.