Background: Relapsing from post-treatment is quite common in people who have experiences of substance use. Health and well-being are important in helping substance users recovering from treatments. However, there has been no research exploring the relationships among physical, mental, and spiritual health and risk of relapse across different categories of substance users.
Methods: A cross-sectional survey was used. Participants were recruited in Southern Taiwan between December 2015 and June 2016. Data was collected from 467 participants who had a history of substance use including Category 1 and 2 substance users or Category 3 and 4 substance users. The inclusion criteria of the sample were (1) having a history of substance use; (2) 20 years of age or older; (3) clear and conscious capacity to complete the questionnaires; and (4) agreement to participate in the study. The questionnaires included the Health of Body, Mind, and Spirit Scale (HBMSS), and the Relapse Prediction Scale (RPS). The HBMSS had 15 items. Total scores on the HBMSS range from 15 to 75, higher scores indicate better health in terms of body, mind, and spirit. The RPS had 39 items. Total scores on the RPS range from 0 to 156, with higher scores indicating a greater potential for relapsing among substance users.
Results: There were 199 participants in substance-use Categories 1 and 2 and 268 in Categories 3 and 4. The average age of the respondents was 32.72 (SD = 10.41) with an age range between 20 and 80. The majority were male (n = 367, 78.6%), single (n = 398, 85.2%), and had a religious belief (n = 333, 71.3%). Commonly used substances in the current sample were Ketamine (n = 317, 67.9%), Amphetamine (n = 157, 33.6%), 3,4-Methylenedioxy-methamphetamine (MDMA) (n = 123, 26.3%), and Heroin (n = 102, 21.8%). Only a small percentage of subjects reported a serious (n = 25, 5.4%) or moderate (n = 60, 12.8%) adverse influence of stress in their daily life. Path analysis results revealed that body-mind-spirit health was negatively predictive of the risk of relapse. Out of several predictors, stress influence and duration of substance use had direct effects on body-mind-spirit health and possibility of relapse intention, respectively. Stress influence and duration of substance use were associated with decreased body-mind-spirit health and increased the risk of relapse scores. In addition, a lack of health history and male gender were associated with increased body-mind-spirit health. Compared with Category 1 and 2 drug abusers, Category 3 and 4 drug abusers reported lower risk of relapse scores.
Conclusions: Stress management and the duration of substance use play an important role in body-mind-spirit health in people with a history of substance use. Healthcare professionals could teach substance users coping strategies to address their stress and problems, which may improve their health and reduce the possibility of relapse intention.