Why do patients suffering from substance use disorders relapse? Insights from clients at a harm reduction centre in Durban, South Africa

Abstract

Relapse to substance abuse is a health risk and a global public health concern. It is a subjective concept, and the reasons for its  occurrence may vary. These reasons are particularly different in the context of harm reduction, as they depend directly on specific harm  reduction goals and principles. As a concept, relapse needs to be better understood by both professionals and clients in the field of  substance use to better mitigate its occurrence. The aim of this study was to identify and explore the causes of relapse examined through  the real-life experiences of clients at a harm reduction centre in Durban, South Africa. This is an in-depth qualitative study that  used convenient non-random sampling to recruit thirty-seven participants. Storytelling was used to collect primary data from participants  who were homeless and suffered from opioid use disorders. All participants were registered in the Opioid Substitution  Therapy programme at Bellhaven Harm Reduction Centre. Data was collected by the researcher assisted by three peer supporters. The  collected data was manually analysed using thematic analysis. The most reported causes for relapse included easy access to substances, boredom, unemployment, negative emotions, peer pressure and broken relationships. The study revealed the need to help clients to be  able to identify their triggers, develop coping skills and access support networks to reduce the potential harm associated with relapse. It  concluded that relapse is less understood, stigmatised, and complex in nature. It is crucial to establish the causes and triggers of relapse  to successfully mitigate its occurrence. To minimise the stigma associated with relapse, it is important for clients, professionals, and  communities to be knowledge empowered to a point where they accept relapse as part of one’s recovery journey.