ปัจจัยที่มีความสัมพันธ์กับการกลับไปใช้ยาเสพติดซ้ำในผู้ป่วยที่ผ่านการบำบัดในคลินิกเลิกยาเสพติด

Chaaim  Wannagit; Rattanapron  Phanpho

Authors

Chaaim Wannagit Ban Kruat Hospital, Ban Kruat District, Buriram Province
Rattanapron Phanpho Faculty of Nursing, Western University, Buriram Campus

Keywords:

Drug relapse, Stress, Patients with substance use, Drug treatment, Associated factors

Abstract

This correlational analytical study aimed to examine factors associated with relapse among patients who had completed treatment at the Drug Dependence Treatment Clinic, Ban Kruat Hospital, Buriram Province. The sample consisted of 125 patients selected using simple random sampling. Data collection instruments included a demographic questionnaire, a stress assessment, a knowledge test on the harmful effects and consequences of drug use, an attitude toward drug use questionnaire, and relapse data. The reliability coefficients of the instruments were 0.82, 0.79 (KR-20), and 0.88, respectively. Data were analyzed using descriptive statistics and binary logistic regression, with the level of statistical significance set at 0.05.

The results showed that 12.8% of the participants relapsed within three months after completing treatment. After controlling for age, stress was significantly associated with relapse. For each one-point increase in the stress score, the odds of relapse increased by 1.33 times (Adjusted OR = 1.33, 95% CI: 1.13 - 1.56, p = 0.001). In contrast, age was not significantly associated with relapse (Adjusted OR = 1.03, 95% CI: 0.98 - 1.08, p = 0.247). These findings highlight the importance of stress assessment and management, together with continuous follow-up care after treatment, to monitor and reduce factors associated with relapse.

References

World Health Organization. Drugs (psychoactive) [Internet]. Geneva: World Health Organization; 2021 [cited 2026 Jan 31]. Available from: https://www.who.int/health-topics/drugs-psychoactive

United Nations Office on Drugs and Crime. World drug report 2022 [Internet]. Vienna: United Nations Office on Drugs and Crime; 2022 [cited 2026 May 10]. Available from: https://www.unodc.org/unodc/en/data-and-analysis/world-drug-report-2022.html

สำนักงานคณะกรรมการป้องกันและปราบปรามยาเสพติด. รายงานผลการดำเนินการป้องกันและแก้ไขปัญหายาเสพติด ปี 2566 [อินเทอร์เน็ต]. กรุงเทพฯ: สำนักงานคณะกรรมการป้องกันและปราบปรามยาเสพติด; 2566 [เข้าถึงเมื่อ 13 กุมภาพันธ์ 2569]. เข้าถึงได้จาก: https://www.oncb.go.th/result-prevent

National Institute on Drug Abuse. Drugs, brains, and behavior: the science of addiction [Internet]. Bethesda (MD): National Institute on Drug Abuse; 2020 [cited 2026 Jan 10]. Available from: https://nida.nih.gov/publications/drugs-brains-behavior-science-addiction

Marlatt GA, Donovan DM, editors. Relapse prevention: maintenance strategies in the treatment of addictive behaviors. 2nd ed. New York: Guilford Press; 2005.

โรงพยาบาลบ้านกรวด. ข้อมูลสถิติผู้ป่วยคลินิกบำบัดรักษาและฟื้นฟูผู้ใช้ยาเสพติด ปีงบประมาณ 2565–2567. บุรีรัมย์: งานผู้ป่วยยาเสพติด โรงพยาบาลบ้านกรวด; 2567.

Bandura A. Social foundations of thought and action: a social cognitive theory. Englewood Cliffs (NJ): Prentice-Hall; 1986.

Krejcie RV, Morgan DW. Determining sample size for research activities. Educ Psychol Meas. 1970;30(3):607–610. doi:10.1177/001316447003000308.

World Health Organization, United Nations Office on Drugs and Crime. International standards for the treatment of drug use disorders: revised edition incorporating results of field-testing [Internet]. Geneva: World Health Organization; 2020 [cited 2026 Aug 27]. Available from: https://www.who.int/publications/i/item/international-standards-for-the-treatment-of-drug-use-disorders

Cronbach LJ. Coefficient alpha and the internal structure of tests. Psychometrika. 1951;16(3):297–334. doi:10.1007/BF02310555.

Kuder GF, Richardson MW. The theory of the estimation of test reliability. Psychometrika. 1937;2(3):151–160. doi:10.1007/BF02288391.

วศรัญ วัฒนธีรางกูร. ประสิทธิผลของมินิธัญญารักษ์และ Matrix Program ต่อการลดการกลับไปเสพซ้ำในผู้ป่วยยาเสพติดที่คลินิกบำบัดยาเสพติด โรงพยาบาลศรีเมืองใหม่. วารสารสิ่งแวดล้อมศึกษาการแพทย์และสุขภาพ. 2568;10(2):250–262.

Ware OD, Geiger GR, Rivas VD, Macias Burgos MA, Nehme-Kotocavage L, Bautista TG. Risk of relapse following discharge from non-hospital residential opioid use disorder treatment: a systematic review of studies published from 2018 to 2022. Subst Abuse Rehabil. 2025;16:105–118. doi:10.2147/SAR.S440214.

Sinha R. Chronic stress, drug use, and vulnerability to addiction. Ann N Y Acad Sci. 2008;1141:105–130. doi:10.1196/annals.1441.030.

Sinha R, Shaham Y, Heilig M. Translational and reverse translational research on the role of stress in drug craving and relapse. Psychopharmacology (Berl). 2011;218(1):69–82. doi:10.1007/s00213-011-2263-y.

Vafaie N, Kober H. Association of drug cues and craving with drug use and relapse: a systematic review and meta-analysis. JAMA Psychiatry. 2022;79(7):641–650. doi:10.1001/jamapsychiatry.2022.1240.