Background: In India, substance abuse has infiltrated all socio-cultural and economic strata causing loss of productivity. Prevention of relapse is crucial for its control. Objectives: To find out the pattern of substance use, relapse rate, its association with various socio-demographic factors and treatment related issues. Methods: An observational study with cross-sectional design during April 2009-March 2010 at a de addiction centre was conducted among consecutive 284 clients admitted with relapse. They were detoxified earlier in the same centre. Data were collected by interviewing clients with schedule and clinical examination. Results: Brown sugar (an adulterated form of Heroin) was primary drug of abuse in urban area contrary to alcohol in rural area. Commonest age of initiation was between 15-20 years. Polydrug abusers (59.1%) were common. Only 31.3% of the relapse cases took regular follow up. Common psychiatric illnesses were anxiety (44.7%) and depression (30.6%). Peer pressure (77.8%) was commonest cause of relapse. Significantly higher relapse episodes were present with increasing age, Muslim religion, ever marriage, poor literacy, current unemployment, living in nuclear rather than joint family, early age of initiation, longer duration of abuse and no follow up. Conclusion: Regular follow up with family, peer and social support are essential along with vocational rehabilitation to prevent relapse.

The technique of colonoscopy-assisted colostomy that we have described offers an acceptable method of creating a stoma without the need for laparotomy.

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