Investigation of factors associated with low adherence to treatment of codependency in family members of psychoactive substance users

Abstract

The aim of this study was to investigate possible factors that prevent adherence to the treatment of codependent family members of problem drug use individuals. A quasi-experimental study was carried out with 133 relatives of psychoactive substances users who called the Brazilian drug hotline (Ligue 132) between 2013 and 2015, from the five regions of Brazil. The following instruments were used: General service protocol; Family assistance protocol; Holyoake Codependency Index; Behavioral Adherence Scale; and Adherence Factor Questionnaire. Univariate analysis of data was performed for categorical variables and Chi-square test for comparison between variables, with p < 0.05. The sample showed a predominance of women (91.7%), especially mothers (82.7%). Among the investigated factors, alcohol as the substance involved in the problem showed a significant association with the non-adherence to treatment through teleintervention of family members.

Family motivations and expectations in the care for psychoactive substance users

“…It stands out that, in addition to premature and discriminatory pre-judgment in regard to the or abuse of psychoactive substances, the individual themselves are stigmatized, treated as ignoble and depreciated. This individual is reduced, judged, and recognized as such (8) . As a result, it becomes clear in the statements that there is a love and care relationship between the psychoactive substance user and their relatives, one that goes beyond prejudgments and social stigmas associated with drug abuse.…”

“…In this regard, the overload of the caregiver of the psychoactive substance user is characterized as a state of psychological distress, emotional tension, family conflicts, and financial problems resulting from the act of caring (8) . The degree of overload of the caregiver is strongly related to the degree of kinship between caregiver and the psychoactive substance user (9) .…”

Motivações e expectativas de familiares no cuidado ao usuário de substâncias psicoativas

“…Destaca-se aqui que, para além de um julgamento prematuro e preconceituoso sobre o uso e abuso de substâncias psicoativas,evidencia-se um olhar estigmatizante do indivíduo, tornando-o como algo indigno e depreciativo, em que este indivíduo é reconhecido e reduzido a esse julgamento (8) . Desse modo fica evidente nos depoimentos que há uma relação de amor e carinho do familiar ao usuário de substâncias psicoativas, que ultrapassa os pré-julgamentos e estigmas relacionados ao consumo de drogas impostos pela sociedade.…”

“…Nesse sentido, a sobrecarga do cuidador do usuário de substâncias psicoativas é caracterizada como um estado de sofrimento psicológico, tensão emocional, conflitos familiares, problemas financeiros oriundos do ato de cuidar (8) . Esse grau de sobrecarga do cuidador está fortemente relacionado ao grau de parentesco do familiar cuidador do usuário de substâncias psicoativas (9) .…”