Psychological, social, and motivational factors in persons who use drugs

Abstract

Background: Persons who use drug need family and society's support in the process of treatment and rehabilitation. Therefore, it is imperative to determine the psychological, social, and motivational factors that can help them in the treatment process. The present study was an attempt to determine the relationship between psychological, social, and motivational factors and the demographics of persons who use drugs (PWUD). Methods: An analytical cross-sectional study was carried out. TCU psychological functioning and motivation scales for the PWUD was first translated into Farsi and validated after securing permission from the copyright holder of the tool. Participants were 250 PWUDs under methadone therapy who were selected through convenient sampling. Before analyzing the collected data, validity and reliability of the tool were confirmed using confirmatory and exploratory factor analyses. Given the scale of demographical data, descriptive and analytic statistics were used to analyze the relationship between demographical variables and psychological, social, and motivational factors. Results: The results of exploratory and confirmatory factor analyses showed that out of 83 statements in the original questionnaire, 55 statements categorized into 11 aspects were usable for Iranian population. The results showed that gender, income, and marital status affect psychological functioning of the PWUD (P < 0.05). However, education level, place of residence, and type of drug and consumption did not have a significant relationship with social functioning of the participants (p > 0.05). There was a significant relationship between age, number of children, and history of using drug and psychological functioning of the participants (P < 0.01). The results showed that the demographics did not have a notable effect on the participants' motivation for treatment; only marital status had a significant relationship with the participants' treatment readiness (P < 0.05). Conclusion: As the results showed, the demographical variables could affect physical, psychological, and social functioning in the participants.

Correlates of motivation for treatment among alcohol service users in Uganda

“…By identifying levels of treatment motivation and their correlates among 100 alcohol service users entering treatment in Kampala (Uganda), we distinguished several factors likely to attract and retain people with AUD in treatment in a low-income country with a limited social awareness of alcohol problems and low belief in treatment effectiveness (Kalema et al, 2017;Kalema et al, 2019). Motivation was confirmed as a multi-layered construct, including several domains with specific correlates (Shahrabadi et al, 2020;Simpson and Joe, 2004). Ugandan alcohol service users' scores for treatment motivation (TCU MOTForm) were comparable to those of a large sample of alcohol and drug users from treatment programmes in the USA (Institute of Behavioral Research, 2005).…”

“…Although motivation has been extensively studied, clinicians are challenged in understanding and explaining motivational dynamics given the multiplicity of factors influencing change-related decisions and behaviours and the diversity in substance using populations (Groshkova, 2009;Shahrabadi et al, 2020), in particular in non-Western societies as cultural differences may require differential therapeutic management. Uganda is a Sub-Saharan African country with a high alcohol-related burden (Graham et al, 2011;Kalema et al, 2015).…”

“…The overwhelming evidence in relation to the TCU model of motivational enhancement and change needs replication in settings outside the USA (De Weert-van Oene et al, 2002;Shahrabadi et al, 2020;Simpson and Joe, 2004). AUDs are among the mental disorders with the lowest treatment rate worldwide, with only 10% or less of the people fulfilling the diagnostic criteria that actually receive treatment in high-income countries (Probst et al, 2015).…”

“…This "treatment gap" may even be bigger in low-income countries due to the limited availability of treatment services and lack of prevention and sensitization campaigns. Denial, resistance and poor treatment engagement are major individual barriers to treatment that can be addressed by motivational interventions (Joe et al, 2002;Lindson et al, 2019;Shahrabadi et al, 2020;Velasquez et al, 2000). Understanding and properly incorporating the concepts of "motivation" and "readiness" into treatment is likely to enable treatment services to address the diverse needs of persons seeking treatment.…”

“…Understanding and properly incorporating the concepts of "motivation" and "readiness" into treatment is likely to enable treatment services to address the diverse needs of persons seeking treatment. Determinants of motivation among substance-using populations include addiction severity, psychopathology and poor quality of life (QoL) (Cengiz et al, 2015;De Maeyer et al, 2011;Shahrabadi et al, 2020;Velasquez et al, 2000), but it remains unclear to what extent determinants of motivation are generic and universal, as well as what their specific role is in internal and external motivation processes (Groshkova, 2009;Joe et al, 2002). By studying motivation for treatment and its possible correlates among alcohol service users in Uganda, we aim to better understand motivational processes and to enhance motivational practices and interventions in low-income countries and beyond.…”