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Artigos no Europe PMC

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• Europe PMC · 2026

  Mental Readiness of Clients and Families Before Discharge From Drug Rehabilitation: Protocol for a Qualitative Study.

  Purwandari E, Permadi AS, Lestari R.

  Background Relapse following drug rehabilitation remains a major mental health challenge in Indonesia. Although rehabilitation programs emphasize individual recovery, postdischarge outcomes are strongly influenced by the family as the primary microsocial environment. However, family mental readiness before discharge from rehabilitation has not been systematically explored, particularly in ways that support structured and scalable postrehabilitation care. Objective This study aims to explore the mental readiness of clients and their families before discharge from drug rehabilitation programs and to develop a conceptual model of family readiness that can inform future scalable assessment and follow-up support strategies. Methods This qualitative study protocol used a descriptive thematic design. Data were collected through semistructured interviews and focus group discussions with clients nearing completion of drug rehabilitation and their family members. Participants were recruited from correctional institutions and a regional mental hospital in Central Java, Indonesia. Data will be analyzed using thematic analysis following the Braun and Clarke framework. Reporting will adhere to the Consolidated Criteria for Reporting Qualitative Research (COREQ). Results This study is funded by the Ministry of Higher Education, Science, and Technology of Indonesia under the 2025 research funding scheme. Data collection was conducted between July 2025 and December 2025, during which 28 participants were successfully recruited and interviewed. The study is structured into sequential phases, including qualitative data analysis, conceptual model development, and dissemination of findings. A manuscript reporting the initial findings was submitted to an international peer-reviewed journal in February 2026 and is currently under review. The findings are expected to generate a conceptual model of family mental readiness prior to discharge from rehabilitation, inform the development of future family-centered support strategies, and contribute to the evidence base for rehabilitation and mental health research. The final outputs of the project are expected to be completed by the end of 2026. Conclusions By conceptualizing readiness as a relational and family-centered process, this study is expected to provide insights that can strengthen relapse prevention strategies and inform family-oriented discharge planning for drug rehabilitation systems. International registered report identifier (irrid) DERR1-10.2196/89763.

• Europe PMC · 2026

  Professional Roles and Work-Related Challenges of Anti-Drug Social Workers in Community-Based Drug Rehabilitation: A Systematic Review.

  Jianping W, Jamir Singh PS, Azman A.

  Background/Objectives: Community-based drug rehabilitation is a key component of public health strategies in China, with anti-drug social workers playing a frontline role in relapse prevention, social reintegration, and long-term recovery. However, the sustainability and effectiveness of this workforce remain uncertain due to complex organisational and structural conditions. This study aims to examine the professional roles, work-related challenges, and coping strategies of anti-drug social workers within community-based rehabilitation systems. Methods: A systematic review was conducted in accordance with PRISMA 2020 guidelines and was registered in PROSPERO (Registration ID: 1381833). The literature published between 2009 and 2025 was identified through Google Scholar, PubMed, Web of Science, and the Electronic Library. A total of 35 Chinese and English-language studies met the inclusion criteria and were analysed to synthesise evidence on social work practice in drug rehabilitation contexts. Results: The findings identify three core professional roles: information provider, resource linker, and relationship repairer. These roles highlight the multifaceted contribution of social workers in bridging institutional systems and client needs. However, their effectiveness is constrained by fragmented governance structures, role conflict, professional identity ambiguity, administrative burden, limited training, and sustained emotional labour. These conditions contribute to occupational stress, burnout risk, and workforce instability, which weaken service continuity and client-centred care. Conclusions: Strengthening community-based drug rehabilitation requires addressing workforce and system-level constraints. Clearer role definition, targeted interdisciplinary training, reduced administrative demands, and structured organisational support are essential to enhance professional capacity, improve service delivery, and support long-term recovery outcomes.

• Europe PMC · 2026

  Digitally delivered cognitive bias modification for interpretation targeting hostile interpretation bias in compulsory drug rehabilitation: A feasibility randomized trial.

  Yalikun S, Ye Z, Qiao J, Du X, Isak G, Liu L, Ren Z.

  Background Hostile interpretation bias (HIB) is a cognitive correlate of aggression. Cognitive bias modification for interpretation (CBM-I) has shown mixed effects on HIB and aggressive behavior, but its feasibility among people who use drugs (PWUD) in compulsory rehabilitation settings remains unclear. This feasibility trial evaluated a digitally delivered CBM-I (dCBM-I) program for PWUD and explored whether changes in HIB were associated with aggression change. Methods In this assessor-blinded feasibility randomized controlled trial, 60 PWUD from a compulsory rehabilitation facility were randomized to dCBM-I or a no-treatment control group. The dCBM-I program comprised four 20-minute sessions over two weeks, completed on researcher-provided tablets with on-site support. Outcomes were assessed at baseline, mid-intervention, post-intervention, and one-month follow-up. Linear mixed models tested intervention effects, and exploratory mediation analysis examined whether HIB change was associated with an indirect pathway from intervention condition to aggression change. Results The program showed high feasibility and acceptability. A significant group × time interaction was observed for HIB, indicating reduced HIB in the dCBM-I group at post-intervention and one-month follow-up. No significant group × time interactions were observed for aggression or secondary symptom outcomes, including anxiety, depression, anger, and craving. Exploratory mediation analysis showed a significant indirect effect through HIB change; however, this finding should be interpreted as hypothesis-generating. Conclusion dCBM-I was feasible and acceptable in this supervised institutional setting and showed evidence of proximal target engagement. Definitive conclusions about behavioral efficacy require adequately powered active-controlled trials.

• Europe PMC · 2026

  Recovery Capital in Chinese Drug Rehabilitation: Exploring Person-Centred and Community-Based Perspectives.

  Song A, Dertadian GC, He J.

  Introduction Chinese drug policy has begun to introduce recovery frameworks and rehabilitation models. These developments follow the recovery movement and align with several principles of recovery capital. However, this approach has tended to focus on what state systems understand recovery to be, often at the expense of how people experiencing drug dependence understand recovery. This study examines the different processes and purposes of recovery capital among those in drug rehabilitation programs in China, to highlight the importance of person-centred and community-based recovery. Methods From May to September 2024, the first author conducted semi-structured interviews with 24 people who had completed compulsory isolation rehabilitation in urban locations in China. Of these, 16 were undergoing community-based rehabilitation and eight had recently completed it. Thematic analysis was conducted to code for themes. Results Our study found that the legal and social stigma consequences of drug use impact how people access recovery resources in China. Data indicate that people's needs around employment, childcare and chronic illness management were often overlooked and that class differences played a significant role in access to recovery-related resources. Finally, participants provide a range of recommendations around making these resources more available and accessible, as well as practical strategies for navigating structural issues and barriers. Discussion and conclusions Our findings confirm a significant mismatch between Chinese national rehabilitation policy frameworks and individual people's visions of recovery. Our study presents evidence for the benefit of reorienting recovery capital as an idea, and recovery policy in practice, around person-centred and community-based concerns.

• Europe PMC · 2026

  Relapse Within One Year after Inpatient Drug Rehabilitation in Peshawar, Pakistan: The Role of Employment and Family Support

  Feroz AK.

  Abstract Background The problem of the high rates of post-rehabilitation relapse is an obscure issue in the field of addiction medicine, especially in such resource-based situations as Pakistan. This research paper assessed the 12-month relapse pattern and determined structural foreteller of abstinence amid male patients after residential care in Peshawar. Methods There were 60 men with a mean age of 30.5 +- 8.4 years who were discharged in five months after completing an inpatient detoxification program between January and December 2024 in a prospective cohort study. The main consequence was relapse, which is the use of any illegal substance. The temporal risk was examined using the survival analysis (Kaplan-Meier) and the effect of interventions about employment and livelihood was done by Fisher Exact Test. Results The overall 12-month relapse rate (n = 36) was 60.0% with the majority (55.6) of the relapse rate within the first 90-days of post-discharge. Unemployment has been found to be a powerful predictor of relapse (P = .003) and unemployed persons were at a greater risk of relapse (83.3% against 38.9%). It is worth noting that a sub-cohort (n = 7) receiving a post-discharge Livelihood Support Initiative had 100-percent abstinence (P

• Europe PMC · 2026

  Outcome of Hepatitis C Screen-and-Treat Program at a Drug Rehabilitation Centre in Perlis State.

  Kaman N, Mohd Suan MA, Samsurizal AA, Abu Bakar R, Abu Hassan MR.

  Introduction Hepatitis C virus (HCV) infection is prevalent among people who inject drugs globally and in Malaysia. Drug rehabilitation centres (PUSPEN) offer opportunities for intervention, but the feasibility of HCV care cascades in these settings requires evaluation. This study aims to evaluate the outcome of an integrated HCV screen-and-treat program implemented at PUSPEN Perlis, Malaysia. Materials and methods This retrospective cohort study analysed data from an HCV screen-and-treat program conducted between October 2022 and December 2023 at PUSPEN Perlis. The program involved initial screening with rapid antibody testing, confirmatory HCV RNA testing, APRIbased fibrosis assessment, and Direct-Acting Antiviral (DAA) treatment, with Sustained Virologic Response at 12 weeks post-treatment (SVR12) as the primary outcome. Results Screening of 461 participants during study period identified 62 (13.4%) as HCV antibody positive. Significant attrition occurred before confirmatory testing, with 34 (54.8%) undergoing HCV RNA tests, of whom 33 (97.0%) were positive. Treatment initiation was also limited, with 17 (51.5%) starting DAA therapy, primarily due to anticipated short rehabilitation stays. One participant transferred during therapy; the remaining 16 completed the 12-week regimen, all achieving SVR12 (100%) without reported adverse effects. Conclusion HCV screen-and-treat programs are feasible in Malaysian drug rehabilitation centres but face challenges in linkage to confirmatory testing and treatment initiation, largely due to limitations imposed by the duration of stay. While DAA therapy is highly effective when completed, strategies addressing diagnostic streamlining, potentially shorter regimens, and continuity of care post-release are crucial to optimise HCV elimination efforts in this vulnerable population.

• Europe PMC · 2026

  Relapse Within One Year After Inpatient Drug Rehabilitation in Peshawar, Pakistan: The Role of Employment and Family Support

  Feroz A.

  Abstract Background The problem of the high rates of post-rehabilitation relapse is an obscure issue in the field of addiction medicine, especially in such resource-based situations as Pakistan. This research paper assessed the 12-month relapse pattern and determined structural foreteller of abstinence amid male patients after residential care in Peshawar. Methods There were 60 men with a mean age of 30.5 +- 8.4 years who were discharged in five months after completing an inpatient detoxification program between January and December 2024 in a prospective cohort study. The main consequence was relapse, which is the use of any illegal substance. The temporal risk was examined using the survival analysis (Kaplan-Meier) and the effect of interventions about employment and livelihood was done by Fisher Exact Test. Results The overall 12-month relapse rate (n = 36) was 60.0% with the majority (55.6) of the relapse rate within the first 90-days of post-discharge. Unemployment has been found to be a powerful predictor of relapse (P = .003) and unemployed persons were at a greater risk of relapse (83.3% against 38.9%). It is worth noting that a sub-cohort (n = 7) receiving a post-discharge Livelihood Support Initiative had 100-percent abstinence (P

• Europe PMC · 2025

  The role of Christianity in residential drug rehabilitation in Hong Kong: A lens of respectability politics.

  Cheng VS, Zhang SY, Jiang W, Chui WH.

  Faith-based programs are widely used for treating addiction in several countries. Although they are predominantly used in Hong Kong, how they function within the Chinese cultural context remains unknown, particularly for irreligious individuals. Therefore, this study examines how respectability politics are applied within a faith-based drug rehabilitation community in Hong Kong, where religious norms and therapeutic practices shape the residents' experiences. Based on ethnographic fieldwork and 29 semi-structured interviews, the findings revealed that respectability politics manifests as an interplay among the concern for faith, public image, and therapy, creating a complex dynamic within such a community and offering transformative experiences for some while coercing and excluding those who do not conform. Our insights underscore the need for inclusive therapeutic approaches that respect diverse backgrounds and beliefs and ultimately enhance the effectiveness of faith-based rehabilitation programs. This study highlights the importance of situating respectability politics within specific cultural contexts to understand how marginalized individuals seek dignity during recovery.