Increasingly developing countries towards developed nation status, the development of adolescents and youth were also seen flourished alongside technological advances. The achievement of this group in the field of education and innovation is very commendable. But there is no denying, there is still no exist a handful of acting not in line with the development of the country. They fall into the growing social problems. Sadly when it was among teenagers as early as age 12 who has begun smoking and sucking the drugs. This study will review an experience of relapse and recovery method used by Rumah PENGASIH in the recovery process. It is seen as a factor that contributes to the confidence of addicts to recover from drug addiction. Using a qualitative method in the form of case studies, this study was carried out at Rumah PENGASIH Amanjaya, Gopeng, and Perak. Respondents selected through the age of 24, 30 and 41-year-old.
Drug addiction is not only destroying the future of individuals involved in fact constitutes a bad image and detrimental to the country. According to statistics issued by the Polis Diraja Malaysia (https://www.rmp.gov.my/) shows an increase of 14% total junkies equivalent 30,847 in 2016 compared with 26,668 in 2015. In addition, the statistics also show an increasing number of new abusers of 22,925 cases compared to 20,281 cases during the same period.
Thus, the bias should be addressed immediately by applying methods of self-cleaning and return the soul to the state of human nature in pure. Drugs are a disease increasingly more common nowadays, especially among the younger generation.
The risk of a repeat drug growing also detected when a trend of drug use at the time is now starting to switch the direction of the original drug addiction such as cannabis, opium, heroin, and morphine to drug addiction mixed synthetic such as amphetamine (ice), methamphetamine, pills is trafficking ecstasy pills, horses, and other more dangerous kind of drugs.
It is not only causing dependency up to contribute to the difficulties to avoid drugs. In fact, it also invites to increase in a range of other social problems such as housebreaking, snatch theft, robbery, murder, robbery, murder, domestic abuse, road accidents, skipping school, threatened and many others. This happens due to the effect of the content of various mixtures of chemicals in the synthetic drug itself resulting in drug users getting lost consideration intellect and moral (Yahya, 1999).
Dependence of drugs as an ongoing basis has resulted in the occurrence of repeat drug situation among former drug users who successfully detected. In other words, a repeat behaviour will continue to occur as long as there is still supply and demand to the drug (Mohamed, Din, Shuaib, & Ishak, 1996).
According to Jason (1991), there is two main factors backed are able to contribute to the problem of drug addiction, namely general and specific factors. Specific factor of how weak individual self, peer influence curiosity, the desire to have fun, the pressure of the soul, and the local environmental conditions that are high risk are the elements that contribute to the drugs using.
Failure to deal with the factors causing the addiction problems may brings to a high dependency on drugs and eventually a trigger on repetition of behaviour. Treatment and drug rehabilitation in this country is a comprehensive effort to restore the former drug users and reduce the dependence on the drug.
Prevention programs, treatment, drug rehab and implemented are intended to restore the former drug users either admitted under court order, referred to voluntary or find a way out of the problem of addiction and a repeat drug after undergoing a programme of recovery held by the rehab centre in a way of helping the addicts to get a new life and stay sobriety ever after.
The study will look on how the Therapeutic Community (TCs) method is different from other method that has been introduced in a way to help the addicts to overcome their addiction. The study would also highlight the matters of relapse among the addicts and how the method use through the TCs gives them a guidance to change their lifestyle to be a better person in the future.
How does Therapeutic Community (TCs) could help to change the drugs addiction to a better life?
What is TCs aim in helping the drugs addiction to overcome the addiction?
What makes relapse happen among the recovery drug addicts?
Purpose of the Study
The study has been conducted with a purpose to let people in the society knows and acknowledge the effort that has been taken by Rumah Pengasih in helping out the substance abuse to change their lifestyle and become a better person in the future. The effort that has been shown by Rumah Pengasih would never been achieved without a help from the societies.
As part of the society, we should stay united and lend a hand to help them walking through the recovery process. Drugs will destroy our life if we never take a step forward to destroy it first. It is a hope that family, society, schools, institutions and organizations would sit together and try to find the solutions of overcomes the matters of drugs problem.
Three participants who recover from drug dependency have been selected from a drug rehab centre. All three of them are male adults, age 24, 30, and 41 years respectively. They agreed to their participation in this study.
Researcher as an instrument plays an important roles in qualitative methodology. This is because researchers can identify processes and phenomena for review, build questions for the coverage of scientific investigations, perform primary data collection procedures and analysis and ably synthesized the data to the validity of the results.
In qualitative research, researchers are the instruments. Researchers are responsible for determining what needs to be reviewed and analyzed during data collection and analysis procedures. Background education and professionalism research will be a useful perspective to give additional value to this study.
Data collected from the participants at a drug rehab centre acquired in depth up to become saturated data to ensure data that help to in-depth understanding of the topic under review. Researchers using partially structured interview. All interviews were recorded. A data collection procedure includes:
Interview the respondents.
Check the details of the respondents from the data kept by the rehab centre.
Repeating an interview session with the respondents.
To ensure the reliability, integrity and credibility of data, specific strategies for triangulation have been used through journals and reviewed by qualified academics. Data were then analyzed using content analysis transcription of interviews and documents. The three factors in the study of qualitative analysis assignment, namely:
The reduction of data,
The data is displayed, and
Conclusions and data verification.
Themes appear through the conversation. Once the theme has been identified from the feedback of the participants, the initial categories will be listed and questions will be formulated to narrow the focus of the study, confirming the preliminary findings and investigate for new or additional information.
Relapse is the use of the drug after someone who was called as a drug addicts stop taking it for a given period. This situation is considered to be one that is normal because it is experienced by most of the addicts who have or are currently undergoing the process of treatment and recovery. However, relapse should not be considered a failure to achieve recovery. It should be seen as a long-term process in achieving recovery because addiction is a disease that is easily repeated.
A stage of relapse likely happens to the most hardcore addicts. However, relapse can be prohibited if a drug addicts have a high level of self confidence to change, understanding, awareness and skills for coping (coping skills) to identify and manage warning signs are the occurrence of relapse in a way that is effective and sustain themselves with recovery. It is able to handle things if they practice a healthy lifestyle.
The theme that emerged from the analysis of data about the occurrence of relapse reasons is:
Society Not Accepted
Influence of Friends
On average respondents interviewed told that the reason the occurrence of relapse is because some feel bored. If prior through the recovery process, every free time activities are filled with smoke the drug. They feel their time is filled with space activities sucking drug with friends or alone. For a drug addict, the level of extreme boredom invites reason to them back to relapse. This is because they can't figure out how that should have been taken to meet the free time aside from smoking drugs.
Attitudes and community acceptance of a cynical former drug addicts also cause most of them back to relapse. The perceptions of a society that is more likely to punish on the sins of past mistakes, caused them to revert to the old activities. According to them, ' beams and so addicts, continue the activities to death '. This is the condition that causes them finds it is too hard to change a public perception that continues to label as well as the attitude of the addicts who are not strong on its own in the face of community opinion against themselves.
The influence of a friend who was equally involved with drugs also causes them to again back to relapse. Call friends to bait former addicts with "miscellaneous expenses" resulted in their return affected. Fellow addicts will start looking for the friend whenever they found out their friend has returned from rehab. Former addicts who have not been strong enough to thwart such trials could easily return to escape addiction. They feel, by taken drugs only they feel release and return to normal. But in fact such activity will continue to trap them back to addiction life. Thus, the ex-addicts are advised and often been reminded to avoid people who are still involved in the symptoms of addiction.
Longing to the drug also causes them to get back to the past activities. On average they feel drug seems to have its own attractions predispose them to be back. The respondent explained that yearning will be available when they see something that could carry memory of yearning towards drugs such as objects, people and places. For example, if viewed evacuator drinks (straw), someone will start to pop back drug "heroin" in a short straw like they used to get it before. Looking at the straw may get them to the memories during wallowing conducted with drugs. A small straw had a powerful attraction and a high desire; they will find the "goods" such as meet the requirements of them.
As a private treatment and Rehabilitation Centre operated by non-governmental organizations through the association of ex-drug addicts, Rumah Pengasih clear work preferably to help addicts who really want to change. This treatment centre started operating in 1993 and prescribed treatment is directed to a system of "Peer Recovery Guidance".This method emphasizes the restructuring of thinking, management and stabilization of emotional, behavioural and spiritual nourishment. Treatment methods carried out here known as the "Therapeutic Community" (TC).
Rumah Pengasih was established with the mission to save guests from addicts survive who are shackled with misery and suffering due to continuous addiction. The concept of therapeutic approach (TC) has been seen as an effective recovery method. It is a method of treatment which is expected to help addicts to recover in leading a better life yet meaningful.
Activities are arranged in mind of loving-kindness is based on modules and programmes using the approach of recovery from inside. Treatment and rehabilitation programme is felt to be more effective when conveying information and input program are those who have experience in the world of addiction. They are the addicts ' has recovered and has been through and undergo treatment and rehabilitation programme at the same place. Now they managed to change and rid themselves of the yoke of drug addiction.
Approach of Therapeutic Community (TC) is an alternative treatment methods adopted by 65 countries and a total of 4227 facility. This approach emphasizes the concept of TC value of family (Family Milieu Concept), an example of historical fairy tales (Role Model), support help peer (Peer Pressure) and coping skills (coping skills) a person resident in an effort towards fully human recovery (whole person recovery).
TCs have seen themselves as a mutual self-help alternative to medically oriented strategies to address addiction and most have not allowed program participants to use medications such as methadone. The use of methadone shows a long-acting opium agonist medication that is effective in treating opium addiction and pain (De Leon, 2015).
Residents at Rumah Pengasih are those who come voluntarily. They came voluntarily because they felt it's the time for them to change and really want to recover so as to get back to normal life as before engaging in addiction. Period of time for them to be in treatment is for 6-12 months. After undergoing the recovery process itself such as the time appointed, they would then be increased to pre-phase of integration and integration.
This shows the phase changes that occur to the resident and continued as an encouragement for them to change. Residents are also encouraged to join support groups help peers comprising the former resident of either become Alumni Members of loving-kindness.
Initially, TCs were solely run by peers in recovery. As time passing by, the changing has been done due to the response of the participants where TCs have begun incorporating with professional staff with substance abuse counselling or mental health training. Some of them are also in a recovery themselves.
Therapeutic Communities (TCs) have a recovery orientation which focusing on the whole person and overall changes of lifestyle. Not only from drug use. Recovery is seen as a gradual, ongoing process of cognitive change through clinical interventions and it is expected that it will take time for program participants to advance through the stages of treatment, setting personal objectives along the way.
The therapeutic community (TC) stand as a model of treatment based on family and community. It is basically a self-help approach which strives to sustain the main characteristics of a pro-social and positive family environment. It includes a structure to provide order in daily living; nurturance through physical and psychological safety; individual acceptance and encouragement, conditional only upon honest participation; and the transmission of health values.
Treatment and rehabilitation at Rumah Pengasih reinforced family during the recovery period. This can be seen through the concept of family hierarchy and hierarchical organization who applied through the concept of family at Rumah Pengasih. The development of family culture is very important in an attempt as an effort to treat the residents in loving. This would makes them feel that they are in a family that is always attentive and caring for each other. It can be seen when they mutually caring, concerned, and advise each other (see Figure
In addition, resident in Rumah Pengasih also applied with a sense of responsibility over themselves and friends. Furthermore, in this cultural of rehabilitation centre, the love between counsellors and staff had also been applied to consider them as a brother who could share their problems and provide guidance to those who want to recover (see Figure
With the existence of such an atmosphere, the resident could easily interact with counsellors and staff in a comfortable way without any obstacles, embarrassment, ashamed and so on. The family atmosphere that exists at Rumah Pengasih is to further strengthen friendly relations between residents and counsellors (see Figure
It is seen as important elements in which the attitude of care, mutual advises, mutual monitoring is essential in increasing the confidence and recovery from time to time. Residents feel they are responsible for helping the recoveries of their friends. Furthermore, it shows the accessibility programme for the treatment and rehabilitation (see Figure
Peers is one of the factors that help to support the method adopted for the purpose of shaping the behaviour of addicts '. One concept that is applied is known as Tools of the House. It is a formation behaviours practiced at Rumah Pengasih. This concept emphasizes the aspects such as a confrontation, encounter, and group sharing and so on. They also highlighted the culture of rebuke the mistakes with the aim to advice. This is not only makes the comment that reprimanded will be impressed with his actions but became a reminder to a reprimand for not doing the same thing.
Resident guests are trained to be an open in pour their feelings such as anger, fear, worry, dissatisfaction and so on. It thereby reduces stress feelings involving emotionally and mentally. In this way too, it helps strengthen the emotional and psychological respectively to persevere emotional control under any circumstances.
Throughout this method, their own friends will act as observers and advisors and teachers unable to rebuke them throughout the program. This is because the busy staff or counsellors do not allow them to be able to spend time in full along with residents. Counsellors and officers are to provide a space for its residents to be the spy each other in monitor and supervise among them. In this regard, partners in the rehabilitation treatment is seen as the best medium to help upgrade errors made and shows the best example on the self, respectively.
At the end of each session, a counsellor on duty will rectify mistakes, opinion and views the wrong resident. Through this, they can accept the reprimand and knows every risk nor consequences occur and take heed of any errors and fix their mistake. The sessions run every week will debate and discuss a topics and different themes. This is for residents to pour what buried in the liver as well as the advice that should be the correct direction in their lives. Residents were given new input and useful for their life when returned to be with their family and community.
A religious teacher was appointed to teach and was assigned to handle the spiritual recovery sessions per week. He will discuss various issues related to religion and spirituality. Religious sessions provide opportunities for residents to ask questions pertaining to the charity worship, prayer, fasting and related rules.
Through this session a resident gain greater understanding of the concept of appreciation of religion prior to put loving-kindness to improve them and gain knowledge of their religion. Residents are also reminded that the internal strength to achieve recovery from feces of drugs is the strength of faith against God Creator. As such, they need to improve their internal attitude in advance so that it could become a protection counter measures of stuck back to escape addiction.
Former drug addicts is one of the examples used in motivate all drug abusers undergoing treatment and rehabilitation to achieve fully capable recovery become useful to society and family. All counsellor and staff working at the Rumah Pengasih is a former drug user who had fully recovered even serves to revive those who undergo treatment at Pengasih.
Indirectly, their presence in Loving can help those who are undergoing treatment to strengthen the mental, emotional, physical and spiritual so that also the same net of filth of drugs. The recovery process will be easier because the counsellors or staff know and savvy about the behaviour and temperament of the drug addicts. This is because they had never been in such situations before.
Rumah Pengasih applied with 3 concepts known as HOW. Each singular brings a meaning such as Honesty (Honesty), Openness (Openness) and Willingness (Willingness). The three core values of loving-kindness are seen as one of the efforts the personality reshapes drug addicts towards a more positive life.
After reaching the level of preparedness, the resident will participate in the Program Integration. After that, they are encouraged to participate in Cluster Support help. The resident will be undergoing the process of the formation of more positive behaviours in terms of healthy emotional.
Rumah Pengasih also organises seminars related to the teachings of Islam to intellectual and spiritual development of the residents. At Rumah Pengasih they also uses religious approach in the treatment process as Islamic values which absorbed is much more effective, especially in terms of family and community that is more concerned. The support of friends and loved ones around is very helpful in preventing drug addiction again. Therefore, the support of friends and also the surrounding society is important in order to drug rehab.
Relapse prevention is a method being used to educate and teach addicts that are working towards recovery so that they would be able to identify and manage to identify the relapse warning signs. Most of the addicts couldn’t be recovered from relapse because they do not understand about the process of occurrence on relapse and how to deal with it. Thus, preventive strategies should be taken and made to help clients build lifestyle without drugs with a focus on healthy lifestyle, learn how difficult to conduct the new life, rational thinking, strengthen spiritual and build social relations and build mutual support.
Self-confidence among drug addicts is an aspect which is important because it helps drug addicts to return to interact in society with a confident feeling and become stronger to deal with the challenges and trials that could come from influence of negative influences from the past life (Muhd & Muhd, 2011; Lettieri, Sayers, & Pearson, 1980).
Jordhy (2014) has been a preoccupation with self confidence as a person's expectations to successfully master the challenges and overcome the obstacles appear. In fact, according to him, confidence is a process where you belief in yourself that everybody is able to do a thing according to the requirements of the internal self.
Therefore, in the sense that more clearly, he has described that self-confidence is a belief of person where they are able to achieve what they want for themselves (Jordhy, 2014).
While master of the West, namely Lettieri et al. (1980) felt self-confidence as a basic trust in someone to overcome obstacles in life. In this situation, an individual believed that they will successfully face the challenges when they have confidence in themselves. There are several studies that associate in a level recovery drug addicts with a number of specific factors.
The three factors are individual factors, social environment and the effectiveness of rehabilitation programmes for drug addiction tendency of relapse up to affect the level of recovery addicts.The recovery efforts are made to addicts to assist them out of heavy drugs. Addiction prevention seminar programme again undertaken by the group support to help peers seen between methods that are used to help support addicts being in recovery. They can share their views and their experiences and lend support to addicts.
In addition, guests will enjoy activities such as mutual cooperation and spiritual activities and motivation; it is to some extent to help them forget about addiction and the desire to use drugs. A hectic and compact activity does not give space to them to reflect on the drugs. This is because extreme boredom and the inability to think rational will invite memory against drugs and at the same time will result in the existence of a desire to get drugs.
Focuses on the mind of a drug will invite to the attitude that led to the sub culture of drug addicts. Lazy attitude, cheating, taking an advantage from others, do not think long, lip and inconsistent in doing a thing is the norm or value carried by addicts during their involvement in drug addiction. Thus, bad attitudes and negative activities should be discarded so that they could return to lead a normal life before they got involved in addiction.
Monitoring given to addicts that being recovered is among the efforts done by the Rumah Pengasih in making sure that they don't caught up again into addiction. The "after care" programme are among the programmes carried out to collect back former residents to get to know their conditions where it was called out every once a month. If found their bill back, they will be called to follow treatment and recovery.
An interview that has been done on the selected respondents acknowledges that the programs implemented in many Rumah Pengasih educate them to think long and trying to change. Support, assistance and attention given, make them feel appreciated and felt that there’s still a hope to change. Although the recovery process may took their time, but with the effort, belief and confident that they gain throughout the recovery process, they would be able to sustain the recovery process with the support from the staff at Rumah Pengasih.
All Staff and Residents at Rumah Pengasih Amanjaya, Perak.
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30 March 2020
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Mohamad Noor, N., Zain, S., & Yahaya, F. H. (2020). Relapse And Reovery Method At Rumah Pengasih. In N. Baba Rahim (Ed.), Multidisciplinary Research as Agent of Change for Industrial Revolution 4.0, vol 81. (pp. 517-527). European Publisher. https://doi.org/10.15405/epsbs.2020.03.03.60