Asian Social Science

It has been noted that many drug addicts relapse to drug use after discharged from successful treatment and rehabilitation programs. Thus it is imperative and timely to address the issues that prompt relapsed addiction. 400 drug addicts on relapse cases were selected from eight drug rehabilitation centres throughout Peninsular Malaysia to examine factors influences the relapsed addiction to drug use. Consistent with previous research, self-efficacy, family support, community support and employers support were identified as main factors that influenced the relapsed addictions tendency amongst addicts.Suggestions to curb relapsed addiction to drugs were discussed in relation to the findings. Keywords: Relapse, Addiction, Drug, Malaysia 1. Introduction The close geographical propinquity to Myanmar, Laos and Thailand (Golden Triangle) and other Southeast Asian countries that produces illicit drugs has intensify drug use in Malaysia. The illicit drug use been well thought-out as major soc ial intimidation in Malaysia.The government, on February 19, 1983, declared drug as national disaster and endeavor with stringent law enforcement together with rehabilitation programs for addicts. Indeed the government through various agencies has put in action strategies to impede drug use, parallel to the mission of attaining a drug-free society by 2015. Nevertheless, even with the country’s stringent enforcement policy, there has been a sizeable ascends in the number of fresh and relapsed drug users (National Anti-Drug Agency (NADA), 2009).NADA entrusted by the Malaysian government to sculpt mechanisms to handle the drug crisis and in particular to trim down relapsed addiction rate. Based on the statistics by NADA (2009), the number of detained drug addicts from January to December 2007 and 2008 were 14,489 and 12,352 respectively. Perhaps, the addiction trend that was recorded by NADA is some sort of a relief to all concern. In 2007, the detained fresh and relapsed addict s were 6,679 and 7,810 respectively.Among the detained drug addicts in 2008, 5,939 (48%) were fresh addicts while 6,413 (52%) were relapsed addicts. Interestingly, in 2008 the statistics revealed a decline of percentages in total number of detained addicts (15%), new addicts (11%) and relapsed addicts (18%) compared to the reported statistics in 2007. Nevertheless, careful observation on the statistics revealed an increase in the number of detained relapsed addicts compared to new drug addicts between 2008 and 2007.Generally, it is well understood that the number of drug addicts should reduce dramatically upon successful completion of treatments or rehabilitation program. However, the reported data explicates that most of the drug addicts failed to sustain the free of drug lifestyle after they have been discharged from rehabilitation treatment program. Mohamad Hussain and Mustafa (2001) reported that there are evidence of 90% relapsed cases among heroin addicts within six months aft er been discharged from the Serenti rehabilitation centres.It also had been found that 40% of the addicts pine for heroin after a month of abstinence. Surprisingly, Serenti rehabilitation centers have relapsed inmates who have followed the rehabilitation sessions for more than five times. Moreover, Habil, (2001) contended that more than 70 percent of those attending drug rehabilitation centres would probably relapse. Reid, Kamarulzaman, and Sran (2007) alleged that though some of the programs had been successful, about 70 to 90 per cent of addicts who underwent rehabilitation probably 37 Vol. 5, No. 12Asian Social Science return to the habit within first year after been discharged if they are compelled and detained at the rehabilitation centres. In any event, the rate of relapse among addicts is of great concern to both governmental and non-governmental bodies. Thus, this research was initiated to examine the factors contributing to relapsed addiction tendency amongst drug addicts i n Malaysia. Indeed this study is significant and timely to fight against drug addictions to the root while achieving the nation’s ambition to reach the zero drugs by 2015. . Factors Contributing to Relapse among Drug Addicts Relapse is a formidable challenge in the treatment of all behavior disorders (Witkiewitz & Marlatt, 2004). Several authors have described relapse as complex, dynamic and unpredictable (Buhringer, 2000; Donovan, 1996; Marlatt, 1996). Whereas according to Mahmood (1996), relapsed addiction means, usage, intake or misuse of psychoactive substances after one had received drug addiction treatment and rehabilitation, physically and psychologically.To Rasmussen (2000), relapse occurred because of the building up of additional crisis such as to look trivially on certain problem, stress, weak or failed forecast, the pessimistic thinking that all issue cannot be resolved and immature actions. Relapsed addicts also confused and overreact due to the inability to thin k clearly, unable to manage feelings and emotions, the difficulty to remember things, unable to control their feelings and easily angered. Various studies have examined the effects of psychosocial factors towards relapse among drug and alcohol dependence.Moos (2007) contended that psychological factors are supposition to contribute to relapse among drug addicts after abstinence. Consistently, anxiety has been linked to increased relapse risk among marijuana addicts (Arendt et al. , 2007; White et al. , 2004). Other relapse promoting factor is self-efficacy, defined as a degree to which an individual feels confident and capable performing a certain behavior in a specific situational context (Bandura, 1977).As described in the cognitive-behavioral model of relapse (Marlatt, Bear & Quigley, 1995), high levels of self-efficacy are predictive of improved alcoholism treatment outcomes (Brown et al. , 1995; Greenfield et. al. , 2000; Rychtarik, Prue, Rapp & King, 1992). The situation is di fferent from the results of research done on 60 alcoholics, which found that individuals who have high self-efficacy after going through rehabilitation treatment, are most unlikely to be addicted again (Allsop, Saunders & Phillips, 2000).Chuah (1990), in his research found that drug addicts who have low self-efficacy would be back to addiction after their release from getting treatment and rehabilitation. Other previous studies have also point out that improvement in self-esteem positively lead to success in rehabilitation programs and it assist in curbing drug addictions (Graham et al. , 1997; Mahmood, 1995; Mahmood et al. ,1998; Mahmood et al. , 1999). Attitude and poor knowledge on drug abuse been reported to be contributing factor of relapsed addictions among drug addicts (Abdullah & Iran, 1997).Besides, less support from family members and the community by large towards former addicts highly promote the relapsed addiction tendency after treatment (Brown et al. , 1995; Miller et al. ,1999; Miller, 1992; Moos & King, 1997). Research by Mohd Taib, Rusli and Mohd Khairi (2000) on family communication patterns amongst addicts’ family and non addicts’ family, showed weak communication patterns and less effective interactions amongst former addicts’ family is one of the high probable factors toward drug addiction.Indeed, family support is much needed to ensure the rehabilitation process success and issues like â€Å"don’t care attitude† and ostracizing former addicts would only failed the rehabilitation process and in the long run caused the former addicts to relapse (Daley & Marlatt, 1992). Amongst other factors that have been associated with relapsed addiction are peer pressures especially from the old friends who still use drugs. Mahmood, et al. (1999) found 50% of old friends influenced former addicts to pick up the drug taking habit after they were discharged from rehabilitation centres.The research also showed that 76% of the old friends assist rehabilitated individuals to get the needed supply of drugs. These situations further induced the relapsed addiction amongst former addicts who has been getting rehabilitation treatments. However, the above research is different from findings by Chuah (1990). He found peers support could help former addicts from not getting back to the old habit. He concluded that high emotional and spiritual support will indirectly increase the addicts’ self confidence and decrease the risk towards relapsed addiction.Gregoire and Snively (2001) reported that addicts who have discharged from rehabilitation centres and living in drug-free social environments could be linked with higher abstinence rates and low in relapse of drug use. Mc Coy and Lai (1997), on the other hand, associates inability to get jobs amongst former addicts who were discharged from rehabilitation centres coupled with lack of financial supports, caused the addicts to go back to addictions. Yunos (1 995) asserted that employers always took advantage on the former addicts by paying low salaries without aking into consideration their qualifications and experience, causing dissatisfactions amongst the former addicts that eventually caused them to quit their jobs. Yahya & Mahmood, (2002), found that the treatment and rehabilitation programs being conducted in any country would faced various challenges. The effectiveness of drug rehabilitation programs also one of the factors, associated with relapsed addictions amongst addicts. This is because some researchers found drug rehabilitation programs conducted on addicts are less effective to jolt them to awake (Mokhtar, 1997, Wellish & Prondergast, 1995).Many research found that the traditional treatment and rehabilitation models failed to help in reducing relapse addiction to drug use (Habil, 2001; 38 Asian Social Science December, 2009 Mahmud Mazlan, Schottenfeld & Chawarski, 2006; Mohamad & Mustafa, 2001; Mahmood, Md Shuaib Che Din a nd Ismail Ishak, 1998; McLellan, 2002; Nestler, 2002; O'Brien, 2006 ; Reid, 2007). Though, sufficient rehabilitation programs are in place, prevention of relapse to drug will pass its best if physiology and psychology strength of addicts faint in due time.In addition, lack of multiple long term treatment modalities, social intervention and additional pharmacological treatment could abet relapse. Hence, relapse to drug use after extended periods of abstinence remains as most intricate clinical problem and research issue in the treatment of drug addiction (Miller et al. , 1999; O'Brien, 2006; Sinha & Li, 2007). Individuals involved in recovery and the treatment of recovering individuals recognize that sustaining a clean and sober life is perhaps significantly more difficult than eliminating the use of the drug.There is a high degree of consensus in the field that relapse is a common element in the recovery process. Nevertheless, examination of factors which contributes to relapse is i ndispensable to develop successful interventions in curbing future relapse to drug-taking behavior (Donovan, 1996; O'Brien, 2006, Sinha & Li, 2007). The present study intended to identify the extent that self-efficacy; support from peers, family, employers, community; and programme effectiveness at drug rehabilitation centres influences the relapsed addiction amongst drug addicts.The findings of this research is advantageous to the government, namely the Home Ministry, NADA, social workers, drug counselors, psychologist and other human services in particular, Malaysia and other regions in general. 3. Method The primary data was obtained through a survey using self-administered questionnaire. Items from established instruments were adopted and modified appropriately to suit the objectives of the study. The instrument consists of five parts. The first part of the questionnaire collected the demographic information of the respondents.Second part consist 42 items developed by Marlatt an d Gordon, (1985) to measure the tendencies of relapsed addiction among the addicts. The items specifically measures three dimensions; negative emotion, interpersonal conflict and social pressure. Part 3, 4 and 5 obtained information pertaining to self-efficacy, sosial-environment factors (support form peer, family, employer, and community) and rehabilitation programme effectiveness respectively. Self-efficacy was measured using 15 items developed by Sherer and Maddux (1982) while 5 items from Abdullah and Iran (1991) was employed to measure attitude towards drug abuse. 0 items developed by Procidano and Heller (1983) used to measure peer and family support.12 items created by the researchers to measure employer and community support. The program effectiveness at drug rehabilitation centres was measured using 26 items developed by Bahaman, et al. (2003). The respondents were asked to respond on a scale ranging from strongly disagree (1) to strongly agree (4). From the analysis, it wa s identified that the Cronbach alpha of all constructs exceeds Nunnally’s (1978) recommended threshold value of 0. 7. Thus, the instrument used in this study showed a good level in terms of reliability.The respondents were chosen by systematic sampling procedure. 400 questionnaires were personally distributed to the relapsed addicts who are undergoing treatments and rehabilitations in eight Narcotics Rehabilitation Centres in Peninsular Malaysia. Counselors from the respective centres help to disseminate and collect the survey. High response rate (100%) for this study is due to high degree of cooperation by the respondents and the centres’ counselors. In addition, the drop and pick method utilized in this survey was very effective.The data were analyzed using SPSS Version 15. 4. Findings and Discussion 4. Respondents’ background Majority of the respondents (86%) involved in this research were aged 30 years and above. 80% of them were Malays and Muslims and in te rms of marital status, 65% were single. From the data on educational level, 91% of the respondents were holding Sijil Pelajaran Malaysia (Malaysian Certificate of Education, equivalent to O’levels). About 47% of them used to work as temporary workers. 4. 2 Factors promoted relapsed addiction amongst drug addicts in Malaysia. Respondents perceptions on all factors contributing to relapsed addiction were categorized as low, moderate and high based on the possible score range.Table 1 shows the summary of the findings. About 97 percent of the respondents indicated moderate to high level of agreement on attitude towards drug abuse. 68 percent of the respondents agreed to moderate level of self-efficacy. In short, the findings showed that respondents received moderate to high level of support from peers (99 percent) and family (96 percent) in their endeavor towards free from drug use. On the other hand respondents reported that they received low to moderate level of support from em ployers (98 percent) and community (94 percent) on the whole.About 99 percent of the respondents indicated moderate to high level of satisfactory with the rehabilitation programme at the respective centres. Table 2 displays the Pearson’s correlation coefficients between the research variables which indicate the strength of relationship between the seven factors with respect to perceived tendency of relapsed addiction to drug use. Out of seven factors identified to promoting relapsed addiction, only four factors showed significant correlation at the 0. 05 level. The factor with the highest correlation to tendency of relapsed addiction to drug use is self-efficacy (r= . 790, p

Marxist Critique of Desiree’s Baby Essay

The Antebellum south, or merely the word plantation, conjures images of white, columned manses shaded by ancient oaks bowed beneath the weight of Spanish moss and centuries. Somehow these monuments of Greek revivalist architecture sparkle in their ivory-coated siding, even while the trunks of their aged arboreal neighbors hide under layer upon soggy layer of dense, green lichen. The white house is a reflection of the inhabitants, its cleanliness in the damp, soiled environment standing as a stark reminder of the hegemony governing the lives of those living not in the house, but hidden nearby. L’Abri, the plantation home of the Aubigny family in Chopin’s Desirà ©e’s Baby, is yellow and has a foreboding black roof made more sinister by the gloomy shadows cast by its requisite antiquated greenery. L’Abri is not unlike any other antebellum mansion of the pre-Civil War era; it represents its inhabitants. The mansion is excellently presented as an example of how little authority color truly wields without an underlying power structure to give it substance. While race figures prominently in Desirà ©e’s Baby, the story is an exemplary specimen for the application of Marxist criticism. Marxist criticism is the recognition of â€Å"inequalities in power between characters† (Gardner 146). It purposes to â€Å"expose the inequalities that underlie all societies† (Gardner 146). These inequalities can have multiple sources, though often the main source is race. But is race a biological reality? Miles posits that races are imagined, in that they â€Å"have no real biological foundation† (26). Miles further observes that differentiations between groups are â€Å"simultaneously inclusive and exclusive† (27) as the characteristics describing one group stand in contrast to another group. The destructive nature of racial categorization is in the claims that biolo gical types determine â€Å"the endowment and behavior of individuals† (Miles 28) depending on their race, and that conflict between them is the â€Å"consequence of their biological constitution† (Miles 28). Furthermore, race can be used to argue that there exists a natural hierarchy that determines positions of inferiority, and by extension, superiority (Miles 28). These assertions give credence to the ownership of slaves and the race-based denial of rights, and are foundational to the idea that the mixing of races is unnatural and even destructive. But race mixing is not mixing if race does not exist as a biological category. While science can find ways to assign race, those categories are blurred as races blend and eventually they will disappear. As a danger to the idea of race, blending is anathema to the superior category. Plantation life was a microcosmic picture of the idea of a need for segregation, wherein each category was given â€Å"its own territory within which its distinctive capacity for ‘civilization’ can be realized† (Miles 30). But Chopin gives an excellent (and perhaps accurate) portrayal of the lack of any real biological basis for what constituted race in Antebellum Louisiana. Chopin describes Armand as dark (402), and Desirà ©e points out to Armand that she is fair-skinned and whiter than he is (403). The baby is â€Å"their child† (Chopin 403) when Armand reveals the ‘truth’ to Desirà ©e, but is Desirà ©e’s child alone only four paragraphs later as she decides to leave (Chopin 404), notwithstanding the actual biological basis upon which the child’s parentage is based. Desirà ©e walks away with the â€Å"golden gleam† (Chopin 404) of the sunlight in her brown hair, taking nothing with her, as befitting her new-found but false identity. She does not take the beaten path, but instead walks through the newly-harvested October fields (Chopin 404), again behaving in a way that befits the new category with which she now identifies. Desirà ©e’s biology belies the reality that she now accepts as â€Å"the stubble bruised her tender feet† (Chopin 404), and she does not know to walk where the branches will not shred her delicate clothing. If Desirà ©e were actually black in the Antebellum south, she would know these things from early childhood. Desirà ©e disappears â€Å"among the reeds and willows that grew thick along the bank of the deep sluggish bayou; and she did not come back again† (404). Desirà ©e’s disappearance is not only her physical departure from L’Abri; it is the disappearance of the white woman that was Desirà ©e. And none of these circumstances is decided by biology, but by what Marxists refer to as a â€Å"struggle for power between different social classes† (Gardner 145). Chopin is delivering a message that power transcends race. What sets Desirà ©e apart in terms of her subjugation by Armand? It is not race, but the lack thereof. Desirà ©e is unable to hide anything about herself because her origins are unknown (Chopin 401). She is a willing captive to Armand as a result of her love and her marriage, but she is not an unwilling captive to race; she is an unwilling captive to her otherness. She does not have doubts about her race, but must live with the reality that â€Å"Armand has told me I am not white† (Chopin 404). Because her origins are unknown and she does not have a name, she must acquiesce to the whims of Armand, who had at first decided to be unconcerned about â€Å"the girl’s obscure origins† (Chopin 401). Armand is the power here. He makes all of the decisions regarding the lives of those within his circle of power, and he does so because he is allowed to do so. Madam Valmondà © has even decided to be unconcerned about Armand’s questionable origins. It is interesting that Desirà ©e’s mother perceives evidence of the baby’s blackness (Chopin 402), but does not explore the possibility that Armand’s blood is the cause. Madam Valmondà © is part of the power structure and victimizes her own daughter, whom she claims to love deeply and sees as a gift from â€Å"a beneficent Providence to be the child of her affection, seeing as she was without child of the flesh† (Chopin 401). Had Desirà ©e been a child of the flesh of Madam Valmondà ©, she would have been accepted, and Madam Valmondà © could have exercised her superiority over Armand and the unanswered questions of his origins. It is remarkable that no one questions Armand’s pedigree even though his mother lived and died in France (Chopin 401). Armand’s mother is perhaps one of the more interesting subjects of Marxist study in the story. One cannot help but wonder why Chopin portrays Monsieur Aubigny as â€Å"easy-going and indulgentâ⠂¬  (Chopin 403). He is a slave owner who married a woman of a different race overseas and asserted his white superiority over her, which is evident in her letter at the end of the story (Chopin 405). She credits God with having given her the ability to hide the reality of her inferiority from her son (Chopin 405). She is lost in the shame of her otherness. She has been so fully convinced by her perceived superiors of her inferiority that she sees the ability to hide her true nature as a gift from her creator. To Monsieur Aubigny’s hidden wife, this is as much a gift as Madam Valmondà ©Ã¢â‚¬â„¢s child of affection. One must question why Aubigny moved to France to marry this woman. And what was the arrangement that allowed her to stay hidden? Did she commit suicide? Is the letter that Armand is reading a final word from her before taking her own life? Note that this was only â€Å"part of an old letter† (Chopin 405), which leaves the true nature of her death unknown. This is power beyond ownership of chattels or social superiority; this power is God-like. Aubigny has happy slaves and is an indulgent tyrant, but to what dark magic has he subjected his French wife? Even if she is dying from something natural at the writing of the letter, it is remarkable that she perceives such powerlessness in herself. Armand is not as devoted as his mother to God. He finds that God has â€Å"dealt cruelly and unjustly with him† (Chopin 404) when he discovers that all is not as it seemed. Armand has a beautiful wife who â€Å"loved him desperately† (Chopin 402) and â€Å"asked no greater blessing of God† (Chopin 402) when he smiled. He has inherited a plantation and slaves to work it. He is rich and possesses the legacy of a good name. Yet in unmitigated spite of all that he has been given, Armand finds God unjust. His world has been suddenly and completely turned on its head because he has reason to believe that his child has inherited inferiority, never guessing that he himself is the source in more ways than one. Armand is a name similar to Adam, and Chopin seems to model him in part after the biblical first man. With the expulsion of Desirà ©e, L’Abri is reminiscent of the biblical garden east of Eden, with the exception that Armand remains. The Mosaic account of the creation of man includes a guideline for marriage, with the command that â€Å"they shall become one flesh† (NASB, Genesis 2.24). A married couple in this sense should be regarded in the same manner as a child and parent – inseparable by nature, regardless of wounds or emotions. This is a picture that does not give place to the other as each partner is regarded equally. It should be noted here that the name Desirà ©e is a French articulation of desire, and it was Adam’s desire that inspired God to give him a mate (NASB, Genesis 2.20). But Adam failed to regard his wife as equal to himself, standing by as she was tempted and choosing not to intervene (NASB, Genesis 3.6). In witnessing her deception and choosing not to intervene, Adam has made Eve the other. He has separated himself from her. Armand allegorically models the actions of Adam, but he gives himself the God-like power to expel his Eve from the garden, while choosing to ignore his own nature. Adam was Armand’s example in choosing to act in spite of all that he had been given, and in Adam’s attempt to fool God into believing that he had been blameless (NASB, Genesis 3.11), he set up a struggle for power. Armand falls easily into this struggle. It is not a stretch to believe that he has doubts about his own race. Exiling Desirà ©e is a tactic that Armand uses to maintain his hegemony. He does not have a foundation of support apart from the societal acceptance of slavery and white superiority. Desirà ©e and Madam Valmondà © are victimized by the very system that they tacitly support. They support it both by their participation as landowners and probable slave-holders and by their acceptance of it even when it forces them to accept inferiority. The superstructure of power in their society is so strong that it can be enforced with nothing more than words, even when those words have no basis in biological fact. It is not the taint of the wrong skin color that makes Desirà ©e a tragic figure; it is her support of a tainted system from which she benefitted until it turned on her. Skin color is a biological reality, but it has been manipulated in support of hegemony. The Antebellum south stood as a physical representation of the realities of race. Large, sparkling, white houses stood proudly fronting the large plantation estates of the white owners therein, while the dark-skinned slaves abode in small, mean cottages hidden in the rear. Kate Chopin depicts a plantation mansion in her short story Desirà ©e’s Baby with a paint color that is darker than the standard, modeling the color of the inhabitants. Nonetheless, the Aubigny family is powerful, benefitting from a superstructure that assigns power by the perception, rather than the reality, of skin color. While race is an important feature of the story, Chopin has written a work that is perfect for a Marxist critique. Works Cited Chopin, Kate. â€Å"Desirà ©e’s Baby.† Anthology of the American Short Story. Ed. James Nagel. Boston, New York: Houghton Mifflin, 2008. 121-135. Print. ISBN: 978-0-618-73220-3 Gardner, James. Writing about Literature: A Portable Guide. Boston: Bedford/St. Martin’s, 2009. Print. ISBN: 978-0-312-60757-9 Miles, Robert. â€Å"Recent Marxist Theories of Nationalism and the Issue of Racism.† The British Journal of Sociology 38.1 (1987): 24-43. Web. 9 Jun. 2012. New American Standard Bible. Trans. The Lockman Foundation. New York: Oxford UP, 1971. Print.