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

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<.001) compared to the 32.1% success rate in ordinary care. The main self-reported precipitant of relapse was family negligence (61.8%). Conclusion Early phase structural/psychosocial voids are main causes of relapse in this population. Medical detoxification is imperative, but sustainable recovery to be possible seems to depend on economic reintegration. Provision of livelihood assets was found to be a powerful neuroprotective intervention and it is recommended to consider vocational support as a center clinical element of an addiction treatment.