The Phases Before, During, and After Becoming a Drug Abuser: Are They Interrelated? ^†

Abstract

This paper focuses on the issue of women’s involvement with drug abuse in Malaysia. The involvement with drug abuse is much more common among men; however, understanding women’s participation in drug use is critical, as it is increasing year-on-year. In this study, the researchers aim to understand the factors that contribute towards the involvement of women in drugs and the effectiveness of treatments provided by drug rehabilitation centers in order to help clients to stay sober. It is vital that this issue be curbed, as it will create a butterfly effect. This is because it not only impacts the individuals themselves, but also the community. Additionally, the situation becomes more critical as the opportunity for women drug abusers to be treated is quite limited compared to the opportunities given to men. Hence, this research finds that it is important to understand the phases before, during, and after becoming a drug abuser as it will also help to determine the effectiveness of the treatment and mitigate the tendency of women drug users to relapse.

1. Introduction

The issue of drug abuse has become a worldwide issue regardless of whether a country is a developed or developing country. It is critical that drug abuse be addressed as it may influence the stability of the country in term of safety, society, and health. However, drugs are important for medical purposes, yet they are often misused by some people. Hence, if a drug is not being used as prescribed, it can lead to an addiction. Addiction may cause negative changes toward an individual mentally, emotionally, and physically.

It is important to curb drug misuse as it can create a butterfly effect within the country. This means that the existence of drug abuse will not only impact the individual (drug abuser), but will also have an impact on the family and community. For instance, in America, the issue of drug abuse costs more than USD 700 billion a year, as there is an increment in the cost of health care, crime, and loss of productivity [1]. As stated above, drug abuse may cause addiction, which is a chronic disease that can disrupt the functions of the brain and body, and if left untreated, it can lead to harmful effects or death [1]; hence, this can create social issues such as prostitution, gambling, and chronic disease.

In Malaysia, since 2018, the number of women participating in drug abuse has increased year-by-year. Referring to

Table 1. Women’s involvement in drug abuse from 2018–2021.

Year	Males	Females
2018	24,025             2.73%	947            19.0%
2019	24,682               −21.59%	1127             −14.73%
2020	19,352	961
2021	117,822	5317

, below, it can be seen that the number of males involved in drug abuse is higher compared to women; however, the percentage of women becoming involved from 2018 to 2019 is much higher compared to men, with the percentages of 19.0% and 2.73%, respectively. However, in 2020, the number of involvements between the two sexes has declined. This is due to the COVID-19 pandemic and the government of Malaysia enforcing a Movement Control Order (MCO), which has indirectly helped the government to curb the issue of drugs. In 2021, the National Anti-Drug Agency reported that the number of women involved in drug abuse started to rise again.

2. Need for This Study

This research will be relevant in understanding the relationship between the phases before, during, and after being a drug abuser. Examining these phases will help to obtain a better understanding of what triggers an individual to become involved with drugs, the effectiveness of treatments at the rehabilitation center, and how the treatments have helped clients to survive after they have been released from the rehabilitation center. In this research, the researcher selected a group of Malay women who are currently serving their time at a rehabilitation center, clients who have been released from the center (alumni), and officers in charge of handling the treatment sessions. By referring to the information given by the selected group of informants, the researcher was able to determine what triggers the involvement of Malay women in drugs and the effectiveness of the treatments provided to them. This proves that this study is able to fill the gap relating to the issue regarding the involvement of women in drugs and how the treatments provided are able to prevent the client from relapsing.

3. Overview of the Drug Abusers’ Life

3.1. Before

During this first phase, the researcher sought to identify the causes that trigger women to be involved with drugs. Generally, there are many reasons that can cause women to participate in drug use. According to [2], one of the reasons that may cause women to be involved with drugs is the influence of their intimate partner. This is because intimate partners play a huge role in an individual’s life, especially women, hence they are more likely to be introduced to drugs by their partner. Furthermore, the association of drugs among women may also be caused by physical violence. When a partner has great control and power over them, the tendency for a woman to be influenced by drugs, either voluntarily or involuntarily, is high. This is because drug abuse is often related to emotional disorders such as stress, anxiety, and depression [3]. In addition, drug abuse can affect learning achievement, cause addiction, and increase mental health issues [4]. Moreover, intimate partners usually share the same equipment to inject drugs, and with that, they are vulnerable to contracting the human immunodeficiency virus (HIV). According to [5], peer influence, a problematic family environment, and sensation-seeking are also contributing factors that cause women to be involved with drugs.

3.2. During

Access to a rehabilitation center plays an important role in treating people who abuse drugs. This is because the rehabilitation center will act as a tool to monitor and guide the individual to recover. However, according to past research, up until now, rehabilitation centers are unable to guarantee the recovery of the clients [6]. Studies have found that this is because clients still have the urge to continue consuming drugs even after they have been released from the center [7]. In ensuring the effectiveness of the treatment toward the clients, early-stage identification needs to be made so that a suitable treatment is able to be given. This proves that it is crucial to provide a treatment that can tackle the root cause of the issue by educating the client about the recovery process and encouraging good practices and activities in their daily life, which then will help them to achieve lifelong recovery. To support the previous statement, [8] suggested that future studies need to evaluate the effectiveness of the current treatment program and whether it needs to be adjusted in order to tailor the program toward the desired goal.

3.3. After

In this phase, the post-treatment process is crucial to be looked into as it will determine whether the client is able to avoid relapse. According to [5], the client tends to start becoming involved with drugs again or relapsing as they face challenges such as having trouble obtaining and retaining jobs. This is because, during their time at the center, most of their basic needs are being taken care of by the center; thus, the client tends to be in a comfort zone. With that, it is important to ensure that the client is able to be independent. Hence, past researchers suggest that a well-established method should work together with the current treatment program so that the root cause of relapse can be addressed [9]. This is because the treatment will determine the quality of life of the clients after they are released from the center [10].

4. Research Questions

4.1. What Are the Factors That Trigger Malay Women to Be Involved with Drugs?

As for this research question, it will assist the researchers in order to identify the factors that has triggered Malay Women to be involved with drugs. Identifying the factors that triggers women to involve with drug is important as it will help the researcher to classify whether the client are willing or being forced to be associating with drugs.

4.2. How Effective Are the Programs Provided by the Rehabilitation Center?

From this research question, the researcher able to understand which programs gave more positive impact toward the client in supporting their journey to be free from drug dependency. The researcher also able to provide modifications to improvise the current treatment program.

5. Methodology

5.1. Research Design

This research is a qualitative study that adopts a case study design. It involves an intensive examination of a real-life setting. By adopting the case study design, interview sessions and focus group discussions will be used in order to gather information from the informants.

5.2. Unit of Analysis

The study involves Malay women from PUSPEN Bachok who have undergone treatment for more than 3 months, previous clients (alumni) who have been released from the center, and officers in charge who were involved during the treatment process. PUSPEN Bachok was chosen as it is a pioneering drug treatment center that only focuses on women.

5.3. Sample Size

Rule of thumb will be applied in this study as it will involve 10–20 knowledgeable people in order to obtain sufficient understanding and help to define the case studied [11].

5.4. Sampling Technique

As for the sampling technique, this study uses purposive sampling. This is because it is a specific issue; hence, the sample will only be among a group of informants that possess the experience and information pertaining the issue studied. Moreover, by applying purposive sampling, it will help the researcher to capitulate useful information from the informants.

5.5. Instrumentation

A set of interview questions will be posed to the informants (female Malay clients, clients who have been released (alumni), and officers in charge at the center). The questions are presented in both Bahasa and English.

5.6. Data Analysis

The analysis of this study will be completed using NVivo version 12 to analyze the information that is obtained from the informants. Other than that, the analysis will include import, explore, code, query, reflect, visualize, and memo [12].

6. Discussion and Conclusions

Figure 1 represents the whole focus of the study. The researcher determines whether the phases before, during, and after becoming a female drug user are interrelated. Hence, this study attempts to determine the factors affecting the tendency for drug abuse among Malay women. Furthermore, this study will also examine the category of admission among women clients, which will determine the intention and willingness to enter into and participate with treatment at the rehabilitation center. However, past studies revealed that the effectiveness of the treatment cannot rely on the program alone, but rather requires the willingness of the client to ensure the effectiveness of the treatment. According to [13], the willingness of the clients plays a crucial role as it will determine their level of participation during the recovery process. This is because, if the client voluntarily participates, they will have a better understanding of their addiction and may be more determined to be recover. The study conducted by [6] found that clients who voluntarily admit themselves into the center are more participative during the treatment process. Voluntary clients are more open to accept and participate during the treatment process, which will help them to reduce the tendency to relapse. One of the informants in the study also mentioned that the rehabilitation center can only provide programs for the clients, and at the end of the day, it fully depends on the individual to be ready and willing to make the changes. This proves that ensuring the client is willing to participate in treatment process is crucial. If the client is being forced to enroll at the center, they will have trouble adapting to the situation and this will affect the smoothness of the treatment process [14]. Moreover, [13] also stated that if a client is not willing to participate, they will lose the opportunity to understand their current situation and what the right treatment is that they need in order to recover. Finally, the effectiveness of the treatment program will depend on the client acknowledging how the program is able to help them to improve their productivity and quality of life after being released. This is because it is important to see how the program is able to help the clients to progress and survive in the real world.

To conclude, this study is important to fill the research gap on women and drug abuse, which is an area that is very understudied, especially focusing on Malay women. It is hoped that this study will be able to help develop a better understanding of the importance of addressing this problem and to plan an effective action plan to reduce the number of relapse cases among women.