Factors Related to Recovery Capital of People with Substance Use Disorder in Northeastern Thailand

Abstract

Introduction Drug problems are an issue currently confronting both Thailand and the global community, with their severity continuing to escalate. Prolonged and high-level substance use can lead to mental illness and may develop hallucinations and psychiatric disorders, which can lead to violent behaviors, self-harm, or harm to close associates. Such consequences pose serious threats to the safety of life, health, and property of family members and the general public, thereby undermining national stability in both economic and social dimensions. Recovery capital refers to all resources available to people with substance use disorders that can support their recovery process. These resources include physical health, psychological flexibility, social relationships, economic aspects, and cultural assets, all aimed at enabling sustainable abstinence and improving quality of life. Accordingly, it is essential to investigate the factors associated with recovery capital among people with substance use disorders in this study.

Objective The objective of this study is to examine the relationships between self-esteem, psychological flexibility, friendship intimacy, and social support, and recovery capital among people with substance use disorders in the Northeastern region of Thailand.

Design This study employed a descriptive correlational design, applying the concept of recovery capital as proposed by Groshkova and colleagues. A comprehensive literature review was conducted, through which the factors associated with recovery capital were categorized into four domains: 1) self-esteem, 2) psychological flexibility, 3) friendship intimacy, and 4) social support.

Methodology The sample consisted of 320 people with substance use disorders in the rehabilitation phase who were receiving treatment at two Thanyarak hospitals in the Northeastern region of Thailand. The sample size was determined based on principles of power analysis, and participants were selected using systematic random sampling. Inclusion criteria were: 1) age 18 years or older; 2) currently undergoing rehabilitation for substance use disorders with rehabilitation duration of at least one month; 3) absence of withdrawal symptoms; 4) voluntary participation and willingness to cooperate in the study; and 5) ability to read and write in Thai. Research instruments included: 1) the Rosenberg Self-Esteem Scale; 2) the Acceptance and Action Questionnaire - Substance Abuse Thai Version (AAQ-SA); 3) the Friendship Intimacy Questionnaire (FIQ); 4) the Multidimensional Scale of Perceived Social Support (MSPSS); and 5) the Brief Assessment of Recovery Capital (BARC-10). The Cronbach’s alpha coefficients for these instruments were .80, .68, .88, .87, and .87, respectively. Data were collected between July 1 and December 31, 2024, through self-administered questionnaires. Descriptive statistics were used to analyze demographic and baseline characteristics, while Pearson’s correlation coefficient was applied to examine the relationships between self-esteem, psychological flexibility, friendship intimacy, and social support with recovery capital among people with substance use disorders.

Results The participants had a mean age of 30.43 years (SD = 7.43). The majority were male (77.20%), single (80.60%), and reported a monthly family income below 25,000 THB (85.94%). The primary substance used was methamphetamine (91.90%), followed by cannabis (2.80%), alcohol (2.50%), cigarettes (1.90%), and mixed substance use (0.90%). The most frequently reported reason for substance use was stress reduction and mood regulation (41.90%). The overall mean score of recovery capital among people with substance use disorders was 44.48 (SD = 10.44). Significant positive correlations were found between recovery capital and self-esteem (r = .425, p < .01), psychological flexibility (r = .392, p < .01), friendship intimacy (r = .256, p < .01), and social support (r = .666, p < .01).

Recommendation Nurses and mental health teams providing care for people with substance use disorders in inpatient rehabilitation units can apply the findings of this study to inform them of treatment and rehabilitation planning. Interventions should be planned to emphasize enhancing knowledge and beliefs related to self-esteem, psychological flexibility, friendship intimacy, and social support, as these factors are positively associated with recovery capital among people with substance use disorders. Future research should further examine the predictive power of these factors for recovery capital.