الفهرس 
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Abstract
Drug and alcohol abuse is an enormous societal problem due to individual suffering as well as associated disruption of families and communities through criminality and violence and health care cost. During the 1990s, at least 134 countries and territories were faced with a drug misuse problem, with three quarters of all countries reporting the use of heroin and two thirds misuse of cocaine.
Substance abuse and dependence have far-reaching social, medical, psychological and economic consequences. Concomitant psychiatric and neurological disorders identified in many substance abusers pose an even greater challenge. Drug abuse is one of the epidemic diseases, the effects of which are not limited to the individual but extend to his or her family and society at large.
Relapse is a process that begins long before a person uses alcohol or substances. Clients and clinicians can recognize the warning signs of a potential relapse. Clients may relapse by drinking, using substance or returning to addictive behavior.
The relapse process usually occurs in two stages:
The first stage: There are factors that either make the individual vulnerable to or precipitate a slip or lapse.
The second stage: There are factors that determine whether a lapse will lead to full-blown relapse or abstinence prolapse.
The aim of our study is to demonstrate the frequency of having relapse among those with substance abuse and detect the different probable factors that may be related to the occurrence of relapse in such patients.
Our study was a cross sectional one upon one hundred subjects, seventy subjects were the relapsed group and thirty subjects were the abstinence group.
Our subjects attended Hot Line Clinic of Minia Psychiatric Hospital in period from the 1st of March to 31st of December 2015. Their ages ranged from 18-60 years.
All patients in both groups were subjected to: complete history taking, clinical examination and other investigations as drugs urine analysis, Addiction Severity Index, Fahmy & El Sherbiny (socioeconomic status scale for health research in Egypt) and TCU/PMES Scales on family, friends and self.
Regarding the comparison between the relapsed group and abstinence group according to age, occupation and education were highly significant in abstinence group (p=0.001, 0.01, 0.03) respectively.
Also in the relapsed group were highly significant in multiple drugs abuse and no follow up, but in the abstinence group were highly significant in mean age of onset and mean average days of abstinence (p=0.001).
Comparison between relapsed group and abstinence group, the relapsed group were highly significant in co-morbid diagnosis, low socioeconomic level and family history of addiction (p=0.001, 0.02, 0.001) respectively.
As regard TCU/PMES scales for both groups, current study found that high statistically significant in relapsed group in conflict, peer activity level and trouble (p=0.001). But high statistically significant in abstinence group in warmth, familiarity with parents, self-esteem and happy environment (p=0.001). And these results show the effect of family, friends and self-rating on the relapsed and abstinence patients.