Developing a Structural Model of Relapse to Substance Use based on Mindfulness and Spiritual Health by Mediating Craving and Self-Efficacy in Substance-Dependent Individuals under the Abstinence-based Treatment

Objective: This study aimed to develop a structural model of substance use relapse based on important risk and protective factors of substance use (e.g., spiritual health, mindfulness, craving, and self-efficacy). Method: This study was a descriptive-correlational design of structural equation modeling type. The statistical population of the study included 700 opiate-dependent individuals who were under the abstinence-based treatment in Behbud Gostran Hamgam and Khaneh Dost Yaran Centers in Tehran. Among which, 200 individuals (100 males and 100 females) were selected using convenience sampling method in 2019 and they responded to the five-factor mindfulness questionnaire, the spiritual well-being scale, the post-detoxification craving scale, the general self-efficacy scale, and the relapse prediction scale. Results: The results showed that the developed model had good fit. Also, among the variables of spiritual health and mindfulness, spiritual health had a significant direct effect on relapse to substance use. In addition, spiritual health and mindfulness had significant indirect effects on relapse to substance use through craving. Conclusion: The results of this study showed the importance of the effects of spiritual health and mindfulness on relapse to substance use. Accordingly, it is suggested that these important risk and protective variables be considered in educational programs to prevent relapse to substance use.