- Critical weaknesses constrain sustainability of recovery outcomes
- Absence of systematic, structured, consistent post-rehab aftercare engagement mechanisms and community-based reinforcement, resource limitations due to insufficient allocations, and persistent and enduring social stigma hinder full reintegration into the community
Critical weaknesses that constrain the sustainability of recovery outcomes of youths affected by substance use in maintaining sobriety and preventing relapse in the context of institutional rehabilitation and treatment programmes include the absence of systematic, structured, consistent post-rehabilitation aftercare engagement mechanisms and community-based reinforcement, resource-related limitations due to insufficient allocations, and the persistent and enduring social stigma faced by recovering individuals which hinder full reintegration into the community.
These findings were made in an article on "The effectiveness of a selected rehabilitation programme implemented in Sri Lanka in preventing youth drug addiction" which was authored by K.A.M. Adhikari and N.B.A. Wijebandara (both attached to the National Institute of Social Development), and published in the Sri Lanka Journal of Social Work's Ninth Volume's Second Issue, last month (November 2025).
Youth drug addiction is one of the most pressing social and health challenges in Sri Lanka. The rising number of young individuals involved in substance abuse has generated growing concern among policymakers, educators, and public health officials. Although several rehabilitation programmes have been introduced to address this issue, relapse rates remain high, raising questions about their effectiveness and sustainability.
According to the National Dangerous Drugs Control Board (NDDCB), the majority of new drug users in Sri Lanka are between 15 and 29 years of age, with an estimated 18,000 new cases reported in 2023 — a 12% increase from the previous year (2022). Similarly, L. Fernando's "Challenges in drug rehabilitation in Sri Lanka: A sociological perspective", and the NDDCB's "Annual report on drug abuse in Sri Lanka (2023)” indicate that synthetic drug use among youth is rapidly rising in both urban and semi-urban areas, reflecting a growing national crisis. These figures underscore the urgency of evaluating existing rehabilitation interventions to ensure that resources are effectively utilised to curb relapse and promote sustained recovery.
Rehabilitation efforts in Sri Lanka focus on detoxification, counseling, and reintegration.
Despite various rehabilitation efforts, youth drug addiction continues to rise in Sri Lanka.
Globally, youth drug addiction remains a critical challenge affecting individuals and societies alike. Substance abuse among youth is often influenced by psychological stress, peer pressure, unemployment, and family dysfunction. Rehabilitation programmes have demonstrated success by adopting community-based and harm-reduction models, emphasising holistic care and reintegration (a European study in Portugal and Switzerland – the European Monitoring Centre for Drugs and Drug Addiction’s “Drug rehabilitation and recovery: Evidence and practice review”).
In the Sri Lankan context, the NDDCB operates several rehabilitation centres focusing on detoxification, counseling, and social reintegration. However, relapse rates remain high, often due to inadequate follow-up mechanisms, social stigma, and limited psychosocial support. K. Perera's "Relapse prevention and youth rehabilitation in Sri Lanka” emphasises the need for structured, evidence-based interventions to sustain recovery.
Methodology
Adhikari et al.'s study was conducted at the Awissawella Puwakpitiya Rehabilitation Centre in the Colombo District, Western Province. This Centre provides comprehensive rehabilitation services to youth drug users, including psychological counseling, vocational training (VT), and aftercare support.
A purposive sampling technique was used. The participants included: 40 rehabilitated youth, five staff members, and one focus group discussion with family members.
Results and discussion
The effectiveness in preventing relapse
The majority remained drug-free for a significant period following rehabilitation.
Approximately 29/72.5% remained abstinent from drugs at least six months after completing the programme, while only seven/17.5% experienced relapse. This relapse rate is notably lower than the national relapse rate reported by the NDDCB, which exceeds 30%. These results demonstrate a moderate to high level of programme effectiveness in relapse prevention.
Most described improved self-awareness, better emotional regulation, and increased confidence to resist peer pressure. One respondent stated, “I learned to recognise when I was getting stressed or tempted. Before, I would take drugs to forget my problems, but now, I know how to control myself.”
Such testimonies reflect the psychological empowerment achieved through the programme’s structured counseling and therapeutic sessions.
Strengths of the programme
The programme’s structure demonstrates several notable strengths. Firstly, psychological counseling emerged as the most influential component, with 85% reporting that it had significantly improved their emotional stability and decision-making. Individual and group counseling sessions are conducted regularly by trained professionals, focusing on emotional regulation, relapse triggers, and self-esteem building.
Secondly, VT and life skills development were identified as major strengths. The participants were trained in practical skills such as carpentry, tailoring, and computing, which increased their employability and self-confidence upon reintegration into society. This component reflects a rehabilitative philosophy consistent with the social reintegration theory, emphasising the importance of providing youth with meaningful social roles after rehabilitation.
Thirdly, peer support and structured routines played a crucial role in maintaining discipline and accountability. The participants benefited from shared experiences and mutual motivation within the rehabilitation environment. One participant commented, “When I saw others improving, it gave me hope that I could also recover.” This peer-based reinforcement supports the social learning theory (Albert Bandura's "Social learning theory", "Modeling theory: Some traditions, trends, and disputes", "Social cognitive theory for personal and social change by enabling the media", and "Growing primacy of human agency in adaptation and change in the electronic era", and A. Bandura and Richard H. Walters' "Social learning and personality development"), which posits that behavioural change is strengthened through observation and the modeling of positive behaviours.
Lastly, the staff’s dedication and empathy were consistently praised by the participants and family members. The supportive relationship between the staff and the residents created a sense of trust and safety, fostering positive therapeutic engagement.
Weaknesses and challenges of the programme
Despite its strengths, several weaknesses and structural challenges limit the programme’s overall effectiveness. A significant limitation identified by both the staff and the participants was the absence of a structured aftercare and monitoring system. Once youth are discharged, the Centre provides minimal follow-up, leaving individuals vulnerable to relapse. About 60% indicated that they received little or no contact from the Centre after completing the programme. This finding raises concerns that relapse often occurs during the reintegration phase due to weak social support mechanisms.
Another challenge involves resource constraints and staffing shortages. Staff members reported that high caseloads and limited funding reduce the time available for individualised counseling and follow-up. The lack of adequate financial and human resources restricts the programme’s capacity to provide holistic care, particularly in rural outreach and family counseling services.
Furthermore, social stigma continues to impede rehabilitation success. Many youths expressed that their communities and even families were hesitant to accept them after rehabilitation, creating a sense of isolation that often led to discouragement. This aligns with the World Health Organisation's "Global report on substance use and mental health" which identifies stigma and social rejection as major barriers to sustainable recovery.
Finally, inter-agency coordination was found to be weak. The programme operates largely within the Centre without strong linkages to external stakeholders such as local health clinics, employers, and social service agencies. Strengthening such partnerships is crucial to ensuring the continuity of care and long-term reintegration.
Role of psychological and social support services
The integration of psychological and social support emerged as a central determinant of the programme’s success. The counseling services addressed the emotional and cognitive dimensions of addiction, while the social support components targeted reintegration and community adaptation. Participants who received consistent counseling and family therapy reported significantly lower relapse tendencies.
Family involvement was another critical factor influencing the outcomes. Family members emphasised that communication, understanding, and emotional support were vital in preventing relapse. One parent expressed, “Earlier, we blamed him; now, we understand his struggle. The family sessions taught us how to help instead of judge.” This finding illustrates that rehabilitation should not be viewed as an isolated institutional process but rather as a family and community-oriented effort.
Moreover, the presence of peer-led support networks within the Centre fostered accountability and mutual assistance. These interactions created a rehabilitative culture, emphasising empathy and shared responsibility. Such peer mechanisms reflect participatory rehabilitation which enhances both self-efficacy and motivation.
Comparative analysis and theoretical implications
When compared to global rehabilitation models, the Awissawella Puwakpitiya programme demonstrates several components consistent with evidence-based approaches, such as individualised counseling, skill development, and community reintegration. However, its limited focus on aftercare contrasts with international models which prioritise continuous monitoring and social inclusion post-rehabilitation.
The findings also resonate with the social capital theory, emphasising that recovery is sustained when individuals have supportive networks of trust, reciprocity, and belonging. In this context, the lack of community-based support represents a critical gap that undermines long-term recovery efforts.
The key findings
The rehabilitation programme demonstrates moderate effectiveness, with more than two-thirds of the participants maintaining sobriety following treatment. The core strengths of the programme lie in its integrated psychosocial approach, particularly the provision of psychological counseling, peer support networks, VT, and the commitment of the professional staff. These elements collectively contribute to the development of coping strategies, self-efficacy, and reintegration readiness among the rehabilitated youth.
Nevertheless, the study identified several critical weaknesses that constrain the sustainability of recovery outcomes. These include the absence of structured aftercare mechanisms, resource limitations, and the enduring social stigma faced by the recovering individuals. Such challenges weaken the continuity of care and increase vulnerability to relapse once the participants leave the institutional settings.
Importantly, the findings underscore that psychological and social support systems play a decisive role in relapse prevention. However, their long-term impact depends on the availability of consistent post-rehabilitation engagement and community-based reinforcement.
Conclusion and recommendations
The findings of this study indicate that the selected rehabilitation programme exhibits moderate effectiveness in preventing relapse and promoting sustainable recovery among youth affected by substance use. The programme’s success can be primarily attributed to its psychological counseling services, structured daily routines, and VT opportunities, which collectively foster behavioural transformation and enhance self-regulation among the participants.
However, several limitations continue to undermine the long-term success of the rehabilitation process. The absence of systematic aftercare mechanisms, insufficient resource allocation, and persistent social stigma hinder full reintegration into the community. These structural and societal challenges suggest that while the institutional rehabilitation model provides an essential foundation for recovery, it remains insufficient in ensuring long-term sobriety without ongoing community and familial support.
In essence, the study highlights the importance of a comprehensive and continuum-based approach to rehabilitation — one that bridges the gap between institutional treatment and community reintegration. Future rehabilitation efforts should therefore move beyond short-term interventions and prioritise sustained psychosocial, familial, and economic empowerment to ensure relapse prevention and social reintegration.
Adhikari et al. proposed the following recommendations to strengthen rehabilitation practices and outcomes.
Establish community-based aftercare and follow-up systems
Develop structured post-rehabilitation monitoring and outreach programmes that provide continuous emotional, social, and professional support for recovered youth. Community rehabilitation centres and local non-governmental organisations could play a central role in coordinating these services.
Integrate family counseling and support into rehabilitation
Incorporate family-based interventions to rebuild trust, improve communication, and create a supportive home environment conducive to recovery. Family counseling should be a mandatory and ongoing component of the rehabilitation process.
Enhance vocational and life skills training
Strengthen skills development and employment linkage programmes to promote economic independence, reduce idleness, and minimise relapse risks. Partnerships with private sector organisations can provide practical training and job placement opportunities.
Increase investment in human and institutional resources
Allocate greater funding for the recruitment and professional development of counselors, social workers, and therapists. Improved facilities and staff training will ensure high-quality service delivery and individualised care.
Implement regular evaluation and policy review
Establish a national mechanism for periodic monitoring and the evaluation of rehabilitation centres to ensure accountability, effectiveness, and consistency across programmes. Evidence-based findings should inform policy formulation and strategic planning.