CHAPTER ONE

INTRODUCTION

1.1 Background to the Study

Drug abuse is a social, psychological and public health concern that affects individuals, families and communities. It generally refers to the harmful or inappropriate use of psychoactive substances, including the non-medical use of certain prescription medicines and the use of illicit drugs. In contemporary health practice, the terms drug use, harmful drug use and drug use disorder are often distinguished because not every instance of drug consumption constitutes a disorder. The World Health Organization (WHO) and the United Nations Office on Drugs and Crime (UNODC) explain that drug use disorders require appropriate health and social care responses, with treatment tailored to the needs and circumstances of the individual. This perspective is important because it recognises that people affected by drug use disorders may require medical treatment, psychological support, rehabilitation and assistance with social functioning rather than being viewed exclusively through a criminal justice lens. Understanding drug abuse as a health and social welfare concern provides the foundation for examining the contribution of social workers to rehabilitation and reintegration (WHO & UNODC, 2020).

Drug use disorders create challenges for health systems and social welfare institutions across the world. Individuals affected by problematic drug use may experience difficulties involving physical health, psychological well-being, family relationships, education, employment and social participation. The WHO and UNODC (2020) emphasise that effective treatment systems should provide evidence-based interventions that respond to the severity of a person’s condition and their individual needs. Their international standards identify different treatment settings and approaches, including outpatient and residential services, psychosocial interventions and continuing care. The standards also emphasise ethical treatment, respect for human rights and coordination between relevant service providers. These principles demonstrate that rehabilitation should not be reduced to the temporary removal of a person from the community or the achievement of abstinence alone. Instead, recovery may involve helping individuals regain stability, develop coping abilities, rebuild relationships and participate meaningfully in society. This broader understanding provides a basis for considering social work as an important component of rehabilitation services (WHO & UNODC, 2020).

In Nigeria, drug use has been identified as a significant public health and social development concern. The Drug Use in Nigeria 2018 survey, published by the National Bureau of Statistics (NBS) and the United Nations Office on Drugs and Crime (UNODC), estimated that 14.4% of people aged 15–64 had used a psychoactive drug other than tobacco or alcohol for non-medical purposes during the preceding year. This corresponded to approximately 14.3 million people. The report also estimated that one in five people who had used drugs in the preceding year was experiencing a drug use disorder. These findings illustrate the scale of drug use and the need for appropriate prevention, treatment and care services. However, the figures represent national estimates based on the survey period and should not be treated as current prevalence estimates for Lagos State or for the rehabilitation centres selected for this study. The national findings nevertheless establish the relevance of examining the services available to people affected by drug use disorders, including the contribution of social workers to their recovery and social functioning (NBS & UNODC, 2019).

The need for rehabilitation in Nigeria extends beyond addressing the immediate physical effects of drug use. The NBS and UNODC (2019) survey documented social and functional difficulties associated with drug use, including problems affecting work, education and family responsibilities. It also identified treatment access barriers, with cost and stigma among the difficulties reported by people who needed assistance. These findings are important because individuals may require support not only to manage drug-related health problems but also to address the social circumstances that complicate recovery. Rehabilitation may therefore involve assessment, counselling, family engagement, life-skills development, vocational assistance and referral to appropriate services. The WHO and UNODC (2020) similarly emphasise the importance of person-centred treatment and coordination between health and social care providers. Social workers can contribute within this framework by identifying clients’ social needs, helping them access services and supporting the development of realistic recovery plans. The effectiveness of these contributions, however, depends on the availability of trained personnel, appropriate resources and collaboration with other professionals.

Social work is concerned with human well-being, social functioning, relationships and the interaction between individuals and their social environments. Within drug rehabilitation settings, social workers may contribute through psychosocial assessment, case management, counselling, family support, advocacy, referral and coordination of care. Their responsibilities may include identifying the social factors affecting a client’s recovery, helping clients access relevant services, supporting communication with family members where appropriate, and preparing individuals for the challenges they may encounter after leaving residential or structured treatment. The WHO and UNODC (2020) standards support multidisciplinary and coordinated approaches to the treatment of drug use disorders, recognising that people may need a combination of health and social interventions. Social workers can therefore form part of a wider team that may include medical practitioners, psychologists, counsellors, nurses and other professionals. Their role is not to replace clinical treatment but to address social needs and barriers that may affect engagement with treatment, continuity of care and recovery.

Rehabilitation and reintegration are related but distinct processes. Rehabilitation focuses on helping individuals improve their health, functioning and ability to manage the challenges associated with drug use disorders. Reintegration concerns the process of returning to and participating in family, community, educational, occupational and social life. The WHO and UNODC (2020) emphasise the importance of continuity of care and coordination with health and social services, including support after intensive treatment. This is relevant because discharge from a rehabilitation centre does not necessarily mean that all recovery-related challenges have ended. Individuals may still face stigma, family conflict, unemployment, unstable housing, limited social support or exposure to circumstances associated with renewed drug use. Social workers may help address these challenges through discharge planning, referrals, follow-up, family engagement and connections to community resources. These interventions can support continuity between treatment within a rehabilitation centre and the practical demands of everyday life after discharge.

Lagos State provides the geographical context for examining the role of social workers in drug rehabilitation and reintegration. The national drug-use survey identified Lagos among the states where respondents reported greater difficulty accessing treatment for drug use disorders, although that finding relates to the survey period and does not establish the present accessibility or quality of services at individual centres in the state (NBS & UNODC, 2019). Understanding the situation in Lagos therefore requires attention to the experiences of service users and the practices of the rehabilitation centres selected for investigation. These centres may differ in their staffing arrangements, treatment approaches, social work services, referral systems and post-discharge support. The WHO and UNODC (2020) standards provide a framework for examining such services through principles of evidence-based care, ethical practice, person-centred treatment and coordination between health and social services. Against this background, the present study seeks to examine the roles performed by social workers in selected rehabilitation centres in Lagos State, the challenges they encounter and their contribution to the rehabilitation and reintegration of people affected by drug abuse.

1.2 Statement of the Problem

Drug abuse and drug use disorders present challenges that may extend beyond the immediate health consequences of substance use. Individuals affected by problematic drug use may experience difficulties in family relationships, employment, education, social participation and access to appropriate care. The Drug Use in Nigeria 2018 survey estimated that 14.4% of Nigerians aged 15–64 had used psychoactive drugs other than tobacco and alcohol for non-medical purposes in the preceding year, while approximately one in five people who had used drugs during that period was experiencing a drug use disorder (NBS & UNODC, 2019). These findings highlight the need for treatment and rehabilitation services that address both health-related and social needs. However, rehabilitation requires more than the provision of treatment within a facility. Individuals may also need assistance with family relationships, social functioning, employment and community participation. This creates a need to examine how rehabilitation services respond to these broader needs and the contribution of social workers within those services.

A further concern is whether individuals receiving rehabilitation services are adequately supported throughout the different stages of recovery. The WHO and UNODC (2020) international standards emphasise person-centred treatment, coordination between health and social care services, and continuity of care. These principles recognise that treatment needs may continue after a person leaves a rehabilitation facility. Where discharge planning, follow-up, family support or referral arrangements are inadequate, individuals may encounter difficulties maintaining progress and accessing assistance in the community. Social workers may help address these concerns through case management, psychosocial support, advocacy and coordination with community services. Nevertheless, the extent to which these responsibilities are carried out may vary between rehabilitation centres depending on staffing, resources, institutional policies and the availability of external support services. It is therefore necessary to investigate the actual roles performed by social workers rather than assume that all centres provide the same services.

Another problem relates to the social barriers that may complicate rehabilitation and reintegration. The NBS and UNODC (2019) survey identified treatment cost and stigma as barriers to accessing drug-related treatment in Nigeria. These challenges may affect whether individuals seek assistance, remain engaged with services or obtain the support they need after treatment. People returning to their communities may also need help rebuilding relationships, accessing education or employment opportunities, and connecting with appropriate health and social welfare services. The WHO and UNODC (2020) standards recognise the importance of comprehensive care and coordination across relevant services. Social workers may be positioned to assist with these needs, but their ability to do so may be influenced by institutional limitations, community attitudes, workload and the availability of reintegration resources. The nature of these challenges within selected rehabilitation centres in Lagos State requires systematic investigation.

The central problem addressed by this study is the need for context-specific evidence concerning the role of social workers in the rehabilitation and reintegration of people affected by drug abuse in selected rehabilitation centres in Lagos State. Although national and international publications establish the importance of comprehensive treatment, continuing care and social support, they do not, by themselves, explain how social work services are organised and delivered in the particular centres selected for this research. There is a need to examine the services provided by social workers, their contribution to clients’ rehabilitation and reintegration, and the challenges that may affect their practice. The study will therefore investigate social workers’ roles in assessment, counselling, case management, family support, referral, discharge planning and reintegration assistance, as applicable to the selected centres. The findings may help identify service gaps and provide information that can support improvements in rehabilitation practice and social care in Lagos State (WHO & UNODC, 2020).

1.3 Aim and Objectives of the Study

1.3.1 Aim of the Study

The aim of this study is to examine the role of social workers in the rehabilitation and reintegration of drug-abuse victims in selected rehabilitation centres in Lagos State.

1.3.2 Specific Objectives

The specific objectives are to:

1. Identify the major roles performed by social workers in the rehabilitation of drug-abuse victims in selected rehabilitation centres in Lagos State.
2. Examine the contribution of social workers to the social reintegration of drug-abuse victims after rehabilitation.
3. Identify the challenges encountered by social workers in providing rehabilitation and reintegration services in the selected centres.
4. Assess the relationship between social work support and the perceived rehabilitation and reintegration outcomes of drug-abuse victims in the selected centres.

1.4 Research Questions

The following research questions will guide the study:

1. What are the major roles performed by social workers in the rehabilitation of drug-abuse victims in selected rehabilitation centres in Lagos State?
2. How do social workers contribute to the social reintegration of drug-abuse victims after rehabilitation?
3. What challenges do social workers encounter in providing rehabilitation and reintegration services in the selected centres?
4. What is the relationship between social work support and the perceived rehabilitation and reintegration outcomes of drug-abuse victims in the selected centres?

1.5 Research Hypothesis

The following null hypothesis will be tested at the 0.05 level of significance:

H₀: There is no significant relationship between social work support and the perceived rehabilitation and reintegration outcomes of drug-abuse victims in selected rehabilitation centres in Lagos State.

1.6 Significance of the Study

The findings of this study are expected to be significant to the following groups:

1.6.1 Drug-Abuse Victims and Service Users

The study may help improve understanding of the support available to individuals undergoing rehabilitation for drug abuse. By examining social workers’ contributions to counselling, family support, case management and reintegration, the research may identify services that can help individuals address social difficulties and prepare for life after rehabilitation.

1.6.2 Social Workers

The study may provide useful information for practising social workers in rehabilitation settings. It may help them reflect on their professional responsibilities, identify challenges affecting their work and recognise opportunities to strengthen assessment, counselling, advocacy, referral and follow-up services.

1.6.3 Rehabilitation Centre Administrators

The findings may assist administrators of rehabilitation centres in understanding the contribution of social work services to client care. The study may also help identify areas requiring attention, including staffing, professional development, case management, discharge planning and coordination with community-based services.

1.6.4 Government and Policymakers

The study may provide information that could assist relevant government agencies and policymakers in reviewing rehabilitation and social welfare services. Its findings may contribute to discussions about professional staffing, service coordination, access to rehabilitation and the development of reintegration support for people affected by drug abuse.

1.6.5 Families of Drug-Abuse Victims

Families may benefit from a better understanding of how social workers can support communication, family relationships and the transition from rehabilitation to community life. The study may also draw attention to the importance of appropriate family involvement, where suitable and consistent with the service user’s safety, preferences and confidentiality.

1.6.6 Non-Governmental Organisations

Non-governmental organisations working in drug prevention, rehabilitation, mental health and community development may find the findings useful when planning support programmes, advocacy initiatives, vocational assistance and community reintegration services.

1.6.7 Researchers and Students

The study may serve as a reference for students and researchers in social work, sociology, psychology, public health and related disciplines. It may also provide a foundation for further research on rehabilitation services, social work practice, recovery support and reintegration in Lagos State and other parts of Nigeria.

1.7 Scope of the Study

The study focuses on the role of social workers in the rehabilitation and reintegration of drug-abuse victims in selected rehabilitation centres in Lagos State.

Geographically, the study will be limited to selected rehabilitation centres in Lagos State. The specific centres will be identified and described in the research methodology.

The content scope covers the roles of social workers in rehabilitation, including psychosocial assessment, counselling, case management, family support, advocacy, referral and discharge planning, where these services are provided. It also examines social workers’ contributions to reintegration, including assistance with family relationships, access to community resources, vocational or educational opportunities and continuing care.

The study will also investigate the challenges encountered by social workers in performing their responsibilities and assess the relationship between social work support and the perceived rehabilitation and reintegration outcomes of service users.

The respondents will be selected from the relevant population within the chosen centres, according to the sampling procedures established in Chapter Three. The findings will be interpreted within the context of the selected centres and will not automatically be generalised to every rehabilitation centre in Lagos State or Nigeria.

1.8 Operational Definition of Terms

For the purpose of this study, the following terms are defined as they will be used in the research.

Drug Abuse: The harmful or inappropriate use of psychoactive substances, including the non-medical use of certain prescription medicines and the use of illicit drugs. In this study, the term refers to drug-related behaviours associated with harm or the need for rehabilitation services.

Drug-Abuse Victims: Individuals who have experienced harm or difficulties associated with drug abuse and who are receiving, or have received, rehabilitation services. The term is used in the context of this research and does not imply that every person who uses drugs has a drug use disorder.

Social Workers: Trained professionals who apply social work knowledge, skills and ethical principles to support individuals, families and communities. In this study, the term refers to social workers involved in providing services within the selected rehabilitation centres.

Rehabilitation: A process of providing appropriate treatment, support and interventions to help individuals affected by drug abuse improve their health, functioning and ability to manage challenges associated with drug use.

Reintegration: The process through which individuals returning from rehabilitation reconnect with family, community, education, employment and other aspects of social life.

Rehabilitation Centre: An institution or facility that provides structured treatment, support or rehabilitation services to individuals affected by drug abuse.

Social Work Support: The professional assistance provided by social workers, including assessment, counselling, case management, advocacy, family support, referrals and coordination of services.

Psychosocial Support: Assistance intended to address the psychological and social needs of individuals, including emotional support, coping skills, interpersonal relationships and access to social resources.

Case Management: A coordinated process through which a social worker or other designated professional assesses a client’s needs, develops a support plan, facilitates access to services and monitors progress.

Continuing Care: Ongoing support provided after or alongside intensive treatment to help individuals maintain recovery, address emerging needs and remain connected to appropriate services.

Perceived Rehabilitation and Reintegration Outcomes: Respondents’ assessments of the progress and support experienced during rehabilitation and reintegration, as measured through the research instrument.