SOCIAL SUPPORT IN RECOVERY FORMER USERS OF PSYCHOACTIVE SUBSTANCES IN MONTENEGRO: A SURVEY STUDY

The survey was conducted with 107 clients treated in the Public Institution for Accommodation, Rehabilitation and Resocialization of Users of Psychoactive Substances in Podgorica (Montenegro) from May 2014 to October 2016. The Multidimensional Social Support Scale (MSPSS) was used. It consists of 12 variables that measure three components of support: Family, Friends and Significant Others. The analysis of the main components with direct oblimin rotation was used to examine the factorability of the MSPSS. After factor analysis conducted, the reliability of the determined scale was tested by Cronbach alpha coefficient through discriminatory validity. Results. All three components showed statistically significant results (p < 0.05). The coefficient of correlation between Friends and Significant Other was 0.510, while between Significant Others and Family it scored 0.617. On the other hand, the coefficient of correlation between Significant Other and Family was 0.525. As we had assumed and as previous results in this area suggested there was a significant link between the Friends and Family components. Also, 85.1% of the respondents stated that social support is important (or extremely important) in the process of rehabilitation and resocialization. Conclusion. Survey emphasizes the important role of the family in the life of respondents. Social support has many benefits and it is often crucial to establishing successful recovery of former users of psychoactive substances.


Introduction
Dependence on psychoactive substances is considered to be physical, mental, social and spiritual illness (1). In the last 40 years, a growing trend of number of addicts has been recorded worldwide (2). Relapse is one of the most important topics in the recovery period (3). It is therefore of utmost importance to determine which factors influence on the prevention of relapse.
Social support is determinant of addiction and due to its multidimensionality it can be defined from different perspectives and operationalized in different ways (4). The sources of social support are numerous and quite diverse, including family, friends, partners, community and associates (5).
Cohen and Wills mention several types of social support. Informational support is important for understanding and dealing with problems, and in literature it is also called counseling and assessment support. Self-esteem support is a person's information that he/she is accepted and respected. By communicating with people who accept and respect him/her, regardless of his or her difficulties or failures, a person develops self-esteem and this type of support is called emotional or close support. The need of each individual for belongingness is met through social companionship in leisure activities, while instrumental support is the one that provides for material support. Empirical research shows high correlations of various social support functions (6). Family is a dominant source of sociability and social support (7)(8)(9)(10). Close relatives are more often a source of emotional and instrumental support, while friends are more important for socializing (11)(12). Instrumental support is often provided by neighbors (13,10). Social relationships are assessed by frequency of social interactions (14) and analyzed through three spheres. The primary sphere implies the closest family relationships; secondary relates to friends, relatives and a closer social community while tertiary relates to participation in organized activities and associations (15). Böhnke warns of the importance of family cohesiveness, intergenerational solidarity and friendships (16). In their study, Spot and Redmond (17) dealt with the role of social support in the period of treatment and prevention of relapse. The authors suggest that the existence of supporting structures and networks plays a significant role during the drug treatment process in people who abuse drugs and in preventing relapse while contributing to the improvement of mental health.
Although the problem of the use of psychoactive substances is a widespread phenomenon, post-rehabilitation and resocialization social support did not find its place in scientific research in Montenegro. This problem can be also seen as a global one. Every adequately conscious society should be interested in providing social support to clients after rehabilitation and resocialization.

Aim
Research of social support as an important component in the process of resocialization of former users of psychoactive substances, so far, has been neglected in Montenegro. However, one of the conditions for quality analysis whose outcome would involve examining of deeper causal relationships is examining of social support structure of the respondents. That is why the main goal of paper is to determine precisely dimension of social support, and its factorablity. A special sub-aim is to identify latent structure of emotional support as specific dimension within the social support scale.

Method
The survey covered 107 clients, former users of psychoactive substances and former residents of the Public Institution for Accommodation, Rehabilitation and Resocialization of Users of Psychoactive Substances in Podgorica. The sample included respondents who completed oneyear rehabilitation and resocialization period. The survey was conducted byface-to-face method with the prior approval of the institution in which the survey was conducted as well as the voluntary consent of the respondents. The total sample covers 42.8% of the total number of clients of the institution for the survey period.
Multidimensional Scale of Perceived Social Support (MSPSS) was used for this survey (18). The scale consists of 12 items indicating dimensionality (factor validity) expressed through three components: family, friends, and significant other. Answers in the Likert scale are ranked from 1 to 7 (1, I strongly disagree-7, I strongly agree). One of the goals was to validate this scale on our sample. By examining the internal compliance of the data, it was found that the results obtained by analysis coincided with the original results of the author of this scale. The analysis of the main components with direct oblimin rotation (19) was used to examine the factorability of MSPSS. After factor analysis is conducted, the reliability of the determined scale will be tested by Cronbach alpha coefficient through discriminatory validity.

Results
Some of the key socio-demographic characteristics of respondents imply that majority of them completed secondary school (70.1%), their average income amount is to 720 Euros (distribution of data indicates asymmetry and presence of below-average values; skeweness = 1.598) The largest number of them was raised in a complete family (81.3%) ( Table 1). Most of the clients stated that they had close and than, very close relationships with mother and father, and the smallest percentage were at a great distance with mother and father. Respondents described their relationship with their partners as very close or close to 33.65%, while 9.4% of the respondents had a distant and mostly sympathetic relationship with their partner. (Table 3)

Emotional support within the MSPSS scale
Emotional support as a sum of the two most common components, in our case Friends and Family, is an important if not the most important part of social support. By examining the correlation coefficients between the three components of MSPSS, the validity of this assumption was determined. All three components show statistically significant results (p <.05). the correlation between Friends and Significant Other is .510, while between Significant Other and Family it scored .617. On the other hand, the correlation between Significant Other and Family is .525. as we have assumed and as previous results in this area suggest there is a significant link between the Friends and Family components. Due to the lack of strong statistical evidence, for now these data represent a sufficient indicator of the accuracy of the assumptions stated in the paper.
In order to examine significance of emotional support, it is formatted synthetic sketch of variables identified in previous section as a part of emotional support. As Table 5. shows, emotional support for former users of psychoactive substances has a big importance. The distribution values range from 8 to 56. The arithmetic mean is 44.75 and the value of the skew is has negative asymmetry.

Social support of former users of psychoactive substances
In order to determine level of social support at former users of psychoactive substances, synthetic sketch of variables, which make this construct, is formed. After the variable is transformed into a material with 5 categories, it is noted importance of social support to the respondents. Cumulatively, 85.1% of the respondents stated that social support is important (or extremely important) ( Table 8).

Discussion
This aim of this paper was to identify the perception of social support of former users of psychoactive substances following their rehabilitation and resocialization in Montenegro.
The results also showed that the scale has good internal and test-retest reliabilities and moderate construct validity (20).
In 2011, a survey in Vietnam showed that parents, wives, brothers and sisters gave most of emotional support families of former addicts. Respondents reported that abstinence was maintained thanks to the support of family members, and emotional support by family was emphasized for day to day functioning. Also emotional support provided by families made a significant contribution to tackling obstacles and problems they encountered and often provided strong motivation to abstain from drugs, care for their health and seek employment (21). Results are very similar with results from Montenegro where the highest percentage respondents in quoted the importance of this construct.
A research carried out in 2015 in China pointed to the importance of social support in recovery period and its significance in long rehabilitation period of addicts (22). In Montenegro, research has shown that to more than three quarters of respondents social support is important or extremely important. Family support proved to be important for the treatment process, while good relationships with other significant persons in life are a significant factor for mental health of clients, and are particularly important from the perspective of social functioning (23). For clients who are in the program for treatment of psychoactive substances abuse, family support may be the most important aspect of social support (24, 18). Clients who perceive family support as good believe to have a safe environment, adequate health and social protection, financial support, possibility to use social resources (25-26), which largely reflects on their quality of life.
The results of our research correlate with the results carried out by Shahzad, Begum and Malik (27) with clients who underwent treatment for drug addiction in rehabilitation centers in Pakistan. Research has shown that availability of social support by the family, friends and employees in the treatment facilities helps clients to better cope with the addiction and is a significant factor in preventing relapse.
In similar research in world, the authors concluded that social and emotional support has a significant role after period of rehabilitation and resocialization. Therefore we can conclude that results from survey is reliable and that cultural differences have not affected on results of survey.

Limitations of the study
The analysis pointed to interesting factorability, but more significant research should involve research on a larger sample. This is very especially important in cases of applying multivariate statistics techniques, which is one of the prerequisites for its application. This could help to analyze the results with some other statistical technique, not just with factor analysis. This would be particularly significant for determining correlation between the components. Since all variables are part of one scale (social support), the question is how much their mutual causality affects on correlation between the components.

Benefits of the study
Taking into account the pioneering contribution of paper to understanding the current problem, especially considering the inadequate examination of the topic, by opening of this insufficiently explored issue sets the foundation for further research in this field.

Conclusion
On the basis of the conducted research, we conclude that emotional support plays an important role in the perceived social support after the period of rehabilitation and resocialization. It is recommended that social support is promoted through intervention programs in dealing with clients in the process of rehabilitation and resocialization.