INSIGHTS-JOURNAL OF HEALTH AND REHABILITATION _______________________________________________________________________________________________________________________________________ © 2025 et al. Open access under CC BY License (Creative Commons). Freely distributable with appropriate citation. 19 RELATIONSHIP BETWEEN FAMILY DYSFUNCTIONING, SELF-ESTEEM AND SUBSTANCE ABUSE IN ADULTS Original Research Saba Younas 1 *, Ayesha Jabbar 1 , Sameen Sadaqat 2 , M. Abdullah Baloch 1 , Amina Ashiq 3 , Muahammad Umair Waheed 3 , Sana Noor Ul Meen 3 , Zunaira Abdul Malik 3 , M. Tauseef Ahmed 1 , Fatima Saeed 4 1 Lecturer, University of Okara 2 Lahore College for Women University 3 University of Okara 4 Government Special Education School, Renala Khurd Corresponding Author: Saba Younas, sh34as.d@gmail.com, Lecturer, University of Okara Acknowledgement: The researchers express gratitude to all participants who voluntarily contributed to this study. Conflict of Interest: None Grant Support & Financial Support: None Publication Date: ABSTRACT Background: Substance abuse is a growing public health concern, particularly in developing countries where young adults represent a significant portion of the population. Psychological and familial factors such as self-esteem and family functioning have been increasingly recognized as influential in substance use behavior. However, limited regional studies exist that explore these dynamics in the adult population of semi-urban areas in Pakistan, including Okara, where substance abuse trends are rising among youth and adult groups. Objective: This study aimed to examine the relationship between family dysfunction, self-esteem, and substance abuse in adults, and to determine whether family functioning and self-esteem could significantly predict substance abuse levels. Methods: A total of 220 participants (192 men and 28 women), aged between 18 and 44 years (M = 24.04, SD = 4.78), were recruited using non-probability random sampling from public locations and university settings in Okara, Pakistan. Data were collected using a demographic sheet, the Family Functioning Index Scale, the Rosenberg Self-Esteem Scale, and the Drug Abuse Screening Test. Statistical analysis included Pearson product-moment correlation, linear regression, and independent t- tests. Results: Substance abuse showed a significant negative correlation with both family functioning (r = -0.47, p < 0.01) and self- esteem (r = -0.21, p < 0.01). A positive correlation was found between family functioning and self-esteem (r = 0.31, p < 0.01). Regression analysis revealed that family functioning (β = -0.47, p < 0.001) and self-esteem (β = -0.218, p < 0.001) significantly predicted substance abuse. Gender comparison showed a significant difference in self-esteem between men and women (t (217) = -4.52, CI [-7.76, -3.05], p < 0.001), with women reporting higher self-esteem. Conclusion: The study emphasizes the importance of fostering healthy family dynamics and promoting self-esteem as preventative measures against substance abuse. Findings support the development of policy-driven mental health and family- strengthening programs aimed at adults in similar populations. Keywords: Adults, Family Relations, Gender Identity, Mental Health, Self Concept, Substance-Related Disorders, Young Adults