Dealing with Substance Abuse Relapse

Relapse is officially defined as a deterioration in health after a period of improvement or a general return to a worse state of being. In terms of addiction, relapse is used to refer to any time a person falls back into a pattern of substance abuse after a substantial effort was made to stop. Many people with addiction disorders relapse at least once after quitting. According to the National Institute on Drug Abuse, 40-60 percent of individuals suffering from addiction relapse.

Addiction to drugs or alcohol is considered to be a mental illness or disease that requires treatment. However, relapse does not mean that treatment has failed or that the relapsed individual is doomed to a life of substance abuse. Because relapse is so common, it’s often thought of as little more than a small step back or speed bump on the road to recovery.

Despite these facts, many people suffering from addiction disorders are discouraged by incidents of relapse and may feel like failures. In reality, there’s likely something that has triggered the relapse and a little additional treatment and/or support is all that is needed to get them back on track.

Common Relapse Triggers

 

 There is a wide range of possible relapse triggers depending on multiple factors, such as the nature of the substance, the person’s life situation, and the person’s commitment to treatment. Often, triggers are simpler than one would think, or in some instances, they may be entirely unexpected.

Common universal relapse triggers include:

  • Overconfidence: Many newly sober individuals feel confident that they will never use their substance of choice again, and that cockiness proves to be their weakness. This can lead to putting oneself in likely triggering situations or failing to follow through with a treatment program.

  • Lack of self-care: Therapy appointments, a healthy diet, exercise, and leisure time are often essential aspects of a treatment plan. Physical health and happiness make staying away from drugs and alcohol a lot easier, and a buildup of stress and exhaustion can easily trigger a relapse.

  • Taking other intoxicants: Certain other drugs, even if they’re much milder than the substance that first caused addiction, can lower inhibitions or remind the person of the pleasant feelings associated with their drug of choice.

  • Depression: Untreated mental health issues can lead to substance abuse and addiction, and if problems like depression remain untreated, relapse is very likely. Depression may also occur if the drug that was abused caused euphoria or other pleasant sensations, as the brain relearns how to produce chemicals like serotonin and dopamine on its own again. A 2008 study found that of the sample of addicted adults who relapsed surveyed, 66.9 percent reported negative intrapersonal states as the cause.

  • Proximity to the drug: This might seem like an obvious to one, but some individuals may not realize just how much temptation can be produced by having easy access to their intoxicant of choice or seeing others intoxicated on the drug.

  • Drug-related social circles: A common step in recovery from addiction is often to cut oneself off from the group of people one used to take the substance with. These people may directly tempt the newly sober individual or simply trigger pleasant memories associated with the drug.

  • Enablers: If there were people in the individual’s life who enabled the addiction, these people may still engage in this counterproductive behavior even after a person stops using. They may suggest activities related to drug use or even suggest taking a small amount of the drug out of a desire to make a struggling person in recovery feel better.

  • Stressful events: This is one of the most common triggers. Any recovering individual needs to be on the lookout for old thought patterns, cravings, and temptation when facing difficult life transitions or loss.

  • Happy events: Surprisingly, happy occasions can be just as triggering as stressful ones. Celebrations of achievements can come with the temptation to treat oneself and cause people to let their guard down. At the same time, many events considered positive come with a lot of stress, such as marriage or a new job. In a 2012 study, it was found that 59 percent of addicted adolescents initially relapsed to substance abuse due to “positive-social” events.

  • Failure to evolve: Over time, treatment plans or certain aspects of a treatment plan can become less effective as the individual’s needs change. This is a common occurrence, but many people view this as a failure of treatment or think that treatment has just stopped working. In reality, the treatment plan may just need a simple adjustment that can be worked out with a therapist or other health professional.

There are many other more specific triggers that could be listed, but these tend to be the most common across all the different types of addiction to various substances (or behaviors/activities).

What Next?

 
stressed man

Again, a relapse is not the end of the world. However, many wonder what’s to be done after a relapse has occurred. Does the initial addiction treatment need to be repeated? Are there other, less intense options?

Much of the time, a relapse indicates a need for an adjustment in the treatment plan. After all, the longer an individual with an addiction disorder remains sober, the less likely it is that a relapse will occur. A study published in the U.S. National Library of Medicine found that of individuals who have been sober for less than a year, fewer than one-third will remain that way. However, those who stay clean for five years or more have only a 15 percent chance of relapsing.

The best course of action depends on the individual and how severe the relapse is. Having a couple drinks one night is not as serious as disappearing to go on a week-long bender. A minor relapse in an individual who is still committed to their treatment plan might simply require a visit to an addiction specialist, therapist, or primary care doctor the person has been working with, to examine the relapse incident and determine whether an adjustment in treatment is needed. If the relapse lasted for an extended period of time, a return to a structured rehabilitation plan may be necessary, especially since the person will likely once again go through withdrawal.

Substance abuse relapse can be thought of as any other kind of medical relapse. The individual’s treatment simply needs to be adjusted and possibly made more aggressive for a time until the person returns to better health. A new round of therapy may be prescribed to deal with new life stressors, and medication may be prescribed temporarily until the risk of further relapse has diminished. For many individuals, outpatient addiction treatment is a great middle-of-the-road option to get them back on track.

Outpatient treatment, as opposed to inpatient treatment, allows people in the program to stay in their own homes and generally move about freely during the program rather than being confined to a treatment facility. Clients are expected to check in for appointments at the hospital or treatment center multiple times per week. This may involve urine tests to check for substance use, individual or group therapy, and/or support group meetings. The treatment is quite active, but not as immersive as inpatient treatment. Clients are able to pretty much go on with their everyday lives as normal.

The best thing one can do following a relapse is simply reach out to others for support. Feeling that one is supported and cared for may be all that is needed to get back on the road to recovery.