Relapse from drug addiction or alcoholism is the most significant threat to any recovery program. And because addiction is only treatable and not curable, this threat is one that is persistent in the lives of recovering addicts and alcoholics. Unfortunately, there are a great many misconceptions and stereotypes concerning those who relapse, especially considering that most addicts relapse a number of times. Often this can be perceived as a sign of weakness or even hopelessness in an individual and may hamper the opportunity for the addict to get the right help at the right time. Understanding what relapse is, why it happens and how to treat it is essential for addicts and the general public to better cope with this frustrating aspect of the disease of addiction.
Relapse is not only common in recovery from addiction, it’s highly likely. This can be compared to other diseases and conditions like mental illness, diabetes, hypertension and asthma. Because addiction is a clinical, progressive neurological disease, relapse rates are just as common as those of other diseases. In fact, relapse from substance abuse or alcoholism is actually less common than relapse from hypertension and asthma, with people relapsing from drug use at a rate of 40-60% versus 50-70% for both hypertension and asthma. (1) And just as people have little control over relapses from other diseases, addicts and alcoholics may find themselves relapsing without knowing why they do it.
Relapse happens differently for each person and there are a multitude of causes. In some cases the relapse is referred to as a “slip,” whereby an addict or alcoholic breaks from their recovery program by using but then quickly abstains again. In other cases the relapse can be chronic and last for years at a time between treatment episodes. In some instances the cause is readily evident such as a traumatic event, while other relapses may appear to have very simple causes, such as encountering an old drug-using friend or being exposed to an environment that reminds the addict of using.
In many cases the primary cause of a relapse from drug abuse or alcoholism is complications related to Post Acute Withdrawal Syndrome or PAWS. PAWS occurs immediately after a person detoxes from a substance and can continue for months or even years. The symptoms of this condition include an inability to think correctly or organize thoughts, difficulties with memory, insomnia, severe drug cravings, depression, lack of physical coordination and many other symptoms. Often these symptoms cause a user to self-medicate using drugs or alcohol. In fact, according to the Wikipedia entry for Post Acute Withdrawal Syndrome, a surprising number of people will suffer from these symptoms and the resulting consequences:
“Post acute withdrawal syndrome affects many aspects of recovery and everyday life, including the ability to keep a job and interact with family and friends. Symptoms occur in over 90% of people withdrawing from a long-term opioid (such as heroin habit), three-quarters of persons recovering from long-term use of alcohol, methamphetamine, or benzodiazepines and to a lesser degree other psychotropic drugs.” (2)
However, not every relapse is caused directly by symptoms of PAWS. Issues like denial – a common characteristic in many addicts – compound the ability of the addict or treatment specialist to pinpoint exactly what the cause of a given relapse was. But despite the vast differences in the types of substances that people become addicted to, causes of relapse episodes are generally the same across all types. In a study for Bond University in Australia, Mellissa Hammerbacher and Michael Lyvers write:
“Consistent with previous studies, the most commonly cited reason for relapse was negative mood states, followed by external pressure to use, desire for positive mood states, and social/family problems. Reasons for relapse did not differ between clients whose primary drug of dependence was heroin, methamphetamine or alcohol.” (3)
Regardless of the cause of a relapse, treatment depends on the individual and the circumstances surrounding their relapse episode. In cases of short slips or drug use that occurs only once or for a very short period of time, an outpatient treatment center may be appropriate depending on what type of treatment the person has undergone previously. Outpatient centers are attended by the recovering addict during the day, where various types of therapy are employed to help the individual. This can include a range of evidence based and reality based treatment practices. In the evenings some outpatient centers permit their clients to return home, while in other settings a supervised clean and sober living environment is provided.
Sometimes, a relapse can last for months or even years before the addict or alcoholic reaches out for help again. In these cases more intense treatment may be required. In instances such as these the best option for recovery is a residential inpatient treatment program, where the individual will live in the same supervised environment where they receive treatment. This type of program provides the best chance for success in recovering from a relapse, even if the person has attended other inpatient programs in the past:
“And sometimes, as with other chronic conditions, episodes of relapse may require a return to prior treatment components. A continuum of care that includes a customized treatment regimen—addressing all aspects of an individual’s life, including medical and mental health services—and follow–up options (e.g., community – or family-based recovery support systems) can be crucial to a person’s success in achieving and maintaining a drug–free lifestyle.” (4)
Ultimately, the causes for relapse are very individual in nature, which requires treatment plans to be developed on an individual basis as well. People in recovery should know that a relapse is nothing to be ashamed of – in fact; many treatment specialists consider relapses to be part of the learning process for addicts and alcoholics. With proper treatment, a relapse can teach the individual a great deal about what triggers their drug use and how to develop effective methods for dealing with these triggers.
If you or someone you loved has recently relapsed and needs help, call the number at the top of your screen now for a free, confidential consultation about what can be done to get you back on track. Remember – the sooner you get treatment, the more you’ll minimize the consequences of a relapse and be able to retain the relationships and opportunities in your life. Call us right now – it’s not worth it to wait.
(1) National Institute on Drug Abuse Treatment and Recovery
(2) Wikipedia Post Acute Withdrawal Syndrome
(3) Hammerbacher, Mellissa Lyvers, Michael Factors Associated with Relapse among Clients in Australian Substance Disorder Treatment Facilities 12/01/2005 Bond University Faculty of Humanities and Social Sciences
(4) National Institute on Drug Abuse Treatment Approaches for Drug Addiction