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Chronic Relapse – How to Break the Cycle

The road to sobriety is riddled with obstacles, potholes, and detours. And while some people might think that the journey to freedom from addiction and dependence is a sure-fire path to a single destination, it’s all too common for voyagers to find themselves taking an unplanned U-turn back to substance use disorder (SUD).

Recent statistics demonstrate that the average relapse rate for all types of substance use disorders is 40-60%. In fact, only 20% of those who successfully complete treatment manages to stay clean after a year. And although these numbers might seem dismal and hopeless, there is a way to break the cycle and kick the habit for good.

What is Relapse and Why Does It Happen?

In the area of substance abuse, relapse is defined as the interruption of sobriety. It’s far more common that most people think, happening to over half of individuals struggling with addiction and dependence – regardless of the substance that they use. Unsurprisingly, relapse can make an individual in recovery feel hopeless, ashamed, and embarrassed. But even those who specialize in the treatment of substance abuse disorders affirm that the process of recovery isn’t a straight path. There are numerous reasons why an individual might return to their old habits, and these reasons often tie together to create an intricate web that’s almost impossible to escape without thorough, intensive support and treatment.

  • Unresolved Traumas – Traumatic experiences like abuse or living in poverty can significantly impact a person’s way of thinking. That’s why many of those who have gone through these events turn to the use of illicit substances to ‘escape’ the strong negative emotions associated with the experiences.

The goal of SUD treatment isn’t to simply undo an addiction or dependence, but to target underlying traumas so that an individual no longer feels the need to escape the negative feelings. When these things aren’t properly resolved, then an individual might confront the same emotions and revert to drug use.

  • Poor or No Support – Family ties and intimate friendships form the bedrock of recovery. These support systems provide individuals the motivation, inspiration, and counsel they need in order to successfully overcome their addiction and dependence. In fact, the concept of a support system is one of the cornerstones of successful treatment programs like Al-Anon.

Some individuals slip back into substance use because they don’t have stable support systems that they can rely on to give them encouragement when they encounter stress, anxiety, disappointment, and other strong emotions after leaving treatment.

  • Triggers – There are lots of different triggers that individuals encounter throughout their day to day lives. These act as ‘temptations’ that remind the individual of their addiction or dependence and ‘trigger’ them to slip back into the habit.

For instance, a recovering alcoholic might be triggered by attending a party where alcoholic drinks are served left and right. An individual with a drug addiction may be tempted into returning to their old ways when placed in the company of individuals with an active substance use disorder.

  • Inability to Cope – During the treatment process, individuals are taught to use a variety of coping techniques that they can use in case they feel they’re placed in a situation that’s too overwhelming. These techniques range from deep breathing exercises, to taking a walk outside, to confiding in a trusted friend.

Sometimes however, individuals in treatment fail to understand how and when these techniques come in to play. So when faced with a potentially dangerous situation, they run to the only solution they know which is substance abuse.

  • Loss of Structure – One of the main objectives of treatment is to make sure that individuals are preoccupied with healthy activities throughout the day. Filling their schedules with things like outdoor exercise, socialization, skills acquisition, and other fun activities helps provide structure and meaning that diverts the mind from substance use.

However, because not everyone has the financial capacity, creativity, or even the initiative to engage in these activities outside of therapy, they’re likely to lose that sense of structure the moment they step out of treatment. Now with more time on their hands, there’s a bigger tendency that they might dwell on thoughts of use.

Why is Relapse So Common?

An important fact to remember when discussing relapse is that drug use is not a choice, it’s a disease. No one chooses to take the drug again and again. While that initial curiosity might have led to the first dose, the subsequent doses are caused by changes in the brain resulting from the use of the drug in the first place. That’s why the FDA tags certain substances as ‘prone to abuse’ or ‘habit forming’ since their chemistry can impact brain function and make a person continue to take the substance over a long period of time even if they want to stop. Illicit drugs and alcohol all work in various ways, distinctly impacting brain physiology and anatomy. In general however, these substances cause two common symptoms of substance use disorders which make it difficult to simply overcome – these are addiction and dependence.

What is Addiction?

Although usually interchanged with ‘dependence’, these two concepts are actually completely different. Addiction refers to the cravings that a person experiences as levels of the substance within their body decreases. Addiction is what urges an individual to take another dose, often described as a strong impulse or want.

What is Dependence?

The other side of the coin is called dependence. This is characterized by a feeling that an individual won’t be able to function without their drug. As the body become accustomed to the presence of the drug, the individual experiences strong, unpleasant withdrawal symptoms when the substance is removed. So to avoid these unwanted feelings, they take another dose simply to function. Relapse is common because illicit substances rewire your brain so that you feel like you can’t live without them. For instance, drugs like cocaine make you feel euphoric, happy, upbeat, and excitable. That’s why a lot of people take it to combat stress. However, with prolonged exposure to the substance, your body becomes far more sensitive to stress. So when the effects of cocaine decrease after a dose, minor stresses like an aching stomach or waiting a little too long in a grocery store line can become especially difficult to cope with. The result is that an individual resorts to the only stress reliever they know – which is cocaine. Many illicit substances work in a similar way.

Does Chronic Relapse Mean That Treatment Has Failed?

The short answer is no, there is no such thing as failing treatment for substance use disorder. The most important fact to remember is that individuals don’t choose to relapse. It’s simply the effect of the drug on their brain chemistry triggered by a host of environmental and social factors. In fact, even treatment experts expect most of their clients to relapse after therapy, so treating relapse is often baked into their program. It doesn’t matter how many times a person fails to stay clean after leaving treatment – it’s always possible to achieve absolute freedom from substance use.

What Happens When a Person Relapses?

The immediate assumption that a healthcare professional can make if an individual relapses after treatment is that the initial program wasn’t a good fit for their specific situation. Remember that the process of SUD recovery isn’t a one-size-fits-all, and every individual case is carefully studied in order to provide each person individualized treatment. According to the National Institute on Drug Abuse, a treatment plan can be considered well laid-out and effective if and when it evolves with the client. As an individual changes throughout the process of treatment, discharge, and relapse, so to should the program adapt to meet them where they are. In case of relapse, an individual may benefit from any or all of the following:

  • Re-enrolling in treatment, counseling, and behavioral therapy sessions
  • Joining or rejoining support groups
  • Restoring relationships with family and friends
  • Establishing new relationships with a stable support system
  • Moving into a sober living facility for structure and scheduling
  • Taking classes on coping mechanisms to successfully confront triggers
  • Enrolling in wellness classes like yoga, swimming, art, music, or fitness

Relapse is Normal

No one should feel ashamed if they relapse. Substance use disorder is a disease, and relapse is just another one of the nasty effects of these destructive drugs. That said, it doesn’t matter how often an individual relapses – it’s always possible to experience full, complete, and uninterrupted sobriety with the right treatment and techniques.

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