For people who have won the battle with addiction and gotten sober, relapse is a real fear. It’s like being in remission from cancer and dealing with the constant worry that it will come back at any time. At times it can feel like all it takes is one wrong step to fall off the wagon.
The unfortunate truth is many people will relapse. The National Institute of Drug Abuse estimates that 40-60% of people will relapse in the first year after getting treatment. Medically speaking, addiction is a “chronic, relapsing disease.” That means if you don’t take steps to actively manage addiction, relapse is highly likely.
Decades of research at addiction treatment centers across the country has given us insight into what increases or decreases the risk of relapse. In those many studies a few factors have become clear, and anyone who is in recovery should be aware of them.
Avoiding Old Environments and Enablers is Essential
Something many people don’t know about the Vietnam War is that the military knew many soldiers were using heroin at the time. It was estimated that as many as 1 in 5 soldiers were using heroin. The military was seriously concerned that the soldiers would return home as addicts that couldn’t function in normal society. So much so, that psychologists were sent to Vietnam to evaluate the soldiers and get them through detox before they were discharged.
The psychologists fully expected that the majority of the treated soldiers would relapse, but something unexpected happened when the soldiers returned home. Around 95% of the soldiers stayed clean and didn’t relapse in the first year.
At first, the researchers who were tracking and caring for the soldiers were stunned. Many didn’t believe the results and contested them. But the numbers didn’t lie. The reason such a high percentage of soldiers stayed clean is because they were out of the environment where the addiction had formed. They were back home, they were surrounded by supportive loved ones, they weren’t around the other soldiers they used drugs with and they didn’t have easy access to heroin. They also no longer had the stress and triggers of warfare that prompted drug use.
In short, their environment had totally changed and in no way reflected the lifestyle that led to drug use. People with substance use disorders have benefited greatly from this research. It told doctors and researchers definitively that environment has a huge impact on relapse. The discovery dramatically changed how addiction recovery centers treat substance use disorders, which at the time mostly focused on trying to increase self-control. This method was largely ineffective. Unlike the soldiers, at the time up to 90% of people who went through addiction treatment and then went back home relapsed in the first year.
The big difference is that the soldiers got far away from the environment they were in when they were abusing drugs. They also weren’t in close contact with other users and suppliers. In contrast, average Americans with substance use disorders were still mostly in the environment where substance abuse occurred, where there were many triggers and where enablers were in close contact.
If you get yourself out of the environment you were in before, cut ties with people connected to the addiction and surround yourself with supportive people the relapse risk goes way down. And if you do relapse, you have the support you need to get things back on track quickly.
Staying in Addiction Treatment Lowers Relapse Risk
You may wonder why there is such a big range in the relapse rate. Being at the 40% end is much better than the 60% end. There are a number of factors at play, but one clear influence is the duration of addiction treatment.
The longer you stay in some form of addiction treatment, the lower your risk is for relapse. Today 90-day residential treatment programs are encouraged rather than the minimum 30 days. And once that program is complete, outpatient addiction treatment provides essential continuum of care. From there (or during), individual counseling, group meetings and Sober Living Homes can reinforce recovery and reduce the risk of relapse over the long-term.
If you consider how long it takes the brain to recover from substance abuse it makes sense that people should be getting help from an addiction treatment center for months, if not years. And some substance abuse disorders are treated with therapies that are designed to work over time to help the brain adjust.
Just as important is the fact that if you are involved in some sort of addiction treatment you’ll have support in place if you do use alcohol or drugs. This can be critical for staying the course rather than relapsing.
At the Lighthouse Recovery Dallas addiction center one of the first things we do is work with a client to create a long-term treatment plan. The goal is for them to find support at our Dallas addiction centers during treatment and well beyond so that long-term recovery is possible. It’s continuum of care that has been proven to help people manage their addiction so they can prevent relapse.