Rehab for Chronic Relapsers
Once you become addicted to a substance, it is often very difficult to stop using it without professional treatment. Even then, treatment and recovery are hard.
Although addiction is treatable, it is chronic – meaning that it is an often recurring condition that you may have to deal with the rest of your life.
What Is Relapse?
Relapse is when a person uses a substance again after a period of abstinence. When this occurs, it does not necessarily mean that a person has returned to habitual and permanent substance use, however – as even a one-time use after completing treatment is considered relapse.
Relapse does not mean that a person has failed. It simply means that a person has more learning and preparation to do.
Leaving the supportive sober environment of treatment can be difficult to cope with, and rates of relapse are just as high for substance abuse as they are for relapse of other chronic health conditions like asthma, hypertension, and type 2 diabetes.1 The recovery journey is different for everyone. And regardless of how many times a person relapses, it’s the end result that matters.
How Common Is Relapse?
It is not a rare thing for individuals to falter a little in their recovery course. In fact, rates of substance abuse relapse hover around 50%.1 Many people struggle with maintaining abstinence, especially in the beginning of their recovery. But the number of times a person relapses has nothing to do with their ultimate potential for success.
Whether or not individuals relapse depends on many different factors, including:
- Their reasons for abusing the drug in the first place.
- How much support they have in their sobriety.
- What kind of life circumstances they face.
- Other individual differences that could impact a person’s ability to resist temptation.
Why Do People Relapse?
People’s reasons for returning to a drug can differ.
For some, cravings may be too difficult to resist – whereas for others, basic boredom may be the culprit.
Many of these reasons relate to the root causes that may lead to abuse of a drug in the first place, as well as what sort of environment the individual returned to following formal treatment.
Some of the more commonly reported reasons behind a relapse include2:
- Feelings of stress or anxiety.
- Relationship problems.
- Feeling bored.
- Believing that they are not addicted anymore.
- Believing that drug use is “safe.”
Gender and Relapse
There also appears to be a gender component.
Women have reported depression, loneliness, and withdrawal pains as being primary motivators to relapse.
Men, however, have reported return to drug use for the following reasons: anger, having too much money, and discontinuing aftercare engagement.2
Cravings are another challenge when it comes to maintaining abstinence in the long-term. Common to many forms of substance abuse, the user’s brain begins to change and adjust to higher levels of certain chemicals. When individuals stop using the substance, their brain has to readjust back down to normal or, in some cases, temporarily decreased levels of stimulation.
This re-stabilization process takes time, and many people will experience the uncomfortable sensation of intense desire for the substance – as their brain is craving the level of stimulation that it grew accustomed to.
Cravings can also arise from the mere habit of having used so regularly before quitting. Breaking this habit and redirecting one’s drive to use towards other healthier solutions is vital for long-term recovery.
The feeling of isolation is another dangerous risk facing recovering users. Social support is critical in the recovery process, and has been associated with a significantly lower risk of relapse – even for those struggling with a dual diagnosis.3-6 Supporting a person during recovery means encouraging that person throughout sobriety, even when that includes periods of relapse.
Support can look many different ways and may include:
- Providing a sober environment.
- Enhancing the person’s sense of self-worth.
- Reminding the person that he or she can successfully maintain recovery, despite the challenges.
Is There Any Hope After Relapse?
There is always hope after relapse – even if a person slips. A person shouldn’t stop walking just because he or she trips a couple times.
When individuals succumb to relapse, they are given an opportunity to use the experience to learn and grow so that they are better prepared the next time they face a use temptation.
Often, preparing a person for returning to life outside of a sober environment involves relapse prevention training – where strategies for identifying and coping with potential relapse scenarios are taught and practiced.7 These coping skills help build up a person’s sense of self-efficacy and confidence in being able to resist future temptations.
Just like people practice fire drills and other risk reduction techniques, recovering substance abusers must practice resisting relapse through any of all of the following techniques7:
- Practicing refusal.
- Learning how to recognize potential relapse situations.
- Developing stress and anxiety buffers.
No matter what type of training a person chooses to engage in, relapse prevention skill development has been shown to actually help people resist the return to substance use – even for individuals who use multiple substances.8
There is always hope after relapse.
Keys to Success for Chronic Relapsers
A person who is experiencing chronic relapse has repeatedly gone through treatment and become sober – but for some reason, abstinence hasn’t seemed to stick so far. In these cases, this individual may need to focus on relapse prevention training, which involves developing a particular set of skills7:
- Self-monitoring of drug use habits before treatment can help a person recognize high-risk situations that could lead to relapse while learning alternative responses to these situations.
- Skill development to offset particular coping mechanism deficits can help address a person’s triggers for drug use. For example, individuals who find that they use drugs when fighting with their partner could focus on developing communication or anger management skills.
- Relapse rehearsal involves imagining a relapse temptation scenario ahead of time and picturing adaptive responses to this scenario. This imagery practice can help prepare a person to take healthy action in high-risk situations.
- Developing positive habits – such as exercise, meditation, and other activities – can help develop skills in seeking long-term benefits despite short-term discomfort. These skills may help overcome the temporary discomforts involved in refusing drugs. Regular jogging has even been associated with a reduction in drinking among individuals struggling with drinking problems.9
- Recognizing the pattern of cravings and how they are triggered can help people avoid putting themselves in risky scenarios. Environmental or bodily cues can often set off a substance craving, which can increase in intensity until it reaches a peak – when it finally begins to decrease until the craving has passed. In the immediate moment, a craving may feel irresistible. But as long as individuals use their learned coping skills, the immediate craving sensations will eventually pass.
Other valuable options for people that struggle with maintaining abstinence include treatment aftercare options, such as:
- Sober living communities (or halfway houses).
- Ongoing outpatient treatment.
- Medication support to help with cravings.
- Free support groups such as Alcoholics Anonymous or SMART.
Get Help If You or a Loved One Struggle with Chronic Relapse
If relapse has become an ongoing pattern in your own life or the life of someone you care about, call us at 1-888-744-0789 Who Answers? to speak with a rehab support specialist that can help you find the right relapse prevention program to get you on the track to lasting recovery.
- McLellan, A. T., Lewis, D. C., O’Brien, C. P., Kleber, H. D. (2000). Drug dependence, a chronic medical illness: implications for treatment, insurance, and outcomes evaluation. JAMA, 284(13). 1689-1695.
- Levy, M. S. (2008). Listening to our clients: the prevention of relapse. Journal of Psychoactive Drugs, 40(2). 167-172.
- Havassy, B. E., Hall, S. M., Wasserman, D. A. (1991). Social support and relapse: commonalities among alcoholics, opiate users, and cigarette smokers. Addictive Behaviors, 16. 235-246.
- Ellis, B., Bernichon, T., Yu, P., Roberts, T., Herrell, J. M. (2004). Effect of social support on substance abuse relapse in a residential treatment setting for women. Evaluation and Program Planning, 27. 213-221.
- Wasserman, D. A., Stewart, A. L., Delucchi, K. L. (2001). Social support and abstinence from opiates and cocaine during opioid maintenance treatment. Drug and Alcohol Dependence, 65. 65-75.
- Warren, J. I., Stein, J. A., Grella, C. E. (2007). Role of social support and self-efficacy in treatment outcomes among clients with co-occurring disorders. Drug and Alcohol Dependence, 89. 267-274.
- Marlatt, G. A., George, W. H. (1984). Relapse prevention: introduction and overview of the model. British Journal of Addiction, 79. 261-273.
- Irvin, J. E., Bowers, C. A., Dunn, M. E., Wang, M. C. (1999). Efficacy of relapse prevention: a meta-analytic review. Journal of Consulting and Clinical Psychology, 67(4). 563-570.
- Murphy, T. J., Pagano, R. R., Marlatt, G. A. (1984). Lifestyle modification with heavy alcohol drinkers: effects of running and meditation. Addiction and Behavior, 11(2). 175-186.