Escaping an addiction can be a challenge. Some individuals will have lost almost everything before they are willing to let go of substance abuse. Making it through recovery and building a new life is a wonderful accomplishment. This person will begin to experience how good life can be when free from addiction. It often comes as a shock to onlookers if this individual then decides to return to their old self-destructive behavior. They have gone to all that effort to fix their life, yet then decide to return to addiction. In a lot of cases the addict won’t be able to provide a logical excuse for their relapse. They will usually be full of remorse but may feel unable to return to the sober life.
The etymology for the word relapse is to fall again. If an addict manages to escape their addiction but later returns to this behavior then they can be said to have relapsed. This can occur during the first few weeks or months of recovery, or it can even occur after many decades of sobriety.
If an individual only briefly returns to their addiction it is usually referred to as a slip rather than a relapse. Some people like to think of it as a near-miss and a sign that something needs to be changed. So long as these individuals get right back on the recovery path, and learn from their mistake, they will escape a full-blown return to substance abuse. It is vital that this individual understands what caused them to slip so that they can prevent it ever happening again.
A relapse is a significant event for someone in recovery. Not only can it be a source of regret, but there are also other dangers such as:
* Many of those individuals who relapse will never get another chance at recovery. Once they are in the midst of addiction there is no guarantee that they will ever have the motivation to quit again. Relapse means death for a lot of these people.
* Those who return to alcohol or drug abuse usually find that they are back where they were before quitting in a very short time period. Even those individuals who have been sober for many years will fall quickly into addiction hell.
* Addiction can be a lot harder to deal with after a period of recovery. The individual now knows that a life without substance abuse can be satisfying, but they may feel helpless to stop their downward trajectory. It is a lot harder to hide behind denial after a period of recovery. There is unlikely to be much enjoyment left in the substance abuse; only the compulsion to keep on using.
* People who relapse will tend to feel a lot of guilt. They know that they have let themselves and other people down.
Those who are in early recovery tend to be most at risk of relapse. They have not yet had the chance to build a life away from substance abuse. The first few months away from alcohol and drug abuse are usually an emotional rollercoaster. If the individual does not have sufficient support, and effective coping mechanisms, it can feel overwhelming. Many will be tempted back to their old way of dealing with life’s problems.
Recovery is more firmly established after a year or two, but the risk of relapse remains. Those who give up addiction will usually have hit a painful rock bottom first of all. As the years go by the memory of this pain begins to fade. The individual may begin to wonder if things were really that bad. Those who were alcoholic may wonder if their years away from this drug have made them strong enough to now be able to drink socially. Such thinking can lead to disastrous consequences.
It can be difficult to understand why anyone would relapse after a long period free of addiction. A possible explanation is provided by Incentive Sensitization Theory. The idea here is that substance abuse actually changes the way the brain works. Alcohol or drugs become associated with the internal reward system. This all takes place unconsciously, but lead to compulsive behaviors of the addict. According to this theory the changes to the brain continue to have an effect even if the individual has been in recovery for many years. This accounts for the cravings for the old drug that can reappear even after long-term abstinence.
It is suggested that relapse isn’t just some random event but instead something that occurs over a period of time. The relapse process provides an outline of how this might occur. The stages of this process are:
* Getting stuck in recovery. All addicts will be faced with challenges in early recovery. They will need to get beyond these in order for life to improve.
* The individual –denies that they are stuck_. Rather than deal the problem the individual tries to ignore it.
* The use of negative coping strategies to deal with their discomfort. Life becomes difficult because of the unresolved blockages in the recovery path. The individual tries to use negative coping strategies such as throwing themselves into work or comfort eating.
* A trigger event leads to an outburst of all the pent up frustrations. This trigger might only be something minor, but the individual may experience extreme emotions.
* Emotions are now out of control
* The inner turmoil that has been building up since the individual became stuck in recovery is now impossible to ignore. It is usually now obvious to other people that something is wrong
* The individual begins to feel out of control.
* A return to alcohol or drugs now appears as a good way to escape the pressure
In AA they use the acronym HALT to help people remember the four most dangerous relapse triggers; these are, hunger, anger, loneliness, and tiredness. Other relapse triggers identified have also been identified including:
* Lying and other forms of dishonesty
* Unrealistic expectations of recovery
* Expecting too much from other people
* Taking recovery for granted
* Abusing other substances
* Feelings of frustration with recovery
* Self pity
It is important for the individual in recovery to be aware of these triggers so that they can be avoided.
The dangers of relapse can be severe so it is essential that everything possible is done to prevent it from occurring. Knowing about the process of relapse and potential triggers is helpful, but it is also important that the individual has strategies for combating these. Relapse prevention tools can include:
* Social support. Speaking to friends or family can be highly beneficial. Allowing something to stew internally can rapidly turn molehills into mountains.
* Support groups can be a great help for those who feel at risk of relapse. Here it is not only possible to find support but also some good advice too.
* Booster sessions. Some rehabs offer booster sessions following the initial treatment. These are useful because they provide the individual with new skills to help them cope better in recovery.
* Exercise can be helpful because it clears the mind. It also helps relieve pent up tension. It is important that people in early recovery don’t go too overboard with exercise as it can almost become another addiction.
* Regular therapy/counseling sessions give the individual the chance to discuss any difficulties they are having.
* Learning about recovery is a great way for people to prepare themselves for relapse triggers. Information is power and the individual can learn to spot the warning signs of relapse and tackle these before they can develop. The internet is a great resource for this type of knowledge.
* Sponsorship is part of the 12 step program approach. It can be a great tool for preventing relapse. As soon as the individual has any thoughts of relapse they can telephone their sponsor. This will be a more experienced friend in recovery who will understand what is going on from personal experience.
* Keeping a journal is a good tool because putting problems on paper can make them appear more manageable. Writing is also therapeutic.
* Meditation techniques like mindfulness can be useful for dealing with cravings and unwanted thoughts.