In the recovery process, individuals must be prepared for the possibility of relapse – when an individual who has abstained from drugs or alcohol uses again. The relapse can be a single event, or it may happen on several occasions.
Relapse rates for drugs and alcohol are similar to those of other chronic diseases. The National Institute of Drug Abuse states that relapse for diseases such as diabetes and hypertension can refer to an individual taking medication improperly or not at all. Individuals with drug and alcohol dependence have relapse rates of 40-60 percent, which is somewhat higher than individuals with diabetes who have relapse rates of 30-50 percent. Relapse rates for hypertension and asthma are higher than that of drug and alcohol dependence, at 50-70 percent.
Signs of Relapse
Recovery from drug and alcohol dependence is a lifelong endeavor. At times, there are signs of impending relapse that can be observed by an individual’s loved ones. These signs may be observed before relapse, so it can be prevented, or they might not appear until after the individual has relapsed. In the latter situation, loved ones can then intervene to arrest the relapse and get the person back on track in recovery. Individuals may also be able to realize subtle changes in their own behavior and mindset, and be able to ask for help before a relapse occurs. Some of the signs of relapse include:
- Emotional instability: As described by a Huffington Post article, individuals make many changes as they pursue sobriety. These changes cause various different emotions, and individuals may often feel overwhelmed. The emotional upheaval that often comes in early recovery may be a trigger to relapse since substance abuse is often used to numb uncomfortable feelings.
- Spending time with friends or in places that are associated with past substance abuse: These activities are classified as triggers – certain situations or behaviors that an individual associates with substance abuse. These triggers often prompt those in recovery to return to substance abuse. They may feel like “just one” drink or hit can’t cause that much harm, but oftentimes, that one action can lead to a full relapse. Individuals should work with their therapists to learn how to avoid triggers and to develop coping skills to deal with triggers when they can’t be avoided.
- Remembering good things about past substance abuse: Individuals in recovery may recall memories of their days using drugs or alcohol, such as specific parties or nights with friends when they had a really good time. It’s often easy to look back and romanticize those memories. In their reverie, individuals may forget why they decided to begin the recovery process – legal troubles, health problems, physical and emotional abuse toward family members, career issues, and more. Again, individuals should discuss these memories, and their viewpoints on them, with their therapists.
- Defensive behavior: If an individual becomes defensive or seems to be in denial, it may be a sign of impending relapse or a sign that relapse has occurred. This defensive behavior may be directed toward family members and friends, and it should be addressed. Family members and friends should not angrily confront their loved one, as this serve as another trigger for the individual. Approaching their loved one with understanding and empathy is instead recommended. In some instances, if the relapse has taken full hold, an intervention may be appropriate.
What Happens Next
The most important thing for individuals to remember if they have experienced a relapse is that it does not indicate that they have failed at recovery. A relapse can mean that a treatment plan may need to be reinstated or that the current treatment plan needs to be reevaluated and modified. Relapse is more common than an individual struggling with drug or alcohol dependence may think; in fact, relapses are likely on the path to recovery.
After relapse has occurred, individuals should immediately take the necessary steps to keep themselves on their recovery path. They may wish to contact their family members, friends, support system, therapist, and/or sponsor for support.
While it can be tempting to take a nihilist attitude toward the relapse, it’s important to get back on track immediately. Some may feel that sobriety is all or nothing – since they slipped, they should just return to substance abuse. This viewpoint doesn’t acknowledge the reality that relapse is often part of the recovery journey. The important part is simply refocusing on recovery.
Following a relapse, individuals often need the most support. Family members, friends, support groups, and therapists are needed to help the individual work through any feelings of disappointment and shame that may be experienced. If an individual has been attending a group such as Narcotics Anonymous, sharing the relapse with the group may also help, as support from peers in recovery can be extremely beneficial.
A relapse prevention plan is a helpful tool that individuals can have on hand. Having this plan does not mean that they are expecting relapse; instead, they are prepared to handle the situation if signs of another relapse occur. The plan may outline the individual’s main reasons for entering recovery in the first place as well as any triggers that contributed to the relapse. The person may outline any warning signs that either the individual or others noticed prior to relapse to help the person be aware if another relapse is on the horizon. In addition, a relapse prevention plan may include guidelines for overall wellbeing, such as an established exercise, eating, and sleep regime, to ensure the person stays in a good physical and mental place to best resist urges to relapse.
Therapy is extremely important during the period following a relapse. The individual’s therapist can help the individual to learn from the situation, helping to establish a firmer foundation in recovery going forward.