Helping a Client/Patient through Issues of Relapse
Recovery is a varied journey that does not have a single route or roadmap. As individual as each person is, so are the ways of achieving a healthier lifestyle free of alcohol or drugs. In addiction treatment, the topic of relapse is one to be grappled with, because it is a significant part of the process of recovering for some individuals. Even in cases where a person is motivated to achieve long-term sobriety, relapse can and does often occur. Relapse can occur even after lengthy periods of abstinence.
But relapse isn’t a sign of failure. It’s merely part of the recovery process for many people.
Signs of Relapse
The National Institute on Alcohol Abuse and Alcoholism(NIAAA) points out the multitude of reasons for relapse. They include:
- Physical feelings of withdrawal
- Anxiety and stress
- Exposure to social situations where substances are present
- Exposure to small amount of the substance
- Exposure to environmental cues that relate to old use patterns
The National Institutes of Health (NIH) has identified some predictors of relapse when it comes to alcohol abuse. Factors that may affect the possibility of relapse include specific demographics, such as marital status, employment status, and age. The drug to which the person was addicted can affect the likelihood of relapse down the road, as certain drugs lead to higher instances of long-term cravings than others. Finally, the person’s personal coping skills are among the most important factors in avoiding relapse. Certainly, having a supportive network of interpersonal relationships helps when it comes to staying sober and avoiding relapse.
The National Institute on Drug Abuse (NIDA) tells us that relapse after a period free from drugs and alcohol does not mean that treatment has failed. This is because addiction is a chronic, ongoing disease, and as such, those who have been able to find sobriety may find themselves struggling at times – and lapsing into old behaviors and coping mechanisms – and using drugs and alcohol once again.
Relapse rates in the field of substance abuse mirror those of some other chronic illnesses like high blood pressure, diabetes, and asthma. With alcohol and drug use, while there are physiological factors to consider, behavioral and environmental factors can make it easy for someone to slip back into old patterns of use.
Treatment after Relapse
Many people have had some success prior to relapse because they have been through treatment. So, if treatment has been completed once, then what? Remember that treatment is an ongoing system of care. While the relapse does not mean that treatment has failed, it can mean that the models and techniques previously used may need to be adjusted, and that new strategies may be necessary in order to achieve a more positive outcome.
Treatment after relapse is important. Everyday Health explains that often, those who relapse begin to use their substance of choice at higher levels, creating new patterns of abuse that become harder to escape.
It is important for the person who has relapsed, and for the person’s support network, to understand that relapse is commonly considered a “normal” part of the addiction disease. As such, treatment should be part of the plan in much the same way it was during one’s first time seeking help. There is hope, and a hopeful and positive approach is important during the fragile time after one has relapsed.
Many people complete 30-day, 60-day, or 90-day inpatient treatment programs. Often, clients leave their programs feeling much stronger, in control, and certain that relapse will not happen to them. When relapse does occur, the treatment provider and client can work together to address what has happened in a way that does not define sobriety as an impossible goal, and also identifies the best options for renewed care. Perhaps inpatient treatment is again the best option. Or, in some instances, outpatient care may be sufficient and successful. As with so many aspects of recovery, the answer is that it depends on the individual person.
A possible alternative to inpatient treatment after relapse is an intensive outpatient program (IOP). The National Center for Biotechnology Information (NCBI) explains that in this kind of program model, clients come together and work in groups on a frequent basis, though they don’t live at the treatment center. This group work can be especially powerful, allowing for individuals to have opportunities to communicate with others who may be experiencing similar issues, especially if socialization is a component that has contributed to relapse. Other benefits of an IOP are:
- Reintroduction of structure into the client’s life
- Reinforcement of positive and healthy ways of interacting
- Exposure to others who are in more advanced phases of recovery
- Development of concepts regarding long-term sobriety
Outpatient therapy is one option to consider when a person has relapsed. It may provide enough structure, discipline, and support to help the person get back on the recovery path. In cases of severe addiction, or for repeated instances of relapse, it’s likely that inpatient treatment is the best option.
Helping Clients Manage Triggers
The Fix explores some of the more common triggers that clients report lead to relapse. Counselors can work on identifying such triggers with their clients in order to craft an individualized plan to deal with these triggers ahead of time in order to limit their power.
Triggers fall into two categories: internal and external. Internal triggers are those that come from within the client, such as feelings, thoughts, and ideas; these are known as emotional drivers. Some internal triggers can be physical, such as anxiety, depression, and fatigue.
External triggers include the people one interacts with and objects that were part of the person’s past alcohol and drug use, like bottles of alcohol or drug paraphernalia. In addition, being in places where the person previously used drugs and alcohol can be a trigger to relapse. Events can be triggers in and of themselves, such as holidays, times of the day when one typically used, weekends, and so on.
Returning to treatment after relapse helps people to look clearly at the external and internal triggers that contributed to using again. Planning for triggers in advance, and mapping out ways to address those triggers, helps people become more aware and mindful. As a result, they will be better prepared to respond well when triggers arise.
Addiction treatment professionals have an important role in explaining the realities of relapse in the cycle of addiction, in helping clients to stay positive and hopeful after relapse has occurred, and in helping clients to define and manage triggers to prevent recurrent relapses over time.
Ultimately, when handled well, relapse can be used as a positive and productive step toward long-term sobriety and a healthy future.