Relapse is a return to abusing drugs or alcohol after a period of being sober, or abstinent, and it is a common aspect of addiction recovery. The National Institute on Drug Abuse (NIDA) compares relapse rates for addiction, at 40-60 percent, to relapse rates for other chronic diseases, such as diabetes, hypertension, and asthma.
Addiction is a disease, as defined by the American Society of Addiction Medicine (ASAM), characterized by a loss of control over drug abuse and drug-seeking behaviors. It affects the circuitry in the brain that is related to the regulation of emotions, decision-making, memory, and reward processing. Mind-altering substances like illicit drugs or alcohol make changes in the brain, and once a drug dependency is established, these changes may become relatively fixed. The National Survey on Drug Use and Health (NSDUH) of 2014 estimated that 21.5 million Americans (that were over the age of 11) suffered from a substance use disorder in the year leading up to the survey.
What Causes Drug Relapse?
Some common relapse triggers include:
- Poor physical health
- Environmental factors, such as a lack of support
- Emotional distress or untreated mental illness
- Impatience, complacency, or overconfidence
Withdrawal symptoms are common after substance abuse is stopped and may include drug cravings, physical discomfort, and emotional symptoms like depression, anxiety, insomnia, and more. It may feel that the temporary relief provided by a return to drugs or alcohol is preferable at times. With abstinence and substance abuse treatment, however, the brain can be healed. A relapse does not indicate that drug abuse treatment has failed, and also does not always mean that a person needs to immediately return to a treatment program. Support groups or a therapy session may sometimes be all that is needed to get someone back on track. Relapse may be more significant at times, and a return to treatment or even a different treatment method may be beneficial in these cases.
Relapse can vary in duration and severity, and there are a variety of methods for helping to reduce and minimize episodes of relapse. Understanding what may function as a trigger for relapse can help an individual to avoid a full-blown return to drug or alcohol abuse.
Relapse likelihood can be minimized with dedication, support, and aftercare services that follow a comprehensive substance abuse treatment program.
Controlling Environmental Triggers and the Importance of Support
When a person is caught up in the throes of drug addiction, the addiction takes precedence over virtually everything else in life. Relationships with family and friends suffer, and regular participation in hobbies that don’t involve substance use often ceases. Once an individual has completed a substance abuse treatment program, it may seem daunting to re-enter life in the outside world.
It is important to stay away from places, people, or things that may have been involved in previous drug or alcohol abuse when fresh out of rehab. For example, staying out of bars and avoiding people that an individual may have used drugs with in the past are good ways to reduce the temptation to return to substance abuse.
Drug and alcohol use may have been a big part of a person’s social life in the past, and it can be helpful to find new hobbies and interests that don’t revolve around drugs or alcohol.
Surrounding oneself with others who are committed to recovery and remaining alcohol- or drug-free is also important to help prevent and reduce relapse. Support groups, 12-Step programs, and family counseling sessions can help with this. Don’t be afraid to ask for help.
The New York State Office of Alcoholism and Substance Abuse Services (OASAS) published the results of a study in 2012 that indicated that around 10 percent of American adults (aged 18 and older) consider themselves to be in recovery from a problem with drug or alcohol use.
Support groups can help individuals and families to remember that they are not alone, and many others are out there to lend a sympathetic ear or advice.
A healthy home environment where everyone is on the same page and educated regarding what to expect during substance abuse treatment and recovery can help to prevent relapse too.
Family and loved ones know a person best and may be suited to best recognize when a potential problem may arise and therefore able to address it promptly.
Regulating Stress Levels
Stress is a common relapse trigger, as reported by the journal Current Psychiatry Reports. By working to minimize outside influences that may produce stress, relapse risks may also be minimized. Taking up a creative activity, such as painting, sculpting, drawing, dancing, songwriting, or playing an instrument, can help to occupy the mind, provide a healthy outlet, and reduce stress.
Yoga and mindfulness meditation are good stress-reducers as well. Mindfulness meditation may actually help to positively rewire a brain that has been disrupted due to addiction. It teaches people to be more aware of themselves, both physically and mentally, Psychology Today publishes. By creating a better sense of self-awareness through breathing, stretching, focus, and meditation, stress can be reduced, and an individual may be able to control drug cravings and circumvent a relapse before it begins. The great thing about yoga and mindfulness meditation is that they don’t require a lot of equipment and can be used virtually anywhere and at any time in order to reduce stress. Massage therapy, chiropractic care, acupuncture, and other holistic methods may help with stress reduction and emotional regulation too.
Substance abuse treatment programs use a variety of methods, including therapy, counseling, education, life skills training, and medications.
Individuals can learn to identify personal stressors, or triggers, during treatment, and this knowledge can help them to learn methods to avoid and manage these triggers during recovery.
It is important to finish any treatment programs in their entirety, and keep taking any prescribed medications or supplements. An estimated 9 million American adults suffer from both a substance use disorder and a mental health disorder, the Substance Abuse and Mental Health Services Administration (SAMHSA) reports. Untreated mental illness, or not taking necessary medications to regulate such illness, can be a potential factor in relapse and relapse severity. Integrated treatment methods can treat both disorders at once, and in so doing so, these programs help to reduce relapse in recovery.
Relationship between Physical and Emotional Health and Recovery
When people get enough sleep, eat balanced meals, and are physically active, they are more psychologically stable and ready to take on what the world may throw at them each day. Sticking to a regular sleep schedule can be key in helping a person to better regulate moods; lack of sleep may be a common relapse trigger.
When people regularly abuse drugs or alcohol, their bodies are likely deficient in important vitamins and minerals, and a healthy diet plan can help to reverse some of this damage. As published in the journal Today’s Dietician, a balanced diet can be a major factor in addiction recovery by helping a person’s brain and body to heal, and it may also help to reduce cravings and lower stress levels.
Being physically active can help to reduce relapse as well, by providing a healthy outlet for stress and raising self-confidence levels. An article in the journal Behavioral Modification showed a positive correlation between aerobic exercise and lower stress levels, better coping mechanisms, and fewer depressive symptoms. Physical exercise may also serve to elevate some of the brain’s natural endorphins that may have been disrupted by substance abuse. Frustration, low self-esteem, and impatience can trigger relapse. By eating better and staying active, people can begin to feel better about themselves physically, which can in turn improve mental clarity and promote continued recovery.
It’s Never Too Late to Get Help