Often times, recovery may seem like an impossible task to an individual suffering from drug addiction. The will to recover for most addicts is usually triggered by an occurrence or epiphany, wrenching them out of the comfort they receive from these addictions into harsh reality. But even when these individuals decide to let go of these affiliations, it becomes more of an “easier said than done” scenario. Most times, on the road to recovery, these addicts begin to deteriorate in treatment, and resort back to drugs. This is called a relapse and is possibly the greatest threat or set back for a recovering addict.
Terence T. Gorski explained that “A relapse is more than just using alcohol or drugs. It is the progressive process of becoming so dysfunctional in recovery that self-medication with alcohol or drugs seems like a reasonable choice.” Relapse rates for addictive diseases usually are in the range of 50% to 90%; however, these rates vary by definition of relapse, severity of addiction, which drug of addiction, length of treatment, and elapsed time from treatment discharge to assessment, as well as other factors.
Relapses are often considered a life and death gamble because taking just a couple of drugs inevitably leads back to massive using within a short period. It is well known that people who relapse can often die from accidents, overdose, suicide or medical problems.
The Relapse Process
Relapses are not just caused by one incident; they are the result of a progression of problems which can be referred to as the “relapse process”. Relapses begin in the mind, much earlier than the moment when the first drug or pill is taken. These thoughts or feelings are aggravated by:
- Stress: Internal feelings and emotions, which are overwhelming;
- Environment: External situations, places and people;
- Exposure: Unhealthy patterns of behavior and habits;
Relapses do not necessarily mean that the treatment being registered has failed; they are after all considered part of the recovery process. They however suggest reinstatement of the treatment or the use of an alternate method.
Lowering the chances of a relapse
The best possible way to prevent a relapse, or considerably lower the chances of one occurring is by first knowing the warning signs. These signs can be anticipated by both the people around the addicts and the addicts themselves, enabling them to take the necessary action. Collectively, these signs are called the relapse warning list. The article Drug and Alcohol Relapse Warning Signs (2011) lists them as follows:
- Return to denying there’s a problem
- Avoidance and defensive behavior
- Crisis building
- Immobilization (inability to take any action)
- Confusion and Over-reaction
- Behavioral loss of control
- Recognition of loss of control
- Option reduction (feeling trapped and that there are only 3 ways out – insanity, suicide or drug use)
- Acute relapse episode
Intervention within any of these stages can re-engage an addict in recovery. Within each of these warning phases are symptoms others can pick up. For instance:
- Stopping or decreasing recovery-related activities
- Isolating from friends, family and peers in recovery
- Becoming defensive in response to questions about your well-being
- The inability to stop thinking about alcohol and other drugs
- Becoming confused, irritable or angry
- Trouble sleeping
- Excessive worrying about others instead of self
The RP model
The Relapse Prevention model is an award winning model proposed by Alan Marlatt and Gordon. It incorporates numerous specific and global intervention strategies that allow each step of the relapse processes to be addressed. Specific interventions include identifying specific high-risk situations for the addict and enhancing his or her skills for coping with those situations, increasing the user’s self-efficacy, eliminating myths regarding the effect of drugs, managing lapses, and restructuring perceptions of the relapse process. Global strategies comprise balancing the client’s lifestyle and helping him or her develop positive addictions, employing stimulus control techniques and urge management techniques, and developing relapse road maps.
The RP model however involves a lot of complexity. For the addict, the easiest way to prevent or arrest the relapse process is to be open about the feelings he or she is experiencing to family members and other people who can intervene. This is best at treating upcoming problems and will bring about change in a positive manner.