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Avoiding Relapse Triggers

Addiction is a chronic disease that can be managed but cannot be cured. In a treatment program, individuals receive a significant amount of information on the nature of addiction, and they learn about how their own addictions may have developed. This educational process is used to help all people who have chronic conditions.

For example, people who have asthma are often asked to learn more about lung health and allergies. This includes how they can control the triggers that make them wheeze. Similarly, people who have heart disease may learn about how cholesterol clogs arteries, and they may be encouraged to steer clear of all fatty foods. These lessons tend to empower people who have chronic conditions to take control and truly change their lives, and it may go a long way toward explaining why people who get treatment for addiction tend to improve more frequently than people who don’t get treatment.

However, the fact is relapse is a very real possibility for almost any addict. Most addicts will need to develop a robust plan to help them prevent a relapse from occurring.

Relapse Basics

A study compared long-term sobriety rates of people who chose to quit drinking on their own without help, and those who quit drinking in a structured addiction program. As expected, those who completed a structured program were more likely to be sober three years later.[1] While addicts sometimes achieve short-term sobriety on their own, they need the educational component of rehabilitation programs in order to make the changes needed in order to maintain long-term sobriety.

That’s not to say that those who attend rehabilitation programs don’t relapse. In fact, it is common for all addicts to relapse. Remember, addiction is a chronic condition, and people are likely to test the boundaries of their recovery from time to time and really see how well they can control their urges. Just as people with diabetes may experiment with eating one candy bar, an alcoholic may try one drink or a drug user may try one hit.

However, there are some things people can do to reduce the risk of relapse.And, if a relapse occurs, there are some things that addicts can do to get back on track.

The Relapse Process

Many addicts suggest that relapses simply come out of the blue with no warning whatsoever. Research suggests that a relapse is related to biology and chemistry. Some even say that a relapse is remarkably easy to spot and to head off in advance. For example, a study found that rats addicted to heroin or cocaine returned to drug use when exposed to stress.[2]

Since drugs had relieved pain in the past, the brain calls for drugs when the pain and stress recurs. Drug use may even be a mammalian response to stress in those with a history of addiction.

Relapses are rarely quick and simple. A person isn’t exposed to a stress and then immediately reverts to drug abuse. Instead, the process might consist of these steps:

  • A form of stress occurs.
  • The person feels unable to handle the stress.
  • The person begins to harbor negative thoughts.
  • The person listens to these thoughts for hours or even days.
  • Drug or alcohol use seems like a reasonable way to handle the pain.
  • The person decides to experiment with drugs or alcohol.
  • The person obtains drugs or alcohol.
  • A relapse occurs.

As this model makes clear, a relapse happens in a series of measurable steps over a period of time. Addicts who understand the relapse cycle are in the best position to stop the process before it moves forward.

The Role of Counseling

In a formal program for addiction, addicts learn how to identify their triggers for substance abuse.They learn a series of techniques to employ when the urge to use grows. This can help some addicts to overcome the urge to relapse. When presented with a stress, these addicts will know that they’ll be tempted to use, and they’ll know just what to do to deal with the temptation. However, even if the cycle isn’t stopped and a small relapse occurs, addicts can still benefit from counseling.

Those who have been through an addiction program often maintain ties with their therapists. When they slip and use, they can call their therapists for a counseling session. In this model, a relapse is used to point out additional lessons the addict needs to master in order to maintain sobriety.

The addict isn’t a failure, and the treatment isn’t considered a failure, either. Instead, a relapse is considered an indication that more lessons are needed to help build upon the success the addict has already enjoyed.

Medications Provide Additional Support

Some addictions cause chemical changes in the brain. This makes a relapse of drug use more likely. These chemical changes are so strong—and so persistent—that they can override the logic the addict uses to control impulses. People with this level of damage may relapse, even when their logical minds don’t want to do so. Medications can be extremely helpful here. Prescription drugs can help to correct the physical damage and make the addict’s ability to resist much stronger.

Medications are particularly helpful for people addicted to opiates like heroin. A study in The Lancet found that for a group of people given replacement therapy for opiates, 75 percent stayed enrolled in treatment and about 75 percent showed no relapse to opiate use after one year. Of those who received a placebo, none remained enrolled in treatment.[3] In other words, replacement therapy allowed them to avoid relapse.

Some individuals use replacement therapy for a few months after they complete an addiction therapy program. Others remain on replacement therapy for the rest of their lives. The urge to relapse is often used as a marker to determine how well the therapy is working. If the person feels no need to relapse, the medication is appropriate. If the urge to relapse is overwhelming, the dose might need to be adjusted. People on medications often need to stay in contact with their therapists or their doctors in order to handle these changes.

Being Part of a Community

For many, joining a support group such as Alcoholics Anonymous or Narcotics Anonymous is a key part of their relapse prevention strategy. By listening to stories of other addicts, they can remember how terrible addiction can be and the great toll addictions can take on those who harbor them. In support groups, addicts find the support of others who have also deal with addiction. If a craving takes place in the middle of the night, an AA member can call his/her sponsor for in-the-moment support. This can be a crucial part of deflecting the urge to use.

Pulling Together a Plan

Those who completed their formal addiction programs likely know just what they’ll be expected to do to maintain their sobriety. By following these plans and remaining ever vigilant for the signs of an oncoming relapse, addicts can do their part to ensure long-term recovery.

At The Canyon, we do our part to ensure that our clients maintain their sobriety. We offer extended care programs to help clients transition from inpatient care to living alone, and we offer alumni programs to help our clients stay connected to recovery. Please contact us to find out more about these approaches.

If The Canyon isn't the right place for you, we'll find you the place that is. 424-387-3118

[1] Rates and predictors of relapse after natural and treated remission from alcohol use disorders. Moos, Rudolf. Published on January 24th, 2006.

[2] Stress-induced relapse to heroin and cocaine seeking in rats: a review.

[3] 1-year retention and social function after buprenorphine-assisted relapse prevention treatment for heroin dependence in Sweden. Kakko, Johan.