WHAT IS RELAPSE, AND WHAT IS IT NOT?
Our bodies and brains are wired to repeat activities that we find pleasurable. After years of repeating a behavior over and over again – a behavior that triggers the “feel food” signals in our brain – it is very likely for us to fall back into that pattern at some point. This happens with drug abuse. Repetitive substance use is something our body gets used to, becomes reliant on, and continues to crave even after the drugs have stopped. When someone gives in to these cravings and uses them after they have been sober or to rehab, it is considered a relapse.
You may be here now wondering what relapse is, and wondering whether or not it happened to your loved one. You may be hurt, upset, afraid, and unsure of what to do. The fact is, relapse is one of the scariest words for people in recovery. But it is also a very normal part of the recovery process – especially for those in the early adjustment stages.
If your loved one has relapsed or is showing potential signs of relapse, you are in the right place. Below, Turnbridge details what relapse means in the treatment community, as well as what it might mean for you and your loved one now.
What is Relapse?
A relapse is defined as the worsening of a clinical condition that had previously improved. In addiction treatment, relapse is the resumption of substance use after an attempt to stop or period of abstinence. For example, someone who returns to drug use after months in rehab would be experiencing a relapse.
It’s important to know that relapse is possible, and often a very normal part of the recovery process. Somewhere between 40 to 60 percent of drug addicts relapse somewhere along their way, according to the National Institute on Drug Abuse (NIDA). Anyone who has faced a substance use disorder is vulnerable to relapse.
While an unfortunate reality, addiction relapse rates are comparable to those of other chronic diseases, such as asthma and hypertension (50 to 70 percent). This is due to the nature of the disease. Even after treatment, relapse is common of all chronic illnesses, particularly for people who stop following their ongoing care plans. “Therefore,” states the NIDA, “substance use disorders should be treated like any other chronic illness. Relapse serves as a sign for resumed, modified, or new treatment.”
While relapse is common in recovery, for some drugs, it can also be very dangerous and lead to overdose. When a person returns to drug use after an extended period of sobriety, they usually have a reduced tolerance to the drug. Their body is not as dependent as it once was, and needs less of the drug to feel its effects. But sometimes, the user does not recognize this. They may take as much of the drug as they did before quitting, and overdose as a result. An overdose happens when the person uses so much of a drug that they experience uncomfortable feelings, life-threatening symptoms, or death.
That said, when a person relapses, it needs to be addressed right away. You and your loved one should speak with a doctor or clinical treatment professional to understand what happened (and why), as well as what steps you can take to prevent it from happening again. This may involve returning to treatment, revising treatment, or trying a different treatment approach.
What is Relapse Not?
Despite how you may feel in this moment – sad, angry, disappointed, discouraged – it’s important to know that relapse does not mean failure. It does not mean that a person has failed at recovery, or that their drug treatment has failed. Relapse does not mean that recovery isn’t possible. Rather, it indicates that something must be re-worked or revised. According to the NIDA, “When a person recovering from an addiction relapses, it indicates that the person needs to speak with their doctor to resume treatment, modify it, or try another treatment.”
Like addiction, sobriety is a learned behavior. It involves not just learning how to get sober, but how to live sober. It involves changing deeply-rooted behaviors that were once an integral part of a person’s lifestyle. As with learning anything new (and difficult), this can take time, trial and error. There are bound to be mistakes along the way. If your loved one has taken a step back on their road to recovery, it does not mean that they are not making progress. They just need to be placed back on the right path.
Relapse is not something to get angry at. If your loved one has relapsed, try to stay calm and be as supportive as possible. Understand that relapse is normal, and that it can be overcome. The last thing your loved one needs in this moment is to feel ashamed and upset, as stressful feelings like that can increase their chances of using again.
Slip vs. Relapse vs. Lapse
You may be thinking now, “Did my loved one relapse, or did he/she just slip up?” There are subtle differences between a slip and a relapse, or a lapse and a relapse, depending on who you ask. Many treatment experts say that a slip is a one-time mishap, a lapse is a very brief slip or return to substance use, and that a relapse is longer in duration and more sustained than the above. A slip or lapse, however, can turn into a relapse if not handled appropriately.
Some addiction professionals differentiate a slip and a relapse by looking at the client’s intention at the time. A slip is usually a single, unplanned use of drugs or alcohol. Relapse, on the other hand, is thought to happen when a recovery plan is completely dismissed.
Under the 12-step model, a slip, a lapse, and a relapse can be more synonymous than that. A slip or lapse could be classified as a relapse, and indicate that a person needs to re-work their 12 steps again. This is designed to help the person regain strength, accountability, and control as they reconnect with themselves and their goals. There is evidence-based research and scientific support behind the 12-steps.
If your loved one has started to use drugs again – whether once, or multiple times – it might not be a matter of slip vs lapse vs relapse. Justifying drinking or drug use as a “slip” can sometimes be a euphemism for a larger problem at bay, and therefore should be addressed in the same way a relapse would – by contacting a clinician, a counselor, or a sponsor. No one should ever feel they need to tackle a relapse on their own. There is an entire recovery community out there willing to help.
Relapse Prevention and Treatment
As science and treatment methods have evolved, more focus has been placed on relapse prevention. Relapse prevention programs help clients identify high-risk situations that can lead to a relapse, and further how to respond to those situations in a healthy way.
Research shows that certain stress cues linked to a person’s substance use (such as people, places, things, and moods), and direct contact with drugs are the most common relapse triggers. Relapse prevention works to combat these triggers, by teaching clients coping mechanisms while in recovery. In Turnbridge’s young adult treatment programs, for example, clients learn how to cope with negative emotions such as depression, boredom, and stress, as well as difficult situations such as peer pressure and parties or celebrations. Drug-using friends, old haunts, and hurtful relationships are other common relapse triggers among adolescents and young adults.
There are many different causes of relapse, and many situations that can lead to temptation while in recovery. A relapse prevention treatment program can teach your loved one how to handle the cravings, the emotions, and the triggers that often arise along the way.
If your loved one has relapsed, you may be heartbroken. But it is fair to assume that your loved one is a bit broken, too. For those who are in recovery, the word “relapse” carries more stigma and shame than it does understanding. More than likely, your loved one feels upset and out of hope. Right now, he/she needs compassion and support above all else. By staying positive yourself, you can help your loved one positively get back on the road to recovery.