Recovering from Relapse

Home » Alcohol » Recovering from Relapse

Probably the two largest focuses in addiction treatment are abstinence religious rituals such as the 12 steps, celebrate recovery, and Naracon (the Scientology version of treatment) and relapse prevention. Those who try to be more scientific try to engage in discussions about relapse prevention but even with all this, the vast majority of people who go to treatment relapse and cannot achieve lifelong sobriety. It is simply unrealistic to believe a patient will be abstinent for the rest of their life. In fact, long-term epidemiological studies show that even in self-help abstinence societies, the survival rate for abstinence is less than 1% across 20 years. Many members of the self-help society Alcoholics Anonymous openly admit that very few stay sober for their lifetime. This naturally extends that it is the responsibility of health practitioners to begin discussions about relapse minimization and relapse control. Engaging a client about what to do in the event of a relapse could save thousands of lives and to give clients an idea of what a “successful” relapse would look like. Yet many practitioners are so determined to convince alcoholics and addicts that perfect abstinence from all drugs including alcohol is so necessary that most programs flat out refuse to engage in this subject. In fact, in many programs, the only response to relapse is to blame the patient for failure, which is ironic at best when the clinician is treating them for a condition that the patient already has admitted a lack of control, simply by showing up for treatment. There are numerous cases where patients are rejected from treatment or incorrectly diagnosed as borderline sociopathic simply for disagreeing with the treatment modality of many rehabs.

Harm reduction, a new approach to addiction, has done a much better job of addressing this issue but really lacks relapse minimization as a formal treatment modality. Relapse minimization is the idea that if a client is attempting to engage in substance avoidance, there still exists a high probability that at some point in their future, drug use or drinking will occur at least once in their lifetime. Harm reduction methods are now encouraging the use of naloxone for first line health practitioners to avoid an overdose of opiate users, yet there still lacks a formal system of training for the client to reduce the damage of use in any activity when the probability of use is greater than 99% for the addicted population even after treatment.

Just as heroin or opiate addicts should be encouraged to carry naloxone, alcoholics should be encouraged to carry naltrexone to reduce the impact of relapse during the using session. Beyond this, educating users how to reduce damage, such as preparing the user for safer use sessions, such as using clean needles, drinking at home rather than in a place where they must drive home, or educating them how to change their attitudes through rational emotive behavioral therapy which can curve the amount of usage during a session. This can then be viewed as a victory rather than a failure when the addict has found that the using session has been minimized by intelligent choices despite the neurological system requires the chemical they are craving. Through this process, relapse over time will become less and less as the addict feels more in control over the situation and gains confidence within themselves to change their behavior.

Giving the addict the feeling of control allows them to make better choices in the future. While some may view this as an encouragement to use further since a successful use occurred, the opposite behavior is enforced when the addict has a goal of avoiding the drug entirely. Studies show that enforcing abstinence through a fear based belief system of a progressive disease actually causes worse relapses than evidence based therapy that empowers the patient and gives them a sense of control and a new attitude towards their addiction. Evidence-based therapy and medicine further enforce the likelihood of spontaneous remission into moderation or avoidance as the client feels more in control of their choices and they have set up a goal of changing their lifestyle using incremental steps than an all or nothing abstinence based program.

Relapse minimization is an important subject to aid the client who is motivated to quit but only when there is evidence across time that it displays an improvement in avoidance rather than an increase in usage. This requires a delicate balance that professionals must keep in mind but when executed successfully, results in optimal outcomes to those motivated to quit illicit drugs entirely or moderate drinking. In general, 90% of patients will reject an abstinence-based model, which makes the approach nearly useless for the majority of those who need it. It is no wonder that only 7% of addicts actually seek treatment when their only choice is all or nothing, abstinence or further uncontrolled use. Health practitioners have a responsibility with this knowledge to help addicts in the best way possible by utilizing a program that makes incremental changes and allows the patient to set their own goals, even if that goal is moderate drinking. Opposing a client’s personal goals, merely causes an environment of conflict and denies the client a voice in their own treatment. Furthermore, case studies prove that moderation a vast majority of the time is far more successful than abstinence when accompanied with medication assistance. The right choice is a program that is utilizing this type of treatment first and then aims towards abstinence only when medication assisted moderation fails. At which point, discussions of relapse minimization are necessary, not just relapse prevention. We don’t blame asthma patients when they have an asthma attack, we give them emergency medication to assist in the matter, addiction medicine should be no different.

Join our Newsletter

Find out how we can help you take control of your addiction and your life. → Click Here to Subscribe

Comments are closed

865-888-4100 | The Goodman Center