A common saying in substance use recovery is, “relapse is a part of recovery.” While it is true that a reoccurrence of substance use is possible (substance use disorders are a chronic disease, which often comes with a period of symptoms re-emerging), it by no means is required in everyone’s recovery, and if it does happen, does not mean that you have failed in your personal recovery. Recovery is a journey, not a destination. It is a journey that lasts a lifetime and will include many obstacles, bad days, and luckily, a whole lot of good days as well.
What Is Relapse?
At its core, a relapse is a return to substance use after a period of intentionally stopping and starting on a path towards recovery. Relapse can often come with many other consequences, though, meaning the contributing factors to the relapse. Whether this is increased stress, not adhering to medication guidelines, or ceasing to engage in aftercare, a relapse should be seen as a process rather than the singular action of returning to substance use.
How Common Is Relapse?
According to the National Institute on Drug Abuse (NIDA), relapse rates for substance use disorders are very similar to rates for other chronic diseases such as diabetes, asthma, and hypertension. Over the course of the disease lifetime, relapse rates are estimated to be at 40-60% (compared to 30-50% for diabetes, 50-70% for hypertension and asthma). Though the relapse rate for addiction is high, it should be treated like any other chronic disease – relapse is a reason for renewed intervention and additional treatment. Relapse should not be seen as a failure, rather, it should be seen as an opportunity to get the help needed to achieve complete remission.
Can Relapse Be Predicted?
Predicting relapse effectively is a goal of many modern researchers working with the National Institutes of Health. Doing so can prove difficult as relapse is a by-product of many different factors. According to NIDA, stress, financial troubles, cessation of aftercare, emotional cues linked to drug use behaviors, and not taking medication as prescribed can lead to relapse. Connection with your clinical aftercare team and your community-based recovery network are crucial to intervening on these contributing factors before a relapse occurs. While we wait for scientific models that can predict relapse, relying on your community and clinicians remains the best defense.
How To Prevent Relapse
Preventing relapse can better be thought of as protecting your recovery. Similar to other chronic illnesses, it is important to participate in all aftercare recommendations from your doctors and clinicians, regularly attend community-based recovery support services and activities, and to have a peer network of support. For many individuals, preventing relapse is a combination of effective coping skills (dealing with life as it is, rather than how you wish it were) and increasing human capital—things like gainful employment, increased education, safe and affordable housing, and access to peer recovery supports.
Can Medications Help Prevent Relapse?
Research conducting by NIDA has shown that many medications can help to decrease cravings and reduce the chances of a relapse occurring. Medications such as naltrexone, methadone, buprenorphine, and others have been developed that work in partnership with behavioral therapy to give greater chances of recovery success. Any medications used to prevent relapse or in treating your substance use disorder should only be used under the direction and administration of a medical professional.
What To Do If A Relapse Happens
With relapse rates for substance use disorders being 40-60%, many individuals starting the recovery process will experience a reoccurrence of use at some point. It is crucial to understand that this is not a failure—imagine if we were to place blame on someone with hypertension or diabetes that a reoccurrence of their symptoms was their own fault. If a relapse does occur, it should be seen as evidence that additional treatment or community-based recovery support should be added to your recovery process. Reaching out to your treatment provider or medical practitioner should be your first step after experiencing a relapse.
Dangers Of Overdose
One of the primary factors for overdose deaths is a relapse after a period of stopping opioid use. With the rise in synthetic opioids becoming available in the U.S., having access to overdose reversal medications such as Narcan/naloxone is a good practice to engage in. Tolerance decreases rapidly after stopping substance use, and if a relapse does occur, many individuals believe they can safely use the same amount as they previously were, which is often not the case.
Whether a relapse happens in your recovery or not, it has no bearing on whether you have been successful or not. Recovery is a multi-faceted process as is the treatment of an addiction. If you do experience a relapse, reach out for the help you need to get back on track.
National Institute on Drug Abuse. “The Science of Addiction”. July 2014. January 2 2017. https://www.drugabuse.gov/publications/drugs-brains-behavior-science-addiction/treatment-recovery
National Institute on Drug Abuse. “What is relapse?”. February 2013. January 2 2017. https://easyread.drugabuse.gov/content/what-relapse