What is Substance Abuse Relapse?
Substance abuse relapse is the return to the abuse of alcohol or drugs after a period of sobriety. The length of the period of sobriety does not matter because addiction is a chronic illness characterized by periods of relapse and remission.
Drug addiction is a complex disease of the brain that is characterized by compulsive, powerful, often uncontrollable, drug use and abuse even in the face of negative consequences.
- Addiction is a primary, chronic disease of brain reward, motivation, memory, and related circuitry. Dysfunction in these circuits leads to characteristic biological, psychological, social, and spiritual manifestations. This is reflected in the individual pursuing reward and/or relief by substance use and other behaviors.
- Addiction is characterized by impairment in behavioral control, craving, inability to consistently abstain, and diminished recognition of significant problems with one’s behaviors and interpersonal relationships.
- Like other chronic diseases, addiction involves cycles of relapse and remission. Without treatment or engagement in recovery activities, addiction is progressive and can result in disability or premature death.
- Many people take drugs to escape physical and emotional discomfort. It’s a short-term fix to a long term problem.
The Relapse Process:
The process of relapse generally begins days or even weeks before the actual event and can be broken down into three separate stages, according to Terence Gorski in his works Counseling for Relapse Prevention and Staying Sober: A Guide for Relapse Prevention.
1. Emotional Relapse/Post-Acute Withdrawal - During this period, there are no active thoughts of substance abuse, but certain behaviors and emotions are creating a space wherein relapse is likely. These are:
- Mood Swings
- Isolation/Not asking for help
- Poor eating habits
Being aware of these triggers and recognizing them can be crucial to preventing relapse. If these aren’t dealt with, a person can become so exhausted and frustrated that they begin to slip into mental relapse.
2. Mental Relapse - In this stage, active thoughts of substance abuse are present, and a mental tug of war begins. Because part of the person does not want to relapse, the other part begins to justify doing so. Some signs of this war include:
- Romanticizing the past and viewing addiction through rose-colored glasses
- Spending time with the same people you used drugs/alcohol with in the past
- Fantasizing about using
- Planning to relapse/thinking about using constantly
- Justification: “One drink won’t hurt anything,” etc.
3. Physical Relapse - Actually using again.
Warning Signs of Drug Abuse/Substance Abuse Relapse:
Behavioral Warning Signs of Drug Abuse:
- Decreased work/school attendance and performance
- Unexplained need for money
- Financial issues
- Getting into trouble
- Sudden change in friends, hangouts, and hobbies
- Secretive and suspicious behavior
Psychological Signs of Drug Abuse:
- Unexplained mood swings
- Sudden change in personality
- Irritable and agitated for no good reason
- Lack of motivation
- Periods of intense hyperactivity
- Paranoid without reason
Physical Signs of Drug Abuse:
- Bloodshot eyes
- Pupils that are larger (or smaller) than normal
- Changes in appetite and sleep schedule
- Tremors, slurred speech
- Impaired coordination
- Unusual smells from body, clothes, or breath
Treatment of Substance Abuse:
Addiction is a treatable chronic disease and can be managed successfully.
The best combination for successful treatment of addiction is to combine medications with behavioral therapy. The treatment plan must be designed specifically for each person's drug abuse patterns and any existing mental illnesses.
Good outcomes require adequate treatment lengths.
A solid support structure is imperative and can be found in family, friends, therapists, other people in recovery and people in the faith community.
What To Do When a Loved One Has a Drug Problem:
Avoid blaming yourself. It’s not your fault and you cannot force someone else to change.
Remember to take care of yourself. You can’t get so caught up in someone else’s problems that you neglect yourself.
Speak up. Don’t watch from afar. Confront the addict with your fears and concerns and specific examples of behavior.
What NOT To Do When a Loved One Has a Drug Problem:
Don’t be a martyr. Avoid emotional appeals that may further push the addict to use.
Don’t bribe, threaten, punish, or preach.
Don’t take over their responsibilities and eliminate their sense of self-worth.
Don’t make excuses for their behavior or fix the consequences of their choices.
Don’t hide or throw out their drugs.
Don’t take drugs with the user.
Don’t argue with the user when they are high.
Try not to feel guilty or responsible for their behavior.
Substance Abuse Relapse Resources:
Addictionsandrecovery.org: a public service website from Dr. Steven M. Melemis with information about addiction and recovery that provides links to resources about treatment.
SoberRecovery.com: an extensive website that has links to addiction treatment and recovery resources in the US, Canada, and overseas.
The Good Drugs Guide provides an informational page on Addiction Prevention and Aftercare.
Substance Abuse Treatment Program Locator: state-by-state locator of drug and alcohol treatment facilities.
Principles of Drug Addiction Treatment – a FAQ index from the National Institute on Drug Abuse
Al-Anon/Ala-Teen: a family support group.
Narcotics Anonymous: an international, community-based association of recovering drug addicts with more than 58,000 weekly meetings in 131 countries worldwide.
Alcoholics Anonymous: a recovery and support group for those with drinking problems.
Narcotics Anonymous Family Group: a family support group.
Cocaine Anonymous: a recovery and support group for those addicted to cocaine.
Marijuana Anonymous: a recovery and support group for those addicted to marijuana.
Crystal Meth Anonymous: a recovery and support group for those addicted to crystal meth.