Author: Claire Godden
Addiction in itself is a chronic brain disease and anyone who is attempting sobriety is at risk for relapse. But what makes some of us stay in recovery while others relapse over and over again? The cycle that is chronic relapse happens for a variety of reasons and can mean that the underlying causes of addiction have either not been fully addressed or treatment needs repeating in order to work properly.
Recovery is a lifelong commitment and relapse is a common and expected part of the process for some. It’s important to remember that chronic relapse does not mean that time in treatment has been wasted. It does not mean that the addict is a failure. It just means that treatments must be repeated or modified in some way to better focus on the triggers that keep leading to relapse.
Reasons for chronic relapse are often the same ones that led the person to addiction in the first place. Issues such as stress, anxiety, boredom, depression, traumatic experiences, and co-occurring mental health disorders must be addressed fully for the individual to have a solid chance at long-term recovery. Chronic relapse is also seen more often when there is a higher level of dependence on the drug and when withdrawal symptoms are worse.
Addiction treatment must also be a two-way street. The more you fully engage in the various therapies and work hard to follow your prescribed plan of action, the better chance you have of staying sober. Clients must stay in treatment as recommended by their team of therapists. Failure to stay in the program for the duration leads to a greatly increased risk of relapse. Also, if you are not honest with yourself or with your therapist, important factors that lead to the initial addiction and now the relapse, will be left untreated.
In order to brave the world without the use of drugs or alcohol, new life and coping skills should have been acquired during treatment. A good treatment program will help the individual gain valuable tools for dealing with the things that drugs previously allowed them to avoid. Patience, hope and belief that it can be done are key when you are learning how to live every hour of every day in a new way. Home and work life, social life, and relationships with family and friends must all be addressed and assessed. Reactive behaviors have to be recognized and managed and new, constructive, hobbies and pastimes may be introduced or reignited. Substance use and abuse has been part of your everyday life and to suddenly stop, means you must consistently replace the destructive activities with others that are positive and productive.
There are signs one can watch for that indicate relapse may be on the horizon. Some of these signs are feeling more depressed or anxious, having trouble sleeping, beginning to avoid people, and no longer actively working to stay healthy and engaged in life. If you feel you are heading for a relapse, reach out to your support system whether it’s a trusted family member, your sponsor or your therapist. If cravings are imminent, remove yourself from the people or from the place that is triggering the cravings and make yourself wait it out. Some say 10 – 15 minutes is enough for cravings to go away. Others will say it could take 1 – 2 hours for them to subside. When you begin to recognize that you may relapse, you must think about the behaviors that got you into treatment in the first place. You must look at everything you’ve gained while sober. If you “slip” – an unintended one-time use of a drug or alcohol – you can see it as disastrous and fall back into full-blown addiction because of the guilt and shame of it all or you can view it as a powerful learning opportunity.
Cognitive Behavioral Therapy (CBT) can be incredibly helpful throughout the entire recovery process and is used to combat negative and distorted thoughts. It can be particularly useful if you slip and begin, for example, thinking about how you “failed” and about what you should or shouldn’t have done to avoid it. This negative thinking will only keep you in that moment replaying your mistake in your mind. You cannot move forward and learn from what you did if you don’t change your thinking. You must look at and analyze what you did it to learn from it but then also look at all you have achieved so far during treatment and all the good things that have happened while you have been sober. Focusing on the positive and the gains you have made is far more beneficial to you than sinking into despair when you experience a slip in your sobriety.
Some key factors to sustaining sobriety and preventing chronic relapse are:
• Support – from your sponsor and other positive peers, family or friends – particularly in the early stages of recovery.
• Hope and belief – the brain can adapt and re-adapt but you have to allow plenty of time for it to do so.
• Learning and maintaining new strategies for everyday life.
• Learning and maintaining new strategies for what to do and how to cope when the unexpected happens.
• Staying motivated – again, support from another person or group may be particularly helpful here.
• Continuing therapy for the addiction and/or continuing other treatments for any
• Staying fit and healthy – looking and feeling good lifts our mood.
• Avoidance of certain people and situations/places.
• Getting organized and keeping busy – fill your life with healthy activities and hobbies.
• Not getting too comfortable with your recovery status – just like driving, stay alert to the dangers.
• Staying connected – stay in regular contact, including regular face-to-face contact where possible, with people who are committed to supporting you long-term and who are positive influences.
One of our primary therapists here at Thrive Treatment, Samantha Levy, says that connections and community are what keep us healthy and whole human beings. She says relapse happens when we slip away from ourselves, from our program, from our people. It happens when we stop talking about what’s not working and stop doing what is. Samantha says you cannot get and stay sober unless you have the will and the want. Fear gets in the way of us believing in ourselves, in something better. It’s easy to stay where we are and in what we know. It’s challenging to take a leap into something new and strange. It is 100% scary. If you stick through it, the bad stuff ends and you will find that there is light on the on the other side. You just have to keep going. She says that sometimes we don’t hold on long enough and that’s where relapse happens – before we’ve had the opportunity to see the light. Time can lead us into a false sense of security where we forget the bad things
Our Clinical Director, David Pavia, says this about chronic relapse:
I don’t think there are any shortcuts in life or sobriety. Confronting yourself is the key. Being willing to be accountable to others is also a big factor. Living in an environment that demands that is a great start. The hardest thing to figure out is whether you will be able to get that out of meetings and sponsor commitments alone or if you need more structure and peer accountability. Individual and group therapy is also a very good idea and all of these things work best together for many reasons. Twelve-step groups, sponsorship, psychotherapy, sober living. are all best done early on in sobriety if you want to give yourself the best chance at staying sober and reaching your best self.
Above all, stay optimistic and hopeful.
What lies behind us and what lies before us are tiny matters compared to what lies within us – Ralph Waldo Emerson