People in early addiction recovery are like ticking time bombs – relapse is often just one stressor away. For many, the holiday season is that stressor. Family conflict erupts. Reality falls short of their expectations. Stress builds. Then, friends, coworkers and family members, even those who don’t ordinarily drink, throw parties or host gatherings where alcohol is readily available. This is a powerful physical and psychological trigger for anyone in early recovery, prompting intense cravings that can feel impossible to resist.
Thanks to scientific research, we have a number of highly effective strategies for reducing the risk of relapse. Unfortunately, some of the most effective approaches are also the least utilized. Here are four relapse prevention tools that can help recovering addicts, especially those with a history of relapse, stay sober over the holidays and beyond:
#1 Integrated Treatment for Underlying Mental Health Disorders
Roughly half of individuals who struggle with drug addiction also have other addictions or mental health disorders. Because appropriate dual diagnosis treatment can be difficult to find, many people end up choosing a therapist or drug rehab that focuses exclusively on substance abuse – or, more likely, pays lip service to treating dual disorders but lacks the staff and resources needed to treat these intricately intertwined issues. Without addressing both the underlying issues (mental health disorders) and the symptom (drug abuse) at the same time, relapse rates are significantly higher.
#2 Long-Term Treatment
There is a widespread misconception that drug rehab is a “cure” for addiction. In reality, residential treatment sets the foundation for the lifelong process that is recovery. Addiction is a chronic, relapsing disease that requires support groups, therapy, outpatient treatment or a sober living home, preferably for at least one year following rehab. Just as other chronic diseases such as diabetes and heart disease require ongoing care and management, studies have shown that the risk of drug relapse is greatly reduced with long-term treatment.
#3 Anti-Craving Medications
A number of non-addictive medications have proven safe and effective in clinical studies to reduce the physical and psychological cravings that often lead to relapse. Naltrexone, which is prescribed as a pill or injection for individuals with a history of alcoholism or opioid abuse, blocks the “high” that these drugs produce. Acamprosate is another medication for alcoholism that not only helps to prevent relapse by decreasing the desire to drink, but also helps the brain to begin functioning normally again.
These medications, among others, provide a type of second immunity: If individuals do relapse, they are more likely to control their drinking or drug use, implement the skills they learned in rehab, and quickly get back into their recovery program. They also help people feel better so that they are able to focus and fully participate in treatment.
Despite compelling evidence that these medications support abstinence and reduce the risk of relapse, many treatment providers overlook the value of using these medications to aid in early recovery. Particularly when individuals have a history of chronic relapse, treatment providers may immediately prescribe Suboxone on a long-term maintenance basis before exploring other options. Although it can be extremely useful during detox and as a maintenance medication in certain cases, Suboxone can be habit-forming. Rather than resolving issues it has the potential to create new ones, leaving users with the need to recover from addictions to two drugs rather than just one.
#4 Get Hands-On Practice Developing New Skills
For people who are prone to relapse, conventional advice – for example, to avoid people, places and things that remind them of drugs or alcohol and cut ties with friends who continue to drink or use – can seem impossible to follow without developing new skills. Any measure of success at work or school requires the ability to manage emotional responses, particularly frustration and anger. In preparation for life in recovery, people also need to be able to ask for help and respond to requests for service – again, without getting overwhelmed or frustrated.
Many drug rehab programs teach these communication and emotion regulation skills through educational videos and lectures. While education is important, many people, especially those with a history of relapse, need a more hands-on approach that also includes experiential therapies, interactive teaching methods and personalized relapse prevention plans. These approaches allow recovering addicts to not only learn new skills, but to begin putting them to use in a safe, supportive setting.
If you’ve been through treatment before and relapsed, you are not alone. Relapse is not a failure, but rather an anticipated part of the recovery process. Prolonged drug use alters the structure and function of the brain, leaving addicts vulnerable to relapse after months and even years of abstinence.
Still, relapse is not inevitable, and those who have relapsed multiple times are not doomed to suffer for life. For some people, putting an end to the rehab-relapse cycle requires a different approach – one that is comprehensive, long-term, interactive and draws upon every available resource to fight relapse.
David Sack, M.D., is board certified in addiction medicine and addiction psychiatry. He is the CEO of Elements Behavioral Health and oversees such treatment programs as Promises Treatment Centers, the new luxury Florida rehab Lucida Treatment Center, and Right Step in Texas. David is a sought-after expert who often appears in the major media.
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Last reviewed: 23 Dec 2013