Relapse

Stinkin' Thinkin': The Mistakes of Relapse and the Lessons of Recovery

If someone has to a personal history of alcoholism, illicit drug addiction, or prescription medication misuse, can that history serve them as they move forward on their sober journey?

The answer is unequivocally “YES”.

In fact, not only CAN the past be an excellent teacher, for someone in recovery, it MUST be.  Everything up to this point –the failures, the missteps, the losses, and the regrets -are an invaluable personal resource that can help support a successful and lasting recovery.

Because just as the quote implies, the converse is also true. Anyone who forgets how addiction brought them to their lowest point or who doesn’t learn from their mistakes are bound to repeat them again and again. And that means failed recovery.

But to find out exactly how and what can be learned from a personal history of an active addiction, we must first take a closer look at relapse – the OPPOSITE of learning.

First Things First – What Is Relapse?

A “relapse” is when a person in recovery returns to actively using alcohol and drugs. More than that, they abandon their efforts at sobriety and go back to dysfunctional, addiction-driven behaviors.

A relapse is more serious than a “slip”, which is when the person briefly uses intoxicants again, quickly realizes their mistake, and then almost immediately resumes their recovery program.  Usually, a slip has very little lasting impact on the person’s life.

But a relapse lasts longer -weeks, months, years, or even permanently.  As a result, the consequences and impact are far worse.

In her book, Trust the Process: How to Enhance Recovery and Prevent Relapse, Linda Free-Gardiner made an excellent point – “One very important fact…you can’t relapse in any disease until you’ve been in recovery from it. This is the truth in any illness. If someone has not yet got into the recovery process, they CANNOT have a relapse.”

If recovery can be understood as learning about the disease of addiction and consciously taking the necessary steps to address the illness, then relapse can be viewed as failing to retain what was learned.

To that end, here are some of the most common mistakes that people in recovery make that can contribute to a slip or relapse, along with the lessons that should be remembered.

Mistake #1 -Thinking That Addiction Is A Choice

Too many people – including struggling alcoholics and addicts -are under the mistaken impression that addiction is somehow a choice. They feel that if a substance abuser really wanted to get better, they would just use their willpower. And when they can’t, it’s because they are selfish or morally weak.

This is a mistake because it causes the person to feel unnecessary guilt and shame at their supposed weaknesses.  These painful negative emotions can push a person back to active use.

Lesson -Addiction Is A Disease

Addiction – properly called Substance Use Disorder -is defined as a “chronic and relapsing brain disease ” by the National Institute on Drug Abuse.  It is a medically-diagnosable illness with recognizable symptoms and established treatment protocols.

Chronic substance abuse causes neurochemical changes within the person’s brain, affecting a number of processes:

  • Cognitive
  • Higher reasoning
  • Impulse control
  • Pleasure
  • Reward
  • Learning
  • Motivation
  • Memory

While initially, the person chooses to drink or use drugs in order to feel good, once these changes occur, they are compelled by their substance-dependent brain to drink/use to keep from feeling bad.

Choice is no longer an option.

And once the person understands this, they will shed themselves of the burdensome guilt and shame that may be holding them back.

Mistake #2 – Thinking Detox is Enough

Many people who are new to recovery think that all they have to do is stop using and drinking and everything will be all right.  They are under the wrong impression that after a few days of detox, the hard part is over.

This is a mistake because it leaves the person unprepared for the hard work ahead.

Lesson -Detox is Not Recovery

But SUD is more complicated than that.

A person whose addiction-driven behaviors led to dysfunctional bad habits doesn’t magically and immediately return to mental and physical health just because they’re currently substance-free. Yes, a person must be free of the physical compulsion to drink/use before they can move forward in recovery, but that is merely a prerequisite to treatment.

The REAL work is just beginning.

Where once the person’s life revolved around chasing the next buzz or high, now they need to learn how to live without intoxicants.  And learning healthier habits will take dedicated effort, time, and a commitment to making the lifestyle changes that support sobriety.

Mistake #3 -Trying to Recover Alone

Many people who want to get clean and sober think that their recovery is completely up to them.  After all, they think, they got themselves into this mess, so it is their sole responsibility to get themselves out of it.

This is a mistake because SUD is bigger than any one person.  Anyone trying to overcome their addiction on their own will find that their personal resources as an individual are almost always inadequate.

Lesson – Recovery Requires Help and Support

Here’s the good news – now, more than ever before, people struggling with addictive disorders have a great deal of resources available to them.  Anyone in an evidence-based rehab program will work with counselors, doctors, and addiction recovery specialists who provide numerous treatment services, including:

  • Individual psychological counseling
  • Peer group therapy
  • Behavior modification
  • Medication assistance
  • Treatment for co-occurring mental illness
  • Nutritional guidance
  • Stress reduction
  • Coping skills
  • Improving communication
  • Couples and family counseling
  • Relapse prevention and response

Mistake #4 – Fighting Cravings and Withdrawal with Willpower

People trying to quit drugs and alcohol on their own usually try to go “cold turkey” – abruptly stopping all use. That’s a mistake for two very important reasons:

FIRST, the extreme drug cravings and painfully uncomfortable withdrawal symptoms can be so severe as to push the person right back into active use.

SECOND, withdrawal from some substances -namely, alcohol or benzodiazepine tranquilizers -can actually be dangerous.  In fact, alcohol or benzo withdrawal can be fatal if not medically-supervised.

Lesson – Medication Assistance Works

But there are FDA-approved medications that can reduce or even totally eliminate drug cravings for most addictive substances.  Other medications can ease symptoms of withdrawal, allowing the person to focus on the other positive messages presented during recovery.

Right now, the “gold standard” of addiction treatment is the combination education, psychological counseling, and anti-craving medication.  Meditation-assisted Treatment allows up to 70% of patients to remain successfully abstinent for at least a year.

Mistake #5 -Thinking that Relapse Happens to Other People

Too often, people began their sober journey with no conception of how to prevent a relapse into active substance use.  They erroneously believe that they can handle everything that their disease will throw at them, and that relapses only happens to other “weaker” people.

That’s a mistake, because relapse is a real possibility for EVERYONE in recovery, and underestimating that reality is a recipe for disaster.

Lesson -Relapse Happens to Most People in Recovery

In fact, relapse is more than a possibility—it’s an unfortunate probability.

According to a 2012 article in Psychology Today, up to 90% of people in addiction recovery will suffer “at least one mild to moderate slip.”

The drug of choice matters a great deal, in terms of the relapse rates.

  • Hallucinogens – 42%
  • Marijuana – 43%
  • Methamphetamine – 52%
  • Cocaine – 62%
  • Alcohol – 68%
  • Heroin – 78%

The reality of relapse means that people in recovery should take their illness all the more seriously and work their program as closely as they can.

Mistake #6 -Believing That Relapse is Inevitable

Alternately, some people are nonchalant about relapse, because they believe that relapse ALWAYS happens. They may even ascribe to a misleading slogan – “Relapse is part of recovery.”

But that is a dangerous assumption, because it basically gives tacit approval to use or drink again, almost as if it is to be expected.

Lesson – Relapse is NOT Part of Recovery

Relapse is not permissible, and anyone trying to recover needs to do whatever it takes to avoid resuming substance use. To be clear, relapse is not part of recovery, it is part of the DISEASE.

There are no guarantees that a full-blown relapse won’t be tragically permanent, because overdose rates in America continue to skyrocket. In 2017 alone, overdoses took the lives of over 72,000 people in this country.

Mistake #7 -Failing to Plan

This is one of the biggest mistakes made by people in an inadequate recovery program is failing to spell out in detail what steps they are going to take to prevent relapse and successfully regain their sobriety.  In other words, they are trying to take a difficult sober journey without a roadmap to their destination.

Lesson -Create A Relapse Prevention Plan

A relapse prevention plan is simply a set of instructions to one’s self, listing the daily and as-needed actions that can be taken to avoid a return to active substance use.  It can be simple – just a couple of pages—or it can be a detailed step-by-step guide.

A good relapse prevention plan might include how to:

  • Avoid triggers
  • Manage cravings and temptation
  • Deal with stress
  • Improve life affected by addiction
  • Practice daily recovery exercises

To use the roadmap analogy again, a sober plan keeps someone on the right path and moving in the right direction.

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