Addiction Relapse Prevention

Addiction relapse prevention plan

Relapse prevention plan

What is relapse? It’s not drinking or using again after a short break to catch your breath. Most people misuse the word relapse. If a person stops using drugs for a short period then starts again with no recovery efforts or improvement in between – that’s just a continuation of addiction. All people with an alcohol or other drug addiction stop for short periods of time — the human body breaks down with uninterrupted use, so there are brief intervals in which the alcoholic or drug addict has to stop for a short period. Relapse is using drugs or drinking again after a period of improvement.

Addiction relapse is also considered a return to heavy, destructive, addictive use. If a person has had a period of improvement and drinks one beer, then realizes that this is crazy, calls someone and gets back into a recovery program, this is a lapse. This is from Everyday Health:

Addiction relapse is generally considered to be the return to substance use after a period of abstinence. However, according to James Garbutt, MD, professor of psychiatry at the University of North Carolina in Chapel Hill and a researcher at the Bowles Center for Alcohol Studies, “Relapse has different definitions. Some would say that it is a return to any amount of substance use, while others would say it is a return to heavy use. The medical profession states that a relapse is a return to destructive or heavier use.”

It’s an important distinction: If you drink one beer on one occasion, you have had a lapse. But if you are abusing regularly or your alcohol or drug abuse is causing negative consequences in any area of your life, you are having a relapse and need professional help.

I would only nitpick the word “abstinence” and substitute “a period of recovery and improvement”. I’m sure the author meant a period of improvement when writing abstinence. In treatment we focus on addiction relapse prevention through Recovery Management. Relapse triggers must be identified and dealt with. It’s not the end of the world if a person in recovery has a lapse or a relapse, but if the person relapses, there’s no guarantee that a return to recovery in imminent. Many people in recovery who relapse never make it back to recovery. It’s best to stay in recovery if you’re in recovery.

Terence Gorski has been one of the foremost authorities on relapse prevention. Go here to learn how to develop a relapse prevention plan – http://www.tgorski.com/gorski_articles/developing_a_relapse_prevention_plan.htm.

 

Outpatient Addiction Treatment

relapse preventionSo, what’s the purpose of outpatient addiction treatment? There are several aspects to addiction treatment, and it’s important to understand the transitional phases. In the beginning, the main goal of treatment is to assess and stabilize. If the assessment shows outpatient treatment is appropriate, then the person is medically assessed to make sure there are no physical complications. Addiction presents itself as an acute, immediate problem, characterized by loss of control, legal problems, relationship problems, financial problems, employment problems, physical problems, emotional problems, etc. Not everyone coming into treatment is dealing with problems in all these areas, but they have problems associated with drug use. When I write “drug use”, I also mean alcohol, which is simply a legal drug, even though it causes more problems, collectively, than any other drug.

Although treatment professionals are presented with symptoms of addiction in the beginning, after a period of assessment and stabilization, treatment shifts to a different client/therapist relationship, an educational/therapy phase. Outpatient treatment doesn’t have the luxury of inpatient treatment where the patients are a captured audience. Outpatient clients go home after group, so it’s important to educate the client on abstinence skills from the beginning. Relapse prevention education should start immediately in outpatient. Once the client enters group, there’s a dual approach of group therapy and education. The client is taught that they are responsible for their recovery, although they don’t have to do it alone — there’s support available. Recovery support can come from different sources: family, employer, 12 Step groups, churches, etc. Clients in addiction outpatient treatment are encouraged to develop relapse prevention plans that best suit them and their situations. Not everyone has a supportive boss, or a job, and not everyone goes to church, and not everyone has a supportive family — so the individual works with the counselor to develop a realistic recovery plan.

As outpatient treatment comes to an end, the client should understand by this point that recovery is a long term process. When the client came into treatment, they presented with an acute, emergency situation with lots of symptoms, but the client learned addiction is a chronic and progressive condition that will only get worse if they don’t manage their recovery long term. Treatment is the difference between dealing with symptomatic problems with symptomatic solutions and dealing with fundamental problems with fundamental solutions. Although outpatient addiction treatment programs deal with symptoms in the stabilization phase, treatment is about applying fundamental solutions to fundamental problems. Too many people deal with the symptoms of addiction and never address the fundamental problems.