01-12-15 Relapse is part of recovery, or is it? Posted in Addiction Treatment, Mental Health

Written by Eileen Spatz

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For the past few decades, addiction treatment stints are usually completed with discharge papers that include one explaining that relapse should be expected and is a normal part of the recovery process. In fact, about 80 percent of alcoholics who have completed a residential program do, in fact, relapse within the year.

Within the treatment industry, relapse is a common occurrence that is often followed by re-admittance of the addict into a treatment program. Because addiction often begins as a result of compulsive behaviors that ultimately rewire the brain, to undo this programming is not akin to flipping the switch to “off.” Overcoming addictive behaviors is an ongoing effort as the person battling the addiction works on avoiding triggers, engaging in cognitive behavioral therapy, participation in a 12-step program, finding new hobbies and interests to replace ones associated with the substance abusing days, and, of course, abstaining from using the addicting substance. All of these activities help to build the recovering addict or alcoholic’s disaster preparedness kit.

There are two schools of thought on the subject of relapse following treatment for addiction. The most popular is the “relapse is part of recovery” approach. Coined the more rational mindset, this allows the recovering addict the benefit of not thinking themselves a total failure if they slip up and fall off the wagon. If relapse is part of the journey of recovery, the alcoholic or addict knows they can climb back up on the wagon and continue on, hopefully learning important lessons as a result of the relapse event.

A relapse, if expected, can be avoided with careful planning and a strong support system. But the planning must be proactive, not passive. A list of possible triggers that sits inside a drawer won’t cut it. Relapse avoidance involves an active role, constantly reassessing the emotional

landscape, avoidance of stress triggers, repairing or eliminating dysfunctional relationships, and active participation in a program that includes strong sponsorship and fellowship. Being involved in volunteer work is also an effective tool in the relapse prevention toolbox because rewiring the brain takes a very long time. Habits are difficult to break, and saying goodbye to friendships that pose a risk to sobriety is often painful. And the sad fact is the brain changes that resulted from addiction are stubborn, and may pose a threat to a sustained recovery for decades. How many times do we hear of someone, such as Phillip Seymour Hoffman, who relapsed and died after 20 years of sobriety? These all too common occurrences buttress the concept of addiction as a lifelong, chronic disease, and that an addict is never fully recovered.

However, there is an opposing view of the significance of relapse in the big picture of addiction treatment and recovery. This viewpoint is based on the abstinence-only model is now considered dated in the mental health and addiction treatment fields. Advocates still forward their often salient points in support of this black or white theory.

In a white paper authored by William L. White in 2010, he offers his thoughts supporting an abstinence-only view. For instance, the phrase, “relapse is part of recovery,” he suggests, “blurs the distinction between pathology and health. Marrying relapse and recovery attaches unwarranted value and nobility to the resumption of drug use and its inevitable consequences.” He continues, “The resumption of drug use by someone with a history of addiction is part of the addiction process—in fact, such persistent use is part of the defining criteria of addiction, not part of the process of getting well.”

Other criticisms of the relapse as part of recovery mindset are based on

simple psychology. The human being will often take the path of least resistance. Accepting that relapse is to be expected gives the addict or alcoholic a subliminal justification to return to the addictive substance. As a result, their life or other innocent lives could be lost or hurt. For instance, what if the resumed use of the substance resulted in suicide or a car accident?

By setting the recovery bar low, it dismisses the efforts and successes of those who have managed to quit the abusive behaviors following treatment and could, instead, become a self-fulfilling prophecy, according to White.

Maybe recovery exists on a continuum that is as diverse as the people in a typical AA meeting. Maybe a certain percentage can and do achieve permanent sobriety, for whatever reasons—their addiction wasn’t so severe, they have a loving, supportive family, they work the steps and adhere closely to the tenets of the program. Others may fall down a few times, but each relapse may become less severe and shorter in length as they learn important lessons each time, and eventually they remain sober. Sadly, others may never attain abstinence and become yet another statistic.

Relapse is common. Maybe there can be a revamping of the phrase “relapse is part of recovery” to “relapse may be an unfortunate occurrence during recovery, but should actively be avoided at all costs.”

Sovereign Health Group is a nationwide residential treatment program for substance or mental health disorders, focusing on dual diagnosis. For more information on addiction and recovery call 866-269-2493.