Relapse refers to returning to a former maladaptive state. In terms of drug and alcohol recovery, relapse proneness is high, depending on severity of substance use, duration and level of treatment implemented toward recovery. According to the National Institute on Drug Abuse, high relapse rates result from deeply embedded behaviors as well as physiological factors. In comparison to chronic medical condition relapse, substance relapse is similar, with rates as high as 60 percent for most in early recovery. Relapse is an indication that continued interventions and treatment are necessary for longer-term success.
Physiology and Craving
According to the National Institute on Alcohol Abuse and Alcoholism, cravings are physiologically associated with relapse in substance users with severe dependency. The Institute notes that a strong relationship between exposure to the substance induces physiological response such as salivating and increased heart rate. Narconon California further explains that over time, chronic drug use causes the body to store traces of the substance in fatty tissue, known as metabolites. In the event of a trigger activating a craving, heart rate increases to induce a veritable fat burning mode. Consequently, the trace substances are activated and released into the bloodstream, then the brain, which induces drug seeking behavior. Essentially, cravings have a biochemical nature and when the recovering person is unaware of this possibility, he may act to satisfying the urge to use the substance.
Recovery Stress
Recovery is rewarding over time, yet challenging for many because it is not necessarily easy to stay sober and deal with life on sober terms. TLC Recovery explains that a process called post-acute withdrawal comprises a grouping of symptoms resultant from damage to the nervous system caused by drug use. Post-acute withdrawal begins after seven days of abstinence and can continue for years. Symptoms include memory problems, emotional overreactions and stress sensitivity. The symptoms can trigger at any time, and for individuals not in a recovery program and unaware of symptoms, relapse can mean a temporary relief from the stress of living sober. In the event of high stress situations, individuals experiencing post acute withdrawal tend to overreact and also have increased bouts of distraction, impaired thinking and physical coordination problems. Post-acute withdrawal does not occur for all people in recovery, however it is significant and can be addressed in a treatment setting.
Stopping What Works
The Addiction Web Site of Terence T. Gorski explains that most people experiencing relapse do so because of stopping the efforts that allowed achievement initially in recovery. This includes stopping the support meetings, reminiscing about good times of past with substance use and believing that nothing can relieve the pain or stress of daily life like the using the substance again. Changes in thinking, feeling and actions taken toward recovery shift completely and cause relapse. For some, the shift happens when vulnerability occurs, such as significant loss, ongoing rejection or due to repeated craving exposure.
References
- Addiction Web Site of Terence T. Gorski: Levels of Relapse Warning Signs
- TLC Recovery: Post Acute Withdrawal
- National Institute on Alcohol Abuse and Alcoholism: Relapse and Craving
- Narcanon California: What Causes a Relapse
- National Institute on Drug Abuse: Does Relapse To Drug Abuse Mean Treatment Has Failed?
