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Relapse PreventionWhat is a relapse?An alcoholic or a drug addict who ceases to use substances and then begins again is considered to be relapsing. Stated differently, it is the return to using drugs and alcohol, or other behaviors after a period of abstinence. There are many factors that combine to increase the likelihood of a person’s relapse. Those include self- reliance, lack of coping mechanisms, high risk situations and other physical or emotional symptoms that can be difficult to manage. Once a relapse has occurred, the user generally feels guilt and shame, and perhaps self-recrimination that can cause him or her to continue use. If you feel at risk, share the problem with your support group and/or seek professional help immediately. The inability to cope with positive or negative feelings is problematic. For the addict and alcoholic, emotional discomfort needs to be managed. What is relapse prevention therapy?Relapse prevention (RPT) is a broad term that describes a number of different strategies and/or therapies used to help the alcoholic or drug addict cope with the stressors of daily life without picking up a drink or a drug. These RPT programs help patients identify high risk situations, and provide them with the tools to cope with physical and emotional anxiety that comes with life experiences. Relapse prevention programs dispel myths about drugs and alcohol, teach clients about the process of relapse, the warning signs of relapse. These programs should also offer family counseling, group and individual counseling and help develop of context for healthy lifestyle behavior such as exercise and good nutritional planning, as well as the value in following an aftercare plan. Every aspect of a patient’s life needs to be addressed in relapse prevention, and strategic plans made for life’s daily challenges. Such work helps the patient gain confidence and a sense of personal control while reducing the chances of relapse. According to Marlatt and Gordon, two pioneers in relapse prevention treatment, high risk situations, lack of coping skills, unrealistic outcome expectancies, lifestyle factors, urges and cravings all contribute to a person’s relapse. A person’s ability to cope with these factors will be based upon his or her knowledge about relapse, self-awarenss, capacity to handle triggers and utilize a support system. RPT enables clients to change habits. It:
Terence Gorski, another pioneer in treatment, divides RPT into a series of steps: Stabilization, Assessment, Relapse Education, and Warning Sign Identification. Patients must continue medication if prescribed, maintain abstinence, continue therapy, build healthy support network, go to 12 step meetings, accept personal responsibility, work on positive communication skills, initiate positive self-talk, and set reasonable goals and measurement of progress to combat the path toward relapse. THE RELAPSE SYNDROME INTERNAL
EXTERNAL
The realities of living life after years of drugging and drinking can be overwhelming. A person may be confronting issues for the first time that may make sobriety feel uncomfortable. Symptoms following treatment can manifest in physical and emotional experiences. Often times, these symptoms were previously undiagnosed. For example, a person may suffer from sound sensitivities, or other stimulus sensitivities (often a sign of ADHD). These sensitivities can be uncomfortable. But, the patient must be willing to share about them with a medical professional so that appropriate steps can be taken to lessen their impact upon a patient’s recovery. Merlene and David Miller, co- researchers and authors with Gorski have explored the “post withdrawal syndrome”. These are the physical and emotional responses that have already been mentioned. They are strong proponents for alternative therapies that, in conjunction with traditional relapse prevention treatment, can help bring normal chemical balance back to the brain. They have done extensive research using amino acid therapy. Many of the amino acids used, such as L-trytophan, L-Glutamine, B vitamins, L-Taurine to name only a few may help replete the neurotransmitters in the brain. Once these neurotransmitters are balanced and functioning many of the symptoms of post withdrawal syndrome will disappear. It should noted that the amino acid therapy is only used as a supplement to a healthy diet. It is not advisable to go to a local drug store and buy every kind of amino acid available. It is advisable to follow a healthy, balanced diet of fresh, not processed, foods. If supplements are desired and/or needed, seek professional help rather than deciding to take massive doses of vitamins or supplements. An overdose of anything, even a vitamin can be toxic. PAWS: Post-Acute Withdrawal Syndrome:
These symptoms need to be discussed with a trained addiction therapist. When these symptoms occur, and if the patient is secretive about experiencing them, the patient becomes vulnerable to relapse. Sometimes these symptoms will be the cause of relapse over and over again. Sadly, these symptoms can be managed with a variety of therapies. Relapse is not a necessary outcome! The Millers also believe that other forms of therapies, in conjunction with traditional relapse prevention techniques should be tried. These therapies include:
Relapse Prevention -- An Individualized Approach to AbstinenceDeveloping a personal relapse prevention plan requires a patient’s involvement. Everyone handles life’s challenges and triumphs differently. What works for one patient will not work for another. This process enables a patient to learn more about him or herself, thus empowering the patient. Therapy has demonstrated that when a patient addresses a problem directly and out loud, that process diminishes the power of the problem. A lapse or relapse does not have to occur if the appropriate response and actions are taken. Warning signs are just that – signs. There is nothing in anyone’s makeup that guarantees relapse will happen. There are always steps that can be taken to avoid the pain and disappointment of a relapse. The physical symptoms discussed above must be addressed and not kept secret. But, one’s thinking process is just as significant in avoiding a relapse. Some thoughts that can produce negative consequences:
Self-destructive thoughts can lead to self-destructive behaviors. Seeking support of others with a positive perspective can help reduce the power of negative self-effacing thoughts. What Happens When A Person Lapses or Relapses? Sometimes an addict or alcoholic will substitute one drug for another. Sometimes, it is accidental, as in addiction to prescribed pain medications other times not. If one does not consume alcohol, but smokes marijuana regularly, he or she is replacing one addiction with another. A substitute addiction can also manifest in compulsive behavior absent of drugs or alcohol such as gambling, overeating, compulsive dieting, excessive exercise, over working or the need for constant sexual behavior for example. All of these activities are detrimental to sobriety and can lead to relapse. The relapse process is progressive, it always begins with an attitude change, denial, inattention to those tools and actions that can short circuit a relapse, confused thinking, distorted decisions, negative perceptions, isolation, lack of communication with a support group, self-destructive behaviors, associations that can trigger drug or alcohol use and more. Without a strong relapse prevention plan in place, without a structure to help the addict live through the daily stressers, the likelihood of repeating detox, sobriety, relapse over and over is increased. But once the relapse has occurred, what does a person do then? The first thing is to stop the relapse. That means the addict must place him or herself in a safe, secure place. No more drugs, no more alcohol, no more participating in addictive behaviors. It may mean going back into treatment, or it may mean going into treatment for the first time. Stabilization is paramount. While going to inpatient treatment away from family and friends is the optimal choice, it may not always be a viable option. In such cases, inpatient treatment near home, followed by outpatient treatment would be the next option. A medication review may also be necessary which may require an increase in therapeutic sessions along with attendance at 12 Step meetings (AA or NA for example) or other recovery meetings. Reviewing the relapse prevention plan is recommend if one had been developed. If not, seek the help of a counselor, a therapist, a 12 Step sponsor, aftercare group, other support group to figure out:
An honest review of everything, feelings, thoughts, decision making process, and actions will provide you with the information necessary to learn how to avoid or stop the slide into a severe relapse.
According to Gorski Negative feelings about self should never stop the addict from beginning the recovery process again with renewed determination and hope. For the addict and alcoholic, the choice to maintain sobriety must be a daily one. What happened in the past cannot be changed, today can be different with different choices. If you need help finding a detox facility or a treatment program call Addiction411 at 1-888-221-5866 to jump start your recovery. Trained coordinators are standing by to answer your questions and help facilitate your move into recovery. You can also live chat or e-mail. Make the call now or anytime 24/7 and someone can help you arrest your addiction. |
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