Drug use is on the rise in the United States, and addiction affects every segment of American society. An equal opportunity disease, addiction does not discriminate between racial, gendered, or socioeconomic lines. Current estimates claim nearly 23.5 million people in the U.S. are addicted to drugs and alcohol. That’s one in ten people over the age of 12. To put it into perspective, that’s the entire population of Texas.
Addiction is a horrible illness; it costs people their lives and livelihood, burdens law enforcement, and destroys families. It costs the economy billions of dollars per year in lost wages and productivity.
In 2016, there were over 60,000 deaths related to a drug overdose. Of those, more than half were directly attributed to opioids. From 2015 to 2016, drug overdose rates rose 21%.
Even though so many people are affected by drug and alcohol addiction and that resources are available to help addicts and their families, only 11% of people with a drug or alcohol addiction will seek treatment. Of those who successfully quit drugs or alcohol, between 40% and 60% will relapse. While these rates may seem dire, relapse does not mean that treatment didn’t work.
Relapse means symptoms have returned. Drug and alcohol addiction are diseases of the brain. Once someone becomes addicted, neurological pathways related to risk, reward, and pleasure become rewired. The individual will always have an addiction disorder, but their symptoms can be successfully managed with ongoing treatment.
Most people who suffer from a significant chronic illness, such as diabetes or hypertension, see a relapse of symptoms. Because there is no shame or stigma attached to these health problems, people seek treatment. A relapsed drug addict, on the other hand, may deny their symptoms out of guilt, and further spiral down into the path of addiction. Since addiction is such a consuming and dangerous illness, relapse prevention is vital for people to live a healthy life after drug abuse.
If someone has abstained from drugs or alcohol for an extended period, but then falls back into addictive behavior, they’ve relapsed.
A relapse could mean the person has a minor ‘slip,’ where they take a drug or a drink, but stop. Or, it could mean the person has binged on their drug of choice. This is especially dangerous with heroin users.
After abstinence from heroin, the person’s tolerance for the drug is very low. But because they haven’t used for awhile, they don’t know their physical limits. They can easily take more than their body can handle, and die.
While it is not at all uncommon for relapse to occur, it indicates that the current treatment plans aren’t adequately addressing the person’s underlying issues. Most relapses, between 60% and 80%, occur within the first six months after treatment. Since addiction is such a complicated, multi-layered issue, and many people suffer from comorbid conditions, it can take awhile for doctors and therapists to fully understand the individual’s unique triggers and circumstance that led to their drug addiction. Doctors and patients need time to craft an ongoing maintenance plan tailored to the individual that successfully addresses all of their needs.
Having an individual in recovery attend outpatient treatment centers is highly effective in preventing relapse or addressing it once it occurs. With an outpatient treatment center, the patient can schedule appointments with their therapist in advance. Often, they are required to attend one-on-one therapy sessions, or group and family therapy sessions. In these settings, clinicians can adequately monitor the patient for any signs of relapse. Also, doctors are available to address any medical issues and can prescribe better medications or up the dosage of existing medicines for people with comorbid mental health issues.
People who are most at-risk for relapse are those with comorbid conditions, those with a lack of social support, and people under a lot of stress. The stress could be centered around conflict or financial difficulties. It could also be ‘good’ stress. People who are in the early months of recovery who experience a significant, positive event, such as a wedding, a new job, or the birth of a child are at high-risk of relapsing.
Drug counselors, therapists, psychologists, and psychiatrists are all equipped to handle drug and alcohol relapses in their patients.
Depending on the severity of the relapse, a patient may require a stay in a medical detox facility or an inpatient rehab center. Usually, though, patients need to meet with their team of caseworkers, therapists, and doctors to address the underlying issues that have led to the relapse. This may involve a change in medication or dosage, increased therapy sessions, or a different mode of therapy. Sometimes, individuals may have to make specific lifestyle changes to prevent another relapse. Therapists can help patients explore what lifestyle issues are causing them to crave drugs or alcohol again, and what they can do to address these issues in a positive way.
People with comorbid conditions do well with pharmacological treatment methods in addition to therapy and counseling. Most people who enter rehab also have depression and anxiety, and SSRIs are highly effective at treating this disorder. With patients who also have comorbid issues, outpatient rehab is critical for monitoring their symptoms, so they don’t fall back into addiction to cope with mental illness.
Relapse is a natural part of the recovery process, and people do not need to feel ashamed for stumbling. Family members also need to support the person in recovery, and not blame them for being ‘weak’ or ‘foolish.’ Addiction is a brain disease, and it is very common for relapse to occur. But, getting treatment quickly is crucial, so they do not continue to use drugs. The risk of overdose and death is high after sobriety since tolerance levels are low.