Relapse
A relapse is a return of symptoms in an individual who has recovered from an illness or has entered a stable period in a chronic illness. In people with drug addictions, a lapse refers to minor episodes of drug use following a period of abstinence, and a relapse refers to major episodes of drug use following abstinence.
Relapse is common among drug addicts. This is true whether sub- stance abusers have quit using drugs as a result of treatment or on their own. For example, up to 60 percent of alcoholics, heroin addicts, and smokers relapse within three months of the end of treatment. Although relapse episodes are common, treatment does help most substance abusers to reduce the frequency and severity of their drug use for long periods after treatment. Health professionals believe that addictions are chronic, or long-term, relapsing disorders. In other words, addicted individuals go through cycles of heavy use, treatment, abstinence or reduced use, and relapse.
Individuals have an increased risk of relapse when they face high- risk situations, or situations that have led to the person's substance use in the past. If the individual believes strongly that he or she can manage the situation without using alcohol or drugs (without relapsing), that person is more likely to avoid relapse. Individuals who lack that strong belief tend to relapse.
Other factors also increase the risk of relapse. Individuals with a family history of substance abuse, who have other psychiatric problems, and whose own histories of substance use are severe are at increased risk for relapse during periods of abstinence. People who go through difficult experiences (such as divorce), who have little support from friends, and who have low motivation for self-improvement are also more likely to relapse. When individuals with these characteristics encounter a high-risk situation, they often return to drug use in an effort to cope.
An important element of relapse is craving. When an individual encounters a situation or experience that has been frequently paired with substance use in the past, this can trigger a craving. For example, a former substance abuser might suddenly experience a craving for cocaine when he sees someone with whom he used to smoke cocaine. In other cases, substance abusers appear to have no control over automatic, ingrained processes that led them to use drugs in the first place. These users have very little insight into the factors that led them to relapse.
Relapses that occur within a few days of a person's becoming abstinent may be due to withdrawal symptoms. Users may seek to relieve these symptoms by taking more of the drug they were addicted to. As part of their treatment, substance abusers should be taught to expect a relapse at some point during the recovery phase. Learning to accept relapse as a temporary disruption on the road to recovery, rather than a permanent failure, will increase the likelihood of a long- term, successful recovery.
Treatment Programs, Centers, and Organizations: a Historical Perspective; Treatment Types: an Overview.
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