Relapse Prevention
A lot has been researched, written, and talked about on
the topic of how a recovering person can prevent relapse back to alcohol or
drug use. Research statistics continue to show that most people who have
received alcohol or drug treatments and/or are in recovery, still have
difficulty not relapsing. There is no mystery in that. “Between
80% and 90% of people treated for alcoholism relapse, even after years of
abstinence (1).” I know that relapse is painful, and I also know it
is preventable. No one has to go back to using alcohol or other drugs. I
will share with you the “how” and “why” of the phenomena of relapse, and how
you can prevent it.
Scientists of addiction and relapse—researchers and physicians—tell us
that alcoholism, drug addiction, and other behavioral disorders are brain
diseases. Many addicts are deficient in neurotransmitter chemicals which
drive us in primal ways to seek relief from pain or to gain pleasure.
A.D.A.M., Inc., accredited by URAC, also known as
the American Accreditation HealthCare Commission (www.urac.org),
states:
Researchers are
particularly interested in systems of neurotransmitters (chemical
messengers) in the brain that are affected by alcohol (or drug use). Some
research is focusing on the way these neurotransmitters…after long-term
alcohol (or drug use)…adapt to the cravings and pain of withdrawal. Such
chemical changes may lead to dependency or to relapse after quitting
in two ways:
·
They increase the need to reduce
agitation, and
·
They increase the desire to restore
pleasurable feelings.
Reducing Agitation.
When a person who is dependent on alcohol or other drugs (AODs) stops using,
chemical responses create an overexcited nervous system and agitation. This
hyperactivity in the brain produces an intense need to calm down and to use
more AODs. One study, in fact, suggested that the need to relieve agitation
may be the more important factor in causing a relapse than restoring
mood.
Restoring Pleasure.
Alcohol and other drugs stimulate the release of neurotransmitters and other
chemicals that produce pleasurable feelings. Over time, however, heavy AOD
use appears to deplete the stores of dopamine and serotonin. (2)
Recovery is a process of
movement away from addictive thinking, feelings mismanagement and behaviors.
Recovery is typically found to be most effective via active participation in
long-term treatment and the AA program. Unfortunately, many people
who strive to abstain relapse. Some AA and disease advocates anticipate
frequent relapse—hence the mantra: “addiction is a chronic, relapsing
disease.” Relapse is not a part of the disease, it is the disease. Why do so
many get stuck, and make poor decisions that lead them into deeper and
deeper pain, misery, and discontent from a stable recovery? The process
often ends with the person believing that alcohol or drug use is a better
choice than feeling this bad. Many believe they are going crazy, and that
something is wrong with them. They may believe these statements, but they
may be mistaken.
Relapse is a process of movement away from stable recovery-based
thinking, feelings management and healthy behaviors, and towards addictive
(stinking) thinking, feelings mismanagement, and compulsivity—eventually
making alcohol and drug use seem like a positive choice. An overexcited,
agitated nervous system and the lack of adequate dopamine and serotonin
leave one feeling anxious and depressed. A self-defeating lifestyle,
co-existing disorder, being an Adult Child of an Alcoholic, and/or
situational life problems often strain and stress the early recovering
person, and then they act out. And all the while the brain is demanding
relief or pleasure restoration.
Relapse has two levels, eleven phases, hundreds of high-risk situations,
and forty-nine warning signs. The primary focus of early relapse problems is
on high risk situations, where you recognize the need to abstain from
alcohol and other drugs in order to resolve your current problems and face
situations which could cause you to use alcohol or drugs in spite of your
commitment to abstain. Things like going to a sporting event without any
recovering people with you, where there is beer and fun; going to concerts,
parties, etc. The main goal here is to immediately identify when you are at
risk of using. Do not minimize thoughts of using or being over-confident
about your recovery. Simply use your recovery tools to prevent relapse.
Competency in this area will allow you to get back on track and continue to
prevent your problems from getting worse. You must be able to abstain from
alcohol and other drugs before you can successfully work on psychotherapy
issues for long-term recovery.
The secondary focus in relapse prevention is on core personality problems
and core lifestyle problems. The self-defeating habits of thinking, feeling,
acting, and relating to self and others creates unnecessary stress, pain,
and problems. Core personality problems are built upon a system of mistaken
beliefs. A mistaken belief is something that we assume to be true but is
actually false. Most of these beliefs are learned in childhood, and are
accepted as true without evidence. They become “the truth as I see it.” This
forms a set of assumptions about yourself, others, and the world. Often
these are created in a family system or cultural taboo which states: Don’t
talk, Don’t trust, Don’t feel. These mistaken beliefs then create a set of
unconscious life and decision rules, called a lifestyle. Core lifestyle
problems are the dysfunctional relationships and habits of daily living that
support and justify our core personality problems. (3)
We can’t ignore core personality and lifestyle issues or communicate that
these issues are not important. These issues will have to be resolved if you
are to learn how to maintain long-term abstinence. The issue is this: You
recognized that you were addicted, learned primary recovery skills, and
learned how to identify and manage high risk situations first. Now that you
have a solid foundation in recovery, it is time to explore and change your
personality and primary lifestyle problems.
Drug use and other addictive behaviors override our brain chemical
deficiencies by tricking our brain cells into dumping massive amounts of
Pleasure chemicals—at the expense of depleting them in the long run.
Think back to when you stopped using alcohol or other drugs, and try to
remember what you felt like. You probably felt down/depressed, angry,
lustful, and sometimes had a panicky mixture of terror and despair. Who
would want to return to that? Patients and their caregivers should
understand that relapses of alcoholism are analogous to recurrent flare-ups
of chronic physical diseases. It is a spiritual malady with a spiritual
solution, but we need to consider the medical aspects and how science can
assist in high-risk reduction. There is one certain way you will not
relapse, and that is to go after your recovery with complete abandon,
letting go absolutely, and depend on God.
David Vaughan, BA, LCDC, ACRPS (Advanced Certified
Relapse Prevention Specialist)
Program Director
Burning Tree Lodge
Notes:
1.
http://adam.about.com/reports/000056_1.htm
2. ibid
3. Gorski, Terrence
