What Is Chronic Relapse?
The general definition of relapse is the deterioration of someone’s state of health after a period of improvement. However, in terms of substance abuse, a relapse is when an individual resumes using a substance after a period of recovery or abstinence. Considering the nature of addiction as a chronic, relapsing disorder, it is common for those recovering from substance abuse to relapse. However, chronic relapse occurs when an individual is stuck in a repeated, cyclical pattern of treatment, recovery, and relapse.
The term “chronic relapse” can hold an air of inevitability that some may find discouraging in the face of recovery, but chronic does not mean permanent. The term defines a set of patterns in order to help counselors and substance abuse professionals better identify what may be causing the repeated relapse and how to adapt a treatment plan to accommodate one’s needs. With a proper support system and a recalibrated treatment plan, those who have experienced chronic relapse can resume their recovery path.
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Relapse Occurs In Stages
While relapse is often discussed as a one-time event, it can be divided into several stages or processes. The initial use of a substance after a period of abstinence is called a lapse, and continued use is considered a relapse. Relapse is both an event and a process, meaning that there is an initial process of regressions that happen before relapse occurs. What may begin as the seemingly benign act of reassociating with past acquaintances associated with substance abuse can swiftly lead to reverting to old patterns. However, there are warning signs that can precede the relapse process. These warning signs include:
- Thinking about, romanticizing, or fantasizing about past substance use.
- Self-isolating in times of need or emotional distress.
- Reassociating with places and people associated with past substance use.
- Stopping the use of medication prescribed to aid in substance abuse recovery.
Within this relapse process, there are opportunities for the individual, or loved ones, to intervene and reintegrate treatment-oriented behaviors like coping skills, reaching out to friends and family, or speaking with a counselor. Again, relapse is not a sign of failure. The National Institute on Drug Abuse (NIDA) even states that relapse rates from substance abuse mirror other chronic conditions like asthma, hypertension, and diabetes. However, with chronic relapse, a different approach is necessary to understand why an individual is reverting to substance use after multiple trials of treatment and recovery.
Why Does Chronic Relapse Happen?
Many aspects can help explain why someone is experiencing a chronic relapse. One common reason why individuals relapse in general is that some assume that the worst of the recovery process will last only a couple of months to a year. After a couple of months, so the assumption goes, an individual can ease their recovery efforts. However, research by the National Library of Medicine shows that 65-70% of individuals will relapse within the first year. Moreover, if an individual surpasses the year without a lapse or relapse, that does not mean that recovery is “completed.” The assumption that recovery has a definitive end could lead an individual in recovery to a vulnerable position; to safeguard against this vulnerable position, it may help to view recovery not as a binary of completed or relapsing but as a process that requires daily actions and choices.
Beyond this assumption, specific daily life factors, psychological factors, and behavioral factors may increase an individual’s risk of relapse or chronic relapse. These risk factors include:
- Maintaining contact with those who still use or sell substances.
- Being around substances or related paraphernalia.
- Spending time in places where one used substances.
- Isolating or withdrawing from loved ones.
- Having untreated physical or mental health issues.
- Inadequate social and emotional support.
- Low self-efficacy or the belief that one can’t control their substance use.
Building A Healthy Foundation For Recovery
Relapse prevention or management is an integral part of substance use disorder (SUD) treatment and recovery that involves one’s history, coping skills, support networks, self-regulation skills, and a myriad of other individual and environmental factors. In order to build a foundation for sustainable recovery, it is important for individuals to work with a licensed treatment professional to identify goals and potential barriers to recovery. Beyond working with a counselor or treatment professional, there are additional building blocks that individuals can use to strengthen their self-efficacy and recovery plan, including continued substance abuse treatment, exercise, rest, and support.
Substance Use Disorder Treatment
Continuing forms of evidence-based behavioral treatment is a direct approach to preventing a chronic relapse. Treatment can vary in formats (individual, group, or couples therapy), settings (outpatient, inpatient), and duration, frequency, and intensity. Additionally, attending support groups like Alcoholics Anonymous, Narcotics Anonymous, and SMART Recovery™ can help individuals connect with those who share similar experiences and struggles. In fact, the duration and frequency of support group attendance are linked to improved outcomes in recovery and abstinence, according to the National Library of Medicine.
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Exercise is a crucial component in maintaining a healthy lifestyle, and according to the National Library of Medicine, exercise can improve physical and psychological health and reduce relapse risk factors like stress, anxiety, depression, and sleep problems. Exercise also positively affects the brain’s reward systems, which are often affected by substance use.
As previously mentioned, sleep issues (i.e., poor sleeping habits, inadequate rest) increase the risk of relapse. Getting enough rest and minimizing stress are necessary for building a healthy foundation for sustained recovery from a SUD.
Building a support system of family and friends increases feelings of connection while minimizing isolation (a risk factor of relapse). Having trusted loved ones present and available in one’s life to offer support and guidance provides a safety net for those in recovery.
Maintained Recovery From Chronic Relapse Is Achievable
The terminology “life-long recovery” may be comforting for some and daunting for others, but what is consistent is the fact that recovery is not a singular event or time-limited goal. Sustained recovery involves many changes that evolve across all elements of an individual’s life, and it is possible for everyone. For more information of treatment options to aid in recovery, contact a treatment provider today.
Ashish Bhatt, MD, MRO
Doctor of Addiction Medicine
Learn about Dr. Ashish Bhatt
Dr. Bhatt has been Addiction Center's Medical Content Director for more than three years, providing his expertise to ensure quality and accuracy.
Doctor of Addiction Medicine
Expert in adult and child psychiatry
Over 20 years of professional experience