Firstly, it is important to reframe what is meant by relapse prevention because there isn't a way to completely, infallibly prevent relapse from occurring.
It's a natural part of the recovery process. So, throw that idea out of the window. Success doesn't mean never relapsing. Success is about making yourself a drug and alcohol free life.
Instead, focus on ways to lessen the likelihood of a relapse. By shifting the focus, you leave room for acceptance of a relapse. By doing so, you increase your chances of dealing with the relapse in a productive way, rather that spiraling into a larger relapse because you feel like you completely failed.
The following discussion should help you to better understand relapse, its role in the life of a recovering alcoholic, and ways to lessen the chances of having a relapse.
How Common Is Relapse?
According to the National Institute on Alcohol Abuse and Alcoholism, roughly 90 percent of all alcoholics will have at least one relapse during the four-year timeframe after they leave treatment. That's 9 out of every 10 recovering alcoholics. That's astounding.
Alcoholism is a chronic disease, which means that it can be treated but cannot be cured. According to the National Institute on Drug Abuse, when compared to other chronic diseases (like hypertension and asthma), relapse rates for addiction are no greater.
If a person with diabetes were to relapse, they would not declare it a failure and abandon treatment. They would work with their doctor to change their present treatment or to reinstate a previous one. That is why relapse needs to be seen as natural.
What Causes Relapse?
There is no single cause for relapse that can be pointed to, but researchers have focused on a few areas.
Some consider impaired control (the inability to stop drinking after the first drink) as a factor in relapse. Research shows that people with more severe dependence on alcohol have a more difficult time stopping after the first drink.
Other theorists point to cravings as a cause of relapse. Some believe that the term craving is empty because it can only be identified after a person has fallen victim to it and begun drinking. Others fully accept it and believe that the term references conditioned response.
When an external cue and an internal one combine they can reinforce a desire or need for alcohol. The last group of theorists believe that a craving for alcohol is like a craving for food and that cravings vary in intensity and are accompanied by withdrawal-like symptoms.
There may also be physiological responses that trigger relapse. Alcoholics, for example, salivate more than other people when they are placed around alcohol and are not allowed to drink. Alcoholics also have larger and faster insulin and glucose responses to drinking a placebo beer than do non-alcoholics. The body does send physical cues that can develop into a cause for relapse.
What Can I Do to Avoid Relapse?
As with the causes of relapse, there is a lot of varying, contradictory information about controlling urges to relapse. The method that works for you may not work for another person. So, take in the advice and try some techniques.
Relapse prevention models often bring up self-efficacy, the concept that your expectations about coping will actually determine the outcome. It's a theory of self-fulfilling prophecy. For instance, the difference between one drink (a lapse) and excessive drinking (a relapse) is affected by your perception and your reaction to the first drink.
Because of the self-efficacy concept, behavioral scientist decided relapse is affected by the collaboration of:
- Conditioned High-Risk Environmental Circumstances
- Skills to Handle the High-Risk Situations
- Level of Self-Efficacy
- The Expected Positive Results of Drinking
If you can control one or more contributing factors, you have a greater chance of keeping a lapse from becoming a relapse.
In an analysis of 48 episodes, relapses were most associated with the following high-risk circumstances:
- Social Pressure
- Frustration and Anger
- Interpersonal Temptation
You have to arrange your life in such a way that you increase your self-efficacy; modify your lifestyle so you can cope in these situations. You also need to recognize and respond properly to the cues that serve as relapse warnings. Make sure that you have self-control strategies in place to reduce the risk of relapse at all times.