Chronic Relapse and Relapse Prevention - Is There More Than One Component?

Chronic Relapse and Relapse Prevention - Is There More Than One Component?

Someone goes in for substance abuse treatment, convinced that this time will be the time they kick their habit, whatever that might be. Six months later they’ve gone through treatment and are out on their own. They’ve changed jobs, friends, made amends…and then that day, the one they hoped would never come…the alcohol, marijuana, cocaine (insert your drug of choice here) gets picked up again. Failure!! But does it mean that drug use will be the story of this person’s life? Will the habit be the end of them? No, not at all!!

Diabetes and Cocaine Addiction- what’s the connection?

A large number of individuals who seek treatment for alcoholism or substance abuse will relapse shortly afterwards. The wrong influences, a disappointment as well as a lack of resolution can cause someone to take on previous bad habits. Relapse following treatment for drug and alcohol addiction is common, predictable and preventable. With the help and guidance of a program as well as motivation on the part of the participant, these relapses can be avoided. Most therapists will say that relapse is part of the learning process. The individual learns what he or she can and cannot do, and that learning eventually leads to recovery.

Studies show that relapse rates for addictive disease are similar to rates for other chronic diseases. Relapsing is part of chronic illness, whether it be physiological or like diabetes or addictive like cocaine use. The theme these two seemingly different problems have is that maintenance of both requires commitment on the part of the individual. Treatments have to be followed, behaviors have to be changed, and responsibility has to be taken. When these guidelines are not followed relapse occurs.

Men vs Women: Is there a difference in Relapse?

It seems that in addiction as when driving, men refuse to stop for directions and often get lost. Yes, that is a light approach to this topic. Research has found that women are more likely to seek assistance, go to support groups, and talk about whatever problems or issues they may be experiencing. Doing so often keeps them from relapsing.

Does age make a difference?

In a study recently conducted by the National Institute on Alcohol Abuse and Alcoholism (NIAAA) which is part of the National Institute of Health (NIH), research shows that individuals who become alcohol dependent before the age of 25 are less likely to seek treatment than those individuals who become dependent at age 30 or older. More frequent multiple dependence episodes, of longer duration have also been found with an earlier onset of dependence (September 1, 2006 issue of Pediatrics). Dependence on any substance usually leads to more episodes of relapse.

Researchers speculate that the reasons why younger individuals may have chronic drinking problems are because first of all, they are in a place in their lives’ where binge drinking is considered an acceptable mode of behavior. Furthermore, it has been found that dependency is usually under diagnosed in this population, again because of binge drinking being part of the culture.

In a recent study researchers from the Youth Alcohol Prevention Center at Boston University School of Public Health, analyzed data from the 2001-2002 National Epidemiologic Survey on Alcohol and Related Conditions (NESARC). This is a representative survey of the U.S. adult population involving face-to-face interviewing. More than 43,000 U.S. civilians over the age of 18 were interviewed. The survey asked many questions related to alcohol abuse and dependence. Respondents were asked about any treatment or help they may have asked for to help with drinking problems. Out of the participants, 4,778 which represent 12.5 percent of the U.S. population indicated that they had been alcohol dependent at some point in their lives.

When analyzing the data, researchers found that about half of these individuals became dependent before the age of 21 and 33 percent became dependent before 25. Only twenty percent became dependent at 30 years or older. Regardless of demographic and behavioral characteristics becoming dependent before the age of 25, meant less of a chance of seeking help. Researchers speculate that fewer commitments, both relationship wise and in the working world may contribute to becoming dependent at an earlier age and not seeking treatment.

The end result of these findings: utilize better screening tools for adolescent and child drinking patterns. Under-diagnosis is dangerous for the community at large. Like chronic illness, the sooner a problem is identified and acknowledged the sooner it can be dealt with. This is a goal healthcare providers need to have for the future.

Dr. Hingson and colleagues call for systematically counseling adolescent patients about their drinking, noting that a recent study found that pediatric medical care providers under-diagnose alcohol use, abuse, and dependence among patients 14 to 18.

Rachel Hayon, BSN, MPH

Alcohol and Development in Youth—A Multidisciplinary Overview Volume 28, Number 3, 2004/2005. Accessed 15 July 2007
Bernstein, E., & Bernstein, J. (2005). Preventing alcohol misuse among adolescents. Ann Emerg Med, 45(4), 430-432.
Hingson, R. (2004). Sex differences in adolescent exposure to alcohol advertising in magazines. Arch Pediatr Adolesc Med, 158(7), 702-704.

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