Part II: An Overview of Relapse | INTERVENE: A Community for Parents

Acceptance, Addiction, Dealing with an Addicted Child, Family members, Recovery, Recovery & Relapse, relapse:

Part II: An Overview of Relapse

Thursday, November 17th, 2011

=An Overview of Relapse

This is a guest blog post by Michael V. Pantalon, PhD, Yale Psychologist, Addiction & Motivation Expert, Speaker, Coach and author of INSTANT INFLUENCE: How to Get Anyone to Do Anythingâ€”Fast! (Little, Brown & Co., May, 2011).

Many people who enter into recovery (i.e., abstinence from their drug of abuse/dependence & engaged in treatment) will relapse at one point or another.Â Though this seems like bad news, the flip side is that relapse can be a manageable part of recovery – some have even said that it has helped them solidify what they need to do in order for it to never happen again.Â How did these people benefit from the pain of relapse?Â What kernels of wisdom and insight might they have gleaned from it?Â And how did their family and significant others help them through that process?

Well, while everyone’s relapse is different to some extent, there are some fairly predictable dynamics that family members should be aware of if they would like to help steer the affected individual through it as easily as possible and in a way that important lessons can be learned and applied in the future.

This is the opposite of the “One-drink-One-drunk” adage that says that the moment an alcoholic who has been in recovery for a period of time (even a long period of time, say 15 years) has a single drink or even sip, they return immediately back to the drunk they were 15 years ago.

While relapses can often set in motion a series of events both environmentally and biochemically that can eventually lead someone back to their worst point or lower, there is no scientific evidence that it happens immediately or that it is inevitable.Â In fact, the scientific literature more clearly states that the manner in which the affected person, as well as significant other around him, HANDLES the relapse is much more predictive of how things will go in the future.

So, it’s not simply the relapse that causes problems, but how it’s handled.Â That said, the reverse is also true (and much more positive and hopeful)…”The better the affected person and his significant others handle the relapse, the better he will do in the future (e.g., the shorter the relapse, the quicker the time back to treatment).”

How have you and your family members handled relapse in the past? Â Did it work? Â Please share with us in the comments section.

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Posted by Michael Pantalon, PhD | Filed under Acceptance, Addiction, Dealing with an Addicted Child, Family members, Recovery, Recovery & Relapse, relapse

For me, relapses were incredibly instructive even as they were destructive of the trust I’d built up with my family in sobriety. It took a long time and a lot of effort to rebuilt that trust after I relapsed, but the lessons I learned prepared me for stable sobriety, which was the key to rebuilding family trust.

What I learned was that Step 1 of the 12 Steps was literally true. I was powerless once I’d taken that first drink. That it took only a few days to return to the depths of depression, despair and desperation I’d felt at my bottom. That there were no vacations from sobriety. And that undealt-with anger and resentment were powerful relapse triggers.

But I didn’t truly understand why I’d relapsed or how typical it was until I learned about the science of addiction. Before then, I didn’t believe addiction was a disease at all, let alone a chronic disease in which relapse was relatively normal. And I didn’t understand why anger and resentment were such powerful relapse triggers. The science explained it to me. For more on the science of addiction (why it’s a disease; what part of the brain is altered by addiction and how that warps behavior; why some get addicted while others don’t; how relapse triggers work, etc.) please check out http://www.addictscience.com.

I would like to make a comment on two interesting articles. Heroin and Cocaine arrests drop, marijuana arrests increase. There are two issues t play here, and if we don’t change the first, we will never change the second. Addiction/Dependence are not crimes, they are chronic diseases, as the AMA accepted in 1956, through the work of Dr. Edward Jellinek. There is no other chronic disease as stigmatized as addiction, perhaps HIV/AIDS, however, it is not politically correct to stigmatize people with that disease. However, addiction(disease) is treated with criminal intervention. Does jail make a diabetic healthy? How about Hypertension, Asthma, any chronic disorder. Imagine if you had diabetes, and you had to cop insulin on the street. Ridiculous? Not hardly. With proper treatment, most diabetics can live a normal life, so it is with alcohol and and drugs. The stigma that addicts live with, only causes more use, more addiction. Prior to 1914 all drugs were legal; not everyone was stoned, as a matter of fact, now that drugs are punished by the criminal justice system, the rate of addiction has gotten higher.
In addition, we have set up another Mafia, except now we call them cartels. If we removed the illegality, and put the tax revenue in our coffers, we could have treatment on demand, instead of jail, not on demand. Think about it. What does an addict spend on drugs, doesn’t matter whether marijuana or heroin, somehow, mostly through illegal means, money is spent. So our current solution? Put them in jail at a cost of $55,000 a year. Keep it simple. Imagine how shoplifting, burglary, prostitution, robbery would drop, if an addict could get their medicine at a fair price. No more “Cartels” why buy something for hundreds of dollars, when you can buy it for a fraction legally. In closing, what other weeds are illegal?

I think it’s important to clarify which drug we’re discussing when we approach the subject of relapse. Having a drink after 15 years sober is probably not going to do serious harm. Even using Meth or Cocaine is not likely to cause a visit to the hospital. But heroin is another matter.

Many overdoses of heroin happen when the addict relapses because his/her body has changed its tolerance to the drug after not using for a while. Sometimes recovery brings with it feelings of depression that can lead to an overdose. Whether intentional or by accident, relapse for a heroin user is life-threatening.

I believe we need to do a better job of providing treatment to individuals who are addicted to opiates. There is a lack of long term treatment that’s needed to carry a person through the roughest part of recovery; through the withdrawals, cravings and depression. An addict can learn a great deal about life if he/she can live to tell the tale. As it is, there are thousands who die each year while we, as a society, argue whether addiction is a disease and whether we should be investing in treatment.

Addicts frequently hate themselves and they need to know that society doesn’t see them as bad people. They don’t need to be scolded or jailed if they relapse. They need our support and understanding.

I personally believe that you have done an outstanding work by posting such a wonderful article. In this contemporary world relapse is resuming the use of drugs or a chemical substance after one or more periods of abstinence. The information you have provided in would surely help most of the people who will read this.

I am beyond excited and grateful to see your posts here on Intervene. Please,please keep them coming…

Thank you for you blog, this is very true. There are more Sober Blogs that might be helpful. Relapse is fatal for a lot of people, and has been life changing for others. Get help

My brother was sober for over 20 years. He had a great job and 2 college degrees. He got married to a woman he met through a Russian marriage agency. Well, after a year of being married, things went wrong and the marriage failed. She had a falsified Russian passport and was on the run from a felony charge in Russia. He was so disappointed, because he was very in love with her. He started spiraling out of control. He couldn’t handle this downfall in his life and felt failure. He didn’t tell anyone. He went to a counselor and started antidepressants. He went online again and met a woman who was an independent contractor in Iraq. He was thrilled. They met when she came back and were on a whirlwind relationship. They went to Thailand together and were so happy. Meanwhile, he was having trouble at his job. He couldn’t keep up with his work as he used to in the past. He was still happy, but got fired at his longtime stable job. He decided to move to the Iraq womans house, here in the U.S., they were going to get married and he was going to look for a job there. He was still feeling vulnerable inside and insecure. He wasn’t getting any jobs. After several months, she decided she didn’t want to get married. Within the month, my brother committed suicide. She found him in his car. When my other brother and sister went down to claim his body, she said she put all my brothers belongings in storage and she would ship them later. That’s another story. It was sketchy-sounding…
It just shows that no matter how long you have been sober, a life changing time, can make you go back to drinking again. You should keep a sponsor and stay in the program especially when you are vulnerable.

If how you handle the relapse is so important, how do you handle it when your loved one (child) relapses?

In my experience, as a parent who has been witness to several relapses over the 15 year journey in addiction of a wonderful son, -who is now in long term recovery-and, also, as someone who has witnessed the relapse of other parents’ sons and daughters; it would be more effective, I believe, to respond to the question of, “How do you handle it when a child relapses” by offering how ‘not to’ respond.

Responses fueled by anger, frustration, impatience and/or issuance of ultimatums are not going to result in help for a son or daughter struggling to regain balance and sense of self efficacy (self efficacy = the-critical-to-recovery belief in their ability to cope effectively with the set back/relapse/lapse).

Rebecca, here is a link to a book that helped my journey as a parent significantly. I hope it might offer you some support and insight for your circumstances relating to responding effectively to a family member who is struggling with a recent relapse/addiction to drugs or alcohol.

Get Your Loved One Sober: Alternatives to Nagging, Pleading, and Threatening by Robert J. Meyers, Brenda L. Wolfe

“The first general consumer book ever on the powerful, award-winning, scientifically proven new system of intervention that is turning the recovery field on its head.

Historically there have been few options available for individuals seeking help for treatment-resistant loved ones suffering from substance abuse.

Coauthor Dr. Robert Meyers spent ten years developing a treatment program that helps Concerned Significant Others (CSOs) both improve the quality of their lives and to learn how to make treatment an attractive option for their partners who are substance abusers. Get Your Loved One Sober describes this multi-faceted program that uses supportive, non-confrontational methods to engage substance abusers into treatment. Called Community Reinforcement and Family Training (CRAFT), the program uses scientifically validated behavioral principles to reduce the loved one’s substance use and to encourage him or her to seek treatment. Equally important, CRAFT also helps loved ones reduce personal stress and introduce meaningful, new sources of satisfaction into their life.

When compared to Johnson Institute and Al-Anon intervention techniques, CRAFT resulted in two and three times the number of loved ones willingly engaging in an alcohol treatment program. Compared to a 64% success rate for CRAFT, the Johnson Institute approach resulted in engaging only three out of ten drinkers and the Al-Anon approach engaged barely more than one out of ten drinkers.”

Wishing you and your loved ones ever-increasing peace, well being, and hope for the road ahead.

I just wanted to say that Patti Herndon made a great post!
You hit the nail directly on the head with how “not” to deal with relapse, very very well done.

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