Addiction Masterclass: The Truth About Relapse

Just about everyone in addiction recovery or people who work in the addiction field will tell you that it's best to avoid relapse, that it could be catastrophic. It becomes something of a boogeyman. And in some ways, they're right. However, there may be a different way to look at it. I'm Evan. I'm your resident mental health and addiction counselor, and this is my addiction masterclass. Some of the most traditional views on relapse for people with severe addictions is that when they go a period of time without using, and they continue to drink or use a drug in any form, they're very likely to continue craving the substance that often they're going to go right back to where they were before, if not worse, because it's a progressive disease.

Now, for many folks, this is true. After going back and having even just one, it reboots the cycle of addiction and consequences for them. Therefore, relapse is something we shouldn't take lightly. This disease can be deadly. And therefore, when people relapse, sometimes they don't make it back. But as I've talked about throughout this series, when it comes to addiction or substance use disorders, things aren't black and white. Everyone experiences addiction differently, and the same goes with relapse.

It's not black and white. There are many forms of relapses. So in this video, let's break down relapse and some of the things we can learn from them. So let's go ahead and break down what a relapse is. Now, relapses occur in many different medical conditions, whether it's cancer or diabetes. When you have a disease that you've treated and successfully put into remission, if that disease reoccurs, that's considered a relapse. So from the medical definition, when we have a substance use disorder, that is based on the amount of symptoms, the consequences that substances caused in your life.

Therefore, if you go back to using a substance, that doesn't necessarily mean that you relapsed by the technical definition. Now, when people have a severe use disorder or when they go back and use the substance, it's very common that the consequences happen right away, and therefore, it is technically a relapse. However, many people in the recovery community, or people with a more traditional attitude would not agree. They would say that going back to that mind or mood altering chemical is that dangerous, and it's almost always going to lead to consequences, and therefore, it's a relapse.

Now, another point of view, maybe more from the harm reduction model, would say that you define your own relapse. If you're someone who is using heroin and your goal is to know longer, use heroin and to use cannabis or alcohol, then that is a success, then you did not, in fact, relapse. So it really just depends on how you look at it. And I find that both approaches do have some merit. However, as a clinician, I cannot say someone has relapsed. I cannot say they've returned to a use disorder if those consequences aren't there.

So it's not just about how an individual defines it. Let's say they're using alcohol and cannabis instead of heroin, and they say, you know what? That's not a relapse yet. It's causing consequences in their lives, it's affecting their relationships. They're getting in legal trouble, then I technically still have to diagnose them with a use disorder, whether they want me to or not. Now, as we talked about in the stages of change video, relapse is part of the stages of change. Yet just because relapse can be part of addiction and the disease model, well, it doesn't mean you have to relapse.

It's just very common. Like many diseases, it is common for the symptoms to reoccur. However, that doesn't mean it's not in your control. With addiction and addiction recovery, like many other disorders like diabetes, there is an element of behavioral choice. For example, how you diet when it comes to type two diabetes, exercise, doing these behavioral things to lower your chances of the disease relapsing. Just like with addiction recovery, if you go to meetings, get a sponsor, go to therapy, these are all protective factors.

These are all things that lower your risk of relapse. And what's interesting is if you look at addiction, compared to other chronic diseases like diabetes, the relapse rates are almost the same. And that's probably because there's this behavioral component that it takes sometimes self will or self control or motivation to go and do those things to lower your risk. And that could be very difficult. Now, even though it's best to avoid relapse at all costs, sometimes there can be a silver lining. For example, if you go and use and continue to have consequences and you decide you want to come back, that's a good opportunity to learn, where did I go wrong?

For example, if someone has a recovery plan and it didn't work out, we could examine and look at what in that plan was missing. What things did we not account for? For example, if somebody was going to the bar and being around alcohol hanging out with certain friends or they were putting themselves in stressful situations that led to the relapse. Well, we can adjust. We can adjust the plan and make it so they are less likely to fall into that trap again. And hopefully we've accounted for, for everything, for all the risk factors.

But sometimes it takes a few tries. Now, in my personal and professional experience, I find relapses typically occur in two general forms. And I call these, number one, a relapse of passion, and number two, a relapse of negligence. So I'm going to go ahead and break these down further in the next video so you get a better understanding of them and how we could avoid them to have more success in recovery.