Quitting alcohol and drugs is not easy. It takes a community, a strategy, and preferably the guidance of professionals. Even under the best of circumstances, you may relapse one or more times.

Everyone responds to treatment and withdrawal differently, and some people may relapse more often than others. When it happens more frequently than what is considered average, it is referred to as a chronic relapse.

Thankfully, all forms of relapse are treatable. But it is important to recognize triggers that could make you relapse.

If you learn to manage those, you can lower your risk of relapse.

Triggers for Relapse in Most People

Drug or alcohol relapse means that you use or even misuse a substance after a period of abstaining from it. Because drugs and alcohol can change how the brain’s reward system responds to gratification, some people may be more likely to continuously relapse over the years.

Regular relapse is to be expected, and it does not mean that treatment for drug or alcohol misuse did not work. Relapsing at least one time is common during recovery. In fact, treatment facilities expect relapse, as it is considered part of recovery.

But even relapsing one time can be difficult, especially if you start to feel as if you have personally failed because you did not follow through on your new skills right away. Relapse can be triggered by both positive and negative events.

  • Stress is often a reason for relapse because drugs are one of the ways people self-medicate to avoid or forget about things they cannot cope with at the moment.
  • Reminders of addiction, such as seeing a bottle or smelling cigarette smoke, can trigger a relapse.
  • Recovery programs often teach you skills to deal with negative or difficult emotions, but these feelings can cause a relapse.
  • Hanging out with friends who use or in places where you used to indulge in your addiction is a common trigger.
  • Celebrating special occasions can be difficult as you learn to stay away from substances. Drinking or taking drugs may be seen as more acceptable on such occasions.

How to Recognize Chronic Relapse

In May 2013, Jimmy Long wrote about his struggle with chronic relapse for The Fix. Long mentioned that he was sober for 12 years but relapsed for another 12 years. He mentioned that he later married a partner who also had drug and alcohol issues.

Throughout his ordeal, Long was arrested, and his partner also dealt with a bevy of consequences. Over time, he learned that his recovery was different, and he often dealt with feelings of guilt.

The Indian Journal of Psychiatry states that addiction is a chronic disease, and relapse is common to the disease. The National Institute on Drug Abuse mentions that relapse often means a person’s treatment must be adjusted.

Relapse means a person must change behaviors that are deep-seated in their psyche.

Gears labelled "relapse" and "recovery"

In February 2012, CBS News covered chronic relapse as it applied to baseball star Josh Hamilton.

An expert interviewed in the report mentioned that substances like alcohol simply wait for the opportunity to strike while you try to recover.

People who are addicted to drugs or alcohol simply crave these substances differently than someone who is not addicted, and that makes drug or alcohol abuse challenging to manage.

CBS News provided one tip that chronic relapses must recognize that they cannot use willpower alone to combat their addiction. Just as 12-step programs say, the report mentions that surrendering can be much more helpful than the stress of trying to stop your cravings on your own.

Chronic Relapse in Teens

Chronic Relapse in Teens

Unfortunately, chronic relapse is especially common among teens, more so in teen boys. Drug and alcohol use typically stems from peer pressure, and many young men experiment with substances because of pressure they feel to be cool. It’s common for them to want to fit in with a new crowd and prove they’re worthy to others. Although most teens will grow out of this experimentation period, others who are genetically prone to addiction can fall into the deadly cycle and develop a substance use disorder.

Addiction is characterized as a chronic and progressive disease, meaning it’ll persist throughout your life. When it’s left untreated, it’ll become more severe. While a treatment program for most young adults is enough to give them a new start, others will begin a pattern of chronic relapse, which is when teens drink or use drugs despite attending treatment. It may lead you to wonder: why are teens more likely to endure chronic relapse?

There are specific risk factors that place teens at risk of chronic relapse. Those in this particular demographic are vulnerable, and even after successful treatment, these influences will increase an adolescent boy’s chances of using drugs or drinking again.

Simply put, teenage boys are at higher risk of chronic relapse because they’re more impressionable. This means that during middle school and high school, peer acceptance and fitting in takes precedence over anything else in their lives. Although it may sound minor to you, put yourself in their shoes and try to remember the things you did to fit in during your adolescence. It explains why the stories and experiences of others will result in a pattern of substance abuse, even when the teen has received treatment. 

The most common risk factors that place teens at a higher risk of chronic relapse include:

  • Periods of high stress
  • Moving away from their friends
  • Peer pressure from classmates or other friends
  • Ending a close friendship or romantic relationship with a person they thought they’d be with forever
  • A lack of support at high or at school
  • When their parents go through a divorce, especially if it’s not amicable
  • Poor coping skills
  • The death of a loved one or close friend

There are other behavioral characteristics and personality traits that can also lead to chronic teen relapse, including learning disabilities, a lack of impulse control, and co-occurring mental illness. For some teens, feeling depressed may be attributed to their age, but it could be a major depressive disorder or other condition contributing to their drug use. When you feel bad, obviously, you want to feel better, and self-medicating to numb how they feel is common. 

Marijuana is the most widely used drug in the world, and it’s the most commonly abused substance for teens boys. Even when they leave treatment, it’s common for them to relapse, especially with marijuana. Many celebrities promote marijuana use, despite their sobriety, calling it “California sober.” This glamorization of the drug is dangerous because marijuana has depressant properties. For those with psychiatric problems, marijuana can worsen them and cause psychosis. The relapse rate for marijuana is high over the first three to four years. 

However, the longer the teen remains in treatment, the lower their chances are for relapse. Below we’ll examine the rates of relapse and how to overcome it. 

Rates of Relapse

Its relapse rates are quite similar to those of other chronic ailments.

In September 2015, the International Journal of High-Risk Behaviors & Addiction published a study outlining things that play a role in reducing instances of relapse.

  • Relapse rates in treatment centers were up to 30.4 percent.
  • Many relapses occurred within the first six months of treatment, though many relapses also occurred after 30 months of treatment.
  • Lower levels of relapse were detected in people who were married as opposed to single people.
  • Patterns for adolescents were different than for adults.

Overcoming and Treating Chronic Relapse

One of the challenging things about treating addiction is that it was once thought that full abstinence is the only acceptable outcome of treatment.

About 40 to 60 percent of those in recovery from addiction relapse at some point. This is similar to relapse rates for people with diabetes (30 to 50 percent) and people with asthma (50 to 70 percent). Some experts say it may be time to treat drug addiction the way doctors treat cancer — as a condition where remission may continue to occur.

“Treatment should change so that people can feel comfortable discussing any relapses with their primary care provider or an addiction specialist. As for now, this is what people do if they have another chronic illness, such as diabetes, and they notice that something is wrong.”

The Indian Journal of Psychiatry offers another point of view regarding lapses versus relapses.

Lapses involve using a small amount of a substance a person was once addicted to. A person who is in treatment for alcohol addiction and has just one drink on one occasion has had a lapse.

Relapses involve returning to prior levels of drug or alcohol use after receiving treatment.

A prolapse occurs when a relapse causes a person to change for the better.

Using Relapse Prevention as a Tool

The Indian Journal of Psychiatry mentions that relapse prevention (RP) uses techniques adapted from cognitive behavioral therapy to help people make changes. It involves identifying high-risk situations, and it has two main goals:

  1. Harm reduction and the prevention of lapses
  2. Managing lapses when they occur and preventing relapses

RP looks at recovery from a different perspective. Instead of assuming that everyone will remain abstinent, this point of view understands that it can be difficult to maintain recovery once treatment has ended.

When looking at relapse in this way, RP also assumes that there are reasons why a person would return to alcohol or drugs, such as:

  • Losing motivation
  • Forgetting skills learned during treatment
  • Coming back to environments that caused a person to rely on alcohol or drugs

In September 2015, the Yale Journal of Biology and Medicine published a paper that discussed four main points in relapse prevention:

  1. Relapse consists of many stages and is a gradual process.
  2. Recovery has various milestones, and each of these can trigger a relapse.
  3. Mind-body relaxation and cognitive behavioral therapy are two tools that assist in the prevention of relapse.
  4. Some basic rules can explain why people relapse.

The Yale Journal of Biology and Medicine also mentions various ways relapse occurs. These include:

Emotional relapse

This involves denial as people are not thinking about avoiding substances. Instead, they may be focused on their past relapse and harbor emotions that set the stage for future relapse.

Mental relapse

A person battles with their desire to use and abstain from a given substance. A person’s cravings may overpower their ability to continue resisting.

Physical relapse

This involves actually using alcohol or drugs, and it relates to opportunity. Often, people are mentally relapsing and cannot control their thoughts, which leads to physical relapse.

Finally, the Yale Journal of Biology and Medicine mentions that people must change their lives if they want to fully leave drugs and alcohol behind. Many people want to return to their old lives but just exclude substances.

This is not possible, as having the same variables in your life can cause you to relapse again. You must be honest with yourself, commit to changing your life, and ask for help no matter how many times you lapse. This can prevent relapses in the future and allow for treatment adjustments that sustain recovery.

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