There’s an ongoing debate in the addiction treatment community about whether relapse should be considered part of recovery. Advocates of this view make some compelling points. For one, a relapse can be extremely discouraging. According to the National Institute on Drug Abuse, between 40 and 60 percent of people will relapse within a year of getting treatment for addiction. The relapse rate may be even higher for easily accessible substances like alcohol. Saying that relapse is part of recovery may make those 40 to 60 percent feel less discouraged and more likely to try again. Perhaps even more importantly, it moderates their families’ expectations. The stigma of addiction is painful enough without adding the stigma of failure as well. Considering relapse as part of recovery might make families more tolerant when things go wrong.
However, we feel there are more compelling reasons not to consider relapse part of recovery. They include the following.
The notion that relapse is part of recovery discounts the danger inherent in a relapse. There are, in fact, real costs to a relapse. First, people are most vulnerable to overdose after a period of sobriety. You may be used to using at a dose that took years to build up to. If you try to use again at that dose after a period of sobriety, your tolerance is gone and the old dose is likely to be too much.
Even if you don’t overdose, there are still plenty of other consequences to a relapse. All the reasons you decided to get sober in the first place still apply. It only takes one night of drinking to get into a an accident, get a DUI, or violate the terms of your probation. A relapse may easily lead back to uncontrolled use, lasting for months or years, bringing with it all the destruction and unhappiness you worked so hard to escape in the first place.
If 40 to 60 of people in recovery relapse within the first year after treatment, it also means that 40 to 60 percent of people don’t relapse within the first year. In other words, you have about as much chance of maintaining sobriety as you do of relapsing. However, saying that relapse is part of recovery assumes that relapse is the normal path to recovery. It might be something that happens during recovery but there’s an equal chance it won’t be. Given the very real dangers inherent in relapse, it is better to emphasize the likelihood of sustained recovery.
Advocates of the idea that relapse is part of recovery believe that it reduces the pain and stigma of a relapse and makes someone more willing to try again. It’s certainly good to try to reduce the pain and stigma and encourage trying again but there’s another side to this coin. The fear of failing, of disappointing one’s family, and wasting months or years of hard work can be a powerful incentive to stay in recovery. If a healthier, more fulfilling life is the carrot of recovery, fear of relapse is the stick. Even if the effect is marginal, every day or every moment of sobriety can help because the longer you stay sober, the easier it gets. One study of 1,200 people found that about two thirds relapsed within the first year but less than half relapsed after the first year and only fifteen percent relapsed after five years. Anything that can keep you in recovery even a little bit longer can improve your chances of long-term success.
On the other hand, believing that relapse is part of recovery provides a convenient excuse for people who decide to relapse. Relapses don’t typically happen out of the blue; there are stages. In the first stage, emotional relapse, you typically feel negative, cynical, angry, or depressed but you still want to stay sober. In the second stage, mental relapse, you may have cravings, reminisce about using, start bargaining, or looking for excuses to relapse. Believing relapse is part of recovery is a convenient excuse. You might decide you’ll have to relapse at some point anyway, so you might as well. People still typically feel conflicted about relapse in the mental stage and it is the last opportunity to save your recovery before a physical relapse.
The idea that relapse is part of recovery lets treatment programs off the hook when their clients relapse. Although treatment centers typically boast of their own success rates, it doesn’t hurt to supply the caveat that relapse is common and it’s no reflection on the quality of treatment. Relapse might even be good for business.
It’s true, of course, that people do relapse even after receiving high quality addiction treatment. When this happens, it typically indicates one of two problem. First, treatment may not have lasted long enough. Treatment programs typically last 30 to 90 days. However, everyone is different and for many people, this relatively short time frame is not nearly long enough to break old habits and establish new, healthier habits. The second common problem is that some people do well in treatment but fail to successfully transition back to regular life. Quality treatment centers attempt to smooth this transition with quality aftercare programs, but once you’re out the door, they have very little influence over what you do. Often, people need a lot more support adjusting to normal daily life than treatment programs can provide.
Finally, the idea that relapse is part of recovery doesn’t distinguish between health and pathology. Recovery isn’t only a matter of abstinence. It’s about changing your thinking, habits, and lifestyle in ways that make substance use unnecessary or even unappealing. As noted above, there are three stages to relapse. Someone in the emotional or mental stage of relapse is not in a good place, although she may be technically still in recovery. There’s very little risk of relapse from a position of strength in recovery.
Hired Power is a transitional service offering individualized addiction recovery assistance from crisis intervention to the first year of recovery and beyond. Some of our services include getting clients into detox and treatment, finding an appropriate treatment center for a client’s specific needs, helping clients transition from treatment to daily living, providing mentorship, sober assistance, and other services. Explore our website or call us at 800-910-9299 for more information.
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