Detox off Drugs

Posts Tagged ‘relapse’

Relapse often occurs to those in recovery, but it is not automatic – and it is preventable. In fact, relapse prevention training is generally included in the final phase of active treatment before the client is released from the program. But, just because you may have had relapse prevention modules doesn’t mean that you have absorbed all you need to in order to ward off relapse. Just as each addict has a unique set of circumstances leading to his or her addiction, and treatment is tailored to best match the individual’s wants and needs, each person in recovery will face numerous stressors, pressures, cravings and cues, that may trigger relapse.

Some stressors, while they may be experienced to a different degree, are somewhat universal. To the extent that the recovering addict falls prey to the stressors and slips into relapse very much depends on how well prepared he or she is to handle the challenges and obstacles that occur – especially in early recovery.

What are some of the most common stressors and, beyond merely identifying them, what can be done about them? Read on.

Unemployment

Once an addict completes treatment and attempts to resume a normal life, one of the first stressors likely to be encountered is job-related. If the individual goes from treatment directly to a sober living home or halfway house, there may be assistance available to help the person transition from active treatment phase to resumption of normal living. A strong component of the transition phase is training in communication skills, how to present oneself for an employment interview, filling out a job application, writing a resume, and, possibly training to open up new employment opportunities.

Some recovering addicts do not go to a halfway house but return directly home. They attempt to pick up where they left off in their job, if they still have one. For some, their job is no longer there, or they were fired or quit as a result of their addiction. Being unemployed is a huge blow to the recovering addict, who now has to face the prospect of finding new employment while trying to negotiate a mountain of accumulated past-due bills, medical expenses, family obligations, and the like.

Add to the pressure the fact that the person may have been the family’s sole provider, and unemployment may become a primary trigger that results in relapse.

If you are a recovering addict and have no job, seek help in getting back into the work world. Use the resources available to you in your 12-step groups such as job fairs, job training, communications training, and financial aid to go back to school, and the like. Your 12-step sponsor and other group members may also be able to recommend programs in the local community that can help. Many alumni members have strong ties to such programs and are more than willing to help out fellow members get back on their feet.

Ask for help – and be willing to accept it. After all, your support system is going to be bedrock of your ongoing recovery. And everyone needs to have gainful employment in order to secure a satisfying and rewarding future.

The Enablers: Family, Friends and Co-Workers

If the family members have not also participated in treatment – such as family treatment programs – the individual in recovery is returning to the same environment he or she left prior to treatment. Family members may become enablers to the person in recovery. They help the addict avoid the consequences of his or her addiction, or they make it easier for the recovering addict to pick up their addictive behaviors that they thought they had left behind.

The same enabling stressors can occur with close friends and co-workers, people with whom the recovering addict spent time engaged in unhealthy and addictive behaviors.

Not everyone in the family will have the same reaction to attending family treatment – if they even went. They may mean well – enablers usually do – but they inadvertently spark or trigger stress that results in the recovering addict’s resumption of the addiction.

How can you help prevent the enabling of family, friends and co-workers? Start by listing ways to avoid relapsing that may be triggered by the actions of these people. You can’t prepare a coping strategy if you don’t have options available to you. Again, don’t try to figure this out on your own. Talk it over with your 12-step sponsor, fellow group members, your therapist or counselor in continuing care or aftercare (if these are part of your overall treatment plan), or an independent therapist trained in recovery strategies.

Source: Drug Addiction Treatment

Even effectively treated people with addictions will confront unexpected situations after they leave a treatment program and return to their home environment. These situations may produce intense periods of craving to re-use alcohol and other drugs. Lapse, defined as re-use of alcohol or drugs at least once following treatment, occurs in at least 50% of those who complete treatment. The most dangerous period for lapse is the first 3-6 months after completion of formal treatment. Relapse, defined as return to excessive or problematic use, is less common, occurring in approximately 20-30% of those who complete formal care in the prior year.

It is critical that patients, their families and friends prepare for the possibility of lapse and relapse. The preparation should include early detection of a lapse and establishment of steps to keep that problem from becoming a full-blown relapse. Two sets of activities can reduce the likelihood of relapse and reduce the severity if it does occur.

Treatment-Related Preparation

A good addiction treatment program prepares patients to:

• recognize they have a problem that will require continued management and monitoring
• learn and practice some of the fundamental skills needed to recognize and overcome the urge to use or drink when these situations emerge
• be engaged in a continuing care program such as AA and receive regular monitoring of substance use through urine screening or breathalyzer
• receive periodic phone calls or in-home visits following care to monitor their recovery

These generic elements of effective planning during treatment are among the best clinical practices available to forestall lapse. This planning should involve families so they can better understand the treatment issues, be prepared to support the recovery plan and be aware of signs of lapse.

Post-Treatment Preparation

To prevent and contain relapse the family should agree to fully participate in planned continuing care activities. Families and all concerned others can take five helpful steps:

• Have copies of the continuing care plan prominently displayed to reduce ambiguity and promote full communication and response.
• Early in formal treatment, ask the family member in treatment to describe in writing some of the very early signs and behaviors that may lead to his/her lapse and relapse. For example, he/she might write something like “I will begin hanging out with my friend Jimmy,” “I will not do my homework” or “I will stop attending AA meetings.” As the family member undergoes continuing care, regularly refer to these written descriptions to monitor the recovery process.
• During formal treatment, as the individual thinks about relapse scenarios, ask what s/he thinks should be done when early relapse signs emerge. Use these words to develop a contract that includes an action plan the family will follow when any of these signs surface. For example, s/he might write “take my cash and credit cards,” or “increase the urine screens.” Be prepared – before the relapse happens – to take the type of actions contracted.
• Receive and display the results of post-treatment urine screens. Discuss any positive results openly and honestly.
• Monitor and support changes that are consistent with a drug-free lifestyle. In other words “catch him doing something good” and then support it appropriately.

Even effectively treated people with addictions will confront unexpected situations after they leave a treatment program and return to their home environment. These situations may produce intense periods of craving to re-use alcohol and other drugs. Lapse, defined as re-use of alcohol or drugs at least once following treatment, occurs in at least 50% of those who complete treatment. The most dangerous period for lapse is the first 3-6 months after completion of formal treatment. Relapse, defined as return to excessive or problematic use, is less common, occurring in approximately 20-30% of those who complete formal care in the prior year.

It is critical that patients, their families and friends prepare for the possibility of lapse and relapse. The preparation should include early detection of a lapse and establishment of steps to keep that problem from becoming a full-blown relapse. Two sets of activities can reduce the likelihood of relapse and reduce the severity if it does occur.

Treatment-Related Preparation

A good addiction treatment program prepares patients to:

• recognize they have a problem that will require continued management and monitoring
• learn and practice some of the fundamental skills needed to recognize and overcome the urge to use or drink when these situations emerge
• be engaged in a continuing care program such as AA and receive regular monitoring of substance use through urine screening or breathalyzer
• receive periodic phone calls or in-home visits following care to monitor their recovery

These generic elements of effective planning during treatment are among the best clinical practices available to forestall lapse. This planning should involve families so they can better understand the treatment issues, be prepared to support the recovery plan and be aware of signs of lapse.

Post-Treatment Preparation

To prevent and contain relapse the family should agree to fully participate in planned continuing care activities. Families and all concerned others can take five helpful steps:

• Have copies of the continuing care plan prominently displayed to reduce ambiguity and promote full communication and response.
• Early in formal treatment, ask the family member in treatment to describe in writing some of the very early signs and behaviors that may lead to his/her lapse and relapse. For example, he/she might write something like “I will begin hanging out with my friend Jimmy,” “I will not do my homework” or “I will stop attending AA meetings.” As the family member undergoes continuing care, regularly refer to these written descriptions to monitor the recovery process.
• During formal treatment, as the individual thinks about relapse scenarios, ask what s/he thinks should be done when early relapse signs emerge. Use these words to develop a contract that includes an action plan the family will follow when any of these signs surface. For example, s/he might write “take my cash and credit cards,” or “increase the urine screens.” Be prepared – before the relapse happens – to take the type of actions contracted.
• Receive and display the results of post-treatment urine screens. Discuss any positive results openly and honestly.
• Monitor and support changes that are consistent with a drug-free lifestyle. In other words “catch him doing something good” and then support it appropriately.

By: Thomas McLellan PHD