Identifying the Signs of Relapse

Dr. John Elgin Wilkaitis

Dr. John Elgin Wilkaitis completed medical school at The University of Mississippi Medical Center and residency in general psychiatry in 2003. He completed a fellowship in Child and Adolescent Psychiatry at Cincinnati Children’s Hospital in 2005. Following this, he served as Chief Medical Officer for 10 years of Brentwood Behavioral Healthcare a private health system including a 105-bed hospital, residential treatment, and intensive outpatient services.

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For those in recovery from drug or alcohol addiction, relapse is considered normal and even expected. However, it can also be dangerous. This is particularly true for those who are trying to overcome an opioid addiction.

What makes relapse so potentially dangerous? One major factor is the high chance of an overdose when a relapse occurs. According to researchers at the Jacobs School of Medicine and Biomedical Sciences at the University of Buffalo, while a number of factors make relapses potentially harmful, the main one is that people lose their tolerance.

Many of those who were in recovery can no longer handle their former dosage of drugs. If they take the same amount they used to take, they can easily overdose. Even if they try to be cautious and take just half of their former dose, because they are no longer used to the drug, it can lead to overdose and even death.

Friends and family members need to be aware of the dangers of relapse for someone who is recovering from addiction. Read on to learn some of the signs to watch for.

What Is Relapse?

According to the National Institutes of Health, addiction relapse occurs when an individual starts to use drugs again after a period of recovery. He or she attempted to stop but was not successful. Unfortunately, a relapse may occur at any time, even if the person has gone through a treatment program. In some cases, even after years of sobriety, someone can relapse. Often, an external event is the trigger.

While this may seem alarming, it is normal, and it does not mean the person has failed or that the treatment program is a failure. However, a user may need to re-enter a recovery program or modify his or her ongoing strategy for sobriety. A relapse is not a time to give up, as many people are able to regain sobriety and go on to lead productive lives afterward.

The NIH notes that newer treatment programs take into account the reality that relapses can occur, and they are better geared than prior options to enable clients to reach success. Professionals are trained to understand the causes of relapse, including compulsive behaviors, and modern recovery programs are better able to help clients navigate potential pitfalls on the road to a lifetime of sobriety.

Stages That Occur in Relapse

The Yale Journal of Biology and Medicine notes that relapse actually happens gradually. It can take weeks or even months for someone in recovery to succumb to their prior addiction. This is a major challenge for anyone trying to stay sober.

The good news is that when a client in a treatment program is trained to perceive the warning signs for a relapse, he or she can use learned coping skills or seek further help if needed. Clients also need to be aware of the emotional, mental and physical stages of relapse.

Emotional Relapse Stage

A person recovering from addiction is not actively considering reusing drugs or alcohol at this stage. Too many memories of the trauma that accompanied their last episode will be fresh in their mind. However, their emotions may still be signaling that a relapse is eminent.

The signs to watch for include:

• Being unable to express feelings
• Avoiding contact with friends and family
• Missing meetings with sponsors, therapists and support groups
• Going to meetings but not participating
• Focusing on other peoples’ problems
• Not taking proper care of their health

Mental Relapse Stage

People in recovery often have mental conflicts when it comes to their drug or alcohol abuse. On the one hand, they understand the dangers and know they need to remain sober. On the other hand, a part of them is very tempted. They may try to convince themselves that the substance is not as bad as they thought or otherwise try to justify why it’s all right to succumb to temptation. Sometimes, the more intelligent the person is, the more cleverly they will try to circumvent the boundaries they have set up for themselves.

The deeper they go into mental relapse without seeking help, the more their resistance may fade. They may feel an ever stronger desire to run from the problems of their daily lives.

Signs of a mental relapse include:

• Experiencing intense cravings for the drugs or alcohol they were addicted to
• Taking trips down memory lane where they reminisce about the halcyon days of addiction, focusing on pleasant times and people and glamorizing the events of that time while skimming over the disastrous consequences
• Bargaining
• Lying
• Thinking of strategies to take drugs or alcohol in a controlled manner
• Searching for opportunities to relapse
• Planning a relapse

Physical Relapse Stage

This is the final stage of relapse. Your friend or family member is once again using drugs or alcohol. This is the hardest phase to overcome, as changes occur in brain chemistry in response to the person once again using the substance they were addicted to. Confident that they won’t get caught, they feel emboldened. This is the most challenging stage of relapse and requires both training and strong coping skills to overcome.

Other Signs That Warn of a Potential Relapse

Many different factors can affect recovery, so it’s important for the recovering individual to have a personalized plan for regaining sobriety in the event of a relapse. Because each person is different, triggers like the following may affect certain people but not others.

Stress

Stress is one condition that can lead to relapse. When clients in recovery are faced with a stressful situation, unless they have learned other coping mechanisms, it’s easy to use drugs or alcohol to make themselves temporarily feel better. For this reason, learning about stress management is one of the key points in many recovery programs. When someone in recovery is given the skills to manage stress, it helps him or her to avoid abusing a substance to achieve the desired result.

Recurrence of the Symptoms of Withdrawal

Alcohol withdrawal symptoms typically last two to 10 days. However, some people experience post-acute withdrawal syndrome, or PAWS. In some cases, these symptoms can last for months or even years.

Common symptoms of PAWS include:
• Feelings of being irritated, uneasy or on edge
• Trouble sleeping
• Difficulty concentrating
• Lack of pleasure in normal activities
• Constant tiredness
• Worsening memory

If your friend or family member is exhibiting these signs, it may be time to seek further help for them.

Lack of Structure

One essential component of the rehab process is helping clients establish new and healthy routines void of drug and alcohol use. When a client establishes a positive daily structure, it provides the framework for living a sober life. Often, rehab programs will provide clients with guidance in establishing these routines.

When someone in recovery seems to lack daily structure, this can be a warning sign of relapse. It may indicate that the person is resuming past habits such as using alcohol or drugs.

Loss of Control

If your friend or family member starts to act in an erratic way, like making irrational decisions or exhibiting overconfidence, this may indicate that they are using again. They may think that since they have been sober for a while, it won’t hurt to occasionally dabble in drugs or alcohol. They think they can handle it, but they can’t.

Recovery From Addiction

Like relapse, recovery has stages. These are abstinence, repair and growth. It’s important that each person moves at a comfortable pace through each stage in this process of recovery.

Abstinence Stage

This is when the client stops using drugs and alcohol. The main focus during this stage is to deal with any cravings and to maintain sobriety. The most important component during this phase is encouraging clients to realize that they have an addiction and to remain actively involved in the process of recovery. This means attending support groups, participating in necessary therapy and developing healthy outlets as substitutes for addictive behaviors.

Often, a client will need to avoid people and places that are associated with their addiction. If there are friends and family members who are still using, the client may need to keep them at a distance for their own safety. Honesty and self-care are very important at this time.

Repair Stage

This is a time for the person to focus on repairing the damage that occurred due to his or her dependence on drugs or alcohol. It is normal to feel guilt, anger and other negative emotions during this time. It’s important that the recovering individual continue to rely on a support network while working through this process.

Repairing relationships with loved ones is often a component of this stage. It’s also important that the client work on modifying past behaviors such as self-criticism. During the transition to a healthy and balanced lifestyle, the person can develop better coping strategies for dealing with the normal stresses of life.

Growth Stage

The final stage is growth. This is when clients can develop the new skills they need to thoroughly address the roots of their addiction. This stage can last a lifetime, and it typically begins after someone has achieved a period of sobriety. This is a critical period in your loved one’s recovery journey, as they are finally ready to face the past traumas that led to their addiction. They can learn to set healthy boundaries for themselves and to participate fully in leading a healthy life.

What Is the Best Way to Prevent a Relapse?

While it is tempting for someone undergoing a relapse to try to cure themselves, the best way to achieve lasting sobriety is to find a reputable treatment center with experienced and compassionate professionals who can help the person navigate the recovery process.

At Defining Wellness Centers in Mississippi, we have board-certified doctors and licensed clinicians who specialize in treating addiction. Various programs are available to help customize a plan that fits your needs or the needs of someone you love. There are gender-specific options as well as dual-diagnosis programs.

An aftercare program is specifically designed to help clients avoid a relapse. This program involves a variety of support systems and services to aid clients after they are discharged from an inpatient treatment program. The aftercare program includes therapeutic recommendations, an outline of coping strategies and tools, guidance for avoiding relapse triggers, and prevention planning. A client-specific program is developed collaboratively between each client and his or her therapist.

The goal is to make sure that ongoing support is a constant presence in the client’s life as long as it’s needed. Not only does the team at Defining Wellness Centers work with the client, but they also engage with family members and other loved ones, as they are an integral part of the recovery process.

Thanks to the wide range of techniques and modalities they offer, the professionals at Defining Wellness Centers are well-equipped to help clients who have relapsed regain their sobriety and work toward achieving their lifetime goals of happiness, productivity and sobriety.

For more information about our programs, contact us today.

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