The National Institute on Drug Abuse tells recovering addicts that relapse is not only possible, but likely, and drug and alcohol counselors view relapse as almost inevitable. Those in recovery become susceptible to a relapse when they confuse abstinence with recovery. Abstinence is necessary, but not sufficient. To be forever recovered requires a change toward a more healthy and fulfilling lifestyle. Yet even people that understand this, and are taking the right steps, can find themselves vulnerable to some of the most potent relapse triggers.
Lack of Support
Recovery often involves attending some form of support group, but this is not always enough to overcome a lack of support from friends and family members. There are several reasons why an addict may not get the emotional support they need from those closest to them. They may be ashamed of their drug or alcohol use, and are keeping the extent of their problem a secret. Even the most well intentioned friends and relatives cannot help if they don’t know about the problem. Even worse, they may say or do things that unintentionally make matters worse.
In other cases, family members may be facing the same issues. Although there is no “addiction gene”, scientific research does show that genetic factors do play a significant role, and that a home with one addict is likely to have another. In these situations, the family home becomes a risky environment. Instead of finding the support and encouragement that’s needed, recovering addicts face the same environment that led to their destructive behavior in the first place.
Stress has long been viewed as enemy number one for anyone in recovery. A relentless workload can build stress and pressure slowly until a tipping point is reached, or stress can come upon us in a tsunami after a loved one passes away or a relationship falls apart.
Dealing with stress is what frequently leads people down the path of addiction to begin with, and that’s why it’s such a powerful foe. It starts with “one to take the edge off” and it works, albeit temporarily. All too soon a distraction becomes a habit and a habit becomes an addiction. To deal with stress requires a two fronted approach. The first part of the strategy is avoidance. The recovering addict should avoid situations and people that are likely to cause them stress. However, stress cannot always be avoided, and effective ways to manage and cope with it are also needed.
Exercise, proper diet and relaxation have long been the go to remedies for stress, but recent research by Brown University is shedding light on a chemical component. Research on rats has identified the area of the brain that triggers a relapse, and the neural transmitters involved. They were then able to block a crucial step in the process using the chemical nor-BMI.
Forgetting the Old Days
Most people in recovery know enough to avoid the people and places that got them into trouble in the first place; at least in the beginning. Being in the company of people that shared an addictive behavior and are still involved in it is obviously risky, but sometimes places that appear quite benign can present the same risks. Addicts have been placed on MRI machines and had their reactions to images analyzed. While pictures of drugs and drug use were expected to provoke a strong reaction, observers were surprised to learn that images of streets and neighborhoods had the same effect, even when they did not contain any clear drug references.
Knowing that drugs are just a phone call away can cause a relapse battle in the mind that is often decided by a trigger that comes out of the blue. The sound of an old friend’s voice on the phone or a depiction of drug use in a film or television program can easily cause an irresistible craving. Most recovering addicts are not able to uproot completely, and as a result are in a constant battle with the past as they try to focus on the future.
Fallout from Recovery
Sometimes avoiding stress and temptation can lead to a whole new set of problems. Shunning friends and family can be necessary, but if the resulting void is not filled with support it can lead to loneliness and self pity. Similarly, the avoidance of stress can cause people to feel disjointed and bored.
These relapse triggers act slowly, building up gradually until they are overwhelming. A caring support structure is good way to keep perspective, but the best way to avoid depression is to be proactively happy. Old destructive behavior should be replaced with new interests and diversions. As they descend into a negative spiral, alcoholics and drug addicts usually lose touch with the things that they once enjoyed. Recovery is the perfect time to rediscover them. Reading a book, going back to the gym or marathoning through a missed television series can all be help in the battle against boredom and depression.
Success can often be a recovering addict’s worst enemy, lying in wait for complacency to take hold. There are two ways that hubris can derail a recovery. The first is a belief that the battle is won and the demons have been vanquished. The second is thinking that a strength of character has developed which makes future addiction unlikely and “just one” is OK. Even if one leads to another, the risks may be downplayed because “I quit before and I can quit again”.
The irony of relapse is that it’s sometimes harder to quit the second time. The fear of impending disaster is replaced by the confidence of inevitable success. Rather than undoing all of the good work that was done before, a relapse can make that work appear to be bricks that have been laid and a path that has been cleared and that can be returned to at any time.
An addict will encounter triumph and disaster on the road to being forever recovered, and would do well to follow the advice of Kipling and “treat those two impostors just the same”.