It is commonly believed that once out of rehabilitation, a person who is in recovery from substance use disorder is already healed and ready to get back where they left off.
This is not true as the post-rehabilitation stage opens another chapter which is mainly aimed at ensuring that the person does not go back to the harmful habit. In treatment jargon, it is referred to as relapsing.
The American Addiction Centers defines a relapse as when a person returns to using drugs or alcohol after a period of sobriety. While a lapse is a brief “slip” where a person may drink or use, but then immediately stop again, a relapse is when a person makes a full-blown return to drinking or using drugs.
It has been proven that one of the most significant reasons behind a relapse is stress. Stress is a natural part of life and everyone has to deal with it at some point. However, it is known to increase relapse risk due to changes in brain activity. Such changes can lead to dependency despite the actual healthier coping behaviour that an addict may have learnt.
Terence Gorski, in his book Developing A Relapse Prevention Plan, first identified three stages of relapse: Emotional, mental and physical. They were based on the foundations of the Alcoholics Anonymous and Narcotics Anonymous support groups. His work in relapse prevention has helped many rehabilitation centres create effective plans for recovering users.
While the exact role of stress in dependence setback is blurry, one reason for this link may have to do with changes in the brain and brain activity as a result of addiction. With time, drug and alcohol use can modify both the stress and dopamine pathways in the brain inhibiting their normal functioning and leading to heightened drug cravings, especially when stress levels are high.
Chronic stress can cause mental health problems such as anxiety or depression and when people in recovery are overwhelmed by stress, they might be tempted to turn to drugs or alcohol for relief.
While the responsibility of dealing with stress is unique to individuals and comes with varied approaches, it is also critical that those people around individuals in recovery should ensure that they do not subject them to any form of stress lest they claw back on the gains made out of drug dependence.
Some recovering drug users also subconsciously put themselves into stressful situations to justify the urge to relapse. These sorts of situations might require a double analysis, in which addiction is assessed along with another underlying mental disorder.
In many cases, a relapse occurs when someone recovering from a drug problem feels that they can’t cope with the stress in their life. If someone first began using drugs to combat stress, the first solution to the problem, whenever they get stressed, is to use drugs.
One way to prepare for this trigger is to evaluate the stress one is experiencing. Although persons in recovery cannot eliminate everything and everyone from their life, they can avoid situations that cause them extreme stress. As a result, it may help to list all the people, places and things that cause excessive stress.
The connection between stress relief and drug use means that a person in recovery needs to develop stress-reduction techniques. This can often be a part of relapse-prevention therapy and is usually included in various rehabilitation programmes.
There is no single set of stress-management techniques that works for everyone. It may take a bit of trial and error to figure out which strategies work best for someone. Being aware of the signs of stress and learning how to handle stressful situations can help reduce the risk of relapse.
Having a strong support network is a key component of relapse prevention and stress management. Many treatment centres work with the families of people dealing with addiction to help them understand the challenges of recovery and learn how they can support their loved ones in the future.
Manager Corporate Communications, Nacada
