Recovery from drug or alcohol abuse or a process addiction isn’t always a neat and tidy process. Relapse is common and many addiction professionals believe it to be a natural part of the process. Just like people with chronic conditions like hypertension, asthma and diabetes slip up in their ongoing recovery regime, so do people struggling with the chronic disease of addiction.
Relapse rates for heroin and opiate addiction hover around 90%, according to some research. One study found that of 109 subjects who had achieved sobriety in heroin rehab, 99 relapsed. Of the 99 people who relapsed, 64 did so within one week. Similarities among those who relapsed included younger ages, heavier opiate use prior to treatment, use of the drug through injection and no aftercare. The Silver Lining: Recent research has shown promising results for opiate-dependent individuals who engage in long-term treatment for addiction. This can include inpatient treatment for at least six weeks followed by outpatient treatment or aftercare, and in some cases, close medication management with opiate agonists such as buprenorphine.
Cocaine is usually abused because of its ability to produce large amounts of the feel-good brain neurotransmitter, dopamine. One national study by researchers at the Institute of Behavioral Research at Texas Christian University followed people who had gone through treatment for cocaine addiction for one year post-rehab. They found that of 1,605 individuals, 377 (23.5%) were using cocaine weekly within a year. However, that dropped from 73% before treatment. The Silver Lining: Higher relapse rates for cocaine use were associated with fewer than 90 days of treatment. Longer stays in drug rehab and aftercare may increase the chances of long-term abstinence from cocaine.
Eating Disorder Relapse
Recovery from eating disorders can be difficult due to the co-occurring mental health issues that often accompany them. Borderline personality disorder, obsessive-compulsive disorder, bipolar disorder and depression are among the most common comorbid conditions. Eating disorder recovery is also complicated by the fact that abstinence from food is not possible as is the case with alcohol and drug addiction recovery. A 2012 study published in Psychiatry Research found that of 100 women who received inpatient or day treatment for anorexia nervosa, 41% relapsed within one year. A study on relapse rates in bulimics assessed subjects before and after treatment, and then again after two years. Within two years, 31% had relapsed, with the majority of relapses occurring within the first six months. Another study by researchers at Oxford University that followed subjects over five years saw as high as 50% relapse rates in bulimics but only 18% in binge eaters. The Silver Lining: As more research is conducted on eating disorders, certain approaches are emerging as promising interventions for long-term recovery. For instance, research by Stanford University, Lucile Packard Children’s Hospital and the University of Chicago found that family-based therapy was twice as effective as individual counseling in promoting full remission of anorexic behaviors in adolescents. Additionally, much research has backed the long-term effectiveness of cognitive behavioral therapy in the treatment of bulimia.
Alcohol Use Disorder Relapse
The National Institute on Alcohol Abuse and Alcoholism (NIAAA) reports that about 90% of people in recovery for alcohol use disorders are likely to relapse at least once over a four-year period. Triggers run far and wide for people in recovery from alcoholism because alcohol is legal and socially accepted — bars, restaurants, grocery stores, convenience stores, even some drug stores carry alcohol these days, not to mention its inclusion in everyday social situations. Additionally, numerous studies have shown that alcoholism frequently co-occurs with mental illness like depression and anxiety. If these underlying issues aren’t fully addressed, the alcoholic is handicapped in their recovery efforts. The Silver Lining: One study found that people who quit drinking without seeking treatment were more likely to relapse within three years. Specialized treatment for alcoholism can work if it’s comprehensive and the client is motivated. The NIAAA notes behavioral therapy, medication and mutual support groups as promising options for long-term recovery.
Gambling Addiction Relapse
Recognized as a disorder by the DSM-5, an estimated 5.77 million people in the U.S are in need of treatment for compulsive gambling, according to the National Council on Problem Gambling. Furthermore, 50% to 75% of gamblers relapse after trying to quit. The National Epidemiologic Survey on Alcohol and Related Conditions found that problem gamblers frequently suffer from drug or alcohol abuse, anxiety and mood and personality disorders as well. The Silver Lining: Researchers at Tel Aviv University found that medicines used to treat other addictions such as naltrexone can also be effective in treating pathological gambling, with some gamblers abstaining from gambling for the duration of the six-month trial. Behavioral therapies are also effective in treating problematic gambling behaviors. Treating the co-occurring disorders that accompany compulsive gambling can also improve recovery outcomes.
Researchers at the University of Vermont found that in a sample of 82 people who abstained from marijuana for two weeks, 71% relapsed within 73 days. Another study published in the Journal of Substance Abuse Treatment followed 67 daily cannabis users and 54 daily tobacco cigarette smokers who had quit using these substances within the last 30 days. They found that relapse in both cases was usually attributed to withdrawal symptoms. The Silver Lining: If withdrawal symptoms are a predictive risk factor for relapse in marijuana users, drug rehab may help. Treatment centers that offer detox have medical teams that can prescribe research-backed medications to ease withdrawal symptoms. Inpatient or outpatient treatment can help the user address co-occurring mental health issues that might propel use as well as monitor withdrawal symptoms that may interfere with recovery.
Some research has shown meth relapse rates to be as high as 88%. Researchers at Australian National University in Canberra found that people who had undergone methamphetamine detox were just as likely to use the drug again after three months as those who had no treatment. The Silver Lining: The same Australian study found that 48% of meth users who followed detox with drug rehab were still sober after three months. Twenty percent of those who attended treatment were still abstinent after one year in contrast to only 7% of people who had undergone only detox or had no treatment. Recovery from meth — and most substances — requires more than detox. It should be followed by a comprehensive addiction and dual diagnosis treatment program.
Not everyone will relapse from chemical and process addictions, but some people will, and when they do, it’s not time to throw in the towel. It’s an opportunity to learn more about themselves, their triggers and what still has room to change in their lives. It’s a chance to exercise self-forgiveness and self-compassion, build resiliency and try again.