Relapse Prevention In Substance Use Disorders

Relapse Prevention In Substance Use Disorders

By Lekmak Wetle Tyoden

It is sometimes daunting for mental health professionals after making every effort through medications, psychotherapies, group sessions, and family sessions and has employed every skill and strategy expected in the profession to treat patients who use, abuse, or are addicted to drugs and substances. After all that has been done and the positive feedback gotten from the patients or clients themselves, it is easy to find yourself as a professional become so hopeful that recovery will be maintained only for you to find yourself repeating the same processes all over again with the same patients or clients few weeks or months down the line because they have gone back to using again (Relapse). This is not something strange, especially in the area of SUDs (substance use disorder), a lot of factors do come to play that make individuals go back to using again and a lot of factors come to play in achieving recovery.

Relapse to substance use after successful rehabilitation treatment is a public health concern worldwide. The relapse rate for SUDs is estimated to be between 40 and 60 percent. Although relapse does occur it doesn't mean that achieving and maintaining recovery is impossible. The key to relapse prevention is to understand that relapse happens gradually. The goal of relapse prevention is to help individuals recognize the early warning signs of relapse and to develop skills that will help them cope to prevent relapse in the process.

As stated in the first paragraph, relapse is simply going back to using the substance again after being abstinent for some time.

There are majorly 3 stages of relapse namely;

* Emotional Relapse
* Mental Relapse
* Physical relapse

Emotional Relapse; at this stage individuals are not thinking about using but their emotions and behaviors are setting them up for relapse eventually. Signs to show that an individual is having an emotional relapse are the persistence of boredom, being hungry, becoming angry or irritable all the time, loneliness, tiredness, and being overwhelmed.

Mental Relapse; at this stage, there is a conflict going on inside the individual's mind. Part of them wants to use substances and another part doesn't. as this goes on, the need for escape increases, and the mental resistance to relapse diminishes. Signs of mental relapse are craving for substance use, thinking about people, places, and things associated with past use, looking for opportunities to use, thinking of ways to better control using, minimizing the consequences of past use, and glamorizing past use and planning a relapse.

Physical Relapse; this is when the individual has gone back to using again. Physical relapse is divided into "lapse" (the initial drink or drug use) and "relapse" (a return to uncontrollable use). In the case of a lapse, an individual may avert back to an emotional relapse where they may experience guilt and shame for using or a mental relapse where the individual finds justification for using uncontrollably or not either way the risk for uncontrollable using becomes high.

Relapse Prevention Plan

It is important that while in recovery, a relapse prevention plan is developed by the individual with the guidance of a counselor. A relapse prevention plan is simply a way to identify and reduce the risks associated with relapse, which helps people stay in recovery for longer periods. It should be written to make references and have clear steps of action to be taken should a relapse seem possible. It also should be tailored to the individual's specific needs and experiences; this will require assessing the individual's history with substance to find out factors that led to a prior relapse.

Things to note in the plan are Triggers; they are both internal and external which include persons, places, thoughts, emotions, and anything else that can potentially lead individuals to relapse. Cravings (the urges that come on the need to make use) and how they can be managed, individuals should identify which of the craving management techniques is suitable for them. Coping tools can be exercising, learning new skills that positively impact, assertiveness, emotional intelligence, time management, follow-ups on treatment, making positive social connections, and the likes. Support groups such as 12-step programs, AA (alcohol anonymous), NA (nicotine anonymous), and so on for encouragement from other individuals to maintain recovery. Goal setting; individuals must set goals for achieving a healthy lifestyle. What they will be doing daily, weekly, monthly, and for a lifetime.

In conclusion, given that substance use disorders are chronic diseases and relapse is common it shouldn't be seen as though persons with this condition and their relapsing rate are failures. As daunting as it can be for mental health professionals, they are always ready to provide the help and care for challenges such as these.