No one gets sober with the intention of relapsing, but it happens. In fact, it happens quite a lot.
Addiction relapse rates hover between 40% and 60%. Try not to beat yourself up. While you shouldn’t diminish the significance of a drug relapse, it’s what you do next that’s most important.
I Relapsed. Now What?
Few things feel worse than relapsing after you’ve put so much time and energy into getting sober. You can turn this around though, and be stronger for it. If you’re wondering if drug relapse means you need to go back to inpatient addiction treatment, here are some questions to help guide your decision.
Was it a Slip or a Full-Blown Drug Relapse?
Some recovery communities like SMART Recovery, distinguish between a slip and relapse. A slip is when you briefly re-engage with drug abuse, immediately feel regret and start taking steps to get back on track. Slips may seemingly come out of the blue. Some examples could be a loved one’s death, a highly triggering social situation or a sudden loss such as a relationship ending or job termination. You didn’t see the trigger coming. You were a bit blindsided by it. Some people look at slips as reminders that life is uncontrollable. They take them as warning signs to be more diligent with recovery work and relapse-prevention plans. SMART Recovery provides tips on ways to do this. If you’re able to pick yourself up by the bootstraps and are confident this was a one-time event, returning to drug addiction treatment may not be necessary.
A drug relapse where drug addicts return to old patterns of alcohol and drug abuse is more serious. This could go on for days or weeks. You may isolate, reconnect with “drug friends,” skip support meetings and engage in all around unhealthy behavior. Even if you haven’t crossed that line into repeated drug abuse, but using again makes you homesick for your old lifestyle, drug rehab is likely the right decision.
What’s Your Support Network Like?
If you’re like most people in addiction recovery, you’ll agree recovery “takes a village.” You need to lean on others especially when you’re facing a drug addiction relapse. Research shows family support can be a critical part of staying sober. Social support and involvement in sober communities like Alcoholics Anonymous and other 12-step programs are linked to a greater sense of self-efficacy, less stress and more success in the recovery process. They also recognize relapse warning signs and can intervene before you spiral back into drug abuse. They’ll offer moral support and help you find treatment options. Only you know what type of help you need from others. For people in recovery, a strong support system often includes a sponsor, peers in recovery, empathetic friends and family, and behavioral health professionals. If you’re feeling like you are going to have to walk this road alone, it might make sense to return to the safe, supportive environment of a treatment center.
Do You Understand Why You Relapsed?
The old saying, “You don’t know where you’re going until you know where you’ve been,” rings true in recovery too. Relapses occur for different reasons. Being able to identify why you experienced a drug relapse is critical. You must understand the reasons you relapsed in order to move forward and prevent it in the future. Maybe it was a stressful event. Perhaps it was as simple as boredom. Many times it’s a combination of several factors. Research shows that cognitive behavioral approaches can help prevent an alcohol or drug relapse from spiraling. Work with your therapist to identify the thought patterns or events that triggered your return to drug abuse. They’ll help you reapply the tools you’ve learned to change your thinking and behaviors around those circumstances as well as the drug relapse in general.
What Kinds of Substances Are You Using?
When you’re off a substance for a period of time, your tolerance drops. Your body can’t handle the amount of drugs that used to get you high. A relapse on drugs of any kind can be dangerous, but some are especially lethal. Opioids are one of the most risky drugs for overdosing. The CDC tied opioids to 47,600 overdose deaths in 2017. That accounts for more than 67% of all drug overdose deaths. There’s a real risk for people with opioids to overdose after a period of abstinence because they try to use heroin in similar quantities as before. With a lowered tolerance, effects of drugs like opioids can be deadly. Cocaine is also risky in drug relapse. In one study of inmates who relapsed on drugs after being without them in prison, cocaine accounted for the most overdose deaths.
It’s impossible to know how much of a drug will cause dangerous consequences, especially when you’re under the influence and chasing the high. You may have made it through this drug relapse, but why risk it? Returning to inpatient treatment might make sense if you abuse drugs with a high risk of overdose like heroin, opioid painkillers, cocaine and benzodiazepines. If you’re using a combination of prescription and illicit drugs this can also be extremely dangerous and you should consider another visit to drug rehab.
Are You Managing Mental Health Issues?
Researchers at Texas Christian University reviewed several studies on substance abuse and mental health disorders. They found that alcohol and drug relapse rates are significantly higher in people with a dual diagnosis. If you have co-occurring disorders like depression, personality disorders or anxiety, make sure you’re managing those symptoms. You’ll be less tempted to self-medicate them with drug and alcohol abuse. See your psychiatric treatment expert. Take any treatment medications as instructed. Go to therapy regularly. If underlying psychiatric conditions are a significant part of your addiction relapse, it might be best to go back to rehab. You’ll have space and time to get psychiatric symptoms in check and regulate medications with the help of dual diagnosis treatment.
Can You Forgive Yourself for Relapsing?
Forgiving yourself for a drug relapse can make the difference between a slip and a quick spiral back into addiction. Known clinically as the abstinence violation effect, some people feel so much failure, guilt and shame over a brief relapse, they “give up” and continue abusing drugs and alcohol, full speed ahead.
Addiction is a chronic illness. Just like other chronic conditions like diabetes and heart disease, you must manage this illness for a lifetime. You must always follow your relapse prevention plan for a sober life. Drug relapse doesn’t mean addiction treatment didn’t work. It doesn’t mean you’re a failure and should throw in the towel. It doesn’t mean you’ll never get better. It means there’s still work to do. There are still lessons to learn. Many people come out of drug relapses more committed to recovery and stronger for it. Listen to what this relapse is trying to tell you.