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Relapse Prevention

RELAPSE PREVENTION STARTS WITH RECOVERY

Understanding Triggers in Drug and Alcohol Relapse

When one battles drug and alcohol addiction, one might relapse. With repeated use, new neurological pathways and brain chemistry are changed, creating dependency, withdrawal symptoms, and drug cravings. 

Since the brain has been programmed to be dependent on substance abuse, an individual may not feel “normal” without the presence of the drug in the system. Returning to drug or alcohol use in the form of a “relapse” becomes a way to combat strong cravings and self-medicate. When you can identify these triggers, you can also avoid and minimize relapse in your response to them.

As a normal stage of addiction recovery, the varying intensities of relapse does not mean failure or the end of the road, but that treatment needs readjustment to decrease episodes whether it’s through programs like detox, therapeutic methods, and a strong and stable support system. There is where helping a person through certain triggers can also help identify ways to prevent relapse.

Stay the Entire Duration of a Medical Detox

Your length of time in treatment is directly linked to increased chances of having a successful recovery and drug and alcohol abstinence. Longer periods of treatment means more established healthy habits that will decrease your chances of experiencing a relapse. Ultimately, this creates new brain pathways and a higher ability of brain healing.

Both emotional and physical aspects should be addressed during medically-supervised detox to avoid and reduce relapse. The Psychiatric Clinics of North America documents an increase in abstinence rates with the use of Cognitive Behavioral Therapy (CBT). These therapies help you work through potentially stressful situations, teaching you effective ways of rerouting your thoughts when dealing with ongoing negative thought patterns.

Medications for Drug or Alcohol Dependence

Another way to minimize relapse and manage triggers is through the use of medications of a treatment program to reduce drug cravings, manage withdrawal symptoms, and rebalance moods. The types of drugs used by clinicians in a treatment setting will vary depending on the drug you’ve become dependent or addicted to. Below we’ll provide you with a brief list of drugs that will help an individual from relapsing.

Opioids

Studies have shown that individuals struggling with opioid use disorders (OUD) following detox are likely to relapse. Relapse is a standard step in the recovery process, but it has the potential to become life-threatening and raise the risk of a fatal overdose. An important step to support someone recovering from opioid addiction is to maintain abstinence through the use of medications. 

Someone in recovery can use medications that reduce the adverse effects of withdrawal or cravings without producing euphoria. The U.S. Food and Drug Administration (FDA) recently approved a drug called lofexidine, a non-opioid to reduce opioid withdrawal symptoms. Methadone, Naltrexone, and buprenorphine are three other commonly used drugs approved for this same purpose.

Alcohol

As of now, there are only three medications approved by the FDA to treat alcohol dependence. None of the medicines are prescribed to those who actively use alcohol. These drugs are for individuals who have stopped drinking and are trying to maintain abstinence. 

Antabuse, which also goes by disulfiram, is the first medicine approved to treat alcohol abuse. Most people who use the drug will vomit if they consume alcohol. It is used as a deterrent to drinking. 

Naltrexone, which is used for opioids, was initially created to treat alcohol dependence. It is an extended-release, monthly injectable marketed as Vivitrol. It works by blocking areas in the brain that people experience euphoria from alcohol. 

Campral is the last drug used to treat dependence. It can help rebalance the brain’s neurotransmitters, thereby, easing symptoms, relieving stress, reducing cravings, and avoiding relapse.

Stimulants

There are no medications currently approved for treating those overcoming a stimulant addiction. Physicians, however, will use a combination of antidepressant drugs to help former users overcome their dopamine depletion after years of heavy drug use. The type of medication depends on the individual, and you must speak with a doctor to determine your course of action.

 Family Counseling and Cognitive Therapy Sessions

The environmental aspect of recovery is crucial for preventing relapse. A person’s surrounding environment and support system is key to better understanding the disease of addiction by learning to recognize potential triggers for relapse and prevent them. 

Family counseling and therapy sessions may help you and your family minimize stress and possible relapse triggers. Your family’s support during your recovery, which can improve the overall family bond and communicative skills. This is why it’s so important to attend all therapy and counseling family and group sessions to ensure your chances for recovery.  

Surrounding yourself with positive and supportive people is key to preventing relapse. This means avoiding people, places, and things connected to drug or alcohol abuse. Peer support and groups like that of the 12-Step programs who are committed to recovery is essential for healthy peer pressure and ongoing emotional and moral support.

Woman taking a pill with water

Studies such as this one in the journal Addiction showed a strong correlation between support and addiction. Alcohol users who participated in support groups like Alcoholics Anonymous (AA) were less likely to relapse.

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Increase Holistic Treatments: Sleep, Exercise, Diet

A holistic approach helps reduce relapse by taking a whole-body approach, especially when it comes to managing your stress. Your lifestyle can significantly impact your probability of reducing and avoiding relapse. Balanced nutrition and healthy levels of physical activity can help with the triggers of turning to drugs and alcohol. When you feel good in your physical body, you can handle things, including stress and triggers in a much more emotionally balanced way. This is where balanced nutrition and increased physical activity come into play.

Sleep

Getting enough sleep each night can help with the symptoms of managing your stress. Studies published by the New York Office of Alcoholism and Substance Abuse Services (OASAS) on not getting enough sleep indicate that insomnia and fatigue can increase one’s risk for relapse. On the other hand, physical exercise and a balanced diet improve an individual’s overall sleep quality.

Diet

Under a diet of drugs and alcohol, your body does not get the valuable nutrients it needs. Lack of nutrition can cause your mental health to deteriorate and not function properly. Adding vegetables and fresh fruit to a high protein diet can prevent relapse. It can also reduce stress and cravings while enhancing sleep, and restoring brain and bodily function.

Other complementary, holistic approaches to improving overall well-being and help reduce or avoid you relapse:

  • Mindfulness meditation will teach you how to exercise more self-awareness, specifically in situations of recognizing and dealing with various triggers associated with relapse.
  • Acupuncture focuses on improving the flow of your body energy and your bodily functions so that your cravings will be subsided or minimized.
  • Massage therapy involves touch to increase blood flow and physical body systems which improve your mental functions.

Exercise

In addition to yoga and meditation for managing your stress, exercise can prevent relapse as well. As published in this study, ongoing exercise reduces the chances of returning to using drugs. It also reroutes brain chemistry and opens new pathways, so you can re-experience a new sense of pleasure that doesn’t involve drugs or alcohol. In fact, you might discover that over time, you are turning to exercise as your go-to outlet for reducing stress, thus improving your self-image and self-esteem.

Sources

Journal of Psychoactive Drugs. Maximizing Social Model Principles in Residential Recovery Settings [Accessed 15 Mar. 2019] from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4220294/

HHS Public Access via Nih.gov. [2010]. Cognitive-Behavioral Therapy for Substance Use Disorders [Accessed 15 Mar. 2019]. from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2897895/

Office of Alcoholism and Substance Abuse Services. Insomnia and Alcohol and Substance Abuse. [Accessed 15 Mar. 2019]. from https://www.oasas.ny.gov/admed/fyi/fyiindepth-insomnia.cfm

Frontiers in Psychiatry. Exercise as a Potential Treatment for Drug Abuse: Evidence from Preclinical Studies [Accessed 15 Mar. 2019] from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3276339/

National Institute on Drug Abuse. (n.d.). How do medications to treat opioid use disorder work? Retrieved from https://www.drugabuse.gov/publications/research-reports/medications-to-treat-opioid-addiction/how-do-medications-to-treat-opioid-addiction-work

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