What is Relapse and How Can You Help Prevent It
When I completed rehab in 2004 counselors were just starting to talk about relapse prevention as part of the treatment education. They wanted to teach us to recognize the warning signs of a forthcoming relapse and have the ability to take the necessary corrective actions. They also wanted to train patients who relapsed to immediately return to sobriety and not make things worse by lingering in their shame and continue using.
Education about relapse prevention is even more important now because of the opioid epidemic and nefarious use of fentanyl in drugs such as heroin and cocaine. Some addicts seek out fentanyl as their drug of choice, drastically increasing their odds of a fatal relapse.
Some of these discussions around the topic have caused me to wonder what people consider a relapse and what is considered continued drug use with a couple of days off.
I don't consider a relapse to have occurred unless it's preceded by a measurable period of documented sobriety. Meaning the recovering person was attending meetings, working a program of recovery, picking up anniversary chips and then succumbs to a drink or a drug because of a defect in their recovery program. Compared to someone who is simply attempting not to drink or use drugs but then picks-up every few days or every couple of weeks. I consider this later description continued use with brief periods of not using; the addict wasn't sober per se, they just weren't using.
An addict or alcoholic may be trying to achieve sobriety and slipping up along the way. In this scenario, I would not say John was two days sober and then relapsed, I would simply say John has not yet achieved sobriety. Either way, he should continue trying not to drink, because at some point John is going to "get it" and then will have achieved sobriety.
The most important thing is to achieve sobriety in the greatest number of addicts and reduce drug-related fatalities.
Here are some signs someone is about relapse and what you can do to help him:
Not going to meetings - not going to meetings is first on this list because its the number one sign of a pending relapse. Every time someone comes back to AA from a relapse they say the same thing; I stopped going to meetings. Attending meetings is the cornerstone of our program and plays a huge role in healing the spiritual malady that contributes to addiction.
If you detect your son or daughter is not going to meetings, ask them about it in your best non-accusatory tone. Come at it from a positive place, try saying, I have noticed how happy and unburdened you are when you're going to meetings. You can propose going to a meeting together and getting dinner afterward. Just remember you're not the AA police your there to provide love and support.
If your son refuses your offer to attend a meeting together ask his interventionist to step in. Interventionists can be crafty in getting their previous clients talking. I am personally invested in my client's wellbeing and want to see them flourish. I want to be aware of how they are progressing and always available to re-engage when needed.
Personality change - personality change is a good indicator that something is going badly and relapse may be on the horizon. A personality change can also indicate he's not taking physician-prescribed meds, lack of sleep, depression or anxiety. All of these are precurses to a relapse. Suggest making an appointment with his psychiatrist and going with him. Always provide positive reinforcement without judgment. I know this is sometimes hard so just do your best.
Lying - Lying is another hallmark of addiction. Addicts lie because they're too ashamed of the truth. That truth maybe they're using or have fallen back into depression or self-harming again. He doesn't want you to be disappointed so he keeps all of this bottled up inside which in turn breeds more problems. Provide a safe place for him to be honest with you. I have the best conversations with my daughter in the car - so invite him to go somewhere with you. The "where" isn't important the time together is.
Isolating - Isolating is a really big deal when it comes to avoiding relapse. The disease of addiction thrives in dark and damp places, that's why it's so important to expose the illness to direct sunlight. I'm sure you get the "mold" inference I am making here. Isolation is also a symptom of mental illness and depression so its important to be particularly aware of your son or daughter doing this.
If they're isolating this is a good opportunity to schedule an appointment with their psychiatrist or prescribing physician. Make sure their meds are being taken as prescribed and try getting them out of the house. Physical action is the antidote to isolation and depression and yet it's the last thing he or she may feel like doing. Invite them on a walk or to do something which requires expelling energy.
Being a professional interventionist and parent of a teenager I know how hard it is to motivate them or show them you're concerned. We're scared something bad is going to happen to our children and it's hard to be there for them in nonjudgmental ways but important for us to our best.
Marc Kantor is a professional interventionist and the founder of South Florida Intervention, based in Boca Raton, FL. If someone you know is struggling with addiction, we can help. For additional information please e-mail us at [email protected].