Content reviewed by Christian Losch, LCSW, LCADC, CEO of Pinelands
Most research on addiction identifies substance use disorder (SUD) as a relapsing disorder. This is because SUD is both chronic and relapsing. When an individual goes through treatment and recovery from addiction, there is no guarantee that they will remain sober forever. As recovery from addiction is a lifelong process, the chance of relapse always exists.
With that being said, many individuals wonder about the effectiveness of relapse prevention programs throughout treatment and recovery from SUD. If SUD is recognized as a relapsing disorder, do relapse prevention programs truly reduce relapse risk? In this article, we will address the current research and discuss the effectiveness of relapse prevention programs for lasting treatment and recovery.
Why is SUD known as a relapsing disorder?
Before understanding the effectiveness of relapse prevention programs, it is important to understand why SUD is called a relapsing disorder. First, let’s highlight two valuable definitions:
- The National Institute on Drug Abuse (NIDA) defines addiction as “a chronic, relapsing disorder characterized by compulsive drug seeking and use despite adverse consequences.”
- The National Institute on Alcohol Abuse and Alcoholism (NIAAA) defines alcohol use disorder (AUD) as “a chronic relapsing brain disease characterized by compulsive alcohol use, loss of control over alcohol intake, and a negative emotional state when not using.”
Why is SUD, including AUD, known as a relapsing disorder? To answer this question, we must first understand how substance use affects the brain.
Substance use causes long-lasting changes to the brain.
An individual’s initial decision to consume alcohol and use other drugs is often voluntary. However, continual use of chemical substances causes changes in brain structure and disrupts normal brain functioning.
One of the most significant ways that substance use changes the brain is by compromising the brain’s reward system. When an individual is healthy and sober, their brain is motivated to repeat pleasurable behaviors needed to thrive. Naturally pleasurable behaviors — including eating, socializing and engaging in hobbies — release dopamine in the brain, which causes an individual to feel good.
However, when an individual first uses alcohol or other drugs, their brain becomes flooded with dopamine. This is an artificial, and therefore unhealthy, means of releasing dopamine. As a result, the individual feels compelled to seek out and use that substance repeatedly in an attempt to achieve the same high.
This process is not always conscious. While many people try and fight the urge to use again, their brains will continue to motivate repeated substance use. Once an individual engages in recurrent substance use, their brain can eventually adapt to dopamine surges. Over time, they may no longer be able to experience pleasure from natural behaviors, which then facilitates their urges to use substances over and over again.
Recovery is possible, but the chances of relapse always exist.
Because substance use changes the brain, the chance of relapse will always exist for someone in recovery from SUD. Treatment works to reverse these brain changes caused by substance use, though changing the brain takes a lifelong commitment. Inevitably, individuals who choose recovery will be at risk for relapse for years, possibly their entire life. For many, relapse is a part of the process of establishing long-term sobriety.
What are relapse prevention programs?
According to the Indian Journal of Psychiatry, relapse prevention “is a strategy for reducing the likelihood and severity of relapse following the cessation or reduction of problematic behaviours.” Relapse prevention is not a one-size-fits-all approach. As noted, the strategy is used following the reduction of problematic behaviors. Relapse prevention techniques should be used in combination with other traditional treatment approaches, such as psychotherapy and group therapy support, to enhance its effectiveness.
In the article titled “Relapse Prevention” by the same journal mentioned above, relapse prevention has two specific aims:
- “Preventing an initial lapse and maintaining abstinence or harm reduction treatment goals
- Providing lapse management if a lapse occurs such that further relapses can be prevented.”
Relapse prevention is a central goal of nearly all addiction treatment programs. Several techniques that may be utilized within a relapse prevention program include:
- Monitoring and screenings
- Peer support
- Emerging interventions, such as transcranial magnetic stimulation (TMS)
Understanding the effectiveness of relapse prevention programs.
In short, relapse prevention programs can lower an individual’s risk of relapse, as that is the main goal of getting sober. However, a few additional considerations must be made to ensure that relapse prevention programs are successful.
Just as there is variation in treatment programs to address individuals’ unique needs, relapse prevention programs can lower an individual’s risk of relapse when relapse prevention tools are tailored to the needs of the individual patient. As such, the following factors must be taken into consideration:
- A patient’s sociocultural environment
- A patient’s level of motivation
- A patient’s severity of SUD
- The presence and severity of co-occurring medical and mental health problems
All in all, the effectiveness of a relapse prevention program depends on the type of program offered as well as the unique needs of the patient. Likewise, programs must be individualized and offer a range of services to ensure the best recovery outcomes and prevent relapse.
Pinelands Recovery Center of Medford is a premier drug and alcohol treatment center that understands the hesitations individuals may have before beginning addiction treatment. We believe in the effectiveness of individualized treatment, which is why we tailor our treatment plans to the unique needs and goals of each patient. We utilize relapse prevention strategies throughout treatment and long-term recovery to ensure lasting success. To learn more, call (877) 557-5372.