Why Addiction Relapse Can Be Stronger Than the Determination to Stay Clean
Addiction relapse – meaning the addict | alcoholic goes back to using drugs or alcohol – is another of the confounding aspects of this brain disease – the brain disease of addiction (aka brain disorder). Not only is the addiction relapse confounding, but equally confusing is the idea that relapse does not mean treatment failed. Really!
[And by the way, there is new language to talk about a person with a severe alcohol or other drug use disorder (what we used to refer to as an addict | alcoholic), as well as alcoholism or drug addiction. Please click here to learn more. For this post, I continue to use the terms most people think of and use when talking about this.]
About Addiction Relapse
Addiction relapse means to fall back into the substance use patterns you / your loved one was/were engaged in prior to treatment and time in recovery. It is not uncommon, and it does not mean you / your loved one didn’t want it badly enough. Basically it means treatment needs to be revisited. Something is missing and needs to be addressed.
To put relapse in perspective, please look at this image similarly shared in NIDA’s archived piece, “Drug Abuse and Addiction: One of America’s Most Challenging Public Health Problems.”
Addiction Relapse should be viewed as CAUSE to re-evaluate treatment and adjust accordingly. It should not be viewed as an indication that treatment has failed and that recovery is impossible. We do not view relapse with other diseases, such as Type 1 Diabetes, Hypertension or Asthma, as failure. We see those relapses (failing to take medication as prescribed, not following diet or exercise recommendations) as an indication something more or different needs to be done. The same should be true with addiction.
As evidenced in this comparison, relapse is common to other chronic diseases.
So why is it that…
Addiction Relapse Can Be Stronger Than the Determination to Stay Clean
It has to do with addiction being a brain disease, aka brain disorder.
You see – disease – by its simplest definition, is something that changes cells in a negative way. If you change cell health in a body organ, you change the health and function of that body organ.
Addiction changes cells in the brain, which is what makes it a brain disease/disorder. One of the features of this disease is cravings – powerful cravings – cravings that will cause an addict | alcoholic to lie, cheat and steal.
Then you have the brain mapping that’s wired around all of the addiction-related activities in order to satisfy these cravings, as well as those that wired around the key risk factors for developing it in the first place. These maps can be triggered by sounds, sights, memories, songs, time of day, flashbacks, friends, seeing an old boyfriend… and depending where in the brain that triggering occurs and how much treatment and recovery there has been, the result can be a relapse.
To understand just what’s involved in what’s considered “effective” addiction treatment, check out NIDA’s Treatment Approaches fo rDrugAddiction DrugFacts. (FYI alcohol is considered a drug.)
Bottom Line
Addiction recovery – living a solid, enjoyable life – one free of the constant fear, thoughts and fall-out of addiction – is absolutely doable. Like other chronic illnesses, it’s a treatable disease; it’s a treatable medical condition.
So know – your loved one / YOU can do this.
And if you want a more comprehensive understanding of alcohol use disorders given this is article so brief, I urge you to read my latest book published in 2019 — not so I can sell books but so you can learn about the huge scientific advances that explains all of this in layman’s terms. It’s titled, “10th Anniversary Edition If You Loved Me, You’d Stop! What you really need to know when you’re loved one drinks too much.”
The first half explains alcohol use disorders (drinking problems) – how they’re developed and treated and what long-term recovery requires. In the case of alcohol abuse, for example, it’s possible to learn to “re-drink,” but in the case of alcoholism, it must be total abstinence from alcohol, yet in both cases, there are other brain healing aspects necessary in order to address “why” a person finds themselves drinking to these extents in the first place (e.g., trauma, anxiety, depression, social environment…).
The second half explains what happens to family members and friends and what they can do to help their loved ones, as well as what they can do to take back control of their physical and emotional health and the quality of their lives. The book comes in both paperback and Kindle (which can be read on an iPad or other eReader device). With the Kindle format, you’re able to get it immediately, which may be helpful for right now, and it allows you to read it without anyone knowing, which may also be helpful.
If you have questions, send me an email to lisaf@BreakingTheCycles.com to schedule a phone call. There is no charge.
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Note: This post was originally published on July 29, 2013. It was updated 2020.
Lisa Frederiksen
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What a lot of useful resources and encouraging information. The whole first year of recovery is to critical to laying down new modes of behavior, practice new ways of thinking and to reinforce mind, body spirit (re) connections. In yoga we call habits of the mind samskara = like ruts in the ground a wheelbarrow can create and follow; negative brain patterns, ways of thinking, become easier to travel down over time BUT with care and support NEW grooves can be created so we can re-pattern the habits of the mind. We find a new path for the wheelbarrow to follow. Yoga and neuroscience have discovered the same key elements. Heal the brain of unhealthy thoughts and the brain will heal itself in total.
I love the yoga analogy for habits of the mind as ruts in the road of a wheelbarrow – so very true!! And as you say, Kyczy, yoga offers a terrific opportunity to grove a new paths.
Very inspiring Lisa. We all need to know that there is hope for ourselves or for our family members. I love this line, “The first 3-6 months following addiction treatment is the period of greatest vulnerability to relapse.” After care is essential and I hope in the future that this becomes a natural followup of treatment. Thanks for the great content.
You’re welcome, Cathy. Work, such as that which you do as a Recovery Coach for Parents of children with this disease, is so important to helping the family and the person with the disease through that first 3-6 months.
Hey Lisa!
Dang, your work is so good – so thorough. And what’s more, you pack so many resources/links in your articles. That’s so very helpful. “Like other chronic illnesses, it’s just a disease. So know – YOU can do this.” I find that observation/challenge accurate, simple, and comforting..
Bill
Why thank you, Bill! And, I know, for myself, it was understanding this as a treatable disease – one that I could then see as separate from my loved ones (i.e., a person with the disease of addiction rather than an addict / alcoholic) – that I could really start to do the work I needed to do to recover myself, as a family member.
Lisa,
Your ability to reconcile misunderstanding about addiction is a true art grounded and informed by science. I SO appreciate your offering of these many useful ways to understand what’s ACTUALLY HAPPENING in an addicted mind. It wasn’t until I was exposed to and began to understand this disease model that I was able to get healthy and thrive in my own recovery.
Thank you for continuing to help so many–in so many ways.
You’re so welcome, Herby! I, like you, found the science to be the key to my finally loosening my grip on what I thought was going on so that I became open to making the changes I needed to make in order to get healthy and thrive in my own recovery as a family member who’d been caught in this dance for decades. For readers who are not aware of your work, I’d like to give a shout out to what you do to help addicts | alcoholics after the initial detox/rehab/treatment – that critically important continuing care to help them heal their mind, body, spirit and avoid relapse – http://recoveryhealthcare.me/
There is something “fresh” to this article. I really like the way you state that the craving is literally stronger than the individuals capacity to manage it. Having said this, I believe it points to some alternative solutions. One is the deepening of the role of the family in recovery. A sort of “Meta” family programming that wraps around the individual. As a professional in the field for many years, we know a deep reality; we spend an inordinate time trying to muster up enough individual “motivation.” It just doesn’t make sense. It takes too much pain; it takes too long; it is too dangerous.
There must be better strategies.
http://www.recoverymaps.com
I’m so glad this article resonates, Jonathan. I just look at your site and can see why! I love your work and approach and encourage family members looking for help to check it out: http://www.recoverymaps.com.
I especially like your comparison of addiction relapse to relapses of other diseases such as diabetes or asthma – and how we should be looking at it as a opportunity to adjust treatment, as it would be viewed in any other disease. Thanks so much for adding that important perspective!
I agree – it’s such an important perspective and scientifically true! It takes the ‘ya but…’ excuse out of the picture. Thanks for your comment, Leslie!
Kudos, Lisa, for yet another well-written, in-depth article. Love how you provide the valid perspective of comparing addiction relapse to other diseases with higher ‘relapse’ rates, but yet their relapse is perceived differently by healthcare providers. I know that as a person with longterm recovery from a gambling addiction, that I went through actual, physical withdrawal symptoms in the first 30 days. I also had to ‘test’ or relapse one last time two weeks after starting a 12step program to realize that I could not gamble like a ‘normal’ person and began the process of taking it one day at a time, attending lots of meetings, and staying connected with others like-minded in recovery. Keep up the great job that you do in providing interesting, well-written and researched articles with numerous links and resources.
Thank you so very much for this kind comment, Karen. It means a great deal to read something like this – truly! And thank you for sharing your physical withdrawal, relapse and longterm recovery experiences – it really helps others see themselves in what someone else went through and know their own similar experience(s) is/are “normal.” Congratulations on your recovery!!!