Preventing Chronic Addiction Relapse Through Dual Diagnosis Rehab
Addiction relapse is a serious concern, as 40-60% of those who had previously recovered from a substance use disorder will likely return to using at some time after receiving treatment1. What are the stages of relapse? And how can approaches used for dual diagnosis rehab help to stop this recurring pattern? Find out more about how to prevent chronic addiction relapse by continuing to read:
The Three Stages of Relapse
The Yale Journal of Biology and Medicine describes the stages of relapse2.
Emotional Relapse
During this stage, recovering patients may believe they won’t return to using because they can recall what it felt like the last time they were struggling to quit. They may falsely believe that this bad experience will be their shield from relapse, and they’re not consciously thinking about using again.
But because they deny their vulnerability to addiction, they are more likely to think they don’t need to keep the possibility of relapse front and center in their minds and will suppress their emotions.
Some of the signs of emotional relapse include:
- Isolation
- Refusing to attend meetings
- Not accepting responsibility for their own problems
- Poor self-care (physical, psychological, and emotional)
By bottling up emotions and denying that relapse is a real possibility, they’re setting themselves up for problems in the future.
Mental Relapse
This stage of relapse has a lot to do with bargaining. Inside their minds, individuals are trying to fight the temptation to use but at the same time, they’re reminiscing about their past experiences and glamorizing them rather than vilifying them. They’re experiencing cravings and are looking for a permissible excuse to go back to that lifestyle.
Some signs of mental relapse include:
- Cravings for the abused substance
- Minimizing the consequences of past use
- Lying
- Trying to find ways to justify using
- Looking for opportunities to use again
- Actively planning to use again
The mental relapse stage is often described as an internal war between staying sober and using again.
Physical Relapse
During this stage, individuals begin to use again on a regular basis. It may begin with one drink or use of the drug but it can quickly lead to uncontrolled use and addiction. It’s important to recognize how mental relapse contributes to returning to alcohol or drug use. It’s likely that individuals will have rehearsed and strategized ways to use again without becoming addicted. Without proper coping skills, they’ll not be able to resist what they feel is the only way to escape the anguish they’re feeling.
How Behavioral and Psychosocial Therapies Can Help Prevent Chronic Addiction Relapse
Addiction is a disease, and like other chronic diseases that can’t be cured, it must be managed. When a person first seeks help for a substance use disorder, the initial treatment may include medical assistance to treat physical addiction. But resolving physical addiction is not the end of the road for a recovering patient.
Alcohol and drug abuse can lead to changes in brain activity that may remain after an individual is no longer physically addicted. Sometimes those brain alterations can lead to the development of mental illness.
Dual Diagnosis Rehab Therapies
Dual diagnosis is the term used when a person presents with signs of both substance abuse and mental illness. Often, an initial intervention will include medication to ease withdrawal from the substance and get control of the mental illness. But once the individual has been stabilized, he or she must learn to manage addiction by learning to change thought patterns that lead to destructive behaviors3.
Cognitive therapies aim to change behaviors by restructuring thought. The term “psychosocial” refers to an individual’s thoughts and behaviors as they relate to social factors and functioning. Psychosocial treatments can include cognitive behavioral therapy, family interventions, contingency management, motivational enhancement therapy, and 12-Step programs.
Cognitive Behavioral Therapy
Cognitive Behavior Therapy helps patients to:
- Develop coping strategies by weighing the consequences of drug use
- Learn to anticipate problems by self-monitoring to identify cravings and high-risk situations
- Develop skills to avoid those harmful situations
The skills learned using CBT approaches are those that can be used to prevent relapse4.
Family Therapy
A family is a system where each part is related to every other part and thus contributes to the well-being of the whole. Family therapy views the family unit (however that is defined for the patient) as capable of bringing about and maintaining positive change for every member of the family5. During family therapy, the goal is to understand the complex relationships between the members and to fix problems that may be preventing the overall health of the family unit.
Contingency Management
Contingency management is a reward system that uses positive reinforcement to persuade individuals to participate in treatment (like individual therapy or group practice) that will help them to remain sober. Studies indicate that rewards or incentive-based approaches are very effective in increasing retention in programs and abstaining from substance abuse6.
Motivational Enhancement Therapy (MET)
This approach tries to rapidly increase internal motivation to change. MET is based on principles that allow the patient to feel supported and heard, but call on the therapist to point out discrepancies or roadblocks to achieving a goal. The therapist will not directly attack or confront a patient’s thinking but will push back slightly so that the patient can find the means to make productive changes based on the progression of his own thoughts and opinions while in therapy. The therapist must make sure to convince the patient that he is capable of making positive change7.
12-Step Programs
The 12-Step process, originally developed by the group Alcoholics Anonymous, includes a series of principles that focus on spirituality and requires that you acknowledge your wrongdoing, accept the past, and recognize that you need a higher power to help you recover.
Twelve-step meetings introduce the idea of social responsibility and the concept of encouraging and supporting others who are suffering from addiction. These groups believe that you can help yourself by supporting others.
Prevent Addiction Relapse with Dual Diagnosis Rehab
Overcoming chronic addiction and preventing relapse relies on therapies that help to reshape thinking, educate patients about the tools they need to stay sober and encourage support from the family unit and the outside community. Silver Sands Recovery, in Prescott, Arizona, understands the complexities of treating dual diagnosis. We will create a custom individual treatment plan that best suits your needs. Our goal is to provide a superior foundation for long-term sobriety. Our highly-trained, compassionate staff will stand by you at every step of your journey. Read more about our dual diagnosis program and contact us for more information.
Sources:
1 https://www.drugabuse.gov/publications/principles-drug-addiction-treatment-research-based-guide-third-edition/frequently-asked-questions/how-effective-drug-addiction-treatment
2 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4553654/
3 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5844161/
4 https://www.drugabuse.gov/publications/principles-drug-addiction-treatment-research-based-guide-third-edition/evidence-based-approaches-to-drug-addiction-treatment/behavioral-therapies/cognitive-behavioral-therapy
5 https://www.ncbi.nlm.nih.gov/books/NBK64269/
6 https://www.drugabuse.gov/publications/principles-drug-addiction-treatment-research-based-guide-third-edition/evidence-based-approaches-to-drug-addiction-treatment/behavioral-therapies/contingency-management-interventions-motivational-incentives
7 https://www.goodtherapy.org/learn-about-therapy/types/motivational-enhancement-therapy
About the author:
Lisa Waknin is the Founder and Director of Silver Sands Recovery, located in Prescott, Arizona. Lisa started Silver Sands Recovery after immersing herself in the addiction treatment world for several years to figure out what could be done differently to help her daughter and others like her to overcome addiction and stay sober. She believes in a hands-on treatment approach, which includes taking someone out of their environment, providing a 90-day program in a structured environment. During treatment, clients not only recover physically but also learn to live their life again. Lisa is a sought-after expert speaker for recovery support groups, charities, schools, communities, and companies wanting to educate themselves on the explosion of opiate and heroin abuse in our country and the best way to understand, treat, and beat it.
