Mistaken Beliefs About Relapse – Does Relapse Mean Treatment Failure?

17. April 2017

By Terence T. Gorski

The only way for recovering people and their families to be free from the fear of relapse is to understand it. Here are some simple point that may be helpful in preventing and managing relapse instead of blinding fearing it. Ironically, the constant fear of relapse lowers the quality of recovery, weakens us, and in doing so increases our risk of relapse. This post will teach you how to correct the most common mistaken belief about relapse.

Mistaken Belief #1:  Relapse Is Self-Inflicted

Relapse, in most cases relapse, is not self-inflicted. Relapse-prone people experience a gradual progression of symptoms that create so much pain that they become unable to function in sobriety.  They turn to addictive use to self-medicate the pain.  These patients can learn to stay sober by recognizing these symptoms as relapse warning signs, identifying the self-defeating thoughts, feelings, and actions they use to cope with them, and learning more effective coping responses.  Unfortunately, most relapse-prone patients never receive relapse prevention therapy, either because treatment centers don’t provide it or their insurance or managed care provider won’t fund it.

Mistaken Belief #2:  Relapse Is An Indication Of Treatment Failure

Relapse is not necessarily a sign of treatment failure. Between one half and two-thirds of all patients treated will relapse, but at least one half of all relapsers will find long-term recovery.  The belief that relapse means that treatment failed ignores the fact that, for many patients, recovery involves a series of relapse episodes.  Each relapse, if properly dealt with in treatment, can become a learning experience which makes the patient less likely to relapse in the future.

Chemically dependent people can be divided into three groups based upon their recovery and relapse history.  One third of all patients are recovery prone and maintain total abstinence from their first serious attempt.   Another third are transitionally-relapse prone and have a series of short-term and low consequence relapse episodes prior to finding long-term abstinence.  The final third, the most difficult patients to treat, are chronically relapse-prone patients can’t find long-term sobriety no matter what they do.

Recovery-prone patients tend to be addicted to a single drug, have higher levels of social and economic stability, and not have dual diagnosis or serious coexisting problems.  They are what are often referred to as “garden variety addicts” who have uncomplicated chemical addictions.

Transitionally relapse-prone patients tend to have more severe addictions that are complicated by other problems.  They have the capacity, however, to learn from each relapse episode and take steps to alter or modify their recovery programs to avoid future relapses.

Chronically relapse-prone patients tend to have severe addictions complicated by serious dual diagnosis.  Most chronic relapsers have either severe post acute withdrawal caused by the effects of chronic alcohol and drug poisoning to the brain, a coexisting personality or mental disorder, or a serious coexisting physical illness.  Many fail to recover because these coexisting conditions are not properly diagnosed and treated.

Mistaken Belief #3:  Once Relapse Occurs The Patient Will Never Recover

Even chronically relapse-prone patients are not hopeless. In 1988, I had dinner with over sixty skid row alcoholics who had completed a relapse prevention program at Alexandria Regional Detox Center.  These people were previously labeled as hopeless and given short-term revolving door non-medical detox.  All were sober for over six months after participating in weekly outpatient relapse prevention groups coupled with twelve step programs.  All of these people wanted to stay sober.  Prior to relapse prevention therapy, they did not know how.  Once they learned effective strategies for identifying and managing relapse warning signs, they were able to stay sober in spite of the other serious problems they experienced.

Best Wishes In Your Ongoing Recovery,

Terence T. Gorski