What Is Relapse?

Relapse_Man_CoverRelapse is not an isolated event. Rather, it is a process of becoming unable to cope with life in sobriety. The process may lead to renewed alcohol or drug use, physical or emotional collapse, or suicide. The relapse process is marked by predictable and identifiable warning signs that begin long before a return to use or collapse occurs. Relapse prevention therapy teaches people to recognize and manage these warning signs so that they can interrupt the progression early and return to the process of recovery.

Studies of life-long patterns of recovery and relapse indicate that not all patients relapse. Approximately one-third achieve permanent abstinence from their first serious attempt at recovery. Another third have a period of brief relapse episodes but eventually achieve long-term abstinence. An additional one-third have chronic relapses that result in eventual death from chemical addiction.

These statistics are consistent with the life-long recovery rates of any chronic lifestyle-related illness. About half of all relapse-prone people eventually achieve permanent abstinence. Many others lead healthier, more stable lives despite periodic relapse episodes.

Classification of Recovery/Relapse History

For the purpose of relapse prevention therapy, chemically dependent people can be categorized according to their recovery/relapse history. These categories are as follows:

  • Recovery-Prone
  • Briefly Relapse-Prone
  • Chronically Relapse-Prone.

These categories correspond with the outcome categories of continuous abstinence, brief relapse, and chronic relapse described above. Relapse-prone individuals can be further divided into three distinct subgroups.

Transition patients fail to recognize or accept that they are suffering from chemical addiction in spite of problems from their use. This failure is usually due to the chemical disruption of the patient’s ability to accurately perceive reality, or to mistaken beliefs.

Unstabilized relapse-prone patients have not been taught to identify the abstinence-based symptoms of PAW and addictive preoccupation. Treatment fails to provide these patients with the skills necessary to interrupt their disease progression and stop using alcohol and drugs. As a result, they are unable to adhere to a recovery program requiring abstinence, treatment, and lifestyle change.

Stabilized relapse-prone patients recognize that they are chemically dependent, need to maintain abstinence to recover, and need to maintain an ongoing recovery program to stay abstinent. They usually attend Alcoholics Anonymous (AA), Narcotics Anonymous (NA), or another 12-step program in addition to receiving ongoing professional treatment. They also make protracted efforts at psychological and physical rehabilitation and recommended lifestyle changes during abstinence. However, despite their efforts, these people develop symptoms of dysfunction that eventually lead them back to alcohol or drug use.

Many counselors mistakenly believe that most relapse-prone patients are not motivated to recover. Clinical experience has not supported this belief. More than 80 percent of relapse-prone patients admitted to the relapse prevention program at Father Martin’s Ashley in Havre de Grace, Maryland, had a history of both recognition of their chemical addiction and motivation to follow aftercare recommendations at time of discharge. In spite of this, they were unable to maintain

abstinence and sought treatment in a specialized relapse prevention program. he or she became aware of during this exercise.

The Gorski Relapse Prevention Therapy (RPT) Workbook

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