A relapse can be a disheartening setback when you use a substance, such as alcohol or marijuana, especially after promising yourself you wouldn’t. People in recovery may experience a return to a cycle of active addiction when they relapse. While relapse does not mean you can’t achieve lasting sobriety, it can be a disheartening setback in your recovery. 

A single lapse in abstinence can result in a full relapse due to a phenomenon known as the abstinence violation effect (AVE). AVE can be affected by various factors in a person’s life. This aspect of relapse prevention can be beneficial to those in addiction treatment or contemplating treatment since it is not necessarily a failure to exercise self-control or abstain from using a substance of abuse.

Find out about the abstinence violation effect and what signs to look for in an upcoming relapse.

What Is Abstinence Violation Effect?

When one returns to substance use after a period of abstinence, they experience a negative cognitive and affective reaction known as an abstinence violation effect in psychotherapy. An individual may experience uncontrollable, stable attributions and feelings of shame and guilt after relapsing as a result of AVE.

An abstinence violation increases the likelihood that a single lapse will lead to a full relapse into negative behavioral or mental health symptoms if abstinence violation effects are present. Those who break sobriety with a single drink or use of a drug are at a high risk of a full relapse into addiction.

Someone may perceive relapse as an action without a conclusion due to the abstinence violation effect. It may occur to some people that since addiction is a chronic disease, they should just keep on using it as long as they use it again. Another thought may be, “I should just continue using it as long as I use drugs or alcohol again.”

Feelings of personal failure can lead to continued substance abuse. Once relapsed, this strongly held belief increases the likelihood of relapse. An individual who feels guilt often uses substances to ease their guilt, which can lead to AVE. Guilt is a difficult emotion for someone to bear, one that can constantly replay in their minds, leading them to use substances again. 

It is estimated that 40% to 60% of people who have been sober for some time will relapse at some point, according to statistics from the National Institute on Drug Abuse (NIDA).

A person with alcohol use disorder (AUD) may feel like drinking when out with friends at their favorite hangout, for example. Relapse prevention requires understanding what triggers substance abuse. As an example, a smoker may feel the urge to smoke when driving long distances or while drinking coffee when they normally enjoy smoking.

Is a Relapse Dangerous?

A person who has abused a substance for a long time is likely to have a higher tolerance for its effects. As a result, when they are abstinent for a period, they will notice their tolerance has declined, making it possible for them to overdose if they start using again at the same level as before.

It does not have to be all-consuming for relapse to occur. It can be a single instance where someone decides to use the substance again. Even a single AVE instance can lead to a long-term relapse. The importance of understanding the stages of relapse and avoiding them cannot be overstated.

Relapse Prevention

It’s easy to conceive of relapses as one-time events that occur during times of weakness. But relapses begin in the mind, not with action. 

In psychology, relapses are seen as the result of an accumulation of events, not a single event. They are the result of a series of events occurring over the course of time, explains psychologist Alan Marlatt, Ph.D

Several issues can occur before a relapse occurs, including a mindset shift caused by triggers or stress. According to Marlatt, this cascading effect leads to a relapse that occurs due to a cascading effect that entails several issues.

Relapse can take the following forms:

  1. A lifestyle imbalance causes you stress.
  2. Your stress has made you crave indulgences to cope.
  3. Your body experiences cravings.
  4. Using drugs again seems rational to you.
  5. The situation you are in is high-risk.
  6. There is no effective coping mechanism in place for you.
  7. There is a decrease in your self-efficacy.
  8. When you lapse and take the drug, you feel ashamed.
  9. Despite this, you continue to take the drug.

This process can be slow or fast, but Marlatt says plenty of coping strategies are available for each of those nine steps to prevent relapses. It is important to note, however, that relapse occurs in three stages: an emotional relapse, a mental relapse, and a physical relapse, even though a wide variety of events can trigger a relapse.

Relapses can take several forms, including:

Emotional Relapse

It is not even on your mind to relapse at this point because of stress, high-risk situations, or inborn anxieties. The negative emotionalhigh functioning alcoholic responses you are experiencing are related to stress, high-risk situations, or inborn anxieties. Because emotional relapses occur so deeply below the surface in your mind, they can be incredibly difficult to recognize. 

This stage is characterized by anxiety, depression, loneliness, and irritability. Everyone experiences negative emotions at some point in their lives. Emotional relapse is not necessarily caused by these natural emotions but rather by how you cope with them. 

Mental Relapse

Mental relapse is characterized by thoughts of using drugs or alcohol again. You may be conflicted between resisting thoughts about drugs and compulsions to use them. It is possible to rationalize the fact that if you continue to use, you might not experience the same consequences as before. 

Physical Relapse

If you take the first drug or drink after achieving sobriety, you have a physical relapse. Marlatt distinguishes between slipping into abstinence for the first time and completely abandoning it. If you seek help early, it is possible to prevent yourself from slipping into uncontrollable active addiction. AVE, however, makes it much more difficult to stop a relapse at this point.

Relapses are unique to each individual, and your experience with them may be different as well. You don’t have to wait until a relapse occurs to seek help if you are concerned that you might be headed for a relapse. There are some common early psychological signs that you might be on the way to a relapse.

‘I’m Overwhelmed’

Drug addiction rewires the brain to consider drug use an important source of reward. Recovery is a challenging road. On top of that, life can be challenging at times. Recovery patients often experience drug cravings when they go through stress. 

Your brain may unconsciously crave drugs when you are feeling overwhelmed. The conscious thought may become that the only way you can cope with your current situation is by taking drugs or alcohol. Unconscious cravings may turn into the conscious thought that the drug or alcohol is all you need to cope. 

‘I Deserve This’

It is important to celebrate a successful recovery and abstinence period. However, some people may think they have earned a drink or a night of drug use. While this might seem counterintuitive, it is a common thought that many people need to recognize if they want to avoid a relapse. While celebrating victories is important, you should also find constructive ways to acknowledge your sobriety. 

‘This Time Will Be Different’

You may also have a similar thought to the reward thought after a period of sobriety. After a period of success in your recovery, you may think you can control your drug or alcohol use again. Even though you may think this time is different, if your drinking and drug use has gotten out of hand in the past, it is unlikely to be different now.

In recovery, relapse is a common part of the process. More than half of those who achieve sobriety relapse, which can be disheartening but can also lead to relapse because you believe that you will relapse. 

Relapse does not mean your recovery is over. Many people reach long-term sobriety after relapsing. However, it’s important to realize that relapse isn’t guaranteed, especially if you are vigilant about managing your recovery.

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