Watching your loved one relapse after weeks, months or even years of hard work can feel more frustrating than the original addiction. Keep in mind this does not mean that he or she is incapable of getting back on track. When relapse occurs, stand firm, provide support and take care of yourself. If you can successfully help a person close to you get through this bump in the road, your relationship will be stronger and healthier in the long run. This is especially crucial for impressionable youth whose brains are not fully developed. Getting on the right path sooner than later is no guarantee, but likely equates to a brighter, more productive future. Whether you are dealing with an alcoholic spouse, teenager or coping with life after drug addiction recovery, be aware that relapse is very common. Relapse rates for people with substance use disorders are similar to relapse rates for chronic medical illnesses such as diabetes, hypertension and asthma, which also have physiological and behavioral components. Thinking about substance abuse addiction as a chronic illness that requires vigilant maintenance can make it easier to understand the significant challenges involved in long-term recovery. 1 Comparative Relapse Rates Drug Addiction: 40% to 60% 1 Type 1 Diabetes: 30% to 50% 1 Hypertension: 50% to 70% 1 Asthma: 50% to 70% 1 Alcohol: 90% 2 The Science Behind Substance Abuse If you have stood by your loved one through addiction and recovery, you likely know a good deal about the disease. Resisting the urge to use again does diminish with time, however, it never completely disappears. Drugs and alcohol leave a lasting impact on brain chemistry. Most drugs flood the brain with dopamine, a type of neurotransmitter that helps control the brain’s reward and pleasure centers. This overstimulation induces feelings of euphoria and happiness, causing an intensely pleasurable “high” that often lead people to misuse drugs or alcohol. With continued drug use, the brain adjusts to the excess dopamine by making less of it and/or reducing the ability of cells in the reward circuit to respond to it. The high the person experiences decreases and they develop a tolerance, requiring more of the substance to achieve the dopamine high they now crave. Long-term substance abuse also affects brain functions that control learning, judgment, decision-making, stress, memory and behaviors. 3 In a recent study found on HelpingOthersLiveSober.org , arguments have been made to support the theory that isolation, pain and distress experienced by users are the primary drivers of addiction – and chemicals are not the primary culprit. During adolescence, social isolation has been linked to addiction (and a variety of other negative outcomes). Isolation appears to have neurological effects that increase the likelihood of addiction in youth. 4 The Keys to Recovery The Substance Abuse and Mental Health Services Administration (SAMHSA) states that the following four major dimensions are key to supporting a life in recovery. 5 Health : Overcoming or managing one’s disease(s) or symptoms, e.g., abstaining from use of alcohol, illicit drugs and non-prescribed medications if one has an addiction problem; and for everyone in recovery, making informed, healthy choices that support physical and emotional well-being. Home : Having a stable and safe place to live. Purpose : Conducting meaningful daily activities, such as a job, school volunteerism, family caretaking or creative endeavors; and the independence, income and resources to participate in society Community : Having relationships and social networks that provide support, friendship, love and hope. Substance abuse treatment may necessitate pharmacological interventions, however helping clients understand and change behavioral patterns, acquire new skills, and integration of social support systems (e.g. 12-step programs) are also key to recovery and abstinence. The benefits of social support are especially well documented in youth being treated for addictions. 4 Research on Social Isolation in Youth A study was conducted on 195 adolescents in residential treatment programs, most of whom were being treated for marijuana dependency and comorbid alcohol abuse. In the 12 months after discharge from residential treatment, 56% had relapsed, 30% were incarcerated and 13% committed a violent crime. Researchers found that youths who were socially isolated upon entering treatment were significantly more likely to relapse, be incarcerated, and commit a violent crime. 4 Coping with Substance Abuse Relapse You may have an in-depth understanding about addiction, however, this does not make it easier to cope with a relapse . When your spouse or teenager has been clean for a year or two, then goes on a bender, it is natural to feel flabbergasted, frustrated and disappointed. The best way to cope with the situation is to lend your support. It is important to stick to any plans you made together regarding dealing with the consequences of his or her addiction, regardless of how you feel at the moment. In order to consistently support your loved one in recovery and relapse, it is key to take care of yourself. Dealing with a relapse can be incredibly frustrating, not to mention terrifying. Try to understand how difficult it is for your loved one to resist the intense cravings whenever you feel you might lose your patience. If you are frazzled and stressed, you will not be able to provide the support necessary for his or her long-term recovery. Do whatever it takes to maintain your own physical and emotional health and take time just for you. This could mean going for a walk, seeing a movie or reading a good book. Exercise, meditation and yoga can help you stay balanced, focused and patient when you feel control slipping away. Taking care of yourself will help you support your loved one and set a good example on ways to develop healthy mechanisms to cope with stress triggers and cravings . Drug addiction must be treated like any other chronic illness with relapse serving as an impetus for renewed interventions.1 Encourage your loved one to seek additional treatment from a therapist, go to a support group and accompany him or her if it is beneficial for both of you. Just as a person with asthma reaches for medication when having an attack, it is crucial that your loved one receives empathetic treatment for relapse and ongoing social support. Drugs, Brains, and Behavior: The Science of Addiction, Treatment and Recovery. National Institute on Drug Abuse website. https://www.drugabuse.gov/publications/drugs-brains-behavior-science-addiction/treatment-recovery Updated July 2014. Accessed August 17, 2016. Alcohol Relapse. Alcohol MD website. Drug Facts: Understanding Drug Use and Addiction. National Institute on Drug Abuse website. https://www.drugabuse.gov/publications/drugfacts/understanding-drug-use-addiction Updated August 2016. Accessed August 17, 2016. Johnson BR, Pagano ME, Lee MT, Post SG. Alone on the Inside: The Impact of Social Isolation and Helping Others on AOD Use and Criminal Activity. Youth Society, 2015 Dec 1. doi: 10.1177/0044118X15617400. http://helpingotherslivesober.org/documents/publications/Alone_on_the_Inside2.pdf Recovery and Recovery Support. Substance Abuse and Mental Health Services Administration website. http://www.samhsa.gov/recovery Updated October 5, 2015. Accessed August 17, 2016.