Family members in the Sanford Family Program often ask, “Why is there so much relapse with addiction?” Right along with the first question, I hear, “My loved one went to treatment and we all participated in the programs. Why did this relapse happen? Doesn’t treatment work?”
Relapse! Does Addiction Treatment Work?
The truth of the matter is that treatment does work, and it does work very well. Some people simply take longer than others to gain an understanding of what it really means to have a substance use disorder (SUD) and then learn how to manage that disease. This is due to many individual and psychosocial factors.
According to Dr. Eric Morse, the relapse rate for addictive disease is almost the same as for diabetes.
The National Institute of Health (NIH) identified addiction as “a complex chronic disease, like type II diabetes, cancer and cardiovascular disease. All these chronic diseases … have environmental risk and protective factors interacting with genetics to determine the course and outcome of the disease”.
As part of my preparation for this article, I interviewed 5 addiction treatment therapists at Sanford. I asked them what clients have told them about what they believed caused their relapse. Here is what clients reported about their relapse events, after achieving varying lengths of sobriety:
What caused relapse events (according to Sanford clients)?
Romance and relationship break ups.
Changes at work considered threatening to jobs – promotion, demotion, or new management.
Feeling overwhelmed or overstimulated by their current life situation.
Arguments with spouses or partners.
Feeling accused of a negative behavior that they did not do.
The feeling of being lonely.
Or feeling bored.
Being surprised by the unexpected presence of addictive substances, in an unexpected place.
Wanting to stay awake and focused at work.
Feeling hopeless or helpless to improve a bad situation.
Feeling strong negative emotion (frustration, anger, hurt, guilt or shame).
Stopping support meetings.
Not following discharge treatment recommendations from any level of care.
Not getting a sponsor or accountability partner.
Feeling so emotionally drained that feelings of “not caring anymore” took over.
The above are reported relapse causes by actual clients. To therapists with extensive experience treating people with SUDs. If the readers of this list have been paying close attention, I’m sure several patterns or themes could be identified. Patterns like, issues with trust, coping skills, and asking for help. Also, recovery support, communication, isolation and not expecting the unexpected. The issues could go on and on!
I also believe, it is important to acknowledge, people do make choices about the behavior they become engaged in. And when a person is compromised by neurological deficiencies, reasonable choices are limited. Remember, there are many dynamics interacting to influence choices.
What is interesting here, is that the National Institute of Health (NIH) and Dr. Eric Morse, found information that backs up what our therapists and clients reported, when they studied successful treatment outcomes. Dr. Morse found the length of treatment could be protective against relapse. And the longer a client stayed in some level of formal SUD treatment, the less likely they were to relapse. The NIH found that a person’s environment could be protective of treatment. The more support a person gained for recovery-based behaviors in their environment, the less likely a person was to relapse.
How Can Family Members Help Prevent Relapse?
So, what does this mean to family members, friends and employers of folks in recovery? I think as readers, you know where I’m going here! Those of us closest to someone in SUD recovery, particularly during those first critical years following treatment, must demonstrate genuine supportive behaviors. We need to learn as much as we can absorb about the disease of addiction.
And one of those learning experiences is that recovery may include relapse. And relapse can actually create great learning experiences. Recovery is a life-long process and goes through stages and changes. Because of this, we must remember to not personalize someone else’s disease-related behaviors. And we must remember to work our own recovery plan. Knowledge, self-care, support for ourselves and acknowledgment of the importance of everyone’s recovery plan is key. And good communication skills in our relationships certainly help.
The Family Program
Sanford Addiction Treatment Centers offers family members and friends of clients a 4-session educational series. We also offer a weekly Family and Friends Support Group. We do not charge for these groups. Clients in treatment with Sanford are offered a continuum of care. This includes residential; intensive outpatient; outpatient; healthy living classes and more. Yes, treatment does work, and treatment that reduces in intensity as it progresses can last for as long as a year.
Addiction recovery is forever. The healthier an immediate environment becomes for someone in recovery from SUDs, as well as for everyone involved, the greater the chances of lasting recovery for those we love.