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Responding to Relapse

Recovery is a journey not an event. There is no "where" to arrive at, no destination, aside from this moment. When family members and loved ones discuss a relapse into active substance addiction such as opiate, alcohol, cannabis or other abusable substances there are commonly two misconceptions:

1. The addicted person who was still in early recovery had been "safe" for a period of time.

2. That the addicted person "messed up" by relapsing.

There is no "safe." Just like sexual activity, there is no safe, only safer. The American Psychology Association does not term a person's abstinence to represent Sustained Full Remission until that person has been clean for 12 consecutive months. This means that persons in early recovery continue to be high risk for the first 12 months and often well beyond depending on their life situations, stressors, and the effectiveness of their ongoing recovery efforts. Relapse, while dangerous, can be an opportunity to inform treatment. Instead of dismissing a relapse it is helpful to explore what was going well and what unmet needs fueled the relapse. Relapse or non-compliance rates for chemical addiction hover around 40-60%, for diabetes 30-50%, for hypertension 50-70%. This means three things:

1. Behavior change is difficult. Our patterns of behavior work to some degree and are reinforced by our relationships and habits.

2. Most patients do not walk away from their visit with healthcare providers understanding the next steps. You are the client, we work for you. Please make sure you get value from the experience and understand the recommendations. If they do not work for you or are unclear, please, discuss this until the recommendations make sense to YOU.

3. We are all ambivalent - we want certain things without letting go of or giving up other things. This is not always possible.

Counseling works. Treatment works. We often cite symptom abatement as success. While this is wonderful it is just the beginning of the rewards of making more well informed choices. Developing the protective factors of long term recovery require sustained effort despite relapses in behavior and or patterns of thinking. We need to change the conversation and focus of recovery. It is critical that we celebrate seeking help as a victory over the disease. We also need to include the understanding that recovery is an ongoing journey that needs to be individuated to the person getting clean and sober. We don't all wear the same shoe size. Recovery needs to be at least this person specific. What is meaningful to one person may have little value to another. I urge you to find a treatment provider who sees you as an individual and is effective in assisting you to find solutions that work for you.

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