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Lapse Or Relapse

What’s the difference and more to the point what to do if this happens or is happening?

By Chris Cordell

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The thought of relapse can be terrifying for anyone that has been abstinent for a period of time, be that a few days, a week or more but a lapse or relapse shouldn’t be the end of long-term abstinence.

One of the biggest obstacles and fears of abstinence is the looming possibility of a lapse or relapse.

As mentioned many times before substance misuse disorders are not moral failings or signs of lack of will power they are chronic brain disorders characterised by an impaired ability to stop or control alcohol or drug use despite adverse social, occupational, or health consequences. In other words, substance use disorders describes a problematic pattern of using alcohol or drugs that results in impairment in daily life or noticeable distress.

One of the many benefits of professional drug and alcohol treatment is that treatment staff prepare people for the possibilities of a relapse by walking them through the potential causes and signs to be aware of that could trigger a relapse and then looking at, and in some cases role playing, coping strategies. While relapse prevention planning is extremely helpful, nothing can fully equip someone for when they face a situation full of triggers, both emotionally and mentally.

That being said The Dayhab model of intensive treatment, i.e. intensive treatment while still living at home and working, is very effective at dealing with real life situations in real time as opposed to a residential treatment model where strategies are learnt in a protective bubble.

We’re here to talk about this if you’d like to learn more. Call us now on 0208 191 9174 or email us directly https://helpmestop.org.uk/contact-us

Can relapse be part of long-term abstinence?

Yes, the concept and reality of relapse is long term abstinence is very common. Substance misuse is by and large a chronic relapsing condition especially in the early days of abstinence. In this respect it is not uncommon for people trying to achieve long terms abstinence to often have one or more relapses along the way. Behaviour change is hard particularly pleasure-based habits like drug and alcohol use are difficult to break because enjoyable behaviour prompts the brain to release dopamine. Dopamine is the reward that strengthens the habit and creates the craving to do it again

According to a 2009 study published in the European Journal of Social Psychology, it takes 18 to 254 days for a person to form a new habit. The study also concluded that, on average, it takes 66 days for a new behaviour to become automatic. Professional drug and alcohol treatment delivered by experienced addiction psychotherapists who are trained in the intricacies of behaviour change is therefore key to relapse prevention.

A relapse can be a hugely psychologically and physically detrimental and in some cases a deadly affair with devastating consequences as it is not uncommon for people to overdose on their return to drug and alcohol use after a period of abstinence. In many circles it is said that when you relapse, you go right back to where you left off, but it’s worse. The shame and guilt of a relapse are worse than the shame and guilt of the use, which can cause many people to lose all hope for themselves. This can further perpetuate their relapse and sometimes hinder them from ever returning to abstinence.

We’re here to talk about this if you’d like to learn more. Call us now on 0208 191 9174 or email us directly https://helpmestop.org.uk/contact-us

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The difference between a lapse and relapse

It’s important to know the difference between a lapse and a relapse, two very different situations that can occur in the road to long term abstinence.

A lapse is a situation where someone has a very brief “slip” where they drink or use, but they stop quickly afterward, avoiding a full relapse into old behaviours. Usually, this happens when a person drinks or uses drugs but instantly regrets this, completely stops and does not pick up again - this often strengthens their will to stay abstinent. In some cases the lapse is due to coming up against something that they hadn’t got a coping strategy for and such the lapse can be a learning experience. Others allow a lapse to turn into a full-blown relapse, returning to their old ways and old substance abuse habits often at much higher levels and frequencies due the shame and guilt.

It is important to understand that not everyone in long term abstinence has experienced a lapse or relapse. However, it is a topic that everyone should be aware, and mindful, of as the propensity to slip back into old behaviour patterns or become complacent and stop doing all the things that were keeping you abstinence in the first place.

Accessing professional drug and alcohol treatment delivered by experienced addiction psychotherapists who are trained in the intricacies of behaviour change and relapse prevention is therefore a good starting point on the journey to long term abstinence.

What are the signs of a lapse/relapse?

The onset of a lapse or relapse often comes with many warning signs. Some of the most common concerns for a potential relapse include:

  • Extreme cravings with no outlet to disengage or distract from them.
  • Thinking that you can moderate or use again without stopping
  • Romanticising about the joys of previous drug and alcohol use and not looking at any of the downsides
  • Isolating or withdrawing from people and activities that were supporting your long-term abstinence
  • Associating with old friends who are still drinking problematically or using drugs
  • Extreme stress or changes in behaviour

Drug and alcohol use is often a coping strategy, a way of dealing with life's ups and downs. When we have a negative experience, we deal with the feelings by consuming a substance. When we have a positive experience, we deal with the feelings by consuming a substance.

As a colleague of mine often says “It's as if drugs and alcohol are the medicine that treat the life disease of feelings”. And it is true, this inability to cope with feelings is indeed often a cause for people to use drugs and alcohol. Many have attempted to avoid life through the use of drugs and alcohol with varying degrees of success. But in truth there is no way of completely immunising oneself against life events and the associated feelings.

There is a saying in recovery - “The good thing about recovery is that you get your feelings back, the bad thing about recovery is that you get your feelings back”. This is often described as “life on life's terms” and for some working through a lapse or relapse is part of this.

How to help someone that has lapsed or relapsed

There are unfortunate misconceptions around a lapse and relapsing, and this creates some dissonance on how to help someone who has encountered or is experiencing one. There are different things to understand when it comes to dealing with lapse and relapse:

  • It is imperative that anyone who has had a lapse or has relapsed understands that they can still return to abstinence, as well as be successful at it. The sooner someone can stop using again, the better chances they have of minimising the damage.
  • It is important to encourage the person to get back into treatment or get professional help as soon as possible. Seeking professional help is key especially if someone has never done this before or that short term lapsing is a regular occurrence. There is no shame in realising that getting on top of drugs and alcohol requires professional help.
  • Do not to shame the person that has lapsed/relapsed or make them feel worse than they already do. Being compassionate to the fact that their lapse/relapse is likely not something they are proud or wanted to have happened is the best way to be there for a person who is actively relapsing. This does not mean enabling then to continue to do it but by showing compassion and understanding about the magnitude of what they are trying to do will help rather than hinder
  • Try to get them to talk through what happened and how they are feeling can be helpful, but it can also cause them to be defensive and possible aggressive so be careful of this and timing is everything. Talking to a trained professional can be really helpful here.

Getting Help with a lapse or relapse

If you or someone you care about is in danger of relapsing do not wait until it’s too late to take action. Contact us today to learn more about the best ways to prevent and treat lapse and relapse, including our online and face to face Dayhab programmes and 1:1 specialist psychotherapy.

We’re here to talk about this if you’d like to learn more. Call us now on 0208 191 9174 or email us directly https://helpmestop.org.uk/contact-us