If I Relapse, Do I Need to Start Rehab Over?
April 2, 2018 – It seems like a pretty straightforward question, but the answer is not that simple. One of the warnings you may receive about relapse is that you should avoid it because it would require you to repeat detox. Many people fear the pain of detox, although those who have been through it say it isn’t as bad as they expected it to be.
Starting rehab over again implies that it’s a linear process. However, that notion is entirely incorrect. There really is no beginning or endpoint to recovery. When you go to a treatment program, you begin learning what it is you need to understand your current situation. Your situation will change many times throughout your stay in the treatment center. You will pass certain hurdles, and new aspects of your condition will emerge. What you need from treatment will change, too.
So, the answer to whether a relapse means you have to go back to rehab is yes and no. A clearer understanding of relapse, what it means, and what causes it will help guide your next steps if you happen to experience a relapse. Knowing how relapse works will give you some base of knowledge to help guide a loved one’s decision if they’re ever faced with a relapse in recovery.
Table of Contents
- What Happens If I Relapse?
- Dangers of Relapse
- Should I Go Back to Rehab?
- I Relapsed, Now What?
What Happens If I Relapse?
As soon as you enter the treatment center, everyone starts talking about the big, bad threat of relapse. It becomes your nemesis, the monster that could ruin your recovery. You could quickly become convinced that a relapse would mark the end of a failed recovery attempt.
Reading between the lines of all the relapse talk, you may see the implication that addiction recovery is a timed and linear process. In fact, it’s neither. The path to recovery is shaped more like a spiral than a straight line. You make some progress, and then you seem to stop for a while before moving forward again. Sometimes it feels like you’re moving backward, but then you see how your backward movement can propel you forward faster.
Relapse is really just a milestone in this long journey. It’s part of the recovery cycle for many people. The relapse rate for addiction recovery is estimated at about the same rate as relapse in other chronic diseases. Approximately 40-60% of people in recovery experience relapse, while about 30-50% of people with diabetes relapse in their treatment.
Here are some of the primary causes of relapse for people recovering from addiction:
LACK OF COMMITMENT — People who enter rehab to satisfy someone else’s insistence generally don’t make it too far. Motivation is an important part of addiction recovery. It’s what gets you through the tough days of this long journey. The best motivation is intrinsic. If you’re trying to quit your habit to please someone in your life, your motivation will not last.
CHANGING PRIORITIES — For recovery to last, it has to be the top priority in your life. When you enter treatment, this is usually the case. You walk away from your family and friends, your work, your whole life to focus on overcoming your addiction. Sometimes people reach a point in their recovery where they feel confident, too confident. They let their focus wander from the healthy lifestyle they’re building, and they stop making time for the meetings and counseling that got them to this point.
POOR PREPARATION — Recovery is not just about getting off the substances. It’s about learning a new way to live, a way that makes it safe for you to exist in a world where substances are available and temptations can arise. An important part of any recovery program is learning strategies to help you transition from the treatment center back into your regular life. Without a firm grasp of these strategies and how to apply them, you could easily experience a relapse.
WEAK SUPPORT SYSTEM — Treatment can embolden people and empower them to be independent. The high of feeling like you have overcome addiction and are cured sometimes makes people overconfident. A treatment program provides a built-in support system and teaches you how to create your own supports in your regular life. If you don’t build a support system and rely on it when you finish treatment, you’re more likely to relapse in your recovery.
In recovery, relapse means you go back to using your substance of choice. Sometimes people in recovery make a decision to use because they think they can do it just one more time, and then continue their program. Sometimes they lose hope, their motivation wanes or they’re desperate for the mental and emotional escape that drugs provided them. There are a number of different relapse scenarios.
Experts can predict when a relapse is likely to occur. There are certain situations that trigger a relapse. If you can identify these triggers, you might be able to prevent the relapse. The most common relapse triggers spell this handy acronym which makes them easier to remember:
HUNGRY — Addictive behaviors are initially adopted as a means of soothing discomfort. Hunger is a common discomfort that often gets misidentified. When you allow yourself to become too hungry, your ability to make rational decisions diminishes. Hunger can quickly turn to some unidentified anxiety. If you have an addiction, your reflex response to this type of discomfort is to use substances. By adopting a healthy eating routine and sticking to it, you can avoid hunger pushing you to relapse. As you learn in treatment, the routine is a good antidote for addiction. When you plan your meals out in advance, you can make good choices about what, when, and how much to eat. Then, every day, you just have to follow your routine. It’s a good idea to anticipate changes in your daily schedule that might interfere with your normal meals. If you’re traveling, for instance, be sure to carry food with you, or plan a stop at mealtime where you can get what you need to maintain your eating routine.
ANGRY — Most addictions are means of escaping emotion that’s too challenging or difficult to deal with. In treatment, you learn that you have to feel your emotions to let them go, and you learn safe ways of doing that. Anger, however, can be very powerful. For most people experiencing emotional issues, anger is either the only emotion they allow themselves to feel or it’s something they’re completely cut off from. When anger becomes too intense, it can trigger the old substance use habits as a means of escape. Adopting strategies that allow you to release your anger in a safe way can help avoid having so much anger that it pushes you to relapse in your recovery. Strenuous exercise is often used to burn the extra energy anger creates, so you don’t take it out on yourself or others. A regular exercise routine can help you manage your anger. It’s also a good idea to recognize when your anger is becoming too much to handle and ask for help.
LONELY — Addiction is a very lonely existence. It forces you to shut out the people who care about you to try to keep your secret. Loneliness and isolation are also created by the lack of self-esteem you feel when you’re not proud of your actions. When you seem to be the only one who cannot get her life together, you’re reluctant to reach out to others. It seems easier to be by yourself. Prolonged isolation and a deep feeling of loneliness can push you to relapse. Socializing can be challenging, but it’s a good idea to have at least one person you feel comfortable around and whom you can trust. When you feel lonely, call that person, even if you have nothing to say. Just the interpersonal connection can help dispel the loneliness and ward off a relapse.
TIRED — Fatigue is similar to hunger, in that it can cause you to make poor decisions. It’s not unusual for people recovering from addiction to experience insomnia or some other type of sleep pattern changes. When you’re tired, you want something to soothe your discomfort. The old substance use habits could easily be rekindled if the fatigue becomes too great. It’s a good idea to establish a regular sleep schedule and stick to it. Even if you cannot sleep at night, find a way to fit a short nap into your day. Keep track of your sleep, and if you become too tired, ask your doctor or counselor for help.
Stopping a relapse before it happens could be the best way to keep moving forward in your recovery. If you recognize one of these relapse triggers, get help right away. Don’t wait to see if it gets worse. You can call your counselor, go to a 12-step meeting or get back into treatment. These triggers are signs that your program isn’t working and needs to be adjusted. Make some changes before a relapse occurs.
Dangers of Relapse
While relapse is part of the recovery experience for many people, it should not be taken lightly. Relapse not only endangers your recovery, but it can endanger your life, more so than your initial addiction.
When you relapse during recovery and go back to using substances, even if it’s just one time, your risk of overdose is high. While your addiction was developing, you may have noticed that your cravings were not satisfied easily. Each time you used, it took more of your substance of choice to reach the high you sought. Your usage also probably became more frequent over time.
Detoxing cleared all of those drugs out of your system for the first time since your addiction started. It may have taken several weeks or longer, but your brain is back to functioning on its own. All of the tolerance you built up during your addiction, the reason you could take larger doses each time, is gone.
One of the problems of using substances for recreational purposes is that they impair your judgment. After using for the length of your addiction, you got a sense of what your body could tolerate. Now that you’re in recovery and completely detoxed, your body cannot tolerate the same amount of substance.
It’s like being on a very strict diet. Before you went on the diet, you could eat four scoops of ice cream in one sitting. After the diet, your stomach is smaller, and your appetite has changed, but your brain still remembers ice cream. When you treat yourself to four scoops of ice cream in celebration of all the weight that you lost, your stomach cannot tolerate it. What used to make you happy now upsets your stomach and makes you feel sick.
Relapsing with drugs works the same way, except getting more than you can tolerate could have deadly consequences. A relapse in your addiction recovery can also create an emotional crisis. Your motivation to succeed with a lasting recovery is gone, and you may be overtaken with a feeling of hopelessness.
Should I Go Back to Rehab?
Understanding the dangers of relapse and the likelihood it will be part of your recovery experience, the key to success is managing relapse. Relapse doesn’t have to be the end of your recovery story. If you can pick yourself up and move forward, it will just be a milestone on your way to a successful, long-term recovery from addiction.
Relapse doesn’t mean you have failed recovery. It does, however, indicate that something is not working for you. Relapse is an opportunity to re-examine your recovery program and make some adjustments. Here are some things to consider when you relapse:
ASK FOR HELP — The success of addiction recovery is based on your willingness to ask for help. If your treatment program didn’t teach you to ask for help, you’ve missed the most important point. No one recovers from addiction alone. Keeping your addiction a secret and trying to handle it yourself, which you probably tried, did not work. It’s not you. That approach doesn’t work for anyone. There is no shame in asking for help. It’s actually a human necessity. We cannot fix every problem or face every crisis on our own. This is why we live together in societies. If your car wouldn’t start, you would ask for help. If you broke your leg, you would ask for help. Your mental health is far more important than your car or your leg, and your brain is exponentially more complex. You need help to recover from addiction.
ADDICTION IS COMPLICATED — There is no one-time fix for addiction. You’re going to have good days and bad days. Even people living without addiction have these ups and downs. Everyone messes up sometimes, everyone fails sometimes. This is the cycle of life. Consider your relapse to be just a temporary failure. It happened, and now you’re ready to move past it. Relapse is only the end of recovery if you let it be.
YOU’RE NOT ALONE — Approximately one-third of the people (thousands of Americans) who attempt recovery experience relapse. Some people experience relapse more than once before they attain lasting recovery. Consider the relapse part of the process and move on. Plenty of people have stood where you are right now and have succeeded because they continued to fight their addiction. You can do it, too.
RELAPSE IS NOT THE END — For all the big talk, relapse doesn’t have to be a big deal. It happened, but you can still keep trying to achieve the healthy lifestyle you’re building. You can overcome addiction — it just didn’t happen today. Set your sights on tomorrow and dig your heels in. Relapse did not ruin your goals.
As long as you’re still alive, there is hope for lasting recovery from addiction. Rebuild your motivation, change your approach, and keep trying. Tackle your problems one at a time, starting with your most recent substance use.
I Relapsed, Now What?
Just like it was imperative to get into treatment as soon as possible, reacting positively to relapse is time-sensitive as well. At the beginning of your recovery, the rush was to stop using substances right away, so the physical and mental damage was lessened. Addiction can take hold quickly, but the longer it goes on, the more likely some of the brain changes become permanent.
When you relapsed, you started with a clean slate and added dangerous chemicals to it for the first time. Some of the previous damage was probably already healed, but it wasn’t all gone. It takes time for your brain chemistry to return to a normal state and for the physical and emotional cravings to go away completely. People recovering from addiction can remain emotionally vulnerable to relapse under certain conditions for a very long time.
Now that it has happened, though, you want to manage your relapse, so it doesn’t grow into a full-blown addiction again. Acting quickly to change your circumstances will lessen the effects of the relapse on your overall recovery efforts. The faster you get back to your healthy routine and get some help analyzing why the relapse occurred, the better off you’ll be.
Here are some reasons you should get back into treatment right away:
DETOX — You need to detox again to break the physical cycle of addiction. It’s never a good idea to detox on your own. Even if you only used one time or a small amount, you should have medically supervised detox. Just because your initial detox was uneventful doesn’t mean the second time around will be.
BREAK THE CYCLE — You need to get away from the people and the places that trigger your substance use. On one level, addiction is a habit. Your body and your brain get used to your addictive behaviors and they expect them. Just like the smell of apple pie makes you hungry, exposure to your old drug haunts gives you cravings. Interaction with certain people may have the same effect on you. Getting back into rehab will put you in a safe environment away from the people and places that trigger your old habits.
LEARN MORE — Most treatment programs are time-limited instead of outcome-based. What this means is that if you put in the time — 30 days, 60 days, or whatever the program prescribes, you’re done — But addiction recovery doesn’t work on a specific timetable. Everyone is different and makes progress at their own pace. Suffering a relapse should be a sign that you have more to learn from treatment. Going through the same program again is not redundant because you will pick up different ideas each time. You learn what your brain is ready to accept and what applies to you in your present state.
BUILT-IN SUPPORT — After a relapse, you need a strong support system to get back to your recovery. You may or may not have developed a strong support system on your own, but in treatment, there is one built-in.
After a relapse, your instinct might be to avoid treatment, assuming it did not work for you. Here are some reasons not to go back to treatment:
- It’s Easier to Develop Coping Strategies Outside of Treatment — It’s relatively easy to stay sober when you’re in treatment. You’re surrounded by people who are struggling with addiction just like you. There are professionals guiding your recovery in an atmosphere designed to be drug-free. Your relapse happened after you left treatment, which suggests that you don’t have a good strategy for living in the real world and managing your addiction. Staying out of treatment and working on your coping skills might be a more effective use of your time.
- The Particular Program Didn’t Work for You — You may have learned a lot in treatment, but ultimately your recovery is not a success — yet. There are all sorts of treatment programs out there, however. It may be that the one you attended was not right for you. If the recovery program was not customized to your unique situation and was not equipped to deal with any co-existing conditions you may have discovered, it’s not surprising you relapsed. Going through the same program again might not provide any new benefits to you.
- You’re Facing Financial Hardship — Most of us live in a world where we don’t get to make a lot of choices about how we spend our time. Stress is one of the most dangerous relapse triggers, and being away from work for extended periods of time can cause great stress on your financial situation. Returning to treatment after your relapse may put added stress on you that would be counter-productive to your recovery efforts.
What is most important after a relapse is that you make a change to your routine quickly. Returning to treatment may be the easiest solution to continue your recovery, but it’s not your only option. If you choose not to return to rehab, you might start with a call to your counselor or attend a 12-step meeting.
Reach out to Tranquil Shores for the advice and support you need after a relapse. We can help you make the decision about what to do next to get your recovery back on track. Let our professional staff give you the support you need to move forward after relapse.