We are all familiar with the idea of substance use relapse. But are all relapses the same? What does it mean when relapse becomes chronic? In this post we answer these questions and identify the root cause of chronic relapse.
What Makes a Pattern of Relapse Chronic?
Chronic relapse is a repeating cycle of quitting a substance and relapsing.
There isn’t really a strict definition out there for chronic relapse. But if you think about something like chronic pain, it’s something you’re constantly living with. We are talking about situations where folks try over and over again to change their behavior without long term success.
“Stopping isn’t hard. Not starting again is.”
—Robert Downey Jr.
We frequently work with people in recovery who have told their family, their loved ones, or their partners, "I'm done. I'm finished. I'm not going to do this anymore."
And they mean it.
But they're trying to make a change on the physical level without making a change on the other levels of our identity - namely, the mental level, the emotional level, and the spiritual level.
By quitting their substance, they are addressing the physical level. But without making changes on the mental or emotional level they aren’t adjusting how they're thinking, believing and feeling. They're just trying to make a change physically without making a change to the things that caused them to use their substance to begin with. They are ignoring and not addressing the underlying core issues.
When people relapse (or slip, as we prefer to call it), they often feel defeated and believe they aren't trying hard enough and simply don’t have the willpower to stop.
But simply put, no one has enough willpower.
Willpower is a finite resource. It's always going to run out. It's going to run out today or tomorrow or next week or next month. Willpower is not the solution, but many people are taught that it is.
And when they aren't successful, they feel like they're a failure. In reality, they just haven't received the mental and emotional-level help that they need with what they're thinking, believing, and feeling.
Treating Chronic Relapse With Dual Diagnosis Support
People turn to substances because they are having trouble coping with what they are feeling. We can break that cycle by addressing these underlying issues.
For some people, an addiction is just a physical problem. In these cases, detoxing from the substance is usually enough to treat the addiction. But when relapse occurs, this is a sign that there are emotional issues that require more intensive psychological treatment.
The next step is getting assistance dealing with the mental and emotional issues that are causing the pain, driving the need for a substance.
This is what we refer to as dual diagnosis treatment, where substance addiction is treated alongside a mental or emotional issue like depression, anxiety, self loathing, hopelessness, trauma, loss and/or despair..
Treatment Options For Chronic Drug and Alcohol Abuse
In the simplest terms, there are two types of treatment for chronic relapse:
1. Outpatient addiction counseling
The less intensive option is outpatient counseling.
Outpatient treatment is treatment in which the patient is not hospitalized overnight. In other words, you commute to the treatment facility for care and then return home. The right outpatient counseling can address issues like chronic relapse and even dual diagnosis concerns. Meeting with a professional counselor a few times per week represents a relatively low time commitment compared to inpatient treatment, allowing you to live your life normally.
But the drawback is that for many it’s not enough, offering a lower chance of success than a more intensive solution.
2. Inpatient drug and alcohol treatment
The more intensive option is inpatient drug and alcohol treatment.
Inpatient treatment or rehab puts you in a controlled environment where you are removed from your usual environment for several weeks, and gives you round-the-clock access to professional counselors. This approach gives you the most face-to-face time with a counselor, and gives you a solid foundation on which to build your recovery.
If you have experienced frequent or chronic relapse, it may be time to consider inpatient rehab.
Inpatient vs. Outpatient: Which Treatment Option Is Best For Me?
If you are just getting started with recovery, counseling and support groups might be a great place to start.
Be advised, however, that nothing will work without a genuine desire to change and a 100% commitment to receiving help and guidance. As the Big Book of Alcoholics Anonymous famously teaches, “half measures availed us nothing.”
However, if outpatient counseling and support programs haven’t worked for you in the past, a more intensive inpatient program might be in order.
Breaking a pattern of chronic relapse is hard especially when a person is immersed and surrounded by triggering situations, people, and places. Inpatient rehab provides a nurturing new environment where you can build new skills and focus on recovery without distraction.
Inpatient vs. outpatient addiction treatment - whichever path you choose, give it your all. And if relapse becomes chronic, know that it’s a signal of unresolved underlying emotional issues that need healing.
Here's a resource to help you determine the treatment option and modality that will be the best fit for you or your loved one.