Instead, it is often a sign that treatment needs to be adjusted or that more support is needed. With the right help, many people are able to recover from relapse and go on to lead healthy and fulfilling lives.
The National Institute on Drug Abuse (NIDA) defines addiction as “a chronic, relapsing disorder characterized by compulsive drug seeking, continued use despite harmful consequences, and long-lasting changes in the brain”. It adds that addiction is “the most severe form of a full spectrum of substance use disorders, and is a medical illness caused by repeated misuse of a substance or substances”.
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Most people are aware that addiction involves compulsive seeking and use of the substance involved but the fact that it is considered a relapsing condition is often overlooked. People going through addiction treatment programmes will be made aware of the risks of relapse, but you may not know how big an issue it actually is.
What is a Relapse?
In medical terms a relapse is defined as the worsening of a clinical condition that had previously improved. This could mean the return of a cancer that was hoped to have been successfully treated, or the reoccurrence of a disease like malaria, which can lie dormant for long periods. In terms of addiction, it refers to returning to drinking or drug use after a period of abstinence. In colloquial terms this may be known as ‘falling off the wagon’, especially in relation to an alcohol addiction.
It’s important to remember that relapse does not necessarily have to mean a return to square one and the end of recovery. It is obviously better if relapse can be avoided entirely, especially as it can be dangerous in some cases. Long-term drug use can see you build up a tolerance to the substance, which can fade during a period of abstinence. When people relapse, they often use the same amount of the drug they did previously and this could potentially lead to an overdose.
In general though, a relapse should be seen as a setback rather than the end of the road. Many people do successfully continue with their recovery journey following one or even a series of relapses.
How Common is Relapse?
Relapse is generally reckoned to be very common, which you might expect from a condition remarked as a ‘relapsing disorder’. A number of studies have shown relapse rates to be as high as 65% to 70% in the 90-day period following treatment.2 NIDA suggests that relapse rates for drug addiction could be between 40% to 60%. The institute adds that these relapse rates are comparable to other chronic diseases such as diabetes (30%-50%), hypertension (50%-70%) and asthma (50%-70%). Despite this, drug treatment is often considered to be a failure when a single instance of relapse occurs, while treatment for other illnesses will be counted as successful even though relapse may occur in the future.3
Relapse Numbers After Rehab
Additionally, these figures do not necessarily tell the whole story when it comes to rehab. The estimated relapse rates cited above apply to people who have undergone treatment for drug and alcohol misuse, but there are a number of different approaches to addiction and substance misuse treatments. Government figures show that 98% of people undergoing treatment for drugs and alcohol in 2019-20 received their treatment in a community-based setting, with only 2% receiving treatment in a residential setting like private rehab.4 This means the baseline rates for relapse in everyone who has undergone treatment cannot necessarily be applied to those who have successfully completed an inpatient rehabilitation programme.
An NHS report on the role of residential rehab within an integrated drug and alcohol treatment system found that “the very best rehabs see three-quarters of their residents overcome addiction”.5 The report noted, however, that other rehab providers achieved much poorer results, which underlines the fact that not all rehabs offer the same level of services. If you do go down the rehab route, it is always best to use a service like Action Rehab, which can help you to find the best place for your own individual circumstances and needs.
The report also noted that, compared to drug and alcohol services overall, residential rehab centres were typically dealing with people with the most severe addiction problems. These people might also have:
- failed in community treatment more than once
- longer and more entrenched drug and alcohol misusing careers
- a range of problem substances
- poorer physical and psychological health
Another interesting study suggests that the average number of attempts to recover from addiction was not the actual experience for many people. Participants reported an average of five ‘Serious attempts’ at recovery but the median was two or three (depending on the analytic approach) and the modal or most commonly occurring number was one serious attempt.7 Essentially, if one person attempted to quit ten times this would pull the average up, even though it was not the experience of most people.
Can Relapse Be Prevented?
There is no guaranteed way to avoid relapse, just as there is no simple ‘cure’ for addiction. The above figures suggest that residential rehab is by far the most effective treatment however and there are a number of reasons for this.
As well as providing a medically supervised detox, a holistic rehab programme attempts to address every aspect of an addiction, including the root causes of any substance misuse issue. This is primarily achieved through an extensive package of psychological therapies such as cognitive behavioural therapy (CBT), group therapy and one to one counselling. There will also be a focus on relapse prevention, with sessions aiming to provide you with the strategies and tools you need to avoid relapse moving forward. A tailored aftercare package can also help by providing additional sessions and support when you need it in those crucial first few weeks and months.
If you do relapse, it’s important not to give up hope and return to old negative cycles of thinking and behaviour. A relapse can be and often is a bump on the road to recovery, especially with the knowledge and skills learned during a comprehensive rehab programme.