Relapse Focus
La Hacienda defines relapse as a process that is recognizable, preventable and treatable. We believe active engagement in a program of recovery is the best way to prevent relapse.
Our therapy enhances the relapsed patient’s potential for long-term sobriety through identifying barriers to recovery and by addressing unresolved problematic issues.
Dictionary Definition of Relapse
Oxford Languages defines relapse as:
- Verb – (of someone suffering from a disease) suffer deterioration after a period of improvement. Example: “One of the patients in recovery from an addictive substance relapsed after four months”
- Noun – a deterioration in someone’s state of health after a temporary improvement. Example: “He responded well to treatment, but then suffered a relapse”
Individualized Approach to Relapse
At La Hacienda Treatment Center we go beyond a generic approach to treating relapse. We assign patients to a group best suited to their needs.
Relapse After Long Sobriety
When a person relapses after a long period of sobriety, they generally experience a lot of shame. This is especially true if being recovered is part of their identity socially and internally.
Many are shocked at the rapid escalation of the disease of addiction when they relapse even after many years of sobriety.
The act of asking for help following their slip back into drug use becomes difficult because they tell themselves, “I know what to do.”
Being in a therapy group with others who have also relapsed to their former state after a long period of sobriety can ease the shame and reinstall the hope that recovery is possible.
Was it Really a Sudden Relapse?
A drug addict or alcoholic may feel like it was sudden when they relapse years after being sober. Generally, they discover they gradually stopped making recovery a priority and slipped into old behaviors, forgetting where they had once been.
Multiple Treatment Episodes and No Lasting Recovery
Some patients have been through multiple addiction treatment programs and can’t seem to stay sober outside of the structured inpatient environment.
They find themselves in and out of the 12-step community, residential facilities, and even a hospital or two. They will say they have worked the steps, changed their ways, and want sobriety, but only achieve partial recovery, then relapse.
Sometimes the return to active drug use or addiction creeps in through a side door of another addiction. Along with being thoroughly honest in addressing all their lingering issues, these patients may need extra structure and accountability to transition to sobriety beyond treatment.
What Causes Relapse?
Relapse most often occurs while living outside of the treatment environment.
Vulnerability to relapse is generally the result of two issues:
- Not knowing the problem and not fully accepting one’s powerlessness.
- Not knowing the solution and not fully understanding the spiritual program of action.
Preventing Relapse to an Addictive Substance
In light of these issues, La Hacienda believes that the best defense against relapse is surrender rather than compliance (Step One), and action rather than complacency about recovery (Steps 2-12).
Here’s what treatment looks like.
Relapse Focus Groups
In relapse focus groups, patients learn to identify mistaken beliefs about relapse and relapse warning signs. They also work through the shame, guilt, and fear associated with having been on the road of recovery and then relapsing.
As a 12-step-based program, we believe the opportunity to put relapsing away for good begins with the first step, admitting we are powerless over the substance we are abusing.
La Hacienda helps relapsed patients in moving beyond their previous “stuck points.”
Confronting Relapse Behavior
Dealing with addiction is not like treating malaria, where an original infection can suddenly reappear years later. It is a disease that persists until people address their relapse behavior head on.
Ignoring the danger of the illness, the afflicted person often denies its symptoms. Substance use, abusing medications, and other bad habits and higher risk behaviors become a daily recurrence despite the danger signs.
A person begins to feel old ways can never change, that a day with non-use is impossible. All attempts to maintain sobriety fail and they end up in a worse state. They blame their relapsing on difficulties in life.
In relapse therapy, clinicians walk patients through difficult life situations and show them how to respond and stay sober despite their problems.
Medications Can be Helpful
The most important thing about relapse prevention is following through with the foundations of what La Hacienda teaches relating to 12-step recovery and counseling.
Medications, however, can play a helpful role, specifically during the first three to six months while the patient’s brain is continuing to heal and recover.
Three medications have been approved by the FDA as it relates to relapse prevention for alcohol. Acamprosate, naltrexone, and disulfiram have all shown benefits in prevention of relapse. Each medication works in different places in the brain. Which one is safest to use depends on the patient’s liver function and other medical issues.
Anti-relapse Medications Vary by Substance
Relapse medications for patients who used alcohol improve success rates by approximately 30 percent compared to placebos. La Hacienda frequently encourages alcohol disorder patients to use a relapse prevention medication for the first three to six months of recovery.
Relapse prevention medications for patients who used opiates are an important part of their aftercare. Relapse to an opioid in this day of fentanyl-contaminated drugs is potentially fatal.
We are strong advocates of the use of naltrexone in opioid patients and more specifically for the use of Vivitrol by injection monthly for six months. This medicine blocks the opiate from reaching the receptor so it can prevent relapse as well as prevent death.
Currently there are no approved medications that prevent relapse for benzodiazepines and stimulants. There are medications that are sometimes prescribed which in smaller studies have shown some benefit and these are occasionally recommended.
Co-occurring Disorders and Relapse
Many of our substance use patients have a dual diagnosis. Complications related to other disorders may also contribute to relapse.
Through the assessment process upon admission, we prepare an individualized treatment plan for patients with therapy and resources that address co-occurring disorders and any other issues specific to them.
In addition to assignment to the relapse group, patients with co-occurring disorders will receive care planned around those conditions.
Relapse Prevention after Treatment
Using what they learn during residential treatment, patients help develop continuing care plans. They are encouraged to find outpatient treatment counselors and 12-step sponsors who are compatible with the relapse prevention concepts they have acquired.
