Addiction is a chronic disease, like heart disease or asthma. As such, it’s not really accurate to think about a “cure” for addiction any more than it would be appropriate to talk about a cure for those diseases. Addiction is something that people can struggle with the rest of their lives.
The good news is that addiction can be effectively treated and managed so that it doesn’t disrupt your health, happiness, or ability to live a productive and fulfilling life. Decades of research on the biology and psychology of substance misuse disorders have led to well-tested, research-based methods to help people recover.
Many people think that a relapse in the course of recovery means they have failed — but that’s not the case. Since addiction is a chronic disease, relapse is a part of the process. Relapse rates for addiction are similar to rates for other chronic medical illnesses, but newer treatments are specially designed to help prevent relapses.
It’s important to keep in mind, though, that when it comes to drugs, relapse can be very dangerous — it’s definitely better to avoid it if at all possible. As recovery progresses, a person’s tolerance to previous levels of drug exposure begins to fall. When a person relapses, they often take the dose they’re used to from before they started recovery, which can lead to hospitalization or even death.
In general, medication is the most effective line of treatment for opioid misuse problems. Medication can block neurotransmitters that foster cravings and might encourage relapse, and it’s especially effective when combined with behavioral therapy or counseling.
For people with problems misusing substances like stimulants or cannabis, there are currently no clinically tested medication to help with treatment, so recovery programs will focus on behavioral and psychological solutions. Treatment should be focused on each individual patient’s drug use patterns, as well as their medical, social, and mental histories.
Medication is also used in many cases to detoxify people from drugs. Detoxification can be an important step in recovery, as it purges the chemical hooks from a person’s system that cause withdrawal and cravings. Detox is not a substitute for treatment, though, and isn’t sufficient to help a person recover on their own. Detox without additional treatment usually leads to relapse.
Medication plays an important role in various stages of substance misuse treatment, helping patients stop using drugs, stay in treatment, and avoid relapse.
Some medications are designed specifically to help patients avoid withdrawal. When patients first stop using a substance they’re addicted to, they can experience severe psychological physiological symptoms, from insomnia to depression, anxiety, and other mental health issues. These symptoms provide a powerful impulse to start using substances again, but reducing the symptoms with medication can help mitigate those urges.
In addition to medicinal treatment, behavioral therapy helps people with substance misuse problems to change their attitudes and behaviors. They’re better able to cope with stressful situations and triggers that might push them to relapse.
Whether it’s cognitive behavioral therapy, which helps patients avoid situations that might push them back into drug use, or family therapy, which helps create a more supportive and functional environment for recovering patients.
No matter what the final process looks like, stopping drug use is only the first step of a long, complicated recovery process. Addiction can cause major disruptions in a person’s life, not just in their own bodies but in their families, careers, and communities.
Because the effects of addiction can be so broad, treatment needs to address the entire problem. And while the long-term effects of addiction may never go away entirely, anyone can find the help they need, with the appropriate support.
Alcohol consumption is very common — over half of Americans say they’ve had an alcoholic beverage in the last month. Unfortunately, alcohol use disorder (AUD) is also common. As of 2015, there were 15.1 million American adults suffering from alcohol use disorder — more than one in 20.
If you’re dealing with AUD yourself, or if you have a family member or friend who struggles with AUD, you’re not alone. AUD can cause significant health problems, social distress, and danger to the person suffering and to others — an estimated 88,000 people a year die of alcohol-related causes.
The care that you’ll need to recover from AUD will vary depending on your history, usage, and the individual symptoms you develop, but it’s common for people experiencing AUD to have withdrawal symptoms when they stop drinking suddenly. That’s where detox comes in.
Detox is the first step of treatment, but it doesn’t replace treatment entirely. When someone who’s developed a chemical dependence on alcohol stops drinking completely and all at once — “cold turkey,” as it’s often called — they can start to develop withdrawal symptoms. These symptoms can come on quickly — within 24 hours in most cases — and often occur while the person still has alcohol in their system.
For some, withdrawal symptoms are relatively mild, much like a bad hangover. Nausea, headache, dehydration, and aversion to bright light and loud noises are common.
Others, especially those who have been dealing with AUD for a long time, will experience much more serious symptoms. These include:
Delirium tremens (DTs), a life-threatening issue that can make you restless, upset, and confused and cause fever, hallucinations, and seizures
Hallucinations, when you see or hear things that aren’t there
Shakiness, especially in your hands
Unstable changes in blood pressure and heart rate
It depends. If you need alcohol on a daily basis just to make your body and brain feel normal, then you most likely have developed a chemical dependence and need help. Don’t try to detox alone, though. Going “cold turkey” without medical supervision isn’t recommended, and can be fatal if not handled properly. If you realize that you need help with AUD, seek out a medical professional.
A detox program will include support to guide you through the withdrawal symptoms, which might last a week or more and hit their peak around 24-72 hours in. Detox programs will often include medication to help ease symptoms, but there’s no beating around the bush — it’s going to be a miserable experience. That’s why support is so important. You’re much more likely to stay on track with a detox program if you have lots of help.
If you’re trying to plan a detox program for yourself or someone else, it helps to think a step further to a rehabilitation program. Detox is just the first step to get the alcohol out of your system — rehab is how you learn to stop misusing it entirely.
An inpatient program takes place at a hospital, rehab center, or detox clinic. You’ll live in the facility full time during the process, and you’ll have help and support available 24/7 to get you through the difficult process.
For patients with less severe AUD, an outpatient program might be a better fit. Outpatient means you still live at home, but get some treatment during the day. This could run a gamut of treatment levels, from full days in therapy and counseling to simply picking up medications.
Once you’ve been detoxed and gotten through your unpleasant withdrawal symptoms, it’s time to start thinking about rehabilitation. Without help, you’re likely to relapse and fall right back into a habit of harmful alcohol use, so it’s important to change your mindset going forward.
Talk to a professional who can assess your history with alcohol, physical and mental health, history of rehabilitation or attempted rehabilitation, and a number of other factors to find the facility or program that’s right for you.
Admitting that you have a problem is the hardest part of any rehabilitation program, but it’s an important first step. Alcohol doesn’t have to control your life, and you don’t have to fight it alone. If you’re concerned about your alcohol use or that of a loved one, don’t hesitate to look for help.
Relapse, broadly speaking, is when a drug or alcohol addiction reappears after a period of remission or recovery. For people who have struggled with substance use disorders, they’re surprisingly common.
In fact, according to the National Institute on Drug Abuse, relapse rates for substance abuse are roughly the same as those for other chronic diseases, like diabetes, asthma, and hypertension — about 40-60 percent.
That doesn’t mean that relapse is a guarantee, however, or that it can’t be mitigated and controlled with careful treatment and support.
There are several factors that affect the rate at which those diagnosed with substance use disorders (SUDs) relapse. One example is participation in a 12-step program like Alcoholics Anonymous. Duration matters as much as simple participation — a study completed in 2006 indicated that 72% of individuals who participated in AA for more than 27 weeks were relapse-free after 16 years — twice the rate of those who didn’t join AA at all.
Despite the variety of data on the subject, two main themes seem consistent: getting treatment for SUD can greatly reduce relapse rates, and relapse rates are highest in the first year of sobriety, with a steep drop-off every year after that.
Even a few days of treatment can make a difference. According to the Partnership for Drug-Free Kids, “Patients who received addiction treatment within 30 days of going through detoxification took 40 percent longer to relapse if they fell off the wagon at all.”
As for the second theme, the evidence indicates that staying sober only gets easier as life goes on. In 2007, the National Institutes of Health published data comparing relapse rates over time during recovery. In their first year of recovery, almost two-thirds of participants recovering from SUD experienced a relapse. For those who stayed sober for a year, that number fell to half. And for patients who managed to stay sober for five years, relapse rates were less than 15 percent.
Rates of alcohol relapse for those with alcohol use disorders are high — the National Institute on Alcoholism and Alcohol Abuse has indicated that 90 percent of alcoholics will experience at least one relapse following treatment.
However, the trend of relapse rates dropping over time still holds true. During the first year of recovery, relapse rates are as high as 80%, but that number drops to 40% after two years of sobriety. Furthermore, individuals who seek support for their addiction are more likely to be clean and sober three years later than those who don’t get help, or who try to quit on their own.
Stimulant drugs like cocaine and methamphetamine are known for their strong addictive properties and high relapse rates, but the premise that recovery helps to prevent relapse still holds. In a study cited by Reuters, 48 percent of meth users who followed a detox and rehabilitation program were still sober three months later and 20 percent were sober after a year — by contrast, only 7 percent of people who had undergone detox only or received no treatment had managed to avoid relapse.
Opiate use disorders have been a hot-button issue in the news recently. Unlike many other addictive substances, opiates can be said to have a true “gateway” to misuse and addiction — prescription painkillers, which are prescribed frequently and in ever-increasing quantities. Individuals who exhibit none of the usual risk factors for substance use disorder are becoming addicted to opiates, and as a result, more than 2.4 million Americans suffer from an opiate use disorder.
The federal government is responding with task forces focused on medication-assisted therapies and pharmacological treatments for opiate addiction, many of which have shown promising results. In addition, there is increasing social pressure for doctors to prescribe opiates more judiciously. In the meantime, techniques like detox and rehabilitation still show success.
There has long been a debate as to whether marijuana can be habit-forming in the first place, and to what extent, but the fact remains that roughly 300,000 people every year seek treatment for cannabis use disorder. Unfortunately, relapse rates are high and the FDA has not currently approved any medication to help treat CUD.
Factors that contribute to marijuana relapse are still somewhat of a mystery, but there is some evidence that daily marijuana smokers who also smoke tobacco cigarettes are more likely to relapse than those who don’t. Additionally, it seems that those who begin marijuana use later in life are more likely to relapse than those who begin as teenagers.
Addiction is a chronic illness — those who suffer from substance use disorders may never be completely free from the risk of relapse. However, relapse rates are at their highest immediately following treatment — 65-70% of patients will relapse within 90 days of finishing treatment — so any research that can identify those at higher risk or relapse is helpful.
Clinical evidence points to several risk factors for relapse. Some are environmental, like stress and being in areas that remind patients of their prior substance misuse. Others are neurological or biological, like cortisol sensitivity, medial frontal gray matter volume, and serum BDNF.
Hopefully, further research will generate a clearer picture of exactly which people are most susceptible to relapse, which clinicians and specialists can then use to screen for those who need more intensive care and treatment.
There’s no magic formula for preventing a relapse if you’re recovering from a substance use disorder. Individuals recovering from substance use disorders often find that avoiding relapse is relatively easy while undergoing treatment and rehabilitation — it’s when they return to their old life and its many triggers that they run into problems.
While you recover, it’s important to recognize and avoid situations that might lead you to relapse. Maybe there’s a particular bar that you used to attend, a park where you used to use, a place you would meet your dealer or certain friends who always encouraged you to drink or use drugs. Avoiding those places and situations is a good first step.
Another useful tip is to stay busy. Research has shown time and time again that a daily routine helps foster discipline in your mind, keeping you focused on productive things like work and exercise and avoiding boredom — another common trigger. Make time to go for a walk, practice meditation, hit the gym, play games with your kids, or take up a creative hobby like painting or woodworking.
Finally, your support network is crucial. Hopefully, your friends from before you went into rehabilitation will be supportive of your new efforts to avoid triggering situations and be willing to help by having alcohol-free parties and finding other activities to engage in. If they’re not, it may be best for you not to spend time with them anymore.
The people you went through rehabilitation with are also a great resource, especially if they’re local. If they’re not, then you can seek out local therapy sessions and support meetings. Finding people that you can talk to who will understand what you’re going through will be a huge help in staying sober.
Recovering from an addiction or substance misuse problem doesn’t end when your rehabilitation program ends. Addiction is a serious medical condition — it requires continuing care and an ongoing treatment plan to ensure that you can maintain a healthy lifestyle for years to come.
As much as we wish it weren’t true, relapse at some point is likely — it’s just the nature of a chronic illness like an addiction. In fact, relapse rates for addiction are similar to those of other chronic illnesses, like asthma, hypertension, and diabetes.
As much as we wish it weren’t true, relapse at some point is likely — it’s just the nature of a chronic illness like an addiction. In fact, relapse rates for addiction are similar to those of other chronic illnesses, like asthma, hypertension, and diabetes.
Treating a chronic medical condition is more than just medication — it involves changing behaviors, and that’s hard to do. It’s important to note, though, that relapse doesn’t mean the original course of treatment has failed. It just means that there’s still more work to do — new treatments, adjusted techniques, or other methods.
That’s where continuing care comes in. Roughly half of the people who struggle with addiction will relapse during recovery, so continuing care is crucial to help you get through your recovery and life a healthier life.
When you undergo full- or part-time treatment for drug and alcohol addiction, you’re given the tools and knowledge to get clean and sober and stay that way. The problem is, those tools and knowledge are much easier to use when you’re in a controlled environment.
When you finish the program and get back to your normal life, your surroundings change. Not only are you lacking the same regular treatment and one-on-one time that you had during your rehabilitation program, but your surroundings have changed.
In many cases, you’re once again surrounded by triggers. Maybe it’s the liquor store where you used to buy alcohol or a park where you used to buy drugs. Maybe it’s being around your old friends, who still use recreational drugs or drink. Maybe it’s your own house and the memories it holds.
This change in circumstances is exactly why you should seek out continuing care, not just through the support of family and friends, but through professional help. This will include attending regular support meetings, continued counseling (including family and marriage counseling, if necessary), and learning to apply the tools you gained in your rehab program to your new life.
After you complete an inpatient or residential rehabilitation program, you’ll usually transition to either an outpatient treatment program or a sober living house, sometimes called a “halfway house.”
An outpatient treatment program takes place in an office or clinic and involves educational sessions and group therapeutic meetings. You can attend these meetings as often as you need to, for as long as you need to, slowly attending fewer and fewer meetings as you progress.
A sober living house offers a little more structure, ensuring that recovering addiction patients can maintain a drug- and alcohol-free environment while they get back on their feet. These programs are sometimes court-mandated.
Continuing care isn’t just about preventing relapse — it’s about helping you build a new life. As anyone who’s struggled with addiction can attest, your social life tends to revolve around the substances you misused and the people who used them with you. Once you go through a rehabilitation program, it’s hard to separate your social life from your substance problem.
Continuing care can help you meet new people and find new activities that don’t involve substance misuse, like exercise, artistic expression, volunteering, and taking classes. There’s no shame in needing help to get back on your feet, and continuing care might be just the help you need.
Being the only sober one at a party can be very uncomfortable — not only do you feel like you’re missing out on the fun, but you’ll be inundated with questions about why you aren’t drinking and might have to give long and awkward answers to those questions.
If you’ve struggled with alcohol addiction and are recovering, being surrounded by drinkers can be difficult, and you don’t need their questions making it any harder. This time of year, with Halloween, holiday parties, Thanksgiving, and Christmas coming up, can be especially difficult. Here’s how to have a good time at all those big social events without drinking — and without having to talk about it.
This seems counterintuitive, but the most obvious sign that you’re not drinking is, well, not drinking. If you’re not holding a drink, someone will probably try to get you one, and you’ll have to explain why you don’t have one to everyone who asks.
The solution? Have a drink in your hand. If you’re carrying a glass with ice and liquid in it, people won’t give you a second glance. It’s easy to put a slice of lime in a glass of seltzer water or Coke or to make straight orange juice or ginger ale look like a cocktail. Most people won’t even notice.
Some people will find out that you don’t drink and want to know why, but people in a party atmosphere generally don’t want to hear about your past struggles with addiction. Lucky for you, the average stranger doesn’t actually care why you’re not drinking — it’s just a reflexive follow-up question.
That means you can brush them off with a simple cliche like “I’m not drinking tonight,” “I’m trying to cut back,” “I have to get up early,” or “I’m the designated driver.” Then change the subject to your local sports team and they probably won’t think about it again.
There’s an exception to this strategy — if you’re around family or co-workers, you’ll probably be seeing them in a context with alcohol again, and you’ll have to make up fresh excuses. If it’s someone you spend a lot of time with, take the time to explain your history with alcohol once, and you shouldn’t have to do it again.
Lots of people get together just to drink and talk. That’s fine, and you might have been one of them. But if you’re not drinking, that’s not the kind of gathering you should be seeking out.
If you’re hosting, make the party about something else! Host a party during a sports game so people have something else to look at and talk about. Do a movie night or a board game night. Serve food — if you have food in your hands, no one will think it’s weird that you don’t have a drink in your hand instead.
If people around you are getting drunk enough to be sloppy, they’re not just going to be pressuring you to drink too — they’re not going to be much fun to hang out with either.
Having a friend at the party who’s also not drinking is a great way to bond with someone over music or conversation instead of alcohol. Chances are, there’s someone else at the party who’s a designated driver or is getting up early, or might even share your history of addiction and be able to sympathize.
If your life used to be dominated by groups of people sitting around with a 12-pack and the TV on in the background, you’re in for a treat — there’s lots of other stuff going on!
Check Groupon or LivingSocial for activities in your area — they’re usually stuffed to the gills with activities that don’t have to center around drinking. Local sports games, dance lessons, planetarium shows, climbing gyms, ropes courses, monster truck shows, plays, murder mystery dinners, and so much more.
Feel like a historical sword fighting course for two? Or maybe a full day of paintball? You’ll never run out of ideas, you’ll keep yourself busy without drinking, and you might even learn some new skills!
Going through a comprehensive addiction recovery program can be extremely helpful to those who struggle with harmful substance use, but recovery doesn’t end when your program does. You may be excited to live substance-free, but you still have lingering fears of relapse and wonder how you’ll stay sober when you get back into your normal social life and routine.
Adjusting to life without the constant support and supervision of counselors and peers can be difficult. You may find yourself in situations that make you want to start using again. With help, you can maintain your sobriety long-term. Here are some steps to take that will make that easier.
Obviously, no one is saying that you have to abandon all your old social connections when you get clean and sober. But there’s no denying the motivating power that peer pressure — even indirect peer pressure simply from being around other people who are using — can have on you.
It’s hard to be the only sober person at a party where everyone’s drinking, so do your best to avoid those situations until you feel like you have a stronger handle on your own urges to use. Hopefully, your friends will be accommodating. Ask them if they’re willing to do a brunch or a football Sunday without alcohol, or find something else to do — a board game night, a hike, or some other way of enjoying yourselves without substances.
Long-term substance use can start to physically rewire the brain — chemicals like serotonin and dopamine, commonly associated with happiness and generally “feeling good,” are gradually replaced by drugs to the point that the brain stops producing them on its own.
Exercise can bring that production back to a natural, healthy state without the help of substances. In addition to producing positive effects on the brain, exercise is a good way to sleep better, maintain a regular schedule, distract yourself from cravings, and reduce stress — all helpful ways to avoid relapse.
For some people, the areas they used to spend time can be major reminders of substance use and misuse. Whether it’s the bars you used to drink at, the places you used to meet your drug dealer or the parks in which you used to get high, these places can be strong triggers for cravings to use again.
Moving to a new home, a new neighborhood, or a new city can be a big step, but it can also help you push the reset button on your cravings. New places to form new memories, new associations, and new, positive habits might be just the push you need to stay clean longer.
If moving isn’t plausible, try to at least change up your surroundings. Consider new furniture in your home, or changing your decor to things that don’t trigger unpleasant memories. Start going to new restaurants and walking new routes around town.
Returning to a job, a commute, bills, and other aspects of daily life can be stressful, and stress can cause cravings to use again — indeed, it might be the reason you started using in the first place. It’s important to avoid feeling the same stressors as you did before, otherwise, a relapse becomes more likely.
Try to establish a daily routine that focuses on your mental health and gives you a chance to relax and unwind. Read a book, take the dog for a walk, or consider starting a meditation routine — there are tons of apps that will remind you to meditate every day and guide you through the process.
Addiction is a chronic illness — it won’t go away overnight, and the effects it has on you may never go away entirely. As a result, 40 to 60 percent of people in recovery will relapse at least once. That doesn’t mean that recovery is impossible, that treatment isn’t working, or that there’s something wrong with you — it means that recovery is really difficult.
For some people, negative emotions like stress, sadness, and anxiety can trigger the cravings that lead them to relapse. For others, it’s the opposite — feelings of happiness and power make them want to celebrate with substance use.
Whatever the trigger, be on the lookout for cravings and thoughts of relapse, and try to catch them before they turn into actions. Have a friend, peer, or sponsor that you can talk to when those thoughts come up — sometimes simply being told that you don’t need to use is enough to talk you down.
When you get a chance, talk to your therapist or go to a meeting. Talking to a professional or to your peers might help you identify where those triggers came from so you can avoid them or resist them better in future.
And remember, this isn’t supposed to be easy! No one expects you to get better and stay better without help, and despite the stigmas associated with addiction, there’s no shame in asking for help.