Relapse Prevention & Treatment
Dr. Kittay is an Expert in Preventing Relapse
Relapse Prevention is obviously the key to long term recovery and sobriety. There are no standard measures of a detox or rehab program’s success. Some define success if a person simple completes the program. Many define it as sobriety at 30 days or 60 days after discharge. These are very crude and misleading. So when a program says it has a 90% success rate be careful!
Key Point: Outpatient Treatment with Dr. Kittay Reduces Relapse.
Dr. Kittay successfully minimizes the risk of relapse by:
- Aggressively Treating Post Addiction Withdrawal Syndromes;
- Providing uninterrupted addiction medicine, psychiatric and psychological care throughout the entire recovery process;
- Maintaining a dependable, supportive care system close to home from Detox to long term Sobriety!
Need to Know: Real Problems with most Residential Programs:
Inpatient and residential programs are usually 30-90 days long, often too short a time to successfully treat most alcohol and drug addictions. They do not properly manage Post Addiction Withdrawal Syndrome (PAWS), a major cause of relapse. People go into rehab and once discharged quickly relapse over and over again, the so called “spin cycle”.
A very serious shortcoming of inpatient and residential programs is their failure to provide or to arrange for uninterrupted ongoing and adequate community alcohol or drug use follow up treatment so vital to long term recovery when a client returns home after “completing” the rehab program.
- In a national epidemiological study of inpatient residential rehabilitation programs, only 14% of patients reported attending/completing ongoing community based programs in the first year after rehab program discharge;
- Relapse rates are very high in the first months after discharge from residential and inpatient substance abuse treatment programs, and patient adherence to post rehab care plans is often low;
- Patients receiving care in a rehab facility and follow up care in another location reduces recovery adherence and increases the risk of relapse;
- Patients bond with their treatment team and do better if they stay with them throughout the entire recovery process;
- Patients insulated from the demands and stresses of their everyday life while staying “In-Residence”; don’t learn how to manage; their “everyday life”—which is usually where their triggers for relapse are!
- Residential case managers are often swamped. When it comes time to send their clients home, they don’t have the “Networking” or “Time” needed to set up great continuing care. Client needs are sacrificed for “expediency
The Stages of Relapse
Relapse is a process, it’s not an event. In order to understand relapse prevention you have to understand the stages of relapse. Relapse starts weeks or even months before the event of physical relapse. There are three stages of relapse:
- Emotional relapse
- Mental relapse
- Physical relapse
I. Emotional Relapse
In emotional relapse, you’re not thinking about using. But your emotions and behaviors are setting you up for a possible relapse in the future.
The signs of emotional relapse are:
- Mood swings
- Not asking for help
- Not going to meetings
- Poor eating habits
- Poor sleep habits
The signs of emotional relapse are also the symptoms of post-acute withdrawal. If you understand post-acute withdrawal it’s easier to avoid relapse, because the early stage of relapse is easiest to pull back from. In the later stages the pull of relapse gets stronger and the sequence of events moves faster.
II. Mental Relapse
In mental relapse there’s a war going on in your mind. Part of you wants to use, but part of you doesn’t. In the early phase of mental relapse you’re just idly thinking about using. But in the later phase you’re definitely thinking about using.
The signs of mental relapse are:
- Thinking about people, places, and things you used with
- Glamorizing your past use
- Hanging out with old using friends
- Fantasizing about using
- Thinking about relapsing
- Planning your relapse around other people’s schedules
III. Physical Relapse
It gets harder to make the right choices as the pull of addiction gets stronger. Physical relapse can be:
Slips: Brief and minimal self limited use that is not associated with addiction behaviors such as not fulfilling professional and personal commitments or lying, stealing which have no serious consequences;
Use: Moderate use over days that are harder to control, beginning to cause problems, need help to control but not associated with major addiction behaviors;
Re-Addiction: Uncontrollable use associated with serious addiction behaviors and professional and personal consequences.
Factors associated with early relapse – less than 1 year are:
- Misunderstanding or denial that addiction is a chronic relapsing disease;
- Not participating in ongoing recovery activities;
- Ongoing Emotional, Work and Family Stresses;
- Inadequate treatment of co-occurring psychiatric or medical co-morbidity;
- Rejection of treatment recommendations.
Factors associated with late Relapse – second Year are:
- Renewed emotional work and family stresses;
- Inadequate treatment of co-occurring psychiatric or medical problems;
- Denial of the risks of re-addiction;
- Not participating in ongoing continuing care activities;
- Rejection of treatment recommendations