People often ask why so many addicts relapse after treatment. The next question is whether addiction treatment is worth the time, the cost and the inconvenience. Good addiction treatment is always worth the effort, although not all treatment is good. How to tell the difference between quality rehab treatment and a facility providing a rehab holiday can be quite difficult. The internet, where most people start the search for help, makes selecting good treatment a difficult task because on the internet, anybody can claim anything and it is easy to mislead the desperate addict or their family. So, treatment quality is the first problem contributing to relapse.
Treatment Quality and Relapse
But the question remains, why is the relapse rate so high even after good quality treatment. The first group, patients who leave treatment early before completing the process, usually relapse before they reach home, despite what they tell us before departure. Of the patients that complete treatment, about 10% of patients will also relapse almost immediately. They have been completely untouched by the treatment experience. It is as if they never were there. Their participation was pure compliance, usually just to please a third party like a spouse.
Early Relapse After Treatment
The remaining 90% leave rehab enthusiastic about the possibility of a sober life, something that has often escaped them for many years. Sadly, about a third will relapse back to substance use within the three months. The reasons are multiple. A sober lifestyle is unfamiliar, intoxication returns as a euphoric memory, the manipulative benefit of treatment has achieved its goal and so the addict persuades themself that a return to substance use is a desirable option.
Challenges Within the First Three Months
In most instances, the nightmare of active addiction returns fairly rapidly, which is always surprising. One would think that with the benefit of hindsight plus the insights gained from a treatment programme plus perhaps some early rewards of sobriety, that a return to using would be careful and controlled. Yet inevitably, the nightmare returns and the addiction is as active as it always was, despite a brief period of sobriety.
The Seven-Month Challenge
For those overcoming the three month barrier, the next challenge occurs at about seven months into the recovery journey. Things are going well and the rewards of recovery are accumulating – relationships, finances, self respect and the notion of addiction as a primary, chronic condition is forgotten. Controlled drug use seems like a viable option. And again the house collapses like a pack of cards. At this point, the addict either seeks further help realising they are in trouble once again or alternately, writes himself off as a “treatment failure”, which becomes a license to carry on using.
Long-Term Recovery and Stability
It takes about two years to find a stable recovery from addiction. In my experience, maintaining a commitment to recovery for two years dramatically reduces relapse. Intermittent use may occur, but if seen as part of recovery and not failure, all will be well.
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