Addiction Relapse

I recently read an article that talked about addiction relapse, I found it very interesting. When an addict relapses most people look at it like a failure, they tried to fight to become sober again, but they lost and they are addicted once again; however, this is not the case at all. Relapse is not a sign of failure it is a sign of recovery, in fact approximately half of the people who try to regain soberness return to heavy use. With 70-90% experiencing some kind of slip, not very many people walk into a treatment center saying they want to get sober and ever use again. These characteristics are much like the characteristics of any chronic disease. Like addiction patients who are receiving treatment, people with illnesses such as diabetes or asthma frequently fail there ongoing treatments, they relapse. So no matter the chronic disease, it's up to you to alter and fix your lifestyle and assume responsibility for managing your own care. The sad part is that removing the drugs from you life is the easy part of recovery, it's changing your behaviors and lifestyle that is hard. Relapse most commonly happens because of drug related cues, these cues can be caused by many different things. Such as drug paraphernalia, visiting places where they have gotten drugs from or even music that you used to listen to while you were getting high. The triggers are cause by addiction two phase information process, the first phase is the reward functions, the reward functions on an addicts brain are hyper-stimulated. Taking drugs feels good for users, which encourages them to replete what they're doing. In the second phase, repeated over stimulation of the reward centers in your brain causes long term changes to how the rest of the brain functions. That includes areas involved in impulsivity, decision making and memory. David Sack M.D. from a Psychology Today article put it into a great analogy "it's like having a flood in your house. You leave the upstairs bathtub running and depart for the weekend. The water overflows and runs into the hall. Like a waterfall it splashes down the stairs and into the living room. When you return, you find that the walls are soaked, mold is forming, and the wood floors are warped and peeling. Your original problem was that the water wasn’t turned off, but now the floor needs to be ripped up and the walls torn out. Turning off the faucet (detoxing) doesn’t undo the damage caused by the water (drugs) to the rest of your house (brain)." In this way it's much like a flood. you have more to deal with than just detoxing.

There are also rat experiments that show the two phase process as well. rats can quickly learn to press a lever that gives them drugs rather than a lever that provides them with food or water. The more rewarding that a drug is the more the rat with press the lever. This should not be surprising though, when we present something such as cocaine to a rat, the rat starts to show behaviors that are not normal, and they start exchanging behaviors such as sleeping for taking drugs. In stage two, rats are not just going crazy for drugs but they are remembering and liking the places that they once received drugs. When a rat is placed in an environment where there are no drugs available the rat will eventually accept that there are no drugs, and they only press the levers that give them food and water, but when they are placed back in an environment where they can get drugs, they automatically return to pressing the lever that gives the drugs to them. They are triggered by the environment and they become very agitated, they expect the drug reward. Human addicts create triggers in the same way, modern brain imaging can show us this. It shows that drug use actually alters the connections between the ventral tegmental area (which is a part of the reward center) and memory hubs in the brain (part of the hippocampus). Triggers become hardwired into there brains as a part collateral brain damage of addiction, this is why addicts become very reactive to cues associated with previous drug use. This is why treatment centers recommend that people going through recovery avoid people, places and things from when the addicts used to use. When you are recovering there are danger zones when most relapses occur, most people relapse between the 30-90 day mark, and things tend to get worse before they get better. Just remember that relapse is not a sign of failure and it's not an addicts fault it is just a part of getting better.