Most addiction treatment programs are not just about helping patients to get clean and sober. It is about helping them to make the lifestyle changes that will allow them to stay that way by resisting the urge to use drugs. In recovery program meeting rooms across America, you can often hear similar tales of a person who has been “in and out of rehab.” It is evident that they have the desire to quit using drugs or drinking, but for some reason, they just can’t seem to shake the urge to use. They may be clean for a few days, weeks, months or even years, but somehow, in the end, they always wind up going back out and using. Sadly, this seems to be a fairly common issue with people in recovery from drug addiction or alcoholism.
Of course, not everyone is like this. There are those who stick to it and remain clean and sober after just one trip to a recovery center. There are those who can maintain sobriety without even needing to go to rehab, choosing to use the strength and support that they find in 12-Step recovery programs. There are even some, although they are few and far between, that don’t even use that or any other method of recovery, just one day choosing to quit using or drinking and never picking it back up.
More commonly, however, most people who are or have been in a recovery program have made multiple unsuccessful attempts at remaining drug or alcohol-free. They are not at fault. Addiction is a powerful thing and does not loosen its grip easily. Once addiction has taken control of a person’s life, it wants to remain in control, and it has all kinds of tricks that allow it to do so.
Subconscious Urges: When Even Sleep is Not an Escape
One of those devious tricks that addiction will play on a person in recovery comes in the form of dreams. According to research that was recently released by the National Center for Biotechnology Information, a department of the National Library of Medicine and the National Institutes of Health, examiners found a direct correlation between the frequency and occurrence of dreams that involved active substance abuse and a person’s increased desire to use drugs or alcohol(1). In a study that was conducted over a five-week period, 86 participants used dream journal methodology to report the regularity and content of their dreams, and rating the level of their cravings afterward.
The study concluded that dreams, where a person is actively using their drug of choice, will sometimes function as a conditioned stimulus to those in recovery from addiction, elevating the urge to use. What this means is that, even when they are asleep, addiction is trying to regain control over the life of a person who is fighting to overcome it. With the deceptive nature of addiction, is it any wonder that a person might relapse at any time? When an individual who has been clean and sober for only a short period wakes up in the morning with the urge to use, one that is decidedly stronger than when they went to bed, how can we expect them to remain clean and sober?
Relapse Prevention: Remaining Substance Free and Controlling the Urge to Use Drugs
The answer, of course, lies in the tools that they have available to them that allow them to face these urges without succumbing to them. Relapse prevention is a crucial part of the recovery process. Without it, most are doomed to repeat the dangerous and deadly cycle of addiction endlessly, until they become completely consumed. In recovery from addiction, it is not enough to just help a patient detox, merely cleansing the body of toxins and sending them back out into the world. To hope for someone who is suffering from addiction to remain clean and sober without addressing the underlying causes of their addictive behaviors and supplying them with the tools to stay substance-free after the completion of a recovery program is nothing short of folly.
So, what are these tools? Well, they are numerous, and they differ for everyone. Each person that comes for treatment is unique, and they all have different needs in an effective recovery program. It for this very reason that the rehabilitation strategy is designed to be adaptable to each patient by offering various options in treatment methods and allowing them a certain level of freedom in determining the direction that their program will take on the path to recovery. While the ultimate goal of leading a drug and alcohol-free life is the same for all patients, there are more ways than one to reach that goal. Each person’s journey to a recovery center was different. Likewise, each patient’s journey through recovery and beyond will be different, even though, ideally, the results will be the same.
While the Relapse Prevention tools a patient uses to remain sober will be different for each, they can be characterized similarly, and grouped into general categories that cover just about every aspect of life after graduating from our program.
- What is causing these cravings? – Identifying the Potential Triggers of Substance Abuse – One of the biggest causes of relapse is what is known as a “trigger.” A trigger can be a person, place, situation, even an active memory or, as we have seen, something as simple as a dream. Some of these triggers are unavoidable. We don’t have any control over our dreams, and we can’t help it if we run into an old drinking buddy at the grocery store. However, in identifying our triggers, we learn to find those things that have strong connotations of drug use or alcoholism and then do everything in our power to remove these things from our lives. Removing triggers is also one way that we reclaim control over our lives and futures from the clutches of addiction.
- Find something else to do – Alternative Responses to the Desire to Use – Another tool that we have to break down our mind’s attachment to a craving or the urge to use is found in the redirection of that attachment to a different result. For example, a person who is trying to quit smoking cigarettes may take to chewing gum or a toothpick whenever the craving for nicotine enters their minds. This example, while simplified, is one way that a person struggling to overcome their addiction might gain a bit of control over their urges. Some clinics and recovery centers have taken this a step further, by using a less potent drug to fend off the cravings of a person addicted to opioids or other narcotics. However, at BDR, we believe that this is not actually recovery from an addiction, but merely the replacement of one drug with another, and will almost always result in relapse. Instead, we encourage our patients to discover healthier and more productive activities to fight the urge to use. Music, art, writing, exercise, meditation, yoga, sports, just about anything that will help them to build up their minds and strengthen their bodies, while simultaneously helping them in avoiding the deadly path of substance abuse.
- Reach out and talk about it – Support Networks and Communication – Perhaps one of the most valuable assets in overcoming the urge to use that a person has at their disposal is the Support Network. Friends or family members who understand what they are going through, who understand how tough it is to beat an addiction and are willing to listen and offer guidance and strength to them, are instrumental in recovery. These interpersonal bonds begin taking root when the patient learns to form healthy relationships, to repair the connections that have been damaged by their substance abuse, and to remove those unhealthy associations that were formed through drug or alcohol use. The extensive Aftercare Department also offers assistance in finding local support groups and recovery meetings for graduates of the program, which are essential in maintaining a clean and sober lifestyle while controlling the urge to use.
An In-Depth Recovery Program
An effective program should place great emphasis on helping patients to discover and address the underlying causes of their addictive behavior. It should also focus intensively on helping patients to find the abilities and strengths within to remain clean and sober after they have completed their recovery program and returned to “normal” life. With Relapse Prevention tools, the program should strive to give patients everything that they need to face the pressures and obstacles of modern life without resorting to drug or alcohol abuse. Graduates will leave the recovery center with a renewed sense of purpose and control in their lives. They understand the level of personal responsibility that they hold in their sobriety. They understand that, while the goal is to help them in any way possible and that every step that they take on the path to recovery, the power to avoid a relapse and remain clean, sober and substance-free remains, ultimately, in their hands alone.