CleanSlate Blog

"Relapse" Sounds Like a Bad Word. But Recovery Often Comes with a Slip.

by Todd Fausnaught, M.D. | Jul 19, 2019

"Relapse."

The word implies “failure.” After beginning treatment for their addiction, patients often feel a sense of shame. Some people may resign themselves to their addiction if they don’t immediately succeed in treatment.

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Because of the stigma and negative associations attached to the word relapse, much work has been done amongst the addiction community to move away from this term. We're now advocating for other terms, like “recurrence of use.” I prefer using the term "slip."

Whatever you call it, the science is clear that addiction is a chronic brain disease. Most people who attempt recovery will experience at least one slip.

But here’s the good news:

A recent study shows that remission only requires a median of two attempts. That’s less than the cultural stereotypes would have us believe.

The study, “How Many Recovery Attempts Does it Take to Successfully Resolve an Alcohol or Drug Problem? Estimates and Correlates From a National Study of Recovering U.S. Adults, explored the number of times that most adults need to attempt addiction treatment before achieving remission. 

Surprisingly, approximately 13% of those who reported having overcome a significant drug or alcohol problem did so without making any “serious” recovery attempts at all. 

The average number of recovery attempts to achieve recovery is 5.35, but this higher number is due to a small group of individuals who need many more recovery attempts than most.  

The researchers found that those who needed more attempts to achieve remission often have a history of depressive and anxiety disorders, prior use of treatment or recovery support services, and are single (rather than married or living with a partner). 

For more than half of the sample pool of the study, only two attempts were needed to achieve remission, regardless of which substance had been used. 

Every patient is different, and so is their recovery path. No matter how many attempts patients need to achieve long-term recovery, they deserve support, not judgment. Slips are a normal part of the process.

Related blog: MAT Facts: Why Is There Any Stigma Against Medication-Assisted Treatment?

Five quality of life factors associated with recovery

The recent study about recovery patterns, published in Alcoholism: Clinical and Experimental Research, looked at a sample pool of people who were trying to quit alcohol, opioid, stimulant, or cannabis.

Recovery from addiction is challenging for most people and usually occurs in gradual stages. As the study notes from past data, more than 50% of people fail to complete addiction treatment, 58% of people enter addiction treatment with one or more prior treatment admissions, and more than 50% of people resume substance use after treatment, often within 90 days of being discharged from treatment. 

Analyzing data from the National Recovery Study, the researchers identified a nationally representative sample of 39,809 adults in the United States and found a sample of 2,002 people who reported to have overcome a significant drug or alcohol problem.

The researchers then assessed five quality of life factors connected with the success of their recovery, including:

  1. Quality of life (the degree to which an individual is healthy, comfortable, and able to participate in or enjoy life events)
  2. Happiness
  3. Self-esteem
  4. Psychological distress
  5. Recovery capital (the volume of internal and external assets that can be brought to bear to initiate and sustain recovery from alcohol and other drug problems) 

Related blog: "Now I Can Buy Groceries!" What Insurance Coverage Vs. Cash For Addiction Treatment Means To Patients

Recovery isn’t one-size fits all

One of the takeaways of the study is that homogenized approaches to addiction undercut success. The more tailored the treatment program is to each individual, the higher the likelihood of progress.

This is our experience at CleanSlate. We recognize that each patient comes to us from a different stage of recovery, with varied influences and circumstances that have brought them to any one of our more than 65 outpatient medication-assisted treatment (MAT) centers across 11 states.

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(Above: CleanSlate staff in Kenosha, WI)

The recent study offers important data to help shape clinical approaches to treatment. The more that patients and families understand what to expect with their recovery path, the more likely they are to remain engaged in treatment.

At CleanSlate, we incorporate the expectation of slips into our approach. We know that patients who are doing well can experience unexpected bumps in the road, and we need to be there for them if that happens – not punish them.

A magical 30-day cure doesn’t exist in treating addiction, which is why we look to maintain a relationship with our patients over the long term. We make care economical, convenient, and easy for patients so that they can remain with us for more than a brief sprint of care. And we help support all aspects of our patients’ recovery, either directly or indirectly - whether the issues are medical, behavioral health, social, or legal. 

Recurrence of use isn’t cause to abandon treatment. It’s an experience that patients can expect - but, fortunately, one that doesn't always happen often on a patient’s path to long-term recovery. 

 

Also read:

The Fuzzy Borders Between Social Drinking And Alcohol Dependence

The Veterans Administration Is Making Progress On The Opioid Battlefield

Medication-Assisted Treatment Works. Here’s 4 Reasons Why It’s Rarely Used.

 


Recovering Trust

Recovery from addiction includes recovering trust. 

 

Download our free Pocket Guide to learn more about the emotional challenges that many patients face on their road to recovery.

 

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Picture of Todd Fausnaught, M.D.

Todd Fausnaught, M.D.

Todd Fausnaught, MD is the Area Medical Director of Pennsylvania for CleanSlate, a leading national medical group that provides office-based outpatient medication treatment for the chronic disease of addiction, primarily alcohol and opioid use disorders.

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