Understanding Substance Use Relapse adapted from material from
Understanding Substance Use Relapse adapted from material from Terence Gorski Presented by Joan E. Huss; LIMHP, LADC Associate Director of Clinical Services Catholic Charities - JOURNEYS
Principles of Relapse � Relapse is the progressive process of becoming so dysfunctional in recovery that self-medication with alcohol or drugs seems like a reasonable choice. � Definition: a reactivation of the symptoms of addiction after those symptoms have gone into remission ◦ Irrational thoughts ◦ Unmanageable feelings ◦ Destructive behaviors
Principles of Relapse � In order to relapse, you first have to be in recovery ◦ ◦ ◦ Understand addiction Apply knowledge to self Accept the painful feelings due to addiction Stop using Work a recovery program
Principles of Relapse �Relapse is a process not an event �Relapse is unconscious and automatic �Either relapse or recovery �Relapse is common and predictable �Relapse is preventable ◦ Rule of thirds �Relapse stages are cumulative and progressive
Discussion Points �Sobriety vs. abstinence �Brain studies on relapse �Role of choice �Role of motivation �Role of will power and selfdiscipline �Hitting “rock bottom”
Ten stage relapse warning signs Internal Change 2. Denial 3. Avoidance and Defensiveness 4. Crisis Building 5. Immobilization 6. Confusion and over-reaction 7. Depression 8. Loss of Control 9. Realization of Loss of Control 10. Option Reduction 1.
Stage 1 Internal Change v Increased stress v Change in thinking v Change in feelings v Change in behavior
Stage 2 Denial v. Concern about well-being v. Denial of the concern
Stage 3 Avoidance and Defensiveness v. Believing that I will never use again v. Worry about others instead of myself v. Defensiveness v. Compulsive behavior v. Impulsive behavior v. Tendencies towards loneliness
Stage 4 Crisis Building v. Tunnel vision v. Minor depression v. Loss of constructive planning v. Plans begin to fail
Stage 5 Immobilization v. Daydreaming and wishful thinking v. Feeling that nothing can be solved v. Immature wish to be happy
Stage 6 Confusion and Overreaction v. Difficulty in thinking clearly v. Difficulty in managing feelings and emotions v. Difficulty in remembering things v. Periods of confusion v. Difficulty managing stress v. Irritation with others v. Easily angered
Stage 7 Depression v. Irregular eating habits v. Lack of desire to take action v. Difficulty sleeping restfully v. Loss of daily structure v. Periods of deep depression
Stage 8 Behavioral loss of control v. Irregular attendance at recovery activities v. I don’t care attitude v. Open rejection of help v. Dissatisfaction with life v. Feelings of powerlessness and helplessness
Stage 9 Recognition of Loss of Control v. Self-pity. v. Thoughts of social drinking. v. Conscious lying. v. Complete loss of selfconfidence.
Stage 10 Option Reduction v. Unreasonable resentment. v. Discontinues all treatment activities v. Overwhelming loneliness, frustration, anger and tension. v. Loss of behavioral control.
Return to Use v. Initial use (the lapse). v. Shame and guilt. v. Helplessness and hopelessness. v. Complete loss of control. v. Bio-psycho-social damage.
References � Terence Gorski � GORSKI-CENAPS model � http: //www. tgorski. com
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