In a perfect world, a person in recovery would be able to ban all drugs and alcohol from every corner of the world. That way, there would be no temptation to use, and there would be no ability to do so. Unfortunately, that really is not possible. The world is filled with temptation, and from time to time, people who are in recovery face challenges in which they must choose to either stay sober or return to a life where they are dominated by drugs and alcohol.
That return could happen in one of two ways: via a relapse or a freelapse. These are the key differences between those two very different events.
The Causes Of
A relapse involves a conscious return to drugs or alcohol after a period of sobriety. A person who relapses to substances makes a decision to move away from sobriety and try out substances of abuse once more.
A relapse could be sparked by almost anything, including:
- An intense mood, either happy or sad
- Peer pressure
- A sense of experimentation
- Chemical changes in the brain
In addition, according to a study in the journal Transplantation, a relapse is associated with a lack of participation in rehab. People who go through rehab learn how to identify crisis situations, and they develop skills they can lean on when in a crisis. People who do not participate in rehab do not pick up these skills, and they remain vulnerable to stumbling into a situation where their sobriety is at risk.
A freelapse also involves a return to drugs or alcohol after a period of sobriety, but people who freelapse often do not make a conscious decision to stray from sobriety. Instead, this issue takes hold due to a factor that may or may not be under the person’s direct control.
A freelapse could be sparked by:
- A medical appointment
- A mischievous friend
- Poorly trained bartenders
- Misguided waitresses
- Distracted hostesses
A freelapse might also be associated with a lack of real rehab skills. People who have fully participated in a comprehensive rehab program know what situations put sobriety at risk. They know how to plan for these situations and avoid them. People who have not done that work may put sobriety at risk through simple neglect, even if they do not want to do so.
How Common is It?
It is not at all uncommon for people to relapse to drugs and alcohol at least once. In fact, in a study in the Journal of Substance Abuse Treatment, researchers tracked people emerging from a substance abuse program, and they tracked their movement in and out of four stages: in the community using, in jail, in treatment, and in the community sober. More than 83 percent of people moved from one point in the cycle to another within a three-year period.
Studies like this have prompted professionals to classify addictions as chronic conditions. People get help, relapse, and then get help again on an incredibly frequent basis. It is part of the disease process.
It is much harder to determine how often people freelapse to drugs and alcohol. That is due, in part, to the fact that many people who freelapse never report the issue to treatment teams or medical professionals. They choose to handle the problem alone instead. It is also due, in part, to the fact that embarrassment seems to go along with freelapse situations. Many people choose to keep the issue hidden, rather than discussing it openly, and that can also make tracking hard.
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How it Happens
People often suggest that a relapse happens suddenly, in an out-of-the-blue fashion, and that there is no way to predict when one will happen and how it will work. In reality, a relapse tends to follow a very specific and predictable set of steps. Any of them provide a moment at which a person with an addiction could choose to do something different. Those steps include:
- Encountering a trigger
- Failing to deal with that trigger effectively
- Thinking about using
- Taking steps to make the use easier to accomplish
- Experimenting once
- Returning to fulltime use
A freelapse is less premeditated. Often, it involves an accidental exposure to a substance that the person finds somehow interesting or appealing. For example, in a study by Challenger, Gray and Christmas of major companies in 2014, 41.2 percent of the companies planning to hold a holiday party also planned to serve alcohol at the party. A person experiencing a freelapse in this environment could:
- Order a nonalcoholic version of an alcoholic drink
- Neglect to watch the bartender make that drink
- Take a sip of the drink
- Discover the alcohol
This is, technically, a return to the ingestion of the substance the person once agreed to stop taking altogether, but there is no planning or plotting involved with that ingestion. It just happened.
An overview in Psychology Today suggests that one-third of people abstinent less than a year will stay sober, while those who make it to five years of sobriety have a relapse rate of just 15 percent. That seems to suggest that many people relapse at least once. It is part of the recovery process.
But that relapse length could vary, depending on how long the person has been sober. Someone new to recovery might relapse and stay relapsed for quite some time. There are no skills to lean on and profound lessons available. But someone late in recovery might relapse for only a brief period, and then take steps to stop the destruction before it worsens.
A freelapse is typically a very short event. The person has an exposure to something that challenges recovery, and the person takes steps to ensure that the slip was an anomaly and not a vision of the future.
There are some freelapses that can last a little longer. For example, some people who go through difficult medical procedures (such as surgeries) are provided with opiate painkillers when the procedure is complete. Healthline reports that these medications are often given for weeks at a time. The freelapse label would apply as long as the person kept taking the medications.
What Happens Next?
Whether the event is considered a relapse or a freelapse, people who return to substance abuse after a period of sobriety need to get clinical help in order to get back on track. For people going through a freelapse or a final relapse, that help might involve little more than talking to a counselor or a support group sponsor for a moment or two. But for people going through a full-blown relapse, or a freelapse that threatens to become a relapse, more intense help is needed.
According to an overview in the journal Alcohol Research and Health, relapse prevention counseling involves identifying high-risk relapse situations, and enhancing a person’s ability to handle those situations. Relapse prevention also involves helping people to develop a healthy, balanced lifestyle, so they will be less prone to relapse in the first place. All of these steps, put together, can help people to both prevent and handle the urge to relapse. And that could be remarkably helpful.
The key is to get help as soon as the first lapse is recognized for the danger that it is. The sooner people do that, the better off they will be.