Understanding Opioid Use Disorder Relapse
Relapse and Opioid Use Disorder (OUD)1
Relapse happens gradually. Sometimes it begins weeks or even months prior to re-initiating substance use.
Stages of Relapse1
Addiction relapse is a gradual process, rather than a single event. Understanding the stages of relapse can help health care professionals (HCPs) recognize early warning signs of relapse:
It is important that HCPs approach individuals experiencing addiction relapse with compassion, not shame
Emotional Relapse
An emotional relapse occurs when an individual remembers their last relapse and doesn’t want to repeat it. At this stage, the person may be in denial of their relapse risk.
Early Warning Signs:
- Isolation
- Fixation on other people’s problems
- Disrupted sleeping or eating patterns
- Bottled-up emotions
- Lack of participation/attendance at meetings
Prevention
- Help individuals acknowledge any denial of relapse risk
- Emphasize the importance of self-care
Mental Relapse
In a mental relapse, the desire to use opioids re-emerges. During this time, the individual may be conflicted between their desire to use opioids and their desire to stay abstinent.
Early Warning Signs:
- Cravings
- Dwelling on people/places or positives associated with past drug use
- Lying or bargaining
- Seeking opportunities to relapse
- Thinking of ways to control drug use
Prevention
- Stress that cravings and continuing thoughts of substance use are a normal part of recovery
- Talk to your patients to identify situations that heighten risk of relapse and discuss how they can be avoided
Physical Relapse
The final stage of relapse is resuming substance use. Physical relapse often occurs when the individual with OUD believes their substance use will not be caught.
Early Warning Signs:
- A single “lapse”, or using drugs once
- Being stuck in the mental relapse phase for a long time
Prevention
- Ensure that patients in recovery understand what types of situations create high risk of relapse and help them learn to avoid those situations
References
- Melemis SM. Relapse Prevention and the Five Rules of Recovery. Yale J Biol Med. 2015;88(3):325-332. Published September 3, 2015.
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