The estimated rate of relapse after rehabilitation or other treatments for substance use disorders, including opioid addiction, is between 40 and 60%. Other chronic diseases, like asthma and hypertension (high blood pressure), have around the same rate of relapse after treatment.
The National Institute on Drug Abuse (NIDA) defines addiction as “a chronic, relapsing disorder characterized by compulsive drug seeking and use despite adverse consequences.” Since the very definition of addiction includes a component of relapsing, it should not be surprising that people relapse after treatment.
Experts in the field of treating substance abuse disorders say that there is no cure for addiction, but that recovery is possible. One study reports that about ten percent of adults say that he or she is in recovery for at least one type of substance abuse disorder.
Why People Relapse
The Partnership for Drug-Free Kids (formerly the Partnership for a Drug-Free America) offers these reasons for relapses:
- The person thinks that he or she has gotten control over their addiction and wants to prove it to themselves. He or she admits that they have struggled with substance use in the past, but convince themselves that they can control their substance abuse and stop using the drug before things get out of control.
- He or she thinks that it will not hurt to take the drug “just one more time.”
- He or she uses the drug as a coping mechanism for stress, usually from work, home, or a difficult relationship.
- He or she has a hard time managing physical or emotional pain without medicating.
- He or she uses one drug as a substitute for another.
- He or she uses the drug as a response to certain triggers associated with previous drug use, like people, locations, or objects.
- He or she gives in to intense cravings for the drug or how it makes him or her feel.
- He or she uses the drug to intentionally attempt to commit suicide.
Risk Factors for Overdose from Relapse
A person who relapses after being drug-free for a while is at a heightened risk of overdose from the relapse. The person’s tolerance to the drug is not as great as it was when he or she took the substance regularly. These factors elevate the chances of overdose:
- A person who relapses after a period of incarceration in which he did not have access to drugs
- Suddenly stopping medications that help a person going through recovery
- Detoxing from another substance “cold turkey”
- Any relapse after completing rehabilitation or another extended period of abstinence
Causes of Addiction to Opioids and Relapse
There are three main categories of factors that might increase a person’s risk of becoming addicted to opioids. These elements might also be keys to understanding why some people relapse after treatment and others do not. The three groups of factors are:
NIDA (which is part of the National Institutes of Health) says that a person’s genetic makeup can comprise around 40 to 60% of a person’s likelihood to become addicted to a substance. Do not assume, however, that a person with a parent or sibling who battles substance abuse is doomed to become an addict. There is no single factor that, by itself, causes addiction.
Many environmental elements can put a person at a higher likelihood of substance abuse than the general population. People who grow up in a chaotic home where drugs are used, who do not perform well in school, and whose parents and peers use drugs are more likely to try drugs, and a portion of the people who experiment with drugs will become addicted.
Here are some risk factors that can increase a person’s chances of becoming addicted to substances:
- Community poverty
- Experimenting with drugs
- Poor social skills
- Lack of involvement by parents
- Aggressive behavior as a child
- Drugs available at school
These elements, on the other hand, can insulate or protect a person from the risk of addiction:
- Healthy, positive relationships with friends and relatives
- Getting good grades
- Exercising good self-control
- Having the support and supervision of parents
- Attending a school with a strong policy against drugs
- Living in a neighborhood with social resources
Some studies suggest that ethnicity is a risk factor for addiction. For example, the CDC reports that non-Hispanic white males who are between 18 and 25 years old and live in large cities have the highest risk of any demographic group of becoming addicted to heroin. Also, heroin use among Americans between 18 and 25 has more than doubled in the last ten years.
Prescription Painkillers and the Heroin Epidemic
Many people suggest that legally-prescribed opioid painkillers created the heroin epidemic in this country. Heroin is an opioid. If a person becomes addicted to opioid painkillers and then cannot get more pills legally, he might turn to heroin to feed the addiction to opioids. The CDC says that nearly half of the people who use heroin were also addicted to prescription opioid painkillers.
Doctors have prescribed opioid painkillers to relieve discomfort from things like sports injuries, car accidents, falls, back injuries, and post-surgical pain. In 2012, health care providers in this country wrote more than 259 million prescriptions for painkillers. American doctors write twice as many prescriptions for painkillers per person as compared to Canadian physicians.
If you or a loved one suffered harm after treatment for substance abuse, it could be the result of medical negligence.