Threats to maintaining abstinence from alcohol and other drugs can arise at any time. Here's how to guard against them.
Using substances again after a period of abstinence is common, yet predictable — and therefore preventable.is a chronic medical condition. Like diabetes or high blood pressure, it can be controlled, but not cured. This does not mean that we ought to take a fatalistic view ofand other drug use disorders, resigning ourselves to the belief that people with a history of addiction will inevitably go back to using.
Rates of recurrence of substance use are comparable to those of uncontrolled blood sugar after an initial period of stabilization. Afound that one year after discharge from addiction treatment, between 40 and 60 percent of patients had not maintained abstinence. The review also noted that each year, between 30 and 50 percent of patients with type 1 diabetes experience recurrent symptoms that require medicalto re-achieve remission.
This finding is striking, yet intuitive. Primary care is a cornerstone of detection and early intervention. In a patient with hypertension that was previously well controlled, a primary care provider may identify a borderline elevated blood pressure during a routine physical, prescribe medications, and arrange close follow up. If the medications are ineffective, they can refer the patient to a specialist—thereby preventing a hypertensive crisis or stroke.
Unlike hypertension, where we can measure a continuous variable and act at an early stage, with substance use, we do not havethat signal a recurrence before it happens. By the time a drug screen turns positive, the person has already used. Yet, it has been said in the recovery world that “relapse” occurs before the person uses the drug again. While this terminology is outdated, the concept remains instructive: return to use is predictable. Cravings may portend a return to substance use.
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