Health & Fitness

Sips, lapses and relapse: Falling back into substance abuse

Addiction is a chronic disease, and like other chronic medical illnesses, symptom recurrence or relapse to alcohol or drug abuse is an ever-present risk. This is because scientists have documented that addiction is a brain disease with changes affecting multiple functions, including learning, memory, motivation, and the ability to experience pleasure and to control behavior.

Ihsan M. Salloum, M.D., is a professor of psychiatry and behavioral sciences at the University of Miami Health System. Photo provided to the Miami Herald

Vulnerability to relapse is particularly increased upon exposure to the abused substance, and a one-time use can lead to a full-blown relapse. People quickly “pick up where they left off” in terms of the severity of their drug abuse.

Many factors may lead to relapse, and the holidays may just accentuate these factors. Three main causes for relapse have been studied extensively. The first one is being exposed to the abused substance itself, such as having a glass of wine for those with alcohol addiction or taking a painkiller for those with addiction to opioids.

The second factor is being exposed to cues that remind them of drug activities, such as drug use paraphernalia, or to people, places or things associated with the abused substance. A third major factor is stress, especially when stress is excessive. The holidays may represent a risk of relapse whether people are trying to feel good or “get high,” or feeling lonely and suffering from the holiday blues.

Relapse is a process, and it usually begins sometime before a person picks up a drink or a drug. The best chance to prevent a full relapse is early intervention. Evidence-based treatments are available and most effective if counseling and medications are combined with involvement in self-help groups.

Counseling helps people recognize the early warning signs of relapse and develop effective coping skills to prevent it. Effective medications are available to treat alcohol, opioid and nicotine addiction. The future is promising because novel treatments, such as the use of stem cell therapy to treat alcohol addiction associated with depression, are currently being tested at the University of Miami Miller School of Medicine.

Ihsan M. Salloum, M.D., is a professor of psychiatry and behavioral sciences at the University of Miami Health System.