How To Identify Signs, Symptoms of Impending Relapse

Demi Lovato
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The tragic backslide of singer-actress Demi Lovato into addiction may have shocked some of her fans, but comes with less surprise to those familiar with the signs and symptoms of an impending relapse.

According to news reports, she was seen in late-night clubs, was struggling to keep her commitments and had even stopped working with her recovery coach. Her most recent single, “Sober,” includes lyrics apologizing to her parents and fans, singing, “I’m so sorry I’m not sober anymore.”

“A pretty big red flag,” says Dr. J. Craig Allen, medical director of Rushford. “This high-profile relapse highlights the risks for anyone with a substance use disorder, which is a chronic and recurring brain disease where the underlying chances in neurocircuitry impact judgment, impulsivity, memory and the reward systems driving decision-making to overvalue a return to use while minimizing the negative consequences.

“Recovery is an ongoing battle. Though it can get easier over time, it always requires active recovery work and an ever-present vigilance for the signs and symptoms of relapse.”

Relapse is not uncommon. In fact, in the case of opioid use disorder, he says about 90 percent of people will relapse if attempting to reach recovery without medication-assisted treatment (MAT). Even with MAT, nearly 50 percent may still relapse, however those in treatment are identified quicker and can access support and interventions to help them get back on the recovery track. The numbers are roughly the same for other addictive substances, including alcohol.

After effective treatment and establishing a network of sober supports, people may be considered “in recovery,” according to Dr. Allen. The challenge is to stay there. One way to help keep that path clear, he says, is to identify the signs and symptoms of impending relapse, which can include:

  • Experiencing cravings and urges to obtain and use drugs or alcohol.
  • Missing appointments, either skipping them intentionally or “forgetting.”
  • Engaging in substance use-related behaviors such as keeping company with the wrong people, venturing to the wrong places, lying or stealing.
  • Avoiding urine tox screens or having unexpected results, such as positive or negative for substances that are or are not supposed to be present.
  • Failing to fulfill obligations and responsibilities.
  • Veering off from any component of the treatment agreement.

If someone is showing or experiencing these signs, it’s important for them to talk to their clinician or get back into treatment. Other important steps include boosting the sober support network through friends, family, recovery coach or community-based groups like Alcoholics Anonymous, Narcotics Anonymous and others.

Relapse happens to many people seeking sobriety, but Dr. Allen calls it another step in the journey and a lesson in handling setbacks.

To find help with a substance abuse issue, click here.


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