We are asked all the time about our "success rate." This question does not come from potential patients as much as it comes from the general public who seem to be curious about the nature of addiction and recovery.
There are lots of ways to think about this. How many people successfully graduate from our residential treatment program? How many of these step down into our intensive outpatient program? How many of these graduate from the outpatient program? And how many of these remain substance free over the next year?
The simple answer to all of these questions is, a lot. A more complex answer is that these successes also are not without relapse.
In his book, Hidden Potential, Adam Grant sites research that suggest relapse it's not just a challenge for our patients. It seems to be how the brain may naturally work.
"After poring over more than a century of evidence on progress, cognitive scientists Wayne Gray and John Lindstedt observed a fascinating arc. When our performance stagnates, before it improves again, it declines. When people’s skills stalled in tasks ranging from Tetris to golf to memorizing facts, they didn’t usually ascend again until after they had deteriorated. When we reach a dead end, to move forward, we may have to head back down the mountain. Once we’ve retreated far enough, we can find another way—a path that will allow us to build the momentum needed to reach the peak. It’s often difficult to accept that we need to retreat."
A relapse is return to use after having achieved a measure of sobriety. But a relapse does not indicate "failure". Research increasingly suggests that relapse is a necessary step in the journey of recovery.
For those who respond to their relapse by reaching out for additional support, a relapse is an opportunity to continue learning.
We who have been working with substance use disorder, and who review the evidence based best practices of treatment and recovery, learn a lot about relapse. There are
Specific strategies that prevent relapse from turning into a full-blown relapse. This is why we respond to relapse, not with judgment, but with gracious support, often in the form of curiousity.
"What contributed to your relapse?"
People in recovery learn that a lapse is a warning signal that they are in danger and need to retire to a quiet place to review these strategies. Here are some recovery skills we help out patients to practice to prevent a lapse from becoming a full-blown return to active and sustained substance use.
Keep calm and address feelings of guilt and self-blame. A lapse is generally a response to stress that has become unmaneagble. Taking on shame does not help and can only hurt.
Renew one's commitment to recovery. After a lapse, take the time to review and renew your motivation. A more hopeful future remains within reach.
Review the situation leading up to the lapse. We call this doing a Relapse Autopsy. A lapse begins weeks before a person "picks up". What were the events that were contributing to the stress in your life? Where did you begin to neglect your support system? What daily personal practices may you have neglected that led to the growing sense of stress that contributed to return to use?
Prior to a lapse, it is important to have a plan already in place to help you return to recovery. Who are your relapse prevention partners who have already agreed to respond to your call for help? Where is your safe place? Where can you go to separate from the people places and things that have contributed to your lapse? Be prepared to return to treatment if your laps requires additional support.
What is our success rate? We'd like to say 100%. It really depends on when you ask.