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Opiate Relapse: Prevention and Addiction Treatment

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Opiate abuse and addiction has become an epidemic, with a vast impact on the health and welfare of individuals and societies worldwide.1 Statistics provided by the National Institute on Drug Abuse offer a snapshot of the epidemic that helps to emphasize just how significant its effect is.1

  • The United States is one of the largest global consumers of opiates, representing almost 100% of the Vicodin (a medication containing hydrocodone) market and 81% of the Percocet (an oxycodone painkiller) market.
  • In 2013, 207 million opiate prescriptions were written in the U.S. alone.
  • It is estimated that anywhere from 26 to 36 million people worldwide abuse opiates. Of this number, 2.1 million are U.S. residents.
  • It is believed that at least 14% of pregnant women will be prescribed opiates during their pregnancies.
  • Between 2000 and 2009, the number of babies born with neonatal abstinence syndrome—a condition resulting from prenatal opioid exposure—rose by 300%.
  • In 2012, more than 5% of the population older than 12 had used an opiate medication for non-medical reasons.
  • In 2010, opiate medications represented 82.8% of the total deaths caused by unintentional overdoses.

Chances of addiction relapse with opiates are higher than those of any other drug addiction, with one study reporting that as many as 91% of those in opioid recovery will experience a relapse.2 The study also found that at least 59% of those who had an opiate relapse would do so within the first week of sobriety, and 80% would relapse within a month after discharging from a detox program.2


What Is a Relapse?

Relapse occurs when a person returns to drug use after a period of abstinence.3 Addiction to any substance or activity is considered by many to be a chronic illness that inherently holds the potential for relapse.3 

It is not uncommon for those on the road to recovery to relapse at least once. Many view relapse as a significant, yet not insurmountable, stumbling block. It’s all part of the recovery process and, should relapse occur, it need not fuel the idea that the person in recovery is a failure, or that treatment efforts have been unsuccessful. A relapse can help you identify triggers you didn’t know existed, and it can be the impetus to learn helpful techniques you didn’t previously know. In fact, the steps you take to address a relapse can help you become stronger in your sobriety than you were before.


Why Do People Relapse on Opiates?

Opiates activate the mesolimbic system of the brain, which is strongly associated with reward and conditioned associations. When a person uses opiates, they trigger a release of dopamine (a neurotransmitter associated with feelings of pleasure) and simultaneously activate parts of the brain that connect surroundings with pleasurable feelings. These feelings then become the reinforcing triggers for an addiction relapse.4

“Opioid drugs may have profound and long-lasting changes on the functioning of the brain that can persist long after opiate use has stopped.”

Unfortunately, chronic use of opiates create changes in the brain that can lead to both dependence and addiction.4 A little-known fact is that these changes can also happen if you are taking opiates for therapeutic reasons and within prescribed doses. Encouraging research findings indicate that some of the brain changes that accompany the development of opioid dependence resolve within days or weeks after detox—effectively reducing the likelihood of a relapse.4 This being said, opioid drugs may cause additional profound and long-lasting changes to the functioning of the brain. These changes can give rise to troublesome cravings and compulsions which can persist long after use has stopped.4


Opioid Relapse Warning Signs

A few risk factors may increase the likelihood that a person relapses on opiates, including:2

While these factors may predispose an individual to relapse, everyone is different. The relapse rate for addiction is extremely high, and relapse therefore seems like an inevitable part of recovery for a lot of people. Recognizing personal signs of potential relapse is an important step in preventing one. Common factors that could increase the chances of relapse include:

  • Stress. This can be daily stress that builds slowly or a life-changing event, including the death of a friend or loved one, a divorce, a move, or even a big promotion.
  • Lack of positive support systems. Support systems include support groups—such as 12-step programs—,family, friends, and co-workers. Surrounding yourself with the people you used drugs with makes you more likely to relapse. However, surrounding yourself with positive and sober people can help you remain strong in your recovery.
  • Falling back into old patterns of thinking, feeling, and behaving. Identifying old patterns can help you understand your personal relapse warning signs. Once you begin noticing them, it may be time to step up your engagement in therapy to help prevent a relapse.

Recovery is a personal journey that requires you to understand why you use and then commit to maintaining a constant awareness of your emotional and thinking states. Once you recognize a personal warning sign, the next step in your personal safety plan is taking immediate action to circumvent a relapse.


What to Do When You Relapse on Opiates

If you or a loved one has recently relapsed on opiates, it is important to remember that this doesn’t mean you can’t still decide to remain sober. Here are some tips for recovering from a relapse:

  • Stop using opiates immediately. Especially when you have a history of opiate addiction, returning to a full-blown addiction is easy, and this will require you to detox all over again.
  • Avoid beating yourself up. This is not helpful and can result in a spiral into old patterns of abuse. First, try to remind yourself that the relapse rate for opioid addiction is as high as 91%, so you are in the majority. Then stop and think about what led to this relapse. Write down thoughts, feelings, behaviors, people, places, or events that may have triggered your desire to use again. This helps you to better understand why you relapsed, as well as understand risk factors in order to prevent future relapse.
  • Contact a support person. Recovery doesn’t have to happen alone. Contact a loved one, friend, sponsor, therapist, or another care provider. These people can provide reassurance that you are cared for and loved and help you to avoid another situation that might lead you to use.
  • Think about seeking further treatment. If you have relapsed, you may need to find a treatment program that will provide you with the ongoing support, encouragement, awareness, and accountability that can help prevent a future relapse.
  • Consider seeking medication therapy. Chronic abuse impacts brain chemistry. This can lead to low impulse control, depression, anxiety, and cravings that, if not addressed, can easily result in a relapse. In some cases, medications may be prescribed to help with some of the psychological issues brought about by addiction. Remember that you may not need to take medication forever, but it can help to keep you safe in the short term.

Going to Treatment After a Relapse

Concerned man listens to therapist after relapsing on opiates

If you or a loved one has recently relapsed, it may be important to follow up with an individual therapist, psychiatrist, or support group. These addiction treatment options can greatly increase your chances of continued sober living after a relapse.

Often, people who relapse experience a surge in negative thoughts and feelings, which can reinforce old patterns of maladaptive substance abuse behaviors and soon lead them back down the path of addiction. Finding a treatment provider or group that you can attend weekly or biweekly can remind you of why you chose to be sober, what your strengths are, and how to remain firm in your decision to live a life of sobriety. Without this, people can feel alone, depressed, and hopeless—all of which can lead them back to opioid relapse.

It is not uncommon for people to return to rehab multiple times before achieving permanent recovery. By re-engaging with a formal treatment program, you’ll be able to learn something new about yourself and your addiction, which will ultimately increase your ability to stay clean.

If you or a loved one has recently relapsed and you aren’t sure what next steps to take, help is available 24/7. American Addiction Centers (AAC) operates a free hotline number you can call for advice and information. Please contact one of our representatives today at to discover treatment options that can help you get back on track after a relapse.


How to Create an Effective Relapse Prevention Plan

An effective opioid relapse prevention plan helps you better understand your warning signs and triggers for relapse and will help you take actions to keep you safe and sober. A good relapse prevention strategy consists of:

  • Recognizing personal warning signs of relapse. Know your internal and external triggers for using. Internal factors include thoughts and feelings that you strongly associate with abusing opiates. External factors might include specific places, items, sounds, or even smells that lead to a desire to use.
  • Knowing what you can do when you recognize a relapse warning sign. It is important to list your most effective coping skills or strongest support sources in your personal relapse plan. These are skills, hobbies, activities, and people that you know can keep you safe at a time when you desperately want to use.
  • Having a plan to follow up with a treatment professional or support group. Engaging in individual counseling or group therapy can be comforting and validating while you are on your journey toward freedom from substance abuse.
  • Developing a recovery action plan. Often, people feel empty or unhappy at the beginning of their sober lives. They haven’t yet replaced their drug habit with something else, so a void is left. Developing a schedule that fits in work, hobbies, and activities focused on sobriety not only helps you to remain focused on your sobriety goal, but can help you derive satisfaction from a sober lifestyle.

Find Addiction Treatment Programs

Living a sober life is a journey that requires a daily recommitment to recovery, but sobriety is not a challenge you or your loved one needs to undertake alone. Rehab facilities are located throughout the U.S., and many offer specialized treatment that can cater to individual needs. You can use SAMHSA’s Behavioral Services Locator to search for opioid addiction treatment centers. Many state government websites will also provide local drug and alcohol resources to those in need. To find your state government’s website, do a web search for your state name and ‘.gov.’ Once your state website is located, substance use resources shouldn’t be hard to find, and they should provide further phone contacts for your assistance.

American Addiction Centers (AAC) is a leading provider of addiction treatment programs and has trusted rehab facilities across the country. Relapse support representatives are available 24 hours a day, 7 days a week to provide you with various resources at all levels of care. Please contact them free today at . You can also call free opiate hotline numbers.

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