The Road to Recovery of a Heroin Addict – Part 2

Overcoming Potential Recovery Challenges

During your substance abuse treatment, you should learn many strategies to assist you in the challenges which can come up during your recovery. Not everyone will experience the same challenges or the areas of challenges, they will be different for every person. However, the general principles to learn for the strategies will apply to anyone that is in substance abuse recovery. Before discussing some of the many types of relapse prevention it is important to understand the types of relapses.

The first type of relapse is emotional relapse. This type of relapse the individual does not think about using but is in a state where they are remembering their last relapse or use. During this emotional relapse the person does not want to repeat the last relapse or go back to using, but these thoughts have substance usage on the mind. It is these thoughts that are laying the groundwork for a relapse, often because the person may be in denial of the potential risk of relapse. Denial of relapse can prevent a person from the effective use of relapse prevention techniques. Some of the signs that you are in an emotional relapse are poor selfcare such as insufficient sleeping, unhealthy eating habits, cessation of exercise, focusing on the problems of others, and discontinuation of attending meeting/therapy or not sharing in those meetings/therapy.

Mental relapse is a state where a person is struggling between the internal desire to start using substances again and the conflicting desire to remain in recovery or abstinence. Individuals in this stage are at the highest risk of relapse during special times in their lives such as social events, holidays, vacations, or other times where justification for substance use will be easiest. It is highly important to know that occasional thoughts about substance usage and cravings are a common part of recovery. Some of the signs that a person is in a mental relapse are, but not limited to, craving a substance, thinking about positive aspects of past use, minimizing the negative consequences of past usage, bargaining, lying about thoughts/behaviors, seeking out ways to relapse, planning on how to use while believing they can maintain control of the usage, and thinking about the people, place, and things they have associated with their past usage.

The third stage of relapse is physical relapse. This occurs when the individual has resumed usage of the substance, no matter the amount or duration. Some view a single usage as a “lapse” which can be correct in some areas, however it is often any single “lapse” will lead to obsession of further usage causing the relapse. Most often physical relapse occurs at a time when the individual has the belief that their substance usage will not be detected by others. It is at this point that a person has fully relapsed.

One of the most important prevention strategies is dealing with cravings and triggers. This is best done with the support of a therapist, if that is not an option, then working with a sponsor from support groups. Another blog on this site goes more in-depth about triggers and how to identify them, it is recommended you also read that blog. One of the strongest triggers are those associated with withdrawal symptoms. Withdrawal symptoms are one area of internal triggers, which also can include stress, happiness, thoughts, among others. External triggers can be when you are exposed to the substance(s) or being around the people, place, and things that remind you of using the substance. It is the triggers, both internal and external, that cause the cravings, which in turn can lead to relapse.

Co-occurring disorders are common with substance abuse. What this means is that there is some other mental disorder that is happening at the same time as the Substance Use Disorder. Some of these other mental health disorders are depression, anxiety, bipolar disorder, attention deficit hyperactivity disorder (ADHD), post-traumatic stress disorder (PTSD) to more complex disorders such as schizophrenia and personality disorders. At times other mental disorders can contribute to substance use or abuse and to the development of Substance Use Disorders. Alternately substance abuse or Substance Use Disorders can also contribute to the development of mental disorders in an individual. Therefore, it is important to work with a mental health professional to see if other co-occurring mental disorders are present and to work on assisting those while working on recovery.

A great relapse prevention is to live a health lifestyle. The reason here is that substance use, and a healthy lifestyle do not go hand in hand. A healthy lifestyle will take some time to get into effect, usually it takes a person about three weeks to establish new habits in their routine. This lifestyle should include better and healthy eating habits, getting adequate amounts of sleep, and exercise. Also, as your body recovers from the negative affects that substance use takes on the body being healthier will assist you in feeling better both physically and mentally, which will assist you in the desire to remain in active recovery.

Success in Recovery

There is no set standard for measuring success in substance abuse recovery, regardless of the substance(s) of choice. Success is highly individualized for everyone and may have different meanings. Either way starting treatment is a success you should be proud of as well as any sustained period of recovery. Some people enter substance use treatment once and never return to active addiction, while others may take years and many attempts at treatment and recovery. It is important to acknowledge any successes in recovery as those are positives and focusing on the positives will assist you more in continued treatment and recovery. As there is no set standard for measuring success in recovery there is some useful data out there.

The use of medication to assist with Opioid Use Disorder has been proven to be effective for treatment outcomes. Per the National Institute on Drug Abuse individuals in opioid and opiate treatment that received either Methadone or Buprenorphine (Suboxone) are 1.82 times more likely to stay in treatment than those without the use of medication. This is a statistically significant increase in recovery, which can be viewed as a success.

Resources for Help and Support

Often when people think of help and support many first would think of some hotlines or helplines that are available. As there are those for many other psychological or mental disorders such as suicide prevention hotlines, there is not the same for substance abuse. If you search the internet, you will find helplines listed, even some from the US Government agency SAMHSA (Substance Abuse and Mental Health Administration). It is always a good idea to reach out in a time of need, but almost all of these helplines are just referral sources for treatment facilities. A basic Google search most of the “helplines” that appear are for treatment facilities, which will just refer you to their own services. If you are in need of immediate help, it is best to call an in-patient treatment facility which operates 24 hours a day or the Emergency Room at your local hospital.

One of the best lines of help you can establish is by setting up a strong support network, such as getting a sponsor with Narcotics Anonymous, more commonly just called N.A. Usually a sponsor will make themselves available at any time for you, as they know what it is like to be early in recovery or to hit points where a person struggles and needs help at unexpected times. Other supports can be family and friends who, most importantly, are sober and know that you are working on recovery. Another great support is a therapist, however they often cannot be an immediate line of help outside of their office hours.

Narcotics Anonymous for some may be challenging with the concept of a higher power. For those you can attend a version that is secular which is non-religious. It is important to note that the concept of a higher power is not particularly religious, that higher power can be anything that gives you the strength to remain in active recovery. If N.A. meetings are not available in your area, Alcoholics Anonymous or A.A. is another option. Most of the time they invite everyone with open arms and understand that addiction affects everyone regardless of the substance of choice.

Rehabilitation Centers and Treatment Programs, such as Milestones Wellness Centers, are great resources for help. These are specialized treatment programs there to assist you in your recovery and provide guidance along the way. There are multiple levels of treatment and finding the correct treatment program all depends on your need. The most intense treatment is that of in-patient treatment. In-patient treatment programs are amazing place to start with treatment as they should be providing a safe place to stay to keep you away from the people, places, and things that you associate with substance usage while you are in the beginning part of your recovery. While at these facilities they should be providing you with individual and group therapies daily. As daily therapy may seem intense, it is a way to work through a lot of therapy in a short time, that would take many months to complete in less intense treatment options.

The next level of treatment is an Intensive Outpatient Program. These are similar to In-Patient programs in the level of services you will receive, however you do not spend the night at these locations. Often people may desire to not stay at a treatment facility, but if your home environment is not safe or there are drugs at your residence, in-patient would be recommended. Intensive Outpatient Programs often require an individual to attend every day or most days of the week and for a good portion of that day, many being around eight or more hours a day. During this time, you will attend individual and group therapy sessions, similar to that of the in-patient treatment programs.

treatment programs. The third level of treatment options is Outpatient Treatment. This treatment level often varies greatly depending on the facility. Outpatient treatment can often be more tailored to meet your needs and areas of concern. Some will offer individual and group therapies, and some may have those as program requirements to continue in treatment. Some offer Medications for Opioid Use Disorder or MOUD, which was previously called Medication Assisted Treatment (MAT). This is the use of medication to assist in the treatment of Opioid Use Disorder, such as that here at Milestones Wellness Centers. The medications used in Medications for Opioid Use Disorder are Buprenorphine (Suboxone), Methadone, and Naltrexone. The purpose of these medications is to assist with withdrawal and cravings while you work on other areas of improving your life and therapy in recovery.

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