High-Risk Situations and Relapse 1

High-Risk Situations and Relapse

Tammy Chisholm

PCN-265

11/06/2021
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High-Risk Situation

One of the most difficult aspects of recovery is the fact that it is a never-ending process

(Milios, 2017). The true journey begins when an addicted individual stops using and accepts

abstinence. Maintaining a substance-free lifestyle is rarely a straight route; rather, it is generally

marked by peaks and valleys, with periods of abstinence punctuated by a temporary return to

drug or alcohol use — a relapse. Nearly 90% of people in treatment for alcohol addiction relapse

at least once over a four-year period, according to the National Institute on Alcohol Abuse and

Alcoholism (NIAAA).

Relapse rates for those in recovery for all types of substance use are roughly 40-60%,

according to the National Institute on Drug Abuse (NIDA) (Milios, 2017). Relapse risk is

divided into three categories, high risk, moderate risk, and low risk. High-risk situations are

those in which an individual is most likely to use their substance of choice — situations that are

similar to, or identical to, those in which the person has previously used. When a person is in

these situations, it is quite difficult to develop appropriate coping techniques to resist using.

In a high-risk situation, interpersonal, situational, and emotional risks might all be present

(MedMark Treatment Centers, 2021). Most high-risk situations fall into one of these categories.

Negative emotional states can come from interpersonal conflicts. As a result, a recovering

addict's chance of relapse may rise. A quarrel with a spouse or loved one, financial difficulties,

or marital problems are all examples of high-risk situations. As a recovered addict, social

circumstances can put one's self-control to the test. Being offered drugs while going home or to

work, visiting parties where alcohol and drugs are present, and seeing others use drugs or alcohol

are just a few examples. Recovering addicts are at danger of relapse if they are in a negative

emotional state. While activities like meditating, exercising, and listening to music can help
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to prevent negative emotions, they can still happen. Loneliness, sadness, frustration, anxiousness,

and tension are all frequent emotions that people in recovery go through. While positive

emotional states should be enjoyed, understanding what they can lead to can help to avoid

from relapsing. People can relax and allow themselves to consume a substance "just this once"

when they are experiencing moments of happiness or excitement. High-risk emotional states

include feeling confident about a job advancement, celebrating a sobriety goal, or feeling

sentimental about a place that brings back fond memories.

High-Risk Situations: Male vs. Female

The majority of studies show that there are gender differences in intrapersonal,

interpersonal, and environmental trans-situational variables that are related to women's drinking

(Rubin, et al, 1996). Prior to the relapse, both men and women reported being in a primarily

negative mood. Both women and men report a mix of negative and positive moods right after

relapsing. Men seemed to have a significantly higher chance of reporting positive moods than

women, especially after drinking.

Women in recovery face persistent challenges that might resurface at any time, making

them vulnerable to relapse (Lliff, 2016). Physical issues, mental health issues, filling voids,

aging, loss, being unhappy with another addiction, the dry drunk phenomena, self-sabotage,

complacency, and character flaws are just a few of them. Early recovery concerns are different

for women than for males, both in terms of the brain and the need for connection, as well as

physiologically. Women may return to chemicals for the same reasons that drove them to begin

using. Relapse concerns can include food/body problems, tension or boredom relief, boosting

mood (psychological health concerns), eliminating sexual inhibitions and intimacy worries, self-

medicating depression, anxiousness, pain, or sleep disorders; and increasing self-esteem.

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Cravings, the start or end of intimate relationships, physical discomfort, spending time alone,

hormonal imbalances, highly stressful times or after times of stress (the aftermath of discontent),

recovery accomplishments ("I did it!"), complacency, and boredom are all examples of high-risk

situations.

When a Client Is More Likely to Have a Relapse

Understanding that relapse occurs in stages is crucial to preventing relapse (Melemis, 2015).

It starts weeks, if not months, before a person picks up a drink or a drug. The purpose of

treatment is to teach people how to spot the early indicators of relapse and how to develop

coping skills to avoid relapse while they are still in the early stages of recovery. This has been

demonstrated to minimize the chance of relapse considerably.

Individuals do not consider using during emotional relapse (Melemis, 2015). They are

aware of their previous relapse and do not wish to repeat it. However, their feelings and

behaviors are preparing them for a future relapse. Denial is a key aspect of emotional relapse

because clients aren't consciously thinking about using at this point. Poor self-care, which is

widely defined to include emotional, psychological, and physical care, is a common denominator

of emotional relapse. The move from emotional to mental relapse is not accidental; it is the

inevitable result of poor self-care for a long time. Individuals who practice poor self-care and

live in emotional relapse for an extended period of time begin to feel uncomfortable in their own

skin. They become agitated, angry, and dissatisfied. As their tension mounts, they consider using

simply to get away.

There is a battle going on inside people's heads during mental relapse (Melemis, 2015). Part

of them desires to use, while the other does not. Individuals' cognitive resistance to relapse

decreases as they progress deeper into mental relapse, but their yearning for escape grows. A
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major purpose of treatment is to assist clients in avoiding high-risk situations. Individuals have a

hard time recognizing and believing that they are in high-risk situations, according to clinical

experience. They mistakenly believe that avoiding high-risk situations demonstrates weakness.

Individuals begin to imagine instances in which it would be acceptable to utilize when

bargaining. When people give themselves permission to use on vacation or on a trip, this is a

popular example. Airports and all-inclusive resorts are known to be high-risk situations during

the early stages of recovery. Another type of bargaining occurs when people begin to believe that

they can relapse on a regular basis, perhaps once or twice a year. Bargaining can also involve

exchanging one addictive substance for another. Clinicians can tell the difference between a

mental relapse and occasional thoughts of using by tracking a client's behavior over time. When

thoughts of using shift in character and become more insistent or frequent, this is a warning

indication.

Individuals in late phases of recovery are at an increased risk of relapse than those in the

early stages (Melemis, 2015). Clients frequently desire to forget about their addiction and forget

that they ever had one. They believe they have lost a significant portion of their lives to addiction

and do not want to devote the remainder of their lives to recovery. They begin to attend fewer

meetings. Individuals begin to focus less on self-care as their lives improve. They try to make up

for lost time by taking on more obligations. In some ways, they are attempting to reclaim their

old lives without the use. They cease doing the activities that helped them get better in the first

place. Clients begin to attend self-help meetings less frequently because they believe they are not

learning anything new. Clients must recognize that one of the advantages of attending meetings

is that they are reminded of the "voice of addiction," which is easy to forget. People believe they

should know more than the basics. They find it nearly humiliating to discuss the fundamentals of
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rehabilitation. They're embarrassed to admit that they still have cravings or that they're not sure if

they have an addiction. People believe that because they have a greater understanding of drugs

and alcohol, they should be able to avoid relapse or minimize the negative repercussions.
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References

Lliff, B. (2016). Women, Addiction and Recovery.

https://www.hazeldenbettyford.org/articles/iliff/unique-challenges-of-women-and-

addiction

MedMark Treatment Centers. (2021). High-Risk Situations for Recovering Addicts.

https://medmark.com/high-risk-situations-for-recovering-addicts/

Melemis, S. (2015). Relapse Prevention and the Five Rules of Recovery.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4553654/

Milios, R. (2017). Common High-Risk Situations in Recovery and How to Manage Them.

https://www.recovery.org/pro/articles/common-high-risk-situations-in-recovery-and-how-

to-manage-them/

Rubin, A. et al (1996). Gender differences in relapse situations.

https://onlinelibrary.wiley.com/doi/pdf/10.1046/j.1360-0443.91.12s1.1.x.