“It’s Easy to Quit Smoking. I’ve Done It a Thousand Times” – Mark Twain
“…there is a saying used in twelve-step programs and in most treatment centers that “Relapse is part of recovery.” It’s another dangerous slogan that is based on a myth, and it only gives people permission to relapse because they think that when they do, they are on the road to recovery.” ― Chris Prentiss
Drug and alcohol addictions are very difficult to kick and if successful about half the time the individual will relapse. “The chronic nature of the disease means that relapsing to drug abuse at some point is not only possible, but likely.” – National Institute on Drug Abuse. Relapse does not mean treatment has failed. Rather, lapsing back to drug use indicates that treatment needs to be reinstated or adjusted or that another treatment tried. Successful drug abuse treatment requires changing deeply imbedded behaviors particularly in response to emotions and stress. Hence, treatment must include therapy to replace maladaptive behaviors with adaptive ones and build mechanisms to effectively regulate emotions and responses to stress.
Mindfulness-Based Relapse Prevention (MBRP) has been developed specifically to prevent relapse after successful recovery from substance abuse. It has been shown to be superior to 12-step programs in preventing addiction relapse (see http://contemplative-studies.org/wp/index.php/2015/08/28/kick-the-drug-habit-with-mindfulness/). MBRP combines meditation with a cognitive therapy based relapse prevention program. The program prepares the individual to deal with high risk situations, contexts and people that have been associated with drug use in the past. So, when they encounter these people or situations in the future they will be better able to refrain from repeating their drug use behaviors. The program also works to develop self-efficacy, helping the individual understand that they have the ability to control their urges and cravings. The addition of meditation appears to strengthen emotion regulation and responses to stress resulting in improved effectiveness and duration of relapse prevention.
In today’s Research News article “Mindfulness-Based Relapse Prevention: History, Mechanisms of Action, and Effects”
Penberthy and colleagues review the published research on MBRP effectiveness in relapse prevention and conclude that MBRP is effective in preventing substance abuse relapse. They point out, however, that there is a lack of long-term follow-up (over 6 months) to establish whether the program works over the long haul.
An important aspect of mindfulness training in relapse prevention is the improvement in emotion regulation that the training produces (see http://contemplative-studies.org/wp/index.php/2015/09/10/take-command-and-control-of-your-emotions/). The individual is better able to sense, feel, and understand the emotions they’re experiencing, the intensity of the emotions are maintained at manageable levels, and the individual can respond more adaptively. Intense emotions are often triggers for relapse. So, the mindfulness training provides the individual the means to understand and cope with the emotions in other ways than substance use.
The improved emotion regulation assists the individual in dealing with what is called the “violation effect.” This occurs when a brief lapse in recovery is followed by powerful negative emotions that amplify the lapse into a full relapse. The development of emotion regulation skills and non-judgmental awareness of emotions is essential to withstanding the negative consequences of a lapse thereby preventing it from escalating.
Meditation training is also been shown to improve the psychological and physiological responses to stress (see http://contemplative-studies.org/wp/index.php/2015/07/17/destress-with-mindfulness/). Substance use is often triggered by highly stressful situations and the individual uses the drugs to help cope with the stress. By developing a different means of dealing effectively with stress meditation training helps the individual to continue abstinence in the face of difficult and stressful situations.
So, although more research is needed especially investigating long-term effectiveness, Mindfulness Based Relapse Prevention appears to be an effective treatment program for assisting the recovered drug or alcohol abuser from relapsing.
“Recovery is a process. It’s decision by decision, step by step, gain by gain, day by day, month by month, and year after year. Trudge Forward!” – DBT-CBT Workbook
CMCS – Center for Mindfulness and Contemplative Studies