What Can Be Done to Prevent Relapses in Drug Addicts?

QUESTION: What can be done to prevent relapses in drug addicts?
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ANSWER: This is an extremely difficult and controversial question. When you
consider the numerous facilities and countless dollars that are spent yearly
in the attempt to curb drug abuse in our country alone, you'd have to assume
that if there were any simple and sure-fired way of controlling the problem,
we'd have discovered it by now. Unfortunately, preventing relapse in narcotic
drug abuse is extremely difficult and management requires highly
individualized treatment. However, prevention is not impossible and the more
we learn about the chemically dependent individual, the better we will be able
to attack the problem.
Studies of chemically addicted people have revealed that in most cases
the addict is not hooked on one particular chemical, but on intoxication
itself. It has been observed that when a drug abuser's drug of choice becomes
unavailable or boring for some reason, he or she almost certainly seeks out a
substitute drug. Based on this finding, the first step in treatment in any
addiction is total abstinence from all potentially addictive chemicals.
Restricting the user's drug of choice is not enough. Even drugs that are
generally not considered habit-forming in the general population can have
mood-altering effects on an addicted patient, and any inclination on that
patient's part to purchase over-the-counter sleeping pills or weight-loss
pills should serve as a strong warning that a chemical relapse is on the way.
Another major step in helping to prevent a drug relapse is counselling.
People become addicted to drugs for a multitude of reasons, and attempting to
understand personal problems that make a person vulnerable to a chemical
dependency can play a large part in preventing a relapse. It has been noted,
for example, that people who deny their addiction or have no crisis-management
skills will very likely have a relapse within the first year of treatment.
Others who have family problems, or suffer from low self-esteem, shame, or
guilt, may experience a relapse at a slightly later point. For this reason,
determining a patient's emotional and psychological state can be of vital
importance. There are a great many self-help and support groups devoted to
helping addicts overcome their dependence and, I'm happy to report, many have
been quite successful in their attempts. Needless to say, however, if a
patient decides to drop out of one of these groups, it should be taken as a
prime indication of an impending relapse.
In certain instances, such as during hospitalization, drugs that can
cause chemical dependence may be necessary for treatment. Though different
from narcotic abuse, the dependency on these drugs can be just as potentially
damaging. However, with the physician's careful attention to dosage and the
patient's understanding of his or her potential addiction, relapse can usually
be avoided.
People who have been chemically addicted face constant danger of relapse
and preventive guidelines can vary a great deal. Counseling and restriction
of all chemically addicting drugs is a must. Careful observation of the
patient's psychological state should be constant, so that signs of addictive
compulsions can be predicted in advance. There are no guarantees, but if a
patient recognizes his or her addiction and wants to break it, recovery is
attainable.