How long does recovery last? What counts as a relapse? There’s a lot of disagreement in the addiction treatment and recovery space about whether you can ever actually be cured of addiction. On the clinical side, most people say no; once you’re in recovery, you’re fighting a battle against addictive substances for life. Outside of the treatment centers, however, that conversation looks different.
In this piece, our goal is to discuss some of these viewpoints and the facts around best practices to maintain lifelong sobriety, despite what you may have heard from friends, family or peers in recovery.
How Relapses Happen
In most recovery groups, there are three different versions of a relapse: a slip, a freelapse and a true relapse.
What Is a Slip?
When a person slips in their recovery from addiction, it means they give in to their cravings or have a weak moment when facing a specific trigger. During addiction treatment, there’s an emphasis placed on relapse prevention, trigger avoidance and the development of new, healthier coping mechanisms, but nothing can prepare a person 100% for a time when they face these scenarios in real life outside of treatment.
For example, if you’re sober but you go to a bar with friends, you may decide that it’s okay to have a drink. If you decide to do so, most people would say you slipped. It’s what happens next that differentiates a slip from a full-on relapse.
What Counts as a Relapse? Slipping vs Relapsing
When that slip is followed by a return to habitual substance use, it becomes a relapse. Often, a person in recovery thinks that because they went through treatment, they’re strong enough to have “just one drink” or use drugs “just this time.” But it’s important to remember that just because you’ve been sober for some amount of time, it doesn’t mean that your brain is prepared to deal with the influence of drugs and alcohol again. Many people who slip, even with the best intentions, find themselves fighting the recovery battle from day one once again.
So, what counts as a relapse? Most groups define it as a return to substance use after a period of sobriety, but there’s a lot of disagreement about what separates a slip and a relapse and whether a slip is a real event at all.
What About a Freelapse?
The danger of slipping in recovery is largely why AA and similar groups adopt such black and white, abstinence-or-nothing policies. When you’re going through a 12-step program, you’re expected to be completely honest with your group and your sponsor and take accountability for even the smallest lapses in recovery. That’s why the concept of a freelapse is hotly debated.
While a slip and a relapse are typically premeditated — the person in question makes a conscious decision to use — a freelapse isn’t. Maybe you ordered a nonalcoholic drink and the bartender got their orders mixed up. Maybe you went to a concert and were exposed to a cloud of marijuana smoke. Or, maybe you had major surgery and were put on a morphine drip in the recovery room.
For those who believe in the freelapse, it’s a period or instance of substance abuse that’s accidental. Essentially, you’re experiencing the same high that you’d associate with the substance, but it doesn’t count against your recovery.
Relapse Is an Important Issue in Recovery
AA groups likely have such stringent rules about what counts as a relapse because, in the context of addiction recovery, relapsing is much more common than most people realize. Addiction is a chronic disease with relapse rates to match. According to the National Institute on Drug Addiction (NIDA), the average relapse rate for those in recovery from substance use disorders is 40% to 60%. This is higher than the relapse rate with treatment for diabetes (30% to 50%) and slightly lower than the rates for high blood pressure and asthma (both 50% to 70%).
The high rate of relapse is the reason people in recovery are so concerned about it. You might spend months in treatment and have a freelapse that sends you down a road back to the beginning of your recovery journey.
How Long Does Recovery Last?
This is another hotly debated issue: Can a person ever be cured of addiction? Some people think that after a certain amount of sober time, a recovery slip or a relapse no longer counts. But this is a dangerous way of thinking, because recovery takes a lifelong commitment.
A study in Psychology Today found that the longer recovering addicts were able to stay sober initially, the less likely they were to suffer a relapse down the road. But this doesn’t mean there’s a point in time at which relapse no longer is a threat: The late actor Philip Seymour Hoffman had been sober for an extended period of time before he started to use again and died of an overdose at the age of 46 in 2014.
Honesty and Accountability Are More Important than Time
While there are always anecdotes that support certain views, there’s a reason why almost every treatment center and licensed addiction specialist will tell you that recovery is a lifelong battle. It’s because even relaxing the way you think about addiction and recovery puts you at risk for relapse.
Addiction treatment is difficult — it’s why so many people try and fail to get clean over and over. There’s rarely an easy day in recovery, which is why AA and other sober groups stress discipline and complete abstinence from addictive substances.
There’s no magic number of years you need to be clean to be out of the woods. That’s why honesty and accountability are so important. Be honest with yourself and your peers in recovery, because you share accountability in each other’s recovery. Be honest about slips, and be constructive about ways to avoid them in the future. And if a relapse does occur, don’t try to hide it — leverage the support you have to get back on the right track in your recovery.
Relapse Prevention at FHE Health
At FHE Health, giving our clients the tools to prevent and overcome slips and relapses is something we feel strongly about, because you won’t have the comfort and stability of a rehab center to lean on forever. We help our clients identify triggers, understand where their impulses are coming from and develop proven strategies to avoid relapse, giving them the best chance to achieve sustainable sobriety after treatment.
If you’re interested in learning more, contact us today.