RELAPSE PREVENTION
© C Y A Chen 2010
Addiction is as much a spiritual disease as it is a biological, psychological and social one. Therefore this aspect cannot be ignored. In addition to advocating for participation in mutual support groups (12-Step programs such as Alcoholics Anonymous, Narcotics Anonymous, as well as Refuge Recovery, Life Ring, SMART Recovery, Women for Sobriety, etc.) as part of your treatment, you will also be referred to a therapist, specializing in addiction medicine, who uses methods such as Cognitive Behavioral Therapies. Although you may be resistant to attending groups such as Alcoholics Anonymous, the long term outcomes of participating in these groups or utilizing the tools taught in these programs, have been shown to be effective.
It's about finding a new life that is meaningful, purposeful, and joyful, without relying on drugs or alcohol. That takes time and is not easy. But one step at a time, exploring how life without using can be more rewarding than one using is part of that spiritual journey.
Good diet and sleep hygiene, exercise such as yoga, along with some form of mindfulness based meditation may be helpful to you in regaining health in recovery.
ALCOHOL USE DISORDER TREATMENT
There is an exciting, growing armamentarium of medications that can be used for relapse prevention in alcohol use disorders. Many of the drugs used to decrease cravings may not be effective for everyone especially those used off-label. There is no definitive way to determine if it will prevent relapse years from now; however, if relapse is a chronic condition for you then it is worth trying medication(s) including injectable naltrexone (Vivitrol®). If it is appropriate, relapse prevention medication(s) will be incorporated as part of your treatment plan in addition to the critical psycho-social supports mentioned above.
Your personally tailored relapse prevention regimen will be explained to you; side effects and along with the risks and benefits of the medication(s) will be discussed, and may be prescribed after you consent to treatment.
OPIOID AGONIST OR MAINTENANCE THERAPY
Since the advent of office based buprenorphine treatment, many have regained a productive life free from using heroin and prescription opioids. Although, long term opioid agonist or maintenance therapy is effective and life-saving, there is no data on the long term physical effects of chronic buprenorphine use. There are some who successfully taper off buprenorphine, and for others indefinite maintenance is preferable. These decisions are made with each patient, individually over time.
Another relapse prevention method is the opioid antagonist medication naltrexone (Vivitrol® which is the injectable form), most effective intramuscularly. We can discuss this form of treatment, its side effects, along with the risks and benefits. This medication may be prescribed after you consent to treatment.
SEDATIVE HYPNOTIC DEPENDENCE TREATMENT
Oftentimes, problems arising from sedative hypnotic dependence stem from long term treatment of chronic insomnia and psychiatric disorders. These problems are likely to continue or may flare up again with tapering or detoxification, therefore, it is important to re-evaluate and treat the underlying disorder, preferably with less addictive agents if possible. It is sometimes not possible to fully discontinue sedative hypnotic drugs such as benzodiazepines because of significant psychiatric illness. Those with significant co-morbid psychiatric disorders and sedative hypnotic dependence will be referred to a psychiatrist.
Good sleep hygiene, exercise, nutrition and strong psycho-social support can often help decrease the severity of insomnia and anxiety symptoms and prevent relapse into problematic sedative hypnotic use.
CANNABIS USE DISORDER TREATMENT
There are no FDA approved drugs for cannabis use prevention; however, there are medications that have been shown to help with decreasing the anxiety that comes with withdrawal from long-term marijuana use.
If the medications initially used for cannabis withdrawal symptoms bring relief and prevent relapse, extended use of these medications may be considered; side effects along with the risks and benefits of medication(s) will be discussed, and may be prescribed after you consent to treatment. However, if your psychiatric symptoms are significant, you will be referred to a psychiatrist.
STIMULANT USE DISORDER TREATMENT
Chronic stimulant use may lead to persistent depression and overall low energy that will take a considerable time to overcome. Various medications for relapse prevention have been studied in those with stimulant dependency. The success of these medications is highly variable. The importance of psycho-social support cannot be emphasized enough. Learning how to identify and avoid triggers along with positive reinforcement must be part of the psycho-therapeutic treatment strategy. A psychiatry referral will be made if clinically indicated.
If relapse prevention medication for cocaine and or methamphetamine is appropriate for you, side effects along with the risks and benefits of the medication(s) will be discussed, and may be prescribed after you consent to treatment.
It's about finding a new life that is meaningful, purposeful, and joyful, without relying on drugs or alcohol. That takes time and is not easy. But one step at a time, exploring how life without using can be more rewarding than one using is part of that spiritual journey.
Good diet and sleep hygiene, exercise such as yoga, along with some form of mindfulness based meditation may be helpful to you in regaining health in recovery.
ALCOHOL USE DISORDER TREATMENT
There is an exciting, growing armamentarium of medications that can be used for relapse prevention in alcohol use disorders. Many of the drugs used to decrease cravings may not be effective for everyone especially those used off-label. There is no definitive way to determine if it will prevent relapse years from now; however, if relapse is a chronic condition for you then it is worth trying medication(s) including injectable naltrexone (Vivitrol®). If it is appropriate, relapse prevention medication(s) will be incorporated as part of your treatment plan in addition to the critical psycho-social supports mentioned above.
Your personally tailored relapse prevention regimen will be explained to you; side effects and along with the risks and benefits of the medication(s) will be discussed, and may be prescribed after you consent to treatment.
OPIOID AGONIST OR MAINTENANCE THERAPY
Since the advent of office based buprenorphine treatment, many have regained a productive life free from using heroin and prescription opioids. Although, long term opioid agonist or maintenance therapy is effective and life-saving, there is no data on the long term physical effects of chronic buprenorphine use. There are some who successfully taper off buprenorphine, and for others indefinite maintenance is preferable. These decisions are made with each patient, individually over time.
Another relapse prevention method is the opioid antagonist medication naltrexone (Vivitrol® which is the injectable form), most effective intramuscularly. We can discuss this form of treatment, its side effects, along with the risks and benefits. This medication may be prescribed after you consent to treatment.
SEDATIVE HYPNOTIC DEPENDENCE TREATMENT
Oftentimes, problems arising from sedative hypnotic dependence stem from long term treatment of chronic insomnia and psychiatric disorders. These problems are likely to continue or may flare up again with tapering or detoxification, therefore, it is important to re-evaluate and treat the underlying disorder, preferably with less addictive agents if possible. It is sometimes not possible to fully discontinue sedative hypnotic drugs such as benzodiazepines because of significant psychiatric illness. Those with significant co-morbid psychiatric disorders and sedative hypnotic dependence will be referred to a psychiatrist.
Good sleep hygiene, exercise, nutrition and strong psycho-social support can often help decrease the severity of insomnia and anxiety symptoms and prevent relapse into problematic sedative hypnotic use.
CANNABIS USE DISORDER TREATMENT
There are no FDA approved drugs for cannabis use prevention; however, there are medications that have been shown to help with decreasing the anxiety that comes with withdrawal from long-term marijuana use.
If the medications initially used for cannabis withdrawal symptoms bring relief and prevent relapse, extended use of these medications may be considered; side effects along with the risks and benefits of medication(s) will be discussed, and may be prescribed after you consent to treatment. However, if your psychiatric symptoms are significant, you will be referred to a psychiatrist.
STIMULANT USE DISORDER TREATMENT
Chronic stimulant use may lead to persistent depression and overall low energy that will take a considerable time to overcome. Various medications for relapse prevention have been studied in those with stimulant dependency. The success of these medications is highly variable. The importance of psycho-social support cannot be emphasized enough. Learning how to identify and avoid triggers along with positive reinforcement must be part of the psycho-therapeutic treatment strategy. A psychiatry referral will be made if clinically indicated.
If relapse prevention medication for cocaine and or methamphetamine is appropriate for you, side effects along with the risks and benefits of the medication(s) will be discussed, and may be prescribed after you consent to treatment.
Copyright © Chwen-Yuen Angie Chen, MD 2013-2023. All Rights Reserved.