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Relapse – Symptoms, Triggers, And Prevention

People, places, and events that are associated with past drug use are common heroin relapse triggers. Avoiding these and other triggers can help prevent cravings and relapse.

Heroin is one of the most addictive drugs in America today. It changes the way a person’s brain and body function, creating severe physical dependence and intense cravings. For this reason, heroin addiction can be very difficult to overcome, but fortunately, recovery is possible.

Addiction is a chronic disease. Because of this, relapse does happen. While a person is especially vulnerable to relapse the first year after treatment, relapse can occur at any point throughout recovery.

Identifying personal relapse triggers, so a person can avoid or learn to cope with them, is a critical part of a strong recovery. 

By learning the triggers and symptoms of relapse, and building a strong relapse prevention plan, a person can increase their chance of long-lasting sobriety

Heroin Relapse Rates

Like with other diseases, relapse is part of the addiction recovery process for some people. Rates of relapse, at around 40 to 60 percent, are similar to those that occur with other chronic diseases like asthma, diabetes, and hypertension.

Without treatment, heroin relapse statistics can be far higher than this. Over 90 percent of people who quit taking heroin cold turkey relapse. Because of this, it’s typically recommended that a person seek professional help during detox.

The success rate for quitting heroin can be dependent on a number of factors. Choosing the right treatment program, including both detox and rehab when necessary, could increase a person’s odds of success.

Heroin relapse rates after rehab may be lower if individuals stay active in their recovery, such as by taking part in an aftercare program.

Heroin Relapse Stages

For many, relapse is a process that develops over weeks and even months before they use heroin. 

When this occurs, relapse takes place in three stages:

Emotional relapse:

Even though a person isn’t thinking about relapse, unhealthy emotions, thoughts, and behaviors can create a negative mindset and lifestyle that leads to relapse. 

At this time, a person may bottle up their emotions, isolate themselves, neglect important habits of self-care, and quit going to meetings. These states can create tension that tempts a person to escape by using drugs.

Mental relapse:

Thoughts of drug use increase. As they become more frequent, a person’s ability to fight them off weakens and the thought of escape becomes more appealing. 

In this stage, a person may have cravings and thoughts about heroin. They may minimize the harm of their previous drug use, while also trying to come up with ways that they can control future use. A person begins to plan relapse at this time and looks for opportunities to do so.

Physical relapse:

This stage is when a person begins to use the drug again, often because they think they won’t get caught. After an initial lapse, or one use, a person may have uncontrollable thoughts of heroin that fuel compulsive drug taking.

Heroin Relapse Warning Signs

Spotting the signs and symptoms of a heroin relapse can help a person get treatment before they fall into a full-blown return to compulsive heroin use. 

If a person is only in the emotional or mental stages of relapse, spotting the red flags of heroin relapse could prevent a person from using the drug again.

Heroin Relapse: Physical Signs 

When a person takes a dose of heroin it can quickly change the way their body functions. As this occurs, an outside observer may be able to see certain physical signs of drug use.

Physical signs and symptoms of a heroin relapse can include:

  • the arms and legs feel heavy
  • dry mouth
  • flushed skin
  • pinpoint pupils
  • nausea and vomiting 

A person who injects may also begin to wear long sleeves in hot or warm weather to cover up evidence of injecting.

Going on the nod, or when a person goes from consciousness to semiconsciousness, can be a sign of heroin intoxication as well.

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Heroin Relapse: Psychological Symptoms

The mental effects and signs of a heroin relapse can include:

  • attention and memory problems
  • clouded thoughts
  • confusion
  • disorientation 
  • euphoria
  • lack of awareness
  • mood swings

Heroin Relapse: Behavioral Signs

As relapse moves from the emotional and mental stages to the physical, a person’s daily routines and behaviors can drastically change as they begin to focus on drug-seeking and using. 

During this transition, and as relapse deepens, a person may display the following behavioral signs of a heroin relapse:

  • new friends
  • declining habits of self-care
  • a lack of interest in hobbies
  • poor performance at work or school 
  • possession of drug paraphernalia
  • quitting 12-step groups
  • secretive behavior
  • withdrawing from loved ones

A person may also become defensive when friends or family ask them if they’ve started using again. They may also try to act like everything is okay and be dismissive of their loved one’s concerns.

Heroin Relapse Dangers

While relapse doesn’t mean a person failed, it can be highly dangerous and even deadly. 

After detoxification and a period of abstinence, a person’s tolerance can drastically drop. If a person relapses and uses a dose they once were accustomed to, it could overwhelm their body and cause a fatal overdose.

Heroin Relapse Triggers

The most common heroin relapse triggers are people, places, events, and emotions that remind a person of past drug use. When exposed to a trigger, a person may encounter strong urges or cravings to use the drug again. 

While some triggers can be avoided, like drug-abusing peers, others, like withdrawing money, can be a part of everyday life.

Other triggers for heroin relapse include:

  • drug paraphernalia
  • people who sold the drug
  • places where the drug was used
  • boredom
  • celebratory events
  • mental illnesses
  • pain or physical illness
  • peer pressure
  • problems at work
  • relationship difficulties
  • social isolation
  • stress
  • trouble at school

Heroin Relapse Prevention Techniques

The best heroin addiction treatment programs include relapse prevention training in their curriculum. Teaching clients about potential triggers, ways to avoid them, and methods for coping with them are key components of these sessions.  

Staying focused on relapse prevention after graduation takes dedication and effort. The following suggestions can help a person maintain or regain a positive, sober recovery:

Build a relapse prevention plan:

Recovery is a dynamic thing, that is, it grows and changes over time. As a person’s life changes, so can their recovery needs. Revisiting relapse prevention techniques, so that they can be updated to meet the changing demands of a person’s life, is crucial.

Identify triggering situations:

During recovery, a person will encounter relapse triggers. However, identifying people, environments, events, or other relapse triggers can help a person avoid them and develop good coping techniques. 

Learn the HALT method:

HALT stands for hungry, angry, lonely, and tired, frequent triggers for relapse. Being mindful of these states and finding ways to avoid or deal with them can help a person avoid relapse.

Create a strong support network:

Having a positive support network provides accountability, encouragement, and positive influences. People who have an active support network are frequently more successful throughout their recovery. 

Join a peer-support group:

Peer-support or self-help groups can be a vital part of recovery, both within and outside treatment. Narcotics Anonymous and SMART Recovery are just two options that may be available in a person’s community. 

Make relapse a learning experience:

Relapse does happen. If it does, learning from it, instead of slipping into self-loathing, can actually be beneficial to a person’s recovery. Pinpointing what triggers cued relapse can help a person successfully avoid and cope with them in the future. 

Build an action plan:

If relapse happens, the way it’s handled can make a huge difference. Assembling a list of people that can be contacted or places a person can go to for help during relapse can help a person get centered in their recovery quicker. 

Stress-reduction techniques:

Learning how to handle stress in a healthy way is a critical component of a healthy recovery. This could include breathing exercises, meditation, or yoga. 

Mindfulness-based relapse prevention:

This brief, group-based outpatient relapse prevention method blends elements of cognitive-behavioral therapy and meditation. Sessions focus on negative emotions and cravings and teach clients how to react to them in a healthy way.

Aftercare programs:

The best facilities extend aftercare support to their alumni. Most communities also have aftercare resources as well. These programs connect people to a recovery-minded, sober community that provides accountability and workable sober living skills.

Heroin Relapse Treatment Programs

Treatment for heroin relapse varies and should fit the unique needs of each patient. 

Not every relapse is the same. Some people may have experienced a minor lapse, while others may have a history of multiple relapses. 

Outpatient treatment may be sufficient for certain people facing a mild relapse, however, those who have struggled with chronic relapse may need the intensive level of care available in an inpatient drug rehab program. 

A relapse doesn’t have to be the end of sobriety. With perseverance and the right combination of help, a person can return to a more fulfilling, sober life.

Contact Addiction Campuses today for more information on heroin relapse and treatment options.

Sources

HUFFPOST — Mindfulness-Based Relapse Prevention Holds Promise For Treating Addiction

Mayo Clinic — Drug addiction (substance use disorder)

National Institute on Drug Abuse — DrugFacts: Heroin, Principles of Drug Addiction Treatment: A Research-Based Guide (Third Edition)

PBS NewsHour — Why a promising heroin addiction treatment is unavailable in many states

US National Library of Medicine — Relapse Prevention and the Five Rules of Recovery

HUFFPOST - https://www.huffpost.com/entry/mindfulness-based-relapse-prevention-interview_n_5645fd24e4b08cda3488638b?guccounter=1&guce_referrer=aHR0cHM6Ly93d3cuZ29vZ2xlLmNvbS8&guce_referrer_sig=AQAAAAXcm2Ksav_fFadAfYvTYXxTBln4HqiR7ma6KRgZbsUW1eCU4-BVLHK2Nr5SRjwObHeRm8w3aL29aPgzRYtn4rLYqzFGeONxmV-z9t1s9ulNF4OsD2OPYfjYJROfgWqXV0fA2CbUpiAfQAQrznp6F1puLkT0MxZzmv2xRuQrgM5j

Mayo Clinic - https://www.mayoclinic.org/diseases-conditions/drug-addiction/symptoms-causes/syc-20365112

National Institute on Drug Abuse - https://www.drugabuse.gov/publications/principles-drug-addiction-treatment-research-based-guide-third-edition/frequently-asked-questions/how-effective-drug-addiction-treatment

PBS NewsHour - https://www.pbs.org/newshour/show/promising-heroin-addiction-treatment-unavailable-many-states

US National Library of Medicine - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4553654/

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