We view addiction as a chronic disease that has complicated roots and necessitates a dynamic approach in order for treatment to be effective. Addiction is not a disease of personal weakness or short-comings. We live in a society that is continually becoming more dehumanized and detached from personal connections and interactions. Meeting for a cup of coffee is being replaced by text messages. Meaningful connections with fellow members of our society is continually being replaced by apps that ask users to swipe left or right. Convenience is taking precedent and prevalence over purpose and true engagement. We contend that this alienation is a major root cause of addiction in our society and that the formation of addiction to substances can best be described by systems that create the environments (sociological, economic, and otherwise in nature) that lead to chronic substance use.
Lapse Vs Relapse
Within this framework, we view addiction as a disease that will likely include instances in which the person recovering from addiction will use substances again. It is vital that health care providers and other professionals in this space distinguish between what constitutes an instance of use versus a state of relapse. “Use” is an acute situation in which the person recovering from their addiction engages in substance abuse. Use can be addressed when there are trusting and empathetic dynamics between the patient and their recovery team to prevent relapse. So, what is relapse? Relapse is the return to chronic substance abuse and some or all of the surrounding realities that accompanied an individual’s substance abuse.
Relapse Prevention Strategies
This dynamic between use and relapse highlights the need for addiction treatment to be rooted in harm reduction, trust, and empathy. When addiction care teams develop these trusting bonds with their patients there is a decreased likelihood of instances of use regressing into states of relapse. For example, we will use the hypothetical example of a patient with heroin addiction named John. John used heroin for 4 years and has now been substance free for 8 months and has been living in a sober living home. One weekend, John goes to a party and uses heroin for the first time since achieving sobriety. If John is being treated by an addiction care team that holds a punitive and judgmental stance towards instances of use, he is unlikely to approach his doctor and tell him the truth. This prevents his doctor form intervening and addressing the situations that led to John’s use that weekend. Without this intervention, John is more likely to use again and eventually reach a point of relapse. In contrast, if John has a trusting relationship with his physician and believes that his physician will continue to help him though his addiction, he is much more likely to tell his physician about his instance of use. This will allow for targeted and caring medical intervention that will prevent John from suffering a relapse and continuing his path of sobriety.
Importance of Harm Reduction
Addiction care is limited in its ability to tackle the sociological roots of addiction but it must be informed by them. Until the systems that create substance abuse are addressed, addiction treatment must operate within the realm of practicality rather than theory. By building harm reduction focused and empathetic addiction care practices we will be able to limit the number of instances in which use becomes relapse.
If you have any questions about harm reduction, how we practice harm reduction tenants at American Addiction Institute, or how you can get involved in harm reduction advocacy please contact our HRI Clinical Operation Coordinator: Mahan Naeim at firstname.lastname@example.org or fill out the form below.