Why Alcohol and Heroin Have the Highest Rate of Relapse
Have you or someone you love struggled to break an addiction to alcohol or heroin? Even with professional assistance, these two dependencies can be especially difficult to break.
Unfortunately, going to rehab or entering recovery does not guarantee lasting sobriety. Breaking free from a cycle of substance abuse is a difficult battle, and relapse rates are quite high. Studies show that about 40-60% of individuals relapse within 30 days of leaving an inpatient treatment center. Those numbers get even higher regarding alcohol and heroin/opioids. Alcohol has a relapse rate of 80% during the first year, while heroin has an astronomical relapse rate of 90%.
Acknowledging the high risk for relapse is essential for individuals struggling with alcohol or heroin dependence. It is also vital to understand the underlying issues behind their addiction, learn their personal triggers, and find methods to cope with these triggers and emotions in a healthy way.
Understanding the common risks associated with relapse can better equip an addict to maintain sobriety and recovery. And when it comes to alcohol and heroin, there are a few specific reasons these two substances have the highest and most challenging relapse rates.
Both alcohol and heroin dependencies are subject to physiological withdrawal symptoms that begin in the human brain. Heroin, for one, is a notoriously addictive drug. Individuals can become addicted after only one use, as heroin binds to the brain’s opioid receptors, flooding the dopamine system and creating intense pleasure and euphoria.
Since our brains are wired to pursue activities that bring us pleasure, it compels us to seek this stimulus repeatedly — in this case, to continue using heroin. Over time, the drug will alter the pathways and structure of the brain, creating a strong dependency. Heroin can also result in the deterioration of the brain’s white matter, which regulates behavior, controls how we respond to stress, and affects decision-making.
Trying to stop heroin produces physical symptoms of withdrawal. Once the brain has adjusted to consistently high levels of heroin, addicts will become physically ill and may experience behavioral side effects when they are not high.
Alcohol also has a profound effect on the brain. It starts by blocking chemical signals between brain cells, which produces the typical signs of intoxication — including slurred speech, poor memory, slow reflexes, and impulsive behavior. Over time, with long periods of heavy alcohol use, the brain becomes accustomed to these blocked signals and compensates. But even when an alcoholic is not drinking, the brain continues to over-activate, causing painful and dangerous withdrawal symptoms.
With continued alcohol use, brain matter also becomes affected, with both the volume of white matter and gray matter being reduced and causing brain shrinkage. These effects are seen in various cognitive impairments and can include problems with memory, attention span, problem-solving, verbal fluency and verbal learning, spatial processing, and impulsivity.
Alcohol and heroin addiction can also produce physical side effects from withdrawal, making recovery even more difficult. In fact, one of the leading causes for relapse within the first week of stopping substance use is to avoid withdrawal symptoms. Alcohol and heroin addicts will experience varying degrees of physical withdrawal that can last up to six months and possibly longer.
Common physical symptoms can include fever, restlessness, insomnia, hot sweats, cold chills, nausea, vomiting, diarrhea, muscle aches, and even seizures and death. It is highly recommended that individuals who stop drinking or using heroin do so in a monitored medical detox for their own safety. There, doctors can provide supervision and prescribe treatments such as Valium or Suboxone to lessen the severity of withdrawal symptoms.
“People, Places, and Things”
Some factors of addiction are behavioral or circumstantial, often summed up under the umbrella terms of "People, Places, and Things." These three words are repeated daily at every inpatient, outpatient, Alcoholics Anonymous, and Narcotics Anonymous meeting as the main reasons for relapse. In regard to alcohol and heroin, which can be highly social or situational drugs, strong associations can easily undermine an addict’s recovery with constant reminders of their previous substance use.
- People: If surrounded by like-minded individuals who also us alcohol or heroin, the addict is highly likely to fall back into the same behavior. Changing friend groups and hanging out with other people in recovery can be incredibly beneficial to maintaining sobriety after leaving the safety of a rehab facility.
- Places: The specific places will depend on the individual, but generally, addicts will benefit from staying away from any location that they associated with alcohol or heroin use. Some of the obvious places are bars, casinos, strip clubs, wineries, and parties.
- Things: This category is more vague and all-inclusive, and can include a number of triggers very personal to the addict. For example, the clinking of glasses or the popping of a bottle might trigger some addicts struggling with alcoholism. And even in a non-drug-related setting, heroin users may experience strong associations and urges in response to needles, lighters, spoons, straws, or belts. These are just a few obvious examples, but each individual may have their own unique triggers to avoid and overcome.
Mental Health Issues
Mental health issues also compound substance abuse. Alcohol and heroin are highly addictive substances on their own, but many users also suffer from deeper, underlying issues. More often than not, these include unaddressed mental health concerns such as post-traumatic stress, personality disorders, anxiety, depression, and mania. Without addressing these, any attempts to stop substance abuse can be temporary and difficult to maintain.
Receiving proper therapeutic treatment goes hand-in-hand with alcohol and drug rehabilitation. Therapists and psychiatrists work with patients to figure out and address the underlying mental health issues. However, there is no quick fix to overcoming drug and alcohol addiction, and continuing these therapy sessions after completing rehab is vital to maintaining sobriety. If mental health issues are unaddressed or the patient quits therapy before it is recommended, they can easily trigger a relapse.
Those living with alcohol or drug addiction have become accustomed to using substances as their primary coping mechanism when experiencing depression, anxiety, or mania. But guidance from a mental health professional can help teach them other ways of handling these issues.
If you have a loved one currently struggling to overcome an alcohol or heroin addiction, we are here to help.
Countrywide Testing is an online retailer of FDA-approved drug and alcohol testing devices, and our SAMHSA-accredited lab services give you quick and reliable results when you need them the most. Our tools can help you determine if a loved one or patient has relapsed and is under the influence of drugs and alcohol, so you know when it's time to get them extra support.
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