How to Deal With Relapse in the Wake of Disaster
By Martha McLaughlin
During a disaster, many urgent tasks demand attention. But for people recovering from addiction, it’s important not to lose sight of recovery tasks as well.
Both logistical and stress-related factors may increase the risk of a relapse when disaster happens, whether it’s because local damage blocks access to needed care or because added stress fuels drug or alcohol cravings.
Let’s take a closer look.
Logistical Recovery Challenges
Logistical recovery challenges are often related to schedule disruptions. This may be especially problematic for people recovering from opioid addiction who rely on methadone to prevent withdrawal. When methadone clinics are closed or inaccessible because of transportation issues, the resulting symptoms may tempt people to look for relief elsewhere.
Disasters may also disrupt self-care routines and create other recovery challenges. For example, during early recovery, people often rely heavily on their support groups or counselors. When someone’s support network is temporarily unavailable, relapse may become more likely.
Stress-related Recovery Challenges
Internally, relapse risk rises when stress does because of the interplay of body chemicals. Drugs of abuse affect neurotransmitters and, over time, can alter the body’s ability to regulate stress. The process of normalization after a person abstains from substance use isn’t instant, and that can leave people in early recovery especially sensitive to the body’s stress response.
Stress hormones can also affect levels of dopamine, the neurotransmitter most often tied to substance abuse. According to National Institute on Drug Abuse researchers, corticosterone increases dopamine activity in the brain. Animal studies show that stress- and drug-related dopamine surges work together in such a way that a dose of cocaine too small to interest an animal who isn’t under stress will motivate one who is.
A similar mechanism is undoubtedly at work in humans. Biological markers have been identified that help predict addiction relapse risk. Among them are those tied to the stress response system, such as measures of cortisol and the cortisol/corticotropin (ACTH) ratio.1
Monitoring Internal Dialogue
All actions are preceded by thoughts and beliefs, and monitoring internal dialogues and attitudes is an important relapse prevention skill. Some potentially problematic mindsets that might arise during a disaster include:
- Making excuses – When a situation is particularly stressful, it’s easy to use that as an excuse for substance use. The thought may be, “In ordinary times, I can handle life without drugs or alcohol, but I can’t be expected to navigate this situation without them.”
- Believing ordinary rules don’t apply – During a disaster, many of the “rules” of everyday life are set aside. School may be canceled, for example, and stores and workplaces closed. It’s easy to fall into the mindset that, since so many other societal norms are being ignored, breaking personal rules is also acceptable.
- Equating substance use with stress relief – It’s important to recognize when stress is building and to mitigate it as much as possible. The problem comes when “I need a break” becomes equivalent to “I need a drink or a fix.”
- Assuming substance use will be short-lived – It’s easy to think, “The effects of the disaster will be temporary. Lights will come back o, and roads will reopen. When life gets back to normal, I will too.”
- Thinking no one will know – When people are distracted with disaster-related tasks, they may not be paying as much attention to the actions of friends and family members. People in recovery may lose a sense of accountability and begin to think they can get away with more.
- Being overconfident – People who have been doing well in their recovery journey may overestimate their resilience and fail to compensate for the additional stress and potential disruption in support routines.
Balancing the body’s stress response is also essential. It’s natural and helpful to go into fight-or-flight mode when a disaster hits, but staying in that physical state for long periods of time is counterproductive. There are many tools for moderating it, including meditation, journaling, stretching, breathing exercises, listening to calming music, progressive muscle relaxation, moderate physical exercise and prayer.
Neither disasters nor relapses are welcome, but a relapse doesn’t mean recovery won’t ultimately be successful. It’s simply a sign that treatment needs to be altered or reinstated. Disasters are an opportunity to learn and grow so future stress can be addressed successfully.
Sources
- 1 Sinha, R. “New Findings on Biological Factors Predicting Addiction Relapse Vulnerability.” Current Psychiatry Reports, October 13, 2011.
