Going Back to Rehab

Recovery from addiction is a lifelong process, with challenges at every stage. Relapse is common, and is often considered a normal part of recovery, but it requires modifying your recovery plan, often by going back to rehab. If you are struggling with your recovery in any way, you should understand your options and when going back to rehab is the best path.

Why Addiction Relapse Occurs

Addiction is a complex disease that is considered chronic, meaning that it can only be managed, not cured. Substance use over a period of time re-trains your brain to need the substance to feel pleasure, and it takes time, sometimes years, for your brain to rewire itself. This means that you’re always living with a risk of relapse.

Relapse may be triggered by the same triggers that drove your substance use in the past and may be people, places, stressful situations, or emotional distress. It may also be triggered by a traumatic event, such as the loss of a loved one. In addiction treatment, you learned coping mechanisms to deal with triggers, but triggers are still powerful and can put you at risk.

Lapse Vs. Relapse

It’s important to understand the difference between a lapse versus a relapse.

• Lapse: A lapse is a one time slip up in which you use your substance of choice. For example, you might go out for a night of drinking with friends, but in the morning, realize your mistake. When a lapse occurs, you should still seek support from a support group meeting or a mentor, but as long as it doesn’t happen again, you probably don’t need to go back to rehab.
• Relapse: A relapse is when you return to your old, addictive behaviors for a period of time. If this happens and you can’t stop, even with support, going back to rehab may be your best course of action.

Stages of Relapse

Relapse typically occurs gradually and can be classified into three distinct stages.

1. Emotional Relapse

First, you may experience some changes emotionally but not be thinking about using yet.

Instead, what’s happening is:

• Emotions and behaviors are starting to shift
• Stress builds up
• Healthy routines and habits start to slip

You also may start to keep your feelings inside, isolate yourself, and stop going to support group meetings or therapy.

2. Mental Relapse

In this stage, you start thinking about using again, even if you don’t act on it right away. There’s usually internal conflict, in which part of you wants to stay sober, but the other part wants to use.

Some things that may occur at this stage include:

• Cravings
• Thinking about past substance use as “the good old days”
• Minimizing consequences
• Bargaining with yourself, i.e. “just one time won’t hurt”
• Thinking about people or places that you relate to substance use
• Planning or fantasizing about using

3. Physical Relapse

This is the actual act of using again. You may feel guilt at this stage, or a sense of hopelessness, as though treatment can never work.

When to Consider Going Back to Rehab

Whether to go back to rehab is a big decision, and depending on what is happening with your addiction, you may be able to try alternatives. If you have just had a single lapse, you may want to reach out to someone from your support groups, such as a sponsor if you have one, or supportive peers who are also in recovery. You can also talk to other people in your support system like family or friends. However, if you still feel that you are on shaky ground and at risk of relapsing, you should consider re-entering treatment.

Similarly, if you are in stage 1 or 2 of relapse, recognizing the signs and getting support may help to you avoid physical relapse. However, again, it depends on how at risk you feel.

If you have fallen into your old habits and are using regularly, if you stop, you may experience withdrawal again. Sometimes, going through withdrawal for a second time can be worse, particularly with alcohol. At this stage, going back to rehab may be critical, both for medically supervised detox and intensive treatment.

You may wonder, however, if rehab is going to work because it didn’t the first time. This should absolutely not prevent you from seeking treatment again. It may require you going about it differently, perhaps by going for a longer period of time, or by entering a treatment facility that takes a different approach, such as holistic treatment or mindfulness-based treatment. Everyone is different, so you may respond better to an alternative.

You may want to consult with a mental health professional who can help you explore what kind of treatment may be best for you. In any case, do not give up on yourself. Recovery is possible.

Alternatives to Inpatient Rehab

In some cases, you may be able to try an outpatient alternative to inpatient treatment if your situation has not gone too far, or if you are in stage 1 or 2 of relapse.

A partial hospitalization program (PHP) is an option that allows you to live at home while attending treatment for four to six hours per day, usually five days a week. The program may last anywhere from four weeks to ten weeks. The treatment consists of therapy similar to that of inpatient treatment, both in groups and individually.

Another option is an intensive outpatient program (IOP) that consists of two to three hours of therapy several days a week for eight to twelve weeks. Often, sessions are held in the evenings so that you can still go to work or attend school. Treatment, again, involves individual and group therapy.

Aftercare

After any form of treatment, aftercare is absolutely critical to maintaining your recovery. This can come from attending support group meetings regularly. This does not mean going now and then, or even once a week. You may need to go several times a week or more so that you’re getting consistent support, at least for a period of time.

Some people also benefit from continuing individual therapy to reinforce coping strategies that you’ve learned and to get ongoing support.

In any case, you need a strong support system around you, and must remember that recovery is a lifelong journey that requires commitment and work.

In Closing

Going back to rehab can be necessary sometimes, and it doesn’t mean that you failed. Addiction is a chronic disease and a lifelong battle, so you need to get the treatment and support that you need when you need it. Bridges of Hope is here to help with many treatment options. We are committed to providing comprehensive, compassionate, and personalized care to support you on your recovery path. Give us a call today to learn more.