Addiction and the Neuroscience of the Brain, Part 3

Understanding Relapse (September 28, 2012). Presented by Joseph Lunievicz, BA, RYT (Director of Training, NDRI).

The focus of this webinar is upon helping participants understand how relapse can occur with chemically dependent drug court clients. Promoting behavior change with clients in drug court includes understanding that relapse can be part of the recovery process. This is expressed through three components of relapse prevention strategies: recognizing the warning signs of relapse; identifying triggers, and developing reinforcement strategies. Mr. Lunievicz uses the National Institution of Drug Abuse's definition of relapse describing it as "an unfolding process in which the resumption of substance use is the last event in a long series of maladaptive responses to internal or external stressors or stimuli." Also defined is the common occurrence known as a "lapse" or "slip" -- "an isolated incident of chemical use, or an isolated episode of behavior change, not immediately resulting in a return to old using patterns."

He explains that substance abuse treatment has always had a compliance component, which is entailed in the concept of "relapse" -- often caused by a participant's lack of skill and lack of self-confidence.

He goes on to explain the effects drugs have on the brain and on behavior, such as:
• addictive preoccupations -- involving physical cravings and obsessive thought patterns;
• acute withdrawal -- occurring within the first few weeks of recovery; and
• post-acute withdrawal -- beginning at six months and occurring for up to two or more years.

Emotional and psychological symptoms of post-acute withdrawal, such as mood swings and tiredness, are discussed along with associated behaviors, such as defiance and denial. Cravings, which are the product of strong memories linked to the effect of drugs on the brain's neurochemistry, and "triggers", stimuli which have been repeatedly associated with the preparation for, anticipation of, or use of drugs and/or alcohol, are also discussed. The expectations for participants in drug courts are listed, along with the caveat that the purpose of sanctions and incentives should be to keep participants engaged in treatment -- not to punish clients, but to help change behavior. The presentation concludes with a brief summary listing the main points of the entire webinar series.