Effectiveness of Relapse Prevention Therapy

In relation to drug abuse, relapse is resuming the use of a chemical substance or drug after a period of abstinence. The term can be said to be a landmark feature of a combination of substance abuse and substance independence. The propensity for dependency, repeated use, and tendencies that take the form of the substance being used, are some of the issues that drug users’ experience. Substances that enhance most severe tendencies in users and pose high pharmacological efficacy, are those that are cleared quickly from the body, in addition to those that bring out the highest tolerance. There can be increased substance tolerance with the increasing dependency in relation to drug in question,

There are a variety of treatment modalities, both conservative and emerging, that clinicians, therapists, and doctors use to treat heroin and opioid dependence. Cognitive behavioral therapy (CBT), motivational interviewing (MI), 12 step programs, and acceptance and commitment therapy (ACT) are just a few that have been used in the past, and even today, in the treatment of substance dependence. Medication-assisted treatment (MAT) is yet another form of therapy; particularly for opioid and heroin dependence, that has been around for decades. However, it has recently begun to spark interest and controversy in light of the growing epidemic.

THESIS STATEMENT: To investigate Methadone maintenance is found to be more effective in treating heroin addiction than 180 day detoxification. The objective is how methadone maintenance, a widely used but controversial method of weaning heroin addicts off the drug—with counseling has psychosocially enriched 180 day methadone assisted detoxification.

For my relapse prevention research paper, I wanted to choose a substance/individual combination which would be convoluted, devoid of a simple or straightforward treatment plan. Due to my interest in healthcare, I decided to address an increasingly prevalent issue in the field, substance dependence to clinically-prescribed opiates. According to the National Survey on Drug Use and Health (NSDUH), the number of opiate prescriptions written in the United States has skyrocketed over the past two decades. In 2013, the United States Department of Health and Human Services reported that there were an estimated 1.9 million illicit opiate users in the United States who were either abusing or dependent prescription pain

The use of drug and substance abuse interventions have resulted in a decrease of relapses throughout the United States due to the amount of support each participant receives, the unique treatments each person gets, and those who receive treatment are automatically better off than those who do not receive treatment.

Reported that he "got in trouble due to comsuming alcohol", and that "I need to comply with treatment because I don't want to go to jail".

If recovering from drugs and alcohol is a process, then a relapse is an event. However, how a relapse is interpreted can be debated. In abstinence-based programs such as Narcotics Anonymous (NA), the basic text notes that relapse does occur and may be the result of an individual not following the program. If an individual stops following the basic principles of the NA program, old thoughts and behaviors may return which can lead to them to engage in the use of drugs or alcohol. Furthermore, the NA text suggests that these behaviors are “reservations” (p. 79) and because addiction is a disease, relapse can occur. As such, any individual who begins using drugs or alcohol again has relapsed. The basic text of NA describes relapse as a “reality” (p. 78) and states “It can and does happen”. When it does, the individual

Counselor met with Pt. for his reschedules individual session and to discuss his current recovery issues and plan dealing with Relapse Prevention Strategies. Pt. reported that he is currently taking 40 mg of methadone and he is responding well. Counselor inquired if he has used any drugs since the last session, which he replied no. Pt. denied having any suicidal ideation and no mental health issues. Pt. reviewed his TX plans without objections. During this week, Pt. has been violating program rules and receiving several verbal intervention form AMS staff especially nurse. Pt. explained his struggles trying to provide a urine analysis because he is sick. Pt. indicated that he is dehydrated and he couldn’t urine when ask to do so. Pt. claimed

Relapse is highly prevalent following treatment for substance abuse, highlighting the need for more effective aftercare interventions. MBRP has the opportunity to improve treatment outcomes (Bowen, S., (2014). Roos et al., (2017) proposed an inverse relationship between treatment outcomes and the severity of Substance Use Disorder (SUD), with symptom severity effecting how much the individual benefited from MBRP treatment. Kelly, J. F., (2013) wrote that TAU, in this case 12-step participation before and after treatment, was able to build resistance to relapse among adults and adolescents. Research into treatment outcomes is essential when time and resources are limited. Information regarding treatment outcomes is clouded

D: Group topic was focused on Dim 5. Reviewing the relapse process, identifying relapse warning signs, discussing how to take steps in the right direction and avoid even small steps back toward alcohol and other drug use. Client was present and actively engaged in the group activity as evidenced by completing the worksheet, and shared personal plans to maintain sobriety. Client stated “

Client is attended 10 out of 13 groups and missed 3 of them during the month of March, 2017. UA collected on 03/06 was positive for alcohol use. Client admitted 03/18/17 as his last day of alcohol use. Client appears to struggle to maintain his sobriety. Relapse prevention and ways to comply with treatment and court mendates were discussed. Client reported that he started taking Disulfiram 250 mg (Medication for alcoholism) on a daily basis to manage his cravings. Client also reported that he will try to attend self-help meeting daily. Client may benefit from a brief inpatient placement due to continued alcohol use.

Just as relapse simple does not happen, neither does addiction. Addiction is quite readily accepted as a disease by the public and by professionals, and similar to the majority of diseases, its prevalence depends on a delicate dance of nature and nurture. Just as an individual that is predisposed to heart disease does not catch the disease by eating a single bag of potato chips, someone predisposed to alcoholism must develop a pattern of drinking before it reaches the severity of a “disorder.” The difficulty of avoiding and preventing relapse is wrapped up in all of these factors. While a person can unintentionally fall into alcoholism, it is much more difficult unintentionally fall out of it, and this is where John is struggling.

Mindfulness-Based Relapse Prevention (MBRP) is an 8-week, group based, psychoeducational intervention that combines traditional cognitive-behavioral relapse prevention strategies with meditation training

Relapse prevention treatment for adolescents must be addressed. However, it must be addressed in a much different way than adults. Adolescents understanding of relapse prevention takes on a totally different meaning to them than adults do. The two case studies on page 303-308 made this very clear.

The cognitive behavioural therapy and relapse prevention aim at improving social skills and self-control and are repeatedly found effective in reducing drinking, therefore making them ideal for treatment of alcohol abuse (79, 1090, 1092–1094). Cognitive behavioural therapy treatment, comprising of behavioural self-control training (including self-monitoring, goal setting, goal achievement rewards, analysis of drinking triggers and learning to cope with those triggers) and stress management interventions have produced better results than that of control treatments in fifty percent of studies (79, 1090, 1095–1097). Follow up studies also show better outcomes for the individuals who display improved self-efficacy at the conclusion of treatment (184, 1098–1100) as well as for those who used mastery or problem solving as a coping mechanism instead of avoiding triggering situations (43, 265, 959, 1101).