Recent evidence suggests that 50% to 90% of people with alcohol use disorder may relapse at least once during the four-year recovery period after receiving treatment. The relapse rate of alcohol is similar to that of nicotine and heroin addiction.
Some researchers believe that the high recurrence rate of alcohol and drug users is due to chemical changes in the brains of alcoholics and drug users that lead to impaired control, which changes the brain’s reward system.of
Some researchers believe that this impaired control is the reason why alcoholics restart to drink their first drink, while other researchers believe that impaired control begins after the first drink, which makes it possible for alcoholics to start drinking once again. Drinking makes it difficult to stop drinking.of
For heavy alcoholics, it is impossible to quit drinking after the first drink. When alcoholics stop drinking, they may experience withdrawal symptoms and cravings for alcohol.
The role of desire in relapse
The concept of drug and alcohol cravings is somewhat controversial, and some researchers believe that environmental stimuli play a greater role in relapse than physiological impulses.of
But a 1974 study by Arnold M. Ludwig and LH Stark found that the best way to determine whether alcohol cravings really exists is to simply ask alcoholics. They ask study participants whether they need to drink, just like asking if someone is hungry.of
Ludwig’s further research found that alcoholics showed classic Pavlovian conditioning to internal and external stimuli to enhance the effects of alcohol.For example, driving past a familiar bar or experiencing negative emotions may trigger a craving for alcohol.
Euphoric memories and appetite impulses
The internal and external cues that evoke the memory of alcohol euphoria trigger an appetite urge similar to hunger in the alcoholic. Similarly, the memory of the discomfort of quitting alcohol can also produce a craving for alcohol.
Other studies have found that exposure to alcohol without drinking alcohol can stimulate the saliva response of alcoholics.A study conducted by Zelig S. Dolinsky in 1987 found that compared with non-alcoholics, alcoholics had a significantly greater and faster response to insulin and glucose drinking placebo beer.
Expect to play a role in relapse
Other researchers speculate that preventing relapse depends on the alcoholics’ expectations of his or her ability to cope with alcohol cues.A theory put forward in 1999 suggested that whether the first drinking will cause the relapse of excessive drinking may depend on the alcoholics:
- Skills to deal with high-risk situations
- Perceived level of personal control
- Expected positive effects of alcohol
Investigators who analyzed 48 relapses found that most were caused by the following high-risk conditions:
- Frustration and anger
- social pressure
- Interpersonal temptation
Play an active role in preventing recurrence
To overcome these high-risk situations, some of the ways that alcoholics can play a more active role in changing behavior include:of
- Make lifestyle changes to enhance your ability to cope with stressful and high-risk situations
- Identify and respond appropriately to internal and external clues that are warning signs of recurrence
- Implement self-control strategies to reduce the risk of recurrence in any situation
One study found that teaching alcoholics how to recognize certain coping skills needed to cope with high-risk situations can help reduce relapse rates.The other method focuses on prompt elimination. Many different strategies have been proposed, but in the end, 50% to 90% of people with alcohol use disorder will relapse at least once.
Drugs that reduce cravings
With the advent of drugs that can reduce cravings, great progress has been made in preventing recurrence. Naltrexone hydrochloride is sold under the trade names Revia and Depade, and sold in sustained-release form under the trade name Vivitrol. It is the first drug approved for the treatment of alcoholism, which reduces the craving for alcohol.
Naltrexone seems to reduce the potentiation of alcohol in the neural pathways of the brain by blocking the opioid receptors and then the effects of endorphins.
According to the Sinclair method, which prescribes the use of naltrexone one hour before drinking, the drug can also prevent the euphoric effects of alcohol and excessive consumption after drinking begins. Over time, naltrexone’s blocking of this euphoric effect can lead to the disappearance of pharmacology and the elimination of alcohol cravings.of
Some researchers have found that combining medication and behavioral therapy, as well as participating in mutually supportive groups, is the most effective way to prevent the relapse of drugs and alcohol.