What is relapse?

Opioid use disorder (OUD) is difficult to manage and associated with an exceptionally high rate of relapse, or "return to use." However, there is good news, as medications for addiction treatment (MAT) are improving and showing promise for patients.

If you are worried about OUD relapse, educating yourself about the risk factors can help you take preventative steps. Learn more about relapse, what it entails, and what you can do to help mitigate the risk below.

Understanding relapse

Relapse refers to the return to active substance use following a period of reduced use or total abstinence. It is more common during the recovery process than many people realize. In fact, relapse is considered indicative of OUD's chronic nature.

Potential risk factors for opioid relapse

Why do people experiencing addiction relapse? Opioid relapse can occur for various reasons. There are many triggers, both external and internal. Examples of external triggers include:

• Places: Places that you associate with opioid use, such as a friend's home where you frequently used, can be triggering.
• People: People can also contribute to opioid relapse, especially individuals who you once used with.
• Activities: Certain habits, like having a drink with friends you once used with, can be triggering as well.

Examples of internal triggers include:

• Stress: Stress often leads to unhealthy coping mechanisms, which can increase the risk of a relapse.
• Overconfidence: People who don't realize that OUD is a chronic condition and think everything is "under control" may end up in triggering situations.
• Mental or physical illness: Mental illness, like depression or anxiety, as well as physical illnesses—often those that cause pain—can trigger relapse.

Additionally, there are a few things that make a person even more likely to relapse than usual. The opioid relapse rate may be higher for people who have used high opiate doses, don't seek aftercare, or have a history of intravenous opioid use.

How to reduce the risk of relapse

Recognize your triggers

One important step toward reducing the risk of relapse is recognizing your triggers. This is the first step in avoiding them because it requires you to change old habits, from where you spend your time to who you spend it with. Although challenging, these lifestyle changes are just as important to successful OUD treatment as other steps, like taking medication.

Use medication

Certain medications, including naltrexone, methadone, and buprenorphine, can help to reduce the risk of relapse. These medications work by reducing withdrawal symptoms that may otherwise encourage relapse, such as:

• Abdominal cramping
• Agitation
• Anxiety
• Diarrhea
• Dilated pupils
• Goosebumps
• Muscle aches
• Nausea
• Increased tearing
• Insomnia
• Runny nose
• Sweating
• Vomiting

Seek mental health support

Although helpful, taking medication alone is rarely enough. You can further reduce the risk of relapse by getting the appropriate mental health support. This is especially important for people who live with other mental health issues on top of their addiction.

Maintain a positive support system

It’s also important to have a support system when battling OUD. Although surrounding yourself with non-sober people can increase your risk of relapse, surrounding yourself with sober people can do just the opposite. Sober friends and family can be helpful resources. The BARC-10 assessment is a helpful tool that people can use to understand their social resources during treatment and recovery.

Additionally, joining a support group can provide comfort. Going to group meetings, counseling, or even getting a sponsor can help immensely. 

Can Suboxone® reduce the risk of relapse?

Suboxone is the brand name given to the combination of buprenorphine and naloxone (important safety information). Buprenorphine partially activates the brain's opioid receptors, while naloxone acts as an opioid antagonist, blocking the brain's opioid receptors and thereby blocking the effect of the opioids.

Taken as prescribed, Suboxone reduces the risk of medication misuse. It reduces opioid cravings and minimizes withdrawal symptoms. Combined with mental health support as part of a comprehensive MAT program, Suboxone is considered the gold standard of care in OUD treatment. In some cases, it's even used for the long term.

Ophelia helps make Suboxone easily accessible by providing MAT online. Eligible patients can have a prescription called into their local pharmacy while getting mental health support online.

What to do if relapse occurs

If opioid relapse occurs, stop using immediately. That can obviously be easier said than done, but if you continue opioid use, you'll have to go through the detox process again. This can be a physically and mentally taxing process that sometimes requires inpatient care.

It's also important to be open about your relapse. Contact a support person, whether it's a therapist, care provider, or friend, to let them know. Having someone by your side to support and reassure you post-relapse is helpful in making sure you quit using and avoid future temptation.

Come up with a treatment plan, ideally with the support of a qualified care provider. This could involve identifying your triggers, recognizing your personal warning signs of relapse, and knowing what to do when a warning sign arises. For example, you might have a go-to sober buddy who you call when you're around a trigger. Your treatment plan may also include things like taking medication or joining a support group.

Finally, don't be too hard on yourself. Remember that OUD is chronic. You can't treat it once and then expect to feel better forever. Accept that you may need to get additional treatment to help prevent future relapse. For example, if you haven't yet tried MAT, now may be the time. Just remember that in order to receive the most accurate help, it’s important to be honest and open with your provider so they can craft a personalized plan if a relapse occurs.

If you have relapsed and are seeking support, Ophelia is here to help. We make MAT accessible to patients, providing both Suboxone prescriptions and comprehensive care online. By addressing both the mental and physical sides of addiction, our clinicians can help patients reduce the risk of relapse. Contact us today to find out if you’re a candidate.