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Understanding Opioid Relapse

An opioid relapse is defined as returning to use of an opioid after a period of abstinence. Opioid relapses are common though and happen to many people in recovery, but they’re also dangerous. Recovery from opioids involves a life that is free from opioids use, but because opioids are so addictive, quitting them can be very difficult.

Many people are faced with an uncontrollable urge to use opioids after they stop, especially while in early recovery. The trouble is that even people with years of sober time may slip-up, and use opioids. Due to the nature of addiction, certain triggers, or old habits can make opioids a lifelong struggle.

A relapse is discouraging for both an individual and their families, but it doesn’t necessarily mean that they’ve failed in recovery. Relapse might mean that an individual needs to go back to the drawing board and consider what made them want to use drugs again. If a person relapses, it’s critical for them to get back into a healthy routine as soon as possible, to avoid falling back into addictive behaviors.

People with opioid addiction (opioid use disorder) suffer from a chronic illness, which means that relapsing at some point is not only possible but likely. Relapse rates are similar for people with opioid addiction to the rates of well-understood chronic illnesses like hypertension, diabetes, and asthma.

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Signs Of An Opioid Relapse

Leading up to, and after the fact, if an individual relapse they may start spending a lot of time alone, or becoming easily agitated. If a person starts showing signs of opioid use, it may be time to intervene. Being able to tell if a person is on opioids can be especially trying for someone who hasn’t ever seen them in the throes of their active addiction.

Some of the most common signs of an opioid relapse are:

  • slurred speech
  • nausea
  • small pupils
  • weight loss or weight gain
  • reduced sex drive
  • spending a lot of time alone
  • dishonest, manipulative, and secretive behaviors
  • loss of interest in healthy behaviors, or passions
  • extreme mood swings – irritability
  • unexplainable need to borrow money
  • the belief that support is no longer needed, or that the problem “wasn’t that bad”
  • belief that a person can return to moderate opioid use without circumstance
  • associating with people who actively use opioids
  • the reappearance of unhealthy behaviors – such as poor diet, and lack of sleep

Those in recovery may be ashamed to admit that they’ve fallen back into opioid use, but it might just mean that they need to invest more time into their recovery program or consider a different approach.

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Opioid Withdrawal Symptoms

Opioid dependence is caused by certain brain abnormalities caused by the recurrent use of the drug. Opioids include a wide range of natural, partially synthetic, or fully synthetic drugs like heroin, codeine, oxycodone, hydrocodone, fentanyl, morphine, and methadone.

A person who’s dependent on opioids feels a physical craving for the drug because when they stop using them, they experience painful withdrawal symptoms. Withdrawals are essentially a body’s physical reaction to the removal of a chemical that, as far as the brain and body are concerned, is needed for normal functioning. Opioid withdrawal symptoms may include:

Early symptoms of withdrawal:

  • agitation
  • anxiety
  • muscle aches
  • increased tearing
  • insomnia
  • runny nose
  • yawning
  • sweating

Late symptoms of withdrawal:

  • abdominal cramping
  • diarrhea
  • dilated pupils
  • goosebumps
  • nausea
  • vomiting

“The abnormalities that produce dependence, well understood by science, appear to resolve after detoxification, within days or weeks after opioid use stops,” (National Institute on Drug Abuse).

Can Opioid Addiction Be Treated?

Opioid addiction is considered treatable by using psychosocial and behavioral therapy and for some a medication-assisted treatment (MAT) with buprenorphine, naltrexone, or clonidine. Yet there isn’t a single, or simple way to treat addiction, nor is there a proven cure for it.

One issue with treating opioid addiction is that it affects each person differently. A treatment program that’s based on individual needs may be necessary to completely abstain from opioids.

Many people in recovery will find themselves romanticizing about past drug use, or see something that causes them to have a sudden urge to use opioids—these are known as triggers. Behavioral treatments aim to teach patients both how to identify and avoid triggers, and how to cope with stress, pain, loss, and emotions.

The brain abnormalities that produce opioid addiction range much wider than opioid dependence, and may include environmental, psychological, or genetic factors. The physical and mental components of addiction can be treated at a rehab center, but recovery from addiction requires changing environmental, and social factors as well. Recovery from opioid addiction requires living a full, purposeful life, on top of behavioral treatments.

Opioid Relapse Prevention

To help prevent relapse, many people find that it helps to keep learning about drug addiction and to be honest and open about emotions, temptations, or expectations in recovery. As far as avoiding places that may cause a trigger, sometimes it helps to ask if there’s a good reason for being there. Many people find that getting involved in a support-based community gives them accountability, and the drug-free relationships they need to stay off opioids.

Those suffering from opioid addiction need support, guidance, and change to remain abstinent from the drug. As part of a person’s recovery support team, it’s important to stay positive about their recovery. Do whatever it takes to help them: whether it’s driving them to counseling appointments, or meetings, and not simply writing off strange behaviors.