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Wednesday, August 26, 2009

Comments

I would like to comment on the relapse article and also to solicit feedback. It's my understanding that Sheff went to numerous 12-step treatment facilities, where it is not uncommon to be told that any use of any substance whatsoever is a relapse. Therefore, with his first "slip" (as I recall it began with taking some pills from his mother's medicine cabinet), the abstinence violation effect went into full effect and he figured he had already blown it and may as well go "all the way."So part of the problem is addressing what clients are taught in the first place about the concept of a lapse versus a relapse.

Clients are also commonly taught that, even if they never had any problem with a particular substance (e.g., alcohol, in the case of a pot-dependent person), use of the nonproblematic substance is still considered a relapse because it will increase the odds of a full-fledged relapse. I am seeking research supporting this notion.

Anne M. Fletcher
Author, Sober for Good

As a former worker in the UK alcohol treatment field, my view is that relapse prevention is the core business of any service for drinkers.
I do however feel sympathy for the predicament of ex-drinkers (& users) who, while working hard to completely reorientate their lives are condemned to chronic, respectable sobriety. Not only do the rest of us take for granted the pleasure - or release - of a temporary holiday from the mundane provided by alcohol, cannabis or whatever our drug of choice may be, it has been argued (by Andrew Weil & many subsequent authors) that is a basic human appetite - but one that those "in recovery" are forbidden to satisfy.
Should relapse prevention therefore include instruction self-induced euphoria? After all, aren't most of the benefits we attribute to psychotropic drugs placebo effects anyway?

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