Addiction is a persistent illness for which there is no cure. Even when people who suffer from substance use disorders are successful in achieving sobriety, they will, in almost every case, experience ongoing urges to use those substances. There can be many factors that lead to these urges, which if left unaddressed can lead to relapse. Relapse rates for people who have received treatment for a substance use disorder hover between 40 and 60 percent.1
When the stress hormone corticosterone is elevated, it increases dopamine activity in the brain. It also raises responsiveness to cocaine. The research team simulated human drug use by letting rats self-administer cocaine before withdrawing the supply.
After a cocaine-free period, the rats were given a very low dose of cocaine. Some of them were then stressed by being given mild electric shocks. The stressed rats relapsed to trying to get more cocaine, while the unstressed rats did not. The results corroborate evidence from people who relapse and cite stress as a contributing factor.
In the Marquette University study, the administration of a low dose of cocaine was the trigger that made the rats want to use cocaine again. A key part of treatment for substance use disorders is helping those who are afflicted with the illness to identify triggers that may lead them to relapse.
Triggers can take many different forms. They can be environmental, psychological or physical. People who have successfully gotten sober may relapse if they are in an environment where others are using substances.
Emotional highs and lows can also trigger a relapse. When celebrating happy occasions like the arrival of a new child or a wedding, people recovering from substance use disorders may feel an increased urge to use. Likewise, bereavements or other unpleasant events can trigger the same urge.
Other Factors Affecting Relapse Rates
Many experts believe that changes in the brain’s structure and chemistry as a result of substance use play a role in relapse rates. A report by a team from the Behavioural and Clinical Neuroscience Institute of Cambridge University reveals that alterations to neural structures in the brain seem to cause the compulsive behavior to remain, even after long periods of abstinence.3
Education level may also play a role in relapse rates. Analysis of data from two studies showed that people who did not complete high school tended to relapse more frequently than those who had college or graduate degrees.4
Many experts use the term “in remission” to describe people who have achieved sobriety. As with other chronic and progressive medical conditions, remission may not be a permanent state. Remission and relapse are often a recurring cycle.