Relapse should not be taken lightly. Addiction is a deadly and progressive illness, like cancer and diabetes, and should be treated as such. A relapse in either of those diseases can throw an individual and their families into a state of turmoil and possible death; and so can addiction. In fact, for opiate users the most common reason they overdose is the yo-yo on again off again use where their tolerance is lowered but they are using the same dose as usual. There are many studies following relapse and most of the numbers show that about 85% of addicts (including alcohol addicts) relapse in the first year. That is a staggering number. There are several reasons for this, one of them being that people are entering treatment at younger ages than ever before and are not as beaten down and ready to surrender as people who were seeking treatment in their later years after losing a great deal. However, there is also the population who earnestly seems to want to get better but they still struggle. This has piqued the interest of many researchers and providers in the field, including myself.
There are, of course, the internal reasons addicts relapse that are out of our control. They have an unwillingness to take suggestions, they think they know what is best for them, or they simply are not ready to stop yet. Those are hard to measure and predict mostly because only the addict knows where they are with that and addicts are notorious liars, making it difficult to gather data and accurately research. However, in the last decade or two our technology to study the brain has advanced dramatically; and while the families of addicts might argue this, every addict has a brain. Therefore that gives researchers something to study and measure.
There are several studies following people over the course of years to look for patterns and possible neuro-biological (brain & body) predictors of relapse. In that research are some fascinating discoveries. For example one study (Sinha, 2013) found individuals with a naturally low tolerance for stress, indicated by naturally high levels of our stress hormone cortisol, relapsed more frequently than those with lower levels. The more stressed we are, the more cortisol is released. Most addicts have what I refer to as a “fragile stress tolerance” and this research is finding there are individuals within the addict population that have an even more fragile tolerance to stress. It is important to remember that stress to an addict in early recovery is not the same as someone who has not been avoiding, numbing, and enhancing their emotions for many years. I have been sober for many years and can tolerate the days I wake up in an off mood. However, for someone in early recovery that doesn’t have a large tolerance for emotions waking up in an off mood may be overwhelming to them. All emotions can be summed up as stress, even positive ones, and if addicts don’t have the ability to withstand stress they are more prone to relapse.
Another area that I find interesting is the discovery that addicts with lower levels of grey matter in the brain relapse more often. A study that scanned the brains of patients as they entered rehab measured their grey matter levels and found relapse occurred more often than the patients that had less grey matter. Grey matter is a major component of our nervous system and helps regulate muscle control and perception; specifically seeing, hearing, memory, emotions, speech, decision making, and SELF- CONTROL. If you know an addict how many times have you questioned, or been baffled by, their perception and decision making?Grey matter is crucial to all these systems working together.
Now one might be asking, “What can we do about naturally occurring deficiencies in grey matter and increased levels of cortisol?” There is actually a lot we can do. We are a society quick to jump to the solution so medication is always a convenient option, and sometimes a necessary one. However, with the same technology they use to understand addiction and many other diseases researchers are studying meditation; and the results cannot be ignored. There are many types of meditation but much of the research I am referring to in this article is about mindfulness meditation. The simple, yet difficult, practice of just noticing one’s breathing. The research has proven that mindfulness meditation can lower the heart rate, release endorphins, and decrease cortisol levels. Also, since mindfulness is not about escaping an emotion but sitting with it and letting it pass it builds an individual’s tolerance for emotions. How many cancer and diabetes patients do you think would meditate if they were told it could actually lower their chances of relapse? The research is also finding that meditation can increase grey matter in the brain, which also naturally decreases with age. They scanned the brains of people who had been meditating long term and found 50 year olds with the grey matter of 20 year olds. That is pretty remarkable; we can actually change our brain and our body through meditation.
My own experience with meditation is just that, since I devoted myself to practicing mindfulness about 5 years ago my life, health, and spirituality has completely changed. Even being 12 years sober at the time I had to admit I did not know how to actually meditate so I sought out to learn. Find what works for you, mindfulness is kind of the buzz right now so there is a lot out there. My suggestion is to start small. There is a great CD called “Meditation for Beginners” by Jack Kornfield, one of the great teachers of meditation. I would suggest only listening to tracks 3 and 4 on disc one until you have the breathing down. That took me 2 years by the way and still can be difficult if I do not practice living mindfully throughout my day.
Whether you are an addict reading this, family of an addict, friend, or professional working with addicts anybody can benefit from meditation. We live in the era of anxiety and your grey matter is deteriorating as you read this so try a month of 5-10 minutes a day and see how you feel.
Thank you for reading and sharing,
Curtis Buzanski, LMFT, LAADC