A message from the Office of the Chief Medical Officer and the Office of the Chief Nursing Officer
“One heart and one mind includes people who are healing, people who use substances." ~ Len Pierre, FNHA Cultural Advisor Harm Reduction
Reducing or quitting substance use—whether it be alcohol, opioids, stimulants, prescription medications, marijuana, commercial cigarettes, refined sugar, or coffee—is a major achievement.
Those of us who have done so know that it takes a lot of work and perseverance, as does making any healthy change to our lifestyle, such as adding regular exercise. We also know that the path to change is not straightforward, but often involves stopping, falling, or even backtracking before continuing onwards.
The recovery journey can be understood as a process of change through which we can improve our health, live a self-determined life, build resilience, and build or re-build satisfying and meaningful relationships. In the early days of making lifestyle changes and recovery, people can go through a lot of emotions.
Recovery is a desired journey and can be exciting as well as anxiety-filled during the first few steps. People in early recovery are learning new skills and ways to cope, and this takes a lot of practice. People on recovery journeys work to understand their reasons for using—including distress, mental health concerns, and different traumas in their lives.
These experiences and circumstances are often still stressors, and still need to be addressed, but with healthier coping mechanisms than using substances. As this is accomplished, the healing happens.
Stress and Relapse
Setbacks and relapses are quite common and can be difficult emotionally, but they can be understood as a normal part of recovery at any point of the journey. They often occur because of stressors.
This year has brought a new and additional stressor to people on recovery journeys with the onset of the COVID-19 pandemic. It has increased the amount of time we spend inside, at home alone, or with family members.
It has increased a lot of unknowns most people have never experienced before, including (but not limited to) job security, personal safety, and a marked reduction in social gatherings and interaction.
All of these factors can increase stress in relationships or cause loneliness, creating the urge to relapse. (Click here for tips on cultivating and using the medicine of resilience.)
A single-use relapse to a substance, or a “slip-up," can be seen as a learning opportunity, i.e., a chance to identify stressors or mental health concerns that need attention and healing.
Frequent relapses signal the need for re-engagement in substance-use treatment with a primary care practitioner, a recovery network, or a doctor or nurse who specializes in substance use. It is helpful to view even this kind of relapse as an opportunity to learn from the experience and to explore how this learning can build resiliency and develop or refine recovery skills for the journey.
Preventing relapse takes planning
Planning ahead for family gatherings or social events is important to prevent relapse, especially if substance use will be involved.
Bring non-alcoholic alternatives, set a time to leave before feeling tired (which can impair judgment and decision-making), and do what you can to avoid known stressors and emotional triggers.
Restoring or maintaining balance by taking care of your basic needs such as sleep, hunger, social connection, and spirituality, will all help prevent relapse, as will working to develop resiliency and new coping skills.
Always think ahead about how a situation may exacerbate mental health or trauma issues that caused the substance use, and about how to help yourself cope in a healthier manner.
When an urge to use does come up, check with yourself to see if the urge is causing irrational thinking. According to Dr. Thomas Horvath, President of SMART Recovery, there are four common misconceptions or faulty beliefs about urges:
1. Urges are excruciating or unbearable.2. Urges can compel you to use.3. Urges will not go away until you drink or use.4. Cravings and urges will drive you crazy.
1. Urges are excruciating or unbearable.
2. Urges can compel you to use.
3. Urges will not go away until you drink or use.
4. Cravings and urges will drive you crazy.
To get past urges, SMART Recovery teaches that we need to believe the truth, not these misconceptions or our feelings, which often lie to us. And the truth is: We can stand them, they are time-limited, they don't make us use or drink, and nobody goes crazy or dies because they want to drink or use drugs.
Recovery takes practice
Finally, when a relapse occurs, it is important to tell yourself that this does not mean you or the person relapsing is weak. Stay focused on helpful thoughts and beliefs to avoid the emotional consequences of relapse such as lost hope, self-criticism, and other unhelpful thoughts.
Responding to relapse with a non-judgmental, compassionate approach can support you or someone who is responding to relapse in a supportive, loving, and helpful way.
Let's remember that substance use and recovery from substance use takes time, practice, lots of effort and support to stay healthy. Each step towards recovery, reduction, abstinence, or a healthier life is reason to celebrate and be proud. Keep on going: You are worth it.
For more information about relapses:
• British Columbia Centre on Substance Use. (2018). From Grief to Action: When Addiction Hits Home. https://www.bccsu.ca/wp-content/uploads/2018/11/Coping-Kit.pdf• SMART Recovery. (2020). Smart Recovery Toolbox. https://www.smartrecovery.org/smart-recovery-toolbox/• FNHA website: recovery supports and resources during the pandemic