Relapse…If you keep up with the SBB you know by now that addiction is a chronic (long-lasting) disease that takes hold in some people who abuse drugs. You may also know that some people can quit their drug use. But often a person will return to using drugs after they have quit. This is what NIDA Scientists call a relapse.
Why does it happen? Addiction changes the wiring of the brain to cause uncontrollable craving and compulsive drug use—despite the consequences. For someone with an addiction, going without the drug for periods of time can make that person feel so anxious and stressed that they need the drug just to stop feeling bad.
A person who is addicted to a drug usually needs professional treatment to quit drug use. This can include medication or "talk therapy (PDF, 1.19 MB)," or a combination of both. It also helps to have support in the family and the community. While quitting drug use is possible, addiction is a long-lasting disease, and treating it takes time-and just because someone gets treatment and stops using a drug does not mean that these strong cravings go away for good, especially when certain cues are present. These cues vary from person to person and can trigger a relapse.
Imagine that your best friend is addicted to cigarettes and says she smokes to relieve stress, but that she recently quit because her boyfriend hates the smell of cigarette smoke. Since she has connected cigarette smoking with stress relief, the next time your friend faces a stressful situation, like a fight with parents or final exams, she will most likely crave a cigarette, increasing her risk of a relapse. Her use of cigarettes, which led to an addiction to nicotine, has also caused her to associate "relaxation" with cigarettes.
Not everyone will relapse once they have quit drug use; it depends on the person, their genes, their environment, and many other factors, including personal commitment and family support.
What's the first thing that comes to mind when you hear the word disease? You might think of cancer, diabetes, or epilepsy. But do you think of drug abuse? Probably not. But, for some people, drug abuse can lead to a disease called addiction.
A disease is when something in the body doesn't work like it's supposed to-an organ or a whole system has something wrong with it and disrupts functioning. Diseases can be caused by many different factors, from your genes (what you inherited from your parents) to germs and viruses to not getting the vitamins that your body needs to stay healthy.
Some diseases can be cured with medication or changes in lifestyle and may never come back. Others are chronic diseases, meaning they last for a long time or can come back again.
Addiction is a chronic disease. Drugs change the way the brain works, and using them can lead to addiction. Once a person is addicted to a drug, they feel the need to take that drug over and over just to feel like their "normal" self. Tracking down and taking the drug usually becomes more important than eating, sleeping, dating, doing school work, or earning money.
Even if they stop using drugs, people with addiction have brains that have been chemically altered, making them vulnerable to relapse (resuming drug use).
To learn more, take a look at The Science of Addiction. Share something you didn't know before.
Musician Elton John recently said he’s been helping rapper pal Eminem work through his problems with substance abuse.
Eminem (aka Slim Shady and, before that, Marshall Mathers from Detroit, MI), was in treatment for substance abuse in 2005. Since then, he has abused prescription drugs like Vicodin, Ambien, and Valium. Some bad things happened after 2005, and maybe that led him to start abusing drugs again. In December 2007, he was devastated when his marriage ended and his closest friend and fellow rapper DeShaun “Proof” Holton died. Eminem was even hospitalized for overdosing on methadone. Then in early 2008, he began a program to recover from his addiction, and he says he’s been off drugs since April 2008.
Skip to now…if you read the lyrics on his latest album, called “Relapse,” Eminem continues to glorify drug use and violence, even while he himself is trying to stay sober. So, here’s a question for you:
Does artistic expression mean you can say whatever you want, even if you know you could be influencing others to hurt themselves by taking drugs?
Elton John has acknowledged his own problems with substance abuse in the past. He says he wants to be there now to help anyone who has addiction problems. It’s good that Eminem has a more experienced artist like Elton John to guide him through this personal struggle. Wouldn’t it be great if this true friend could also help Eminem use his talents to contribute a positive musical message to the world?
Most people know that addiction, can be overcome with treatment. But like many other diseases, it is often a winding road to get there. So, what are the steps to a healthier, drug-free life?
Seek treatment. The first step to recovery is to decide to seek treatment. It’s hard for people to recognize or admit they have a problem, even when they are putting their lives – or the lives of others – at risk. It doesn’t help that the brain’s decision-making center is impaired when under the influence of drugs or alcohol. Treatment may mean medications, behavioral counseling, or a combination of the two.
Learn new habits. Relapse (or returning to drug use) is common with addiction and is an expected part of treatment. Returning to the people, places, or things associated with former drug use can actually trigger relapse—before the addicted person is even aware of it. Behavioral therapy can teach the person in recovery to avoid these triggers and learn new coping skills so they can make better decisions.
Take it one step at a time. Recovery takes time. Treatment works best when it is long-term, at least 90 days in most cases. And because people treated for drug addiction are vulnerable to relapse even after they’ve been off drugs for a long while, most treatment professionals would say that someone with a past drug or alcohol problem is “in recovery” for a lifetime.
Find treatment. If you are interested in finding drug abuse treatment for yourself or a friend or family member, look up facilities near you by using the Substance Abuse Facility Treatment Locator, provided by the Substance Abuse and Mental Health Administration.
My name is Sarah and before my high school senior year, I spent a summer at NIDA as an intern with the Center for Clinical Trials Network (CCTN). Never heard of it? Neither had I. I discovered that the goal of the CCTN is to improve the quality of drug abuse treatment throughout the whole country by doing safe and interesting scientific studies with humans. By the way, human studies are called “Clinical Trials.” These are trials or tests done to evaluate the effectiveness and safety of different medications or approaches by monitoring their effects on large groups of people, like a big “clinic” full of patients, but in a research setting.
As the name implies, the CCTN works as a network that includes scientific investigators all over the country. These investigators work together to develop and carry out clinical trials to evaluate behavioral and medical treatments for drug addiction, and to discover new ways to make existing treatments more effective.
So what did I learn about clinical trials? Clinical trials provide the best standard for demonstrating that a certain behavioral treatment or medicine really works and is also safe for humans. In the area of drug addiction, there is a great need for safe and effective treatments that are tailored to the specific addiction, such as heroin, cocaine, or marijuana.
I also learned that drug addiction is a chronic, relapsing condition. It may be easy to break one cycle of addiction, but it is very difficult to keep the patient from falling into another. One analogy is to think about the obese patient who can lose weight in the short run, but over time experiences many cycles of weight loss and gain, without really achieving an ideal body weight.
In a similar way, the addicted patient will receive successful treatment to break the addiction, but will continue to have cycles of relapse, requiring further treatments. The addicted patient might have a relapse towards the initial drug, but it can also be for a new substance or a combination of substances (e.g. initial addiction to marijuana, then addiction to opiates, then addiction to opiates and prescription drugs). Thus I discovered the true goal of the CCTN is to promote the development of treatments, or a combination of treatments, that will not only treat the addiction, but will also prevent future relapses.
More on clinical trials
While clinical trials are a way to develop new treatments and advance the scientific and clinical knowledge base from humans who volunteer to participate, I also learned that the volunteers themselves can benefit from their participation in clinical trials. For example, patients with difficult diseases like cancer can participate in a clinical trial in hopes of finding a cure, or at least a more effective treatment.
For more information on clinical trials, NIH maintains a clinical trials registry known as ClinicalTrials.gov, which contains information on trials supported by federal funds. There you can find information about a trial's purpose, who may participate, locations, and more.
Many of you probably heard that the European tour just launched by the talented Amy Winehouse has been canceled after fans watched the diva stumble under the lights in Serbia. Reports say audience members in Belgrade booed her off the stage Saturday night just a few songs into the first concert of the tour when she couldn’t even remember the lyrics to her own songs. The Grammy winner was scheduled for a dream tour—to Istanbul, Athens, Spain, Switzerland, Italy, Austria, Poland, Hungary and Romania—but those dates have all been cancelled. The Serbian media called the concert a "scandal," with Belgrade’s daily newspaper calling it "the worst performance in the history of Belgrade."
It is ironic that Amy Winehouse became famous for her song "Rehab," where she sang: "They tried to make me go to rehab. I said 'No, no, no.'" After the song became a hit, she actually said “yes” to drug and alcohol rehab in London, where she stayed for a month. If she has turned again to drugs, people will ask the same questions about if rehab works, and why big stars risk everything for drugs…
We’ve talked about rehab before, but Amy Winehouse’s struggle highlights what rehab is all about: addiction is a chronic disease, which means it has to be managed throughout your whole life. People relapse to drug addiction just like they do with other chronic illnesses like diabetes, hypertension, and asthma. To successfully treat a chronic disease, you have to change deeply imbedded behaviors—and that takes practice. For example, a diabetic has to learn how to manage a restricted diet, just as a person struggling with addiction has to learn how to manage cravings. Relapse does not mean treatment failure, but that treatment needs to be adjusted or changed altogether.
Sadly, many people are able to hide their addiction from the world and never get help. For famous people, every slip is recorded by fans and posted for millions to see. But famous or not, being successful in recovery takes a lot of support—which it sounds like Amy Winehouse has. Her representative put out this statement: "Everyone involved wishes to do everything they can to help her return to her best and she will be given as long as it takes for this to happen."
R.I.P Amy Winehouse 1983-2011
Poet and playwright T.S. Eliot said, “A play should give you something to think about.” That’s exactly what happens with a new NIDA project—called the Addiction Performance Project. It illustrates the emotional toll drug addiction takes on people and their families and gets the audience to talk about it. At a recent performance, award-winning professional actors, including Debra Winger, performed a dramatic reading of Act III of Eugene O’Neill’s Long Day's Journey Into Night. Based on O’Neill’s own family, this play shows how, over the course of just 1 day, a family can fall apart when addiction rules over it. In this family, the mother is addicted to morphine and starts abusing it again, and the father and sons, who are alcoholics, drink to cope with her relapse. By putting a human face on addiction, the Addiction Performance Project helps break down the stigma—or discrimination and judgment—associated with this disease. The Addiction Performance Project reading is followed by a discussion with scientists, doctors, and medical students on the challenges and opportunities in treating people who are addicted to drugs. Watch the video below to see snippets of the Addiction Performance Project, performed here by Blythe Danner (Gwyneth Paltrow’s mother) and other actors.