Countering The Abstinence Violation Effect: Supporting Recovery Through Relapse

However, it is also possible that adaptations will be needed for individuals with nonabstinence goals (e.g., additional support with goal setting and monitoring drug use; ongoing care to support maintenance goals), and currently there is a dearth of research in this area. An additional concern is that the lack of research supporting the efficacy of established interventions for achieving nonabstinence goals presents a barrier to implementation. A focus on abstinence is pervasive in SUD treatment, defining success in both research and practice, and punitive measures are often imposed on those who do not abstain. Most adults with SUD do not seek treatment because they do not wish to stop using substances, though many also recognize a need for help. This narrative review considers the need for increased research attention on nonabstinence psychosocial treatment of SUD – especially drug use disorders – as a potential way to engage and retain more people in treatment, to engage people in treatment earlier, and to improve treatment effectiveness.

Overcoming Setbacks: Building Resilience in Recovery

Another possible outcome of a lapse is that the client may manage to abstain and thus continue to go forward in the path of positive change, “prolapse”4. Many researchers define relapse as a process rather than as a discrete event and thus attempt to characterize the factors contributing to relapse3. By implementing certain strategies, people can develop resilience, self-compassion, and adaptive coping skills to counteract the effects of the AVE and maintain lifelong sobriety. The Abstinence Violation Effect is a psychological phenomenon that occurs when a person experiences relapse after attempting to abstain from drug or alcohol use. When someone abuses a substance for a long time, they will have a higher tolerance for its effects. It is for this reason that someone’s tolerance declines following a period of abstinence and that they may overdose if they start using again at the same level as before.

Develop Coping Skills

• Clinicians in relapse prevention programs and the field of clinical psychology as a whole point out that relapse occurs only after a long-term pattern of specific feelings, thoughts, and behavior.
• For example, someone who has been on a diet might have a small slip-up and then binge on unhealthy foods.
• The AVE process typically involves a triggering event or cue, such as encountering a tempting situation, feeling stressed, or experiencing a moment of weakness.
• In the 1980s and 1990s, the HIV/AIDS epidemic prompted recognition of the role of drug use in disease transmission, generating new urgency around the adoption of a public health-focused approach to researching and treating drug use problems (Sobell & Sobell, 1995).
• Unfortunately, few quantitative, survey-based studies have included substance use during treatment as a potential reason for treatment noncompletion, representing a significant gap in this body of literature (for a review, see Brorson, Ajo Arnevik, Rand-Hendriksen, & Duckert, 2013).

It emerges when someone interprets a lapse as evidence of moral failure, lost hope, or proof that recovery is impossible. This common risk factor is something mental health professionals at ReachLink work diligently to address, as this mindset generally undermines future success. Evidence of the abstinence violation effect can be seen in any individual who attributes a lapse and subsequent relapse to entirely uncontrollable conditions, such as a perceived character flaw or adherence to the constraints of addiction. In realistic, healthy approaches to addiction recovery, relapse is seen as a very real possibility, and actions are taken to the abstinence violation effect refers to minimize the risks involved. An important part of this process involves developing self-awareness and creating a thorough understanding of what triggers the desire to engage in certain behaviors.

How to Spot a Narcissist on Social Media: Red Flags You Can’t Ignore

The abstinence violation effect (AVE) describes the tendency of people recovering from addiction to spiral out of control when they experience even a minor relapse. Instead of continuing with recovery, AVE refers to relapsing heavily after a single violation. I’ve heard of AA meetings where a member with over 10 years of sobriety ends what is alcoholism up drinking (let’s say as an attempt to cope with the loss of a loved one or other tragic event). Many would rather keep on drinking rather than come back to a primary source of support in shame. It seems akin to failing one exam during senior year in high school and being sent back to first grade as a result! AVE and its emotional and cognitive components should be explored and addressed as part of CBT.

Regarding SUD treatment, there has been a significant increase in availability of medication for opioid use disorder, especially buprenorphine, over the past two decades (opioid agonist therapies including buprenorphine https://mmtvc.ac.ke/teen-alcohol-and-drug-use-keeps-declining/ are often placed under the “umbrella” of harm reduction treatments; Alderks, 2013). Nonabstinence goals have become more widely accepted in SUD treatment in much of Europe, and evidence suggests that acceptance of controlled drinking has increased among U.S. treatment providers since the 1980s and 1990s (Rosenberg, Grant, & Davis, 2020). Importantly, there has also been increasing acceptance of non-abstinence outcomes as a metric for assessing treatment effectiveness in SUD research, even at the highest levels of scientific leadership (Volkow, 2020).