Motivation to change, for any behavior or habit, isn’t just about desire and self-control. Motivation is ever-changing. At any given moment, something else can take priority. You are affected by a multitude of needs and wants, both yours and the people in your orbit.
The month of January is full of discarded new year’s resolutions. What behavior or habit have you tried to change, and how successful were you? How many times did a particular goal show up on that list of resolutions? If you’re like many people, permanent change is elusive. You try, fail, try again, and fail again. (It isn’t really a failure, rather a lack of readiness to accomplish your goal.)
Now imagine someone working at recovery. Addiction is a disease of the brain, and recovery is more complex than keeping your desk clean or getting enough exercise . Dr. Stephen Gilman, MD, an addiction specialist in NYC, states that ‘there is a high rate of relapse for opiate addiction. At one year after stopping opiates, there is an 85% chance of relapse.” With other substances there is a wide range. “Alcohol relapse depends on the individual, but can range from 30-70%.”
Those are staggeringly high numbers. If your loved one has been in and out of treatment centers, you understand these statistics. How do motivation and other factors affect recovery?
First understand that treatment is step one of recovery. A person undergoing 30, 60 or 90 days of treatment is ridding his body of substances and beginning to understand the disease and what brought him to substance use. He may also be learning new strategies for living clean and sober.
Keep in mind, though, that a residential treatment program is a bubble of sorts, where the responsibilities and stressors of everyday life are absent. Most of the people, places, and things that trigger the desire to use are outside the bubble. It’s easier to have a higher level of motivation while in treatment.
Now your loved one leaves treatment, and hopefully, his motivation to stay clean is high. If he doesn’t go on to an IOP (intensive outpatient program) or sober living home, there is nothing between him and the world where it all started. Even if he does have a transitional program, there are no guarantees he will be able to maintain long-term recovery. This is the nature of the disease of addiction. It is unlike many other diseases where following a regimen and taking your meds can cure you.
What are risk factors for addiction relapse?
Dr. Gilman goes on to say, “A powerful need to stimulate reward centers within the brain can be the trigger point for an addict who is used to getting a certain drug. Both external and internal factors can create the urge to use drugs or alcohol again.” In other words, things happen and thoughts occur that are difficult to deal with, and the brain craves something, the drug, to alleviate the pain.
This need can far outweigh motivation, logic and knowledge about the dangers of addiction and relapse. The brain knows what it needs and is determined to get what it wants.
Upon returning to the ’real’ world, your loved one faces many challenges, things that may seem ordinary and more manageable to you:
* bouncing back from stress or sadness
* fatigue due to the mental and emotional effort required to make healthier choices
* the social acceptability of drinking
* isolation and feeling different from others
* the expectations of ‘normal’ life from family and friends
What helps a person with Substance Use Disorder (SUD) keep his motivation up to maintain a clean, sober and fulfilling life?
* ongoing supports such as IOP, sober living, NA, AA, Smart Recovery, therapy, recovery coach, meditation, healthy diet, etc.
* alcohol free social venues and events
* understanding the many aspects of addiction
* having a plan in case of relapse. (Known as a WRAP - Wellness Recovery Action Plan - this
document includes a daily wellness plan, identifying triggers and their warning signs, and a list of
people who can provide additional support. There are action plans for every step.) A WRAP can
help a ‘slip up’ from becoming a full-blown relapse.
* family members who have a commitment to learning about this disease, and to making changes
in how they talk to and relate to their loved one.
* having meaningful and satisfying goals
* experiencing small successes and building on them
Motivation is a key component of change; however, it requires a foundation of knowledge, awareness, preparation and support in order to be successful. Use this information to support the person you love so dearly. You can influence their ongoing journey to long-term recovery.
==========================
To learn more about the WRAP and creating a relationship that contributes to their recovery, schedule your confidential consultation by writing to me at fern@familyrecoverypartners.com.