Updated: Oct 19, 2021
By Joi Honer
“The problem with stigma around mental health is really about the stories that we tell ourselves as a society” ~ Matthew Quick
When talking about the journey of recovery from substance use disorder, we often use the term “relapse” to describe someone who has returned to using a substance after a period of attempted recovery.
Typically, people who return to use after an attempt of recovery experience a sense of inadequacy, fear, shame and confusion. They and their loved ones often feel like they have failed. Some members of the recovery community, unfortunately, even shame people who have returned to use.
The stigma that centers on a reoccurrence of use (also known as relapse) serves no one and is actually counterproductive to ongoing recovery. It creates a barrier to hope that recovery is possible and achievable.
Why we respond with judgement
The rates of “relapse“ for substance use disorders and other chronic illnesses with a behavioral component are actually quite similar. So, when science tells us that a return to use is common in the journey of recovery, why do we respond with such judgment? That’s a complex question but a few reasons may be:
Fear – While it can be deadly, a return to use is much more complicated than just making a choice. Responding with fear-based judgment may give individuals a sense of control over their own recovery. And for loved ones, fear may trigger a harsh response, before they even think the response through.
Anger – A loved one’s anger is rooted in fear, and may stem from feeling that the return to use is somehow personal. “If she loved me she would stay sober.”
Disappointment - We want to believe that the prescription for recovery always works, and it many cases it does. But the complexity of what each individual needs to recover varies significantly, and people sometimes find out what doesn’t work through a return to use.
How to respond supportively to recurrence of use
Viewing recovery only as a success or failure disregards the fact that, medically, we know this is a chronic disease. Recovery and a person’s readiness to change are on a continuum. So how can we respond to someone’s reoccurrence of use in a productive and supportive way? Below are some examples:
I love you, I am sorry this happened.
I am here for you and I know that this is challenging.
If you want to talk about what happened, I’d be happy to listen.
This does not mean you failed, this is just a stepping stone in your journey.
I believe in you and your ability to grow from this. I support your recovery.
When we try to put a complex disease in a black-and-white framework, we set ourselves and our loved ones up for failure. Let us respect the science around this disease, respect ourselves and others in recovery, through lessening the stigma and shame around a reoccurrence of use. Let’s foster hope and resilience. Recovery is always possible!
William R. Miller (2015) Retire the Concept of “Relapse”, Substance Use & Misuse, 50:8-9, 976-977, DOI: 10.3109/10826084.2015.1042333