What Is Relapse?

[ginsa]

When I was in Detox I attended the Rehab classes. I learned there that Relapse is a thought process. It doesn't necessarily mean using, but using can be the end result. I'm curious to know what anyone else thinks about the subject. Relapse has the potential to be so discouraging...I hope that more knowledge about it can empower others in their recovery.

[ChronicPain1]

I'm bored and the pain management forum has very limited postings. That and I like talking about the difference between addiction and dependence, because there's been a lot of non-addicts thinking they are addicts, and a lot of ex-addicts telling everyone they are addicts.

They switched me to fentanyl 25mcg because 1) It was lower than the recommended conversion from 180mg of morphine a day and 2) so that my tolerance for morphine would decrease since they're different drugs.

The 25mcg Fentanyl did absolutely nothing for me anyway, so for a month I was in tremendous pain until I went back on the morphine at a lower dose.

[worried878]

true...physical dependence does not mean someone is an addict...pain or no pain..i do think people can become an addict without the dr knowing/and they can also have a pain problem and be an addict at the same time..some r lucky and can control their narcotic intake..others can not..as a rule people who post here//being an addiction forum//often leads one to believe they could have a possible..and i say possible addiction///no matter how well they control their narcotic intake ...neither morphine nor fentanyl are drugs sold on the street as a rule//cept morphine on the street and taken IV  is virtually heroin...fentanyl 25mcg would kick the normal populations rear end without a paddle///in fact it would probably put most here on a high or to sleep for a bit as it is stronger than most narcotics in general///never heard it used to decrease tolerence..have heard it used to decrease abuse cos u dont "pop it" u wear it for 3 days instead so for many chronic painers this can work and get rid of the popping a pill habit

anyway....most here have had a problem with narcotic intake..pain or no pain..their choice is to try and get off..or try and stay off narcotics..and u deserve congrats on ur steel will power to be able to control ur narcotic intake...that is for sure...but do not get why u drifted over to this forum????

[ChronicPain1]

Wow that's depressing to hear, withdrawal does not mean you're an addict. At all. Anyone who takes opiates for a time will become physically dependent on the medications, that's just the nature of them. You will withdraw regardless, but it doesn't mean you're an addict.

Yeah I was up to Morphine 60mg 3x daily and I was switched to Fentanyl 25mcg for a month to reduce my tolerance. Now I'm on Morphine 30mg 3x and it works like I've never taken it before. I wish there was a way to prevent tolerance too, then we'd never have to go up. But if the pain gets much worse some times you have to.

Basically Physical dependence and Psychological dependence are different, some doctors get it and some don't. If you crave and need the drugs and go above and beyond to get them, you may be an addict. However there is psuedo addiction when a patient is in so much pain that they want more to make it stop. Good doctors know the difference, and luckily mine does.

[ginsa]

Thanks for the link...I'm checking it out. So far I am able to manage pain with ibuprofen alternated with acetaminophen and using my TENS units. As much as I like the euphoria of opiates i would rather never go there again...

[123456m]

I think most of the time its the feeling that opiates give a person thta makes them take them. I am not at all underestimating Chronic pain.
But there are many non naro choices that work.
You see with opiates for pain relief you kind of have the best of both worlds for a while. Not only does your pain go away but you start feeling great! Full of energy, social or whatever. But with non narcos that can do the same job as opiates in most cases and they  just take the pain away and your bla feeling is still there. just my opinion.
Peace

Heres a good link
http://wehelpwhathurts.homestead.com/whichmedication.html

[ginsa]

What I have encountered is an all or nothing kind of attitude in both Mental Health care providers and the staff at the Detox center I went to. They seem not to think it matters whether your drug was prescribed for chronic pain or used recreationally. Its almost as if they are using withdrawl as the baseline for addiction. Have withdrawl...addict. No withdrawl....not an addict. Or even more simply, they may not recognize a  difference between addiction and dependence. I know that this is not true of all treatment facilities.

I took my medication within the protocol, only exceeded the 40mg a day allowed twice, and only by 10mg. I am still treated as an addict because I had withdrawl. I don't even have cravings for the opiate ( not yet anyway ), but my pdoc is prescribing Naltrexone 50mg to prevent relapse. I don't get it, but I am going along with it to get the Naltrexone which I have wanted to use for LDN therapy.

I quit taking Opiates because I had built up such a tolerance that my choices were graduate up to a stronger opiate or quit. I chose to quit because I'm only 49 and pain is just going to get worse. I want to have opiates work for me by the time I get to be 60. Hopefully by then a drug like Oxytrex will be on the market that combines Oxycodone and Naltrexone to give us a compound that reduces tolerance.

I am curious as to whether using 10 years from now for chronic pain will be viewed by the health care establishment as relapse. My experience so far makes me think "yes". In the meantime, I've decided to accept the "addict" label because resisting was getting me nowhere with my pdoc or therapist. It may even work out to my advantage.  I  also figure it can't hurt to apply the practical suggestions for avoiding relapse.

The bottom line is that if the only way to have any quality of life later on is to take opiate pain meds again, I'll do it. I wont worry about whether I'm relapsing at that point. But I am sure going to think long and hard before I do.

[ChronicPain1]

Eh that's far too vague and frankly drags non-addicts into the web. Physical dependence from opiates and addiction are not the same thing at all. If you quit taking pain meds and aren't an addict, then take them again because your pain is severe, that doesn't make it a relapse.

[ginsa]

Yup, like hatred = murder and lust = adultery. It all begins in the brain. Very powerful.

[outotown]

Very good post, kinda like the prodigal son in the bible, It say he ask his father for his inhiertance then after some days he departed into a far country. In other words his mind was already in the far country before he ask for the pills, oh i mean his inhiertance. Good post something we need to be aware of

[123456m]

Excellent post and question all recurring drug use with the exception of servere pain requiring being in the hosipital begins with a single thought. The brain is super intelligence. It knows what gives its pleaseuse and it is ever so patient. It will wait and wait just for the right time to interject the thought oh just take one it will not hurt a bit you been clean for your years and off you go.That thought must be dismiss at all costs. I often wondered if hypnosis could help if this area.

[worried878]

yey...good point..many times people build a defense mechansim almost like a spider web to protect the fact that they need drugs...it becomes like a need for food or water..the body/brain/ will often kick in to protect that need/including denial as part of that protection mechanism..if u ever studied Maslowe's Hieracrchy of Needs then u will find that drugs r not in that hieracrchy but not everyone has that basic need that an addict may acquire...but if it is a need in some cases it can be bumped right up to the top..above even food or water...kinda scary

[ginsa]

A sampling of the thinking that is part of relapse is, "I really, really wanted to quit , so I won't use again" or "My drugs were prescribed and I followed protocol", or "I don't need help, because I'm not like, a  "real addict" ".  Overconfidence, shame, guilt, depression and anxiety are all enemies of recovery and any negative or misguided thinking that springs from these things is considered relapse because it can eventually lead to use.

Recovery has to be a very thoughtful process. Minimizing what led to addiction               (or dependence), or the power that drugs have can send a person back on a self-destructive course. I used to think that anthrpromorphizing drugs was a little silly, but truthfully...drugs don't care why we used or what our education or socio-economic background is. When we gave ourselves over to them we became dependent on them. That doesn't mean we are bad people or loosers, that's just the way it works. Period.

[IBKleen]

You are so right---relapse is the end result. The relapse always begins before you pick up the drug.

It can be something as simple as "I feel good today...one won't hurt" or "I feel horrible today..I need one" or "Look at far I have come, I've got this!!".

Our best thinking gets us into trouble.

I always need to keep my thoughts in check and that is why I have a sponsor and people around me who are going through the same thing as me. I can say something so innocent and they will call me on it.

If I think it is a good idea, it very rarely is.....just my experience.

Great post btw!!!!

[worried878]

I do kinda understand what they meant....u can use again..for instance after a surgery or sumpin...and it is not a relapse...cos u were not using for the wrong reasons and it was for a legit reason and not for the "high"   not a good idea for an addict to have pain meds in their possession even for pain less someone is holding them..but some can control it..some can not....relapse is very real and the stts of those who will remain clean the first, second or even 3rd time they quit are discouraging...and that is why a plan is so important..a plan during recovery and recovery is for life...aftercare is often the missing ingredient needed for success

[ImGettingClean]

I always thought relapse was just using again; i never looked at it your way...

Can you expain further what you meant by "Relapse is a thought process"....