Addiction Recovery — Relapse Triggers

In treatment clients identify their relapse triggers and develop plans to deal with these triggers. What is a relapse trigger? Here’s a definition from Psychology Today:

A trigger can be thought of as anything that brings back thoughts, feelings, and memories that have to do with addiction (like a computer reminding a sex addict (link is external) of porn). In addiction research, these are often simply called cues. The word comes from learning research in which a reward (or punishment) is paired with something (the cue). For instance, in Pavlov (link is external)‘s classic experiment, a dog heard a bell ring right before it would get served its daily portion of meat. The dog quickly learned to associate the bell with food, and would begin salivating as soon as the bell would ring, even before the food was presented. In this case, the bell was the cue, and food the reward it was paired with. The story in drug addiction is similar. I’m sure many of you can relate to the overwhelming memories and emotions that seem to come out of nowhere when you hear music you used to get high to or pass a street where you used to buy drugs (or sex). Each of those examples is a trigger that is simply bringing about a similar reaction to Pavlov’s dog’s salivation. Seeing these things, or hearing them, creates an immediate response to the reward that it was paired with, the drug!

As we go through life we develop value-judgments. When I first tasted ice cream, I developed a value-judgment that ice cream is good. If I see a commercial for ice cream, I immediately think about how good ice cream tastes. This response to the ice cream commercial seems to be automatic, as if I saw the ice cream then automatically had a pleasurable feeling, but actually there was another step. My mind went back to the first impression I developed regarding ice cream, the value-judgment that ice cream is good. In recovery, the process must be slowed down so that when there is a trigger that causes craving for the drug, the recovering person thinks it through and re-evaluates.

Most alcoholics once had enjoyable experiences with alcohol, especially in the beginning, so they developed a value judgment that alcohol is good. With alcohol the value-judgment is even stronger because alcohol affects the pleasure center in the brain. We might like ice cream, but we really crave sex and food (in general), and drugs in some brains when drugs, including alcohol, are introduced.

In treatment, clients have to re-evaluate their relationship to alcohol and other drugs. The process of treatment is a way to change the value-judgment to meet the new reality of addiction and consequences from drug use. This can be a long process — ask anyone who goes on a diet, or decides to start an exercise program  rather than lying around watching TV. It’s difficult to change value-judgments we’ve held deeply for years, sometimes decades. In recovery, though, these value-judgments must be changed or the triggers will lead to relapse and more consequences.