SOMETIMES RELAPSE IS EVIDENCE THAT RECOVERY FAILED

Someone enters treatment

They’re told they have a chronic, relapsing condition

They stop using

They attend meetings
Work a programme
Learn their triggers
Manage their cravings
Build their life around recovery

Then, five years later, they return to using

And something strange happens

Almost immediately, the explanation turns towards them

Their disease was still there

They became complacent

They stopped doing what worked

They lost connection

They weren’t vigilant enough

They didn’t prioritise their recovery

Maybe…..

But there is another possibility we seem far less willing to consider

Maybe what we gave them wasn’t enough!!

Maybe abstinence changed the behaviour without changing whatever made that behaviour necessary

Maybe they became extraordinarily good at managing themselves without becoming fundamentally freer

Maybe the explanation we gave them never adequately understood their experience in the first place

Maybe the intervention worked exactly as designed, and what it was designed to achieve wasn’t enough

I spent 22 years in recovery

For much of that time, if somebody returned to using, I knew how to explain it

I rarely remember asking whether we might have failed them

That’s uncomfortable now…

Because the prevailing logic has an extraordinary protection built into it

If the person remains abstinent, recovery worked

If the person returns to using, their disease progressed

The system gets the success –  The person gets the failure

I’m not suggesting every relapse means treatment failed

That would simply replace one certainty with another

I’m asking why treatment failure isn’t routinely considered as one of the possibilities

In almost every other area of healthcare, if an intervention repeatedly fails to produce the outcome we hoped for, we examine the intervention

In addiction, we have become remarkably comfortable examining the patient

Perhaps returning to use doesn’t automatically tell us something about the chronicity of their disease

Perhaps sometimes it tells us something about the limits of our understanding

And perhaps the question after someone returns to using shouldn’t immediately be:

What did they stop doing?

Maybe we should also have the courage to ask

What did we fail to understand?