How to help an alcoholic person not to relapse?

Tips and strategies used to help people addicted to alcohol not to relapse.

The process of maintaining abstinence, that is, of not consuming drugs, is complicated; for this reason it is important not to lower one's guard and to continue working to avoid relapse.

During therapy, given the difficulty and lability of the situation, it is essential to begin to train and make the patient aware of the possible situations of risk of relapse that may be encountered along the way, so that he/she can deal with them effectively. For this purpose there are specific programs to prevent relapse of substance use such as alcohol.

Similarly, it will also be important that the subject's close environment such as family and friends collaborate, that they reinforce, support and motivate them to continue with the process and help them to create a healthy environment, away from stimuli, places, situations and people that encourage them to consume and thus be a support with whom they can communicate, express how they feel without being judged and support them if they need to ask for professional help.

In this article you will find a summary of the main characteristics of alcoholism and some help techniques and strategies used by health and social professionals. strategies used by health professionals and by people in the addicted person's environment that are used to help prevent relapse in alcohol consumption..

Characteristics of alcoholism

Alcoholism is one of the most common substance use disorders.It is classified in the fifth edition of the Diagnostic Manual of the American Psychiatric Association (DSM 5) as a pathology capable of seriously impairing a person's quality of life. Statistically, it emerges differently according to the sex of the population, with a proportion of 12.2% in men versus 4.9% in women; we see how alcohol use disorder is more prevalent in men than in women, as is the case with other addictions. There are also differences according to age, with 4.6% in subjects between 12 and 17 years of age as opposed to subjects over 18 years of age with 8.5%.

Thus, the age of onset of the disorder tends to be between 20 and 30 years of age, in the youth stage, when it is common to consume alcoholic beverages in leisure contexts, with the first intoxication usually occurring at the age of 18.The first alcohol intoxication usually occurs before the age of 20.

Similarly, this condition also influences the possibility of developing another comorbid disorder, doubling the probability of developing another psychiatric disorder, the most typical of which are bipolar disorder, schizophrenia, depressive and anxiety disorders and antisocial personality disorder.

Alcohol acts as a depressant of the central nervous systemIt affects and damages different brain areas such as the mammillary bodies, which are part of the limbic system and are mainly related to memory, or the thalamus, an organ of emotional and sensory integration that sends and receives information from the cerebral cortex. Thus, alcohol is the psychoactive substance that has the greatest impact on the personal and social life and health of affected individuals, increasing the risk of suicide and mortality.

For these reasons mentioned above, it will be essential to carry out an effective treatment of alcohol disorder, as well as to work and prepare the patient for possible relapse risk situations.

Ways to help a person not to relapse into alcoholism.

As with other addictive disorders, relapse in consumption is likely to occur. For this reason, it will be important to work with, prepare and give tools to patients so that they are able to face different risk situations that increase the risk of relapse. different risk situations that increase the likelihood of relapse both during treatment and, above all, at the end of therapy, when they no longer receive as much support, and when they are no longer able to use alcohol.The process of maintaining abstinence is just as complicated as that of detoxification.

In the same way the support and work that is given to avoid relapses comes from the therapist, but it is also fundamental and beneficial that the patient's environment such as his family and friends are informed of the problem and collaborate in the treatment and maintenance of abstinence.

Training in relapse prevention from the professional environment

In this way it will be essential to start working with the patient during the therapy sessions on possible situations of risk of relapse and possible consumption that may occur. For this reason there is a specific model for the prevention of relapse created by Marlatt and GordonThis model states that there are different variables that influence relapse, whether individual, physiological, situational or sociocultural.

These authors point out that an essential component of this training is to explain to the patient the difference between a fall and a relapse, since it generates confusion, but they are not at all the same thing. In the first case, in the fall, there is only isolated consumption, i.e. the patient has returned to drinking in a specific situation or moment. Relapse, on the other hand, does involve a return to the habit of drinking.

Similarly, Marlatt and Gordon distinguish three cognitive factors that influence the relapse process: self-efficacy, which is the self-confidence to achieve one's goals, expectations of the outcomes of consumption, and attribution of causality..

Thus, specific programs are proposed for relapse prevention, including components such as psychoeducation, where the patient is taught the difference between a fall and a relapse, announcing that relapses are possible and that they do not mean the end of the rehabilitation process, they are not a failure; taking into account and analyzing the variables that can cause relapse; working on skills to cope with these risk situations, training to remain firm in non-consumption and working on coping and lifestyle to promote abstinence.

In this way, it is important to talk to the subject about the possibility of relapse so that an action plan can be created to prevent it.. He/she will also be asked about all possible stimuli and risk situations that he/she may encounter and take into account especially those that are more likely to appear; for example, certain people with whom he/she usually drank, places such as bars and friends' houses where consumption was habitual or objects and times of the day or particular days that he/she relates to drinking.

Also social events may also play a role, such as the celebration of afor example the celebration of a birthday or going out to a party where alcohol is much more likely to be found, or the state in which the individual is in if he/she is living a stressful situation. Let us not forget that alcohol use disorder may have other associated conditions or disorders that may also make maintenance difficult.

Likewise, if the patient is aware of the factors that can lead to relapse, he/she can choose to avoid them, i.e. stop exposing him/herself to them, for example, it would be better not to associate with the group of friends with whom he/she always consumed alcohol for a while, or if this cannot be avoided, such as during a festive season, try to be accompanied and have the support of a friend who does not associate with alcohol and thus reinforce non-consumption.

In the same way, we will recommend you to relate and interact with a healthy environment, that is to say that you try to look for new places or relate with people who do not drink alcohol, since the environment where you move will be decisive to maintain abstinence. It may be favorable to attend a support or help group where you can interact with other subjects who are in the same situation reinforcing each other and avoiding harmful stimuli for the process, there are also bars where the sale of alcohol is not allowed, helping to maintain a healthy environment.

Support from the people around you.

As we have already explained, obtaining the support of the people around you, especially the people closest to the person who has developed the addiction, will be essential, as these helpers will act as support and reinforcement in situations where difficulties may occur and which are beyond the clinical context. We can understand these family members and friends as the "scaffolding" on which the new lifestyle and set of healthy habits will be built. when he or she has left therapy sessions or the inpatient treatment program.

In this way it is important that these people maintain a constant flow of communication with the health professionals who have treated or are treating the person, so that they have the guidelines and advice that are adapted to the addict's needs and at the same time have information from reliable sources.

As helpers of the person who is overcoming alcoholism, he/she will find in us a confidant with whom he/she can express what he/she feels, what difficulties he/she is having... and without feeling the pressure of prejudices and constant moral evaluations. We will try to motivate her to continue with the process and we will acknowledge her progress.Each small progress and each day without using is fundamental.

In the same way, we will try to be understanding and a good reference. We will take into account the person's circumstances and will be careful not to We will try not to engage in behavior that could precipitate a relapse, such as drinking in front of him/her. such as drinking in front of him/her, and we will not force him/her to do things for which he/she is not prepared, such as attending a party where alcohol is sure to be present.

So apart from being a support and an important element of support, since as we said it is essential that the patient's environment cooperates, we will also be aware of possible changes, behaviors or signs that may lead us to think that he is at risk of relapse so that we can recommend him to go and ask for help as soon as possible to a professional, to avoid consumption or if there has been a fall that he does not end up relapsing.