To boost your immune system and prevent colds, focus on maintaining a healthy lifestyle, including regular exercise, a balanced diet, adequate sleep, and stress management. Some studies suggest that moderate alcohol consumption, particularly red wine, may have certain heart-healthy benefits. Yes, alcohol consumption can increase the risk of contracting other respiratory infections, such as pneumonia or bronchitis. Yes, chronic alcohol abuse can lead to long-term negative effects on the immune system, making individuals more susceptible to infections and diseases. Moderate alcohol consumption may have limited effects on the immune system, but excessive or chronic alcohol use can weaken immune function.

• Learn more about complementary treatments for cold and flu.
• Moderate alcohol consumption may have limited effects on the immune system, but excessive or chronic alcohol use can weaken immune function.
• Remember, prevention is key when it comes to protecting your immune system and overall well-being.
• It impairs the production and release of immune system cells called cytokines, which are responsible for regulating inflammation and fighting off infections.
• To boost your immune system and prevent colds, focus on maintaining a healthy lifestyle, including regular exercise, a balanced diet, adequate sleep, and stress management.

The symptoms will usually get better on their own within 10–14 days.

• This guide explores the proven effects of alcohol on your body’s ability to manage symptoms and heal.
• It can dehydrate the body further and worsen symptoms such as a sore throat or cough.
• No, the type of alcohol does not significantly impact the immune system.
• For context, one standard alcoholic drink in the United States contains around 14 g (0.6 fl oz) of pure alcohol.
• Yes, alcohol consumption can increase the risk of contracting other respiratory infections, such as pneumonia or bronchitis.

Over-the-counter medications

Furthermore, alcohol consumption dehydrates our bodies, which affects the ability of our mucous membranes to trap and eliminate viruses. Alcohol also damages the cells lining our respiratory system, making it easier for viruses to invade and cause colds. Whether alcohol can increase your resistance to colds is a question that baffles many. However, its impact on our health, particularly in relation to colds and infections, has been a topic of debate.

According to an older 2015 review, this may be because moderate alcohol consumption has been shown to enhance immune function. There is some evidence that drinking a small amount of alcohol may reduce the number of colds people get per year. The interaction between alcohol and common cold medications, particularly those containing acetaminophen, poses a significant danger. This guide explores the proven effects of alcohol on your body’s ability to manage symptoms and heal. When a cold strikes, determining whether to consume alcohol requires understanding its physiological effects on a body already stressed by infection.

They tested the space inside the nose and the level of airway resistance in 31 adults, 2 hours after they drank alcohol. A small 2022 study tested the effects of alcohol on airflow through the nose. The consumption of alcohol may lead to nasal congestion. Although some people claim that alcohol is a decongestant, the reverse may be true.

More in Examining RSV Flu, and the Common Cold

Learn more about complementary treatments for cold and flu. Check with a doctor to ensure that it is safe to use an OTC cold product before using it. Some cold and flu products are not suitable for children under certain ages. All of these changes increase a person’s vulnerability to infections and disease.

Home Remedies

Generally, health authorities do not recommend consuming alcohol during a cold. Although alcohol cannot treat colds, there is limited evidence that moderate consumption of alcohol may help reduce the frequency of colds. No, alcohol cannot treat or cure the common cold. That said, excessive alcohol consumption is highly damaging to human health and increases the risk of infection.

However, other studies suggest that moderate alcohol consumption may decrease the number of colds people get overall. Some older research suggests that moderate alcohol consumption may reduce the frequency of colds. To stay healthy and ward off colds, it is essential to practice moderation when consuming alcohol and prioritize a healthy lifestyle. In fact, it weakens your immune system and makes you more susceptible to cold viruses and other respiratory infections.

However, the negative impact on the immune system outweighs these potential advantages. It can dehydrate the body further and worsen symptoms such as a sore throat or cough. For men, this means consuming up to two standard drinks per day, while women should limit their intake to one standard drink per day. In fact, it may weaken your immune system and prolong the duration of your illness.

When you use/abuse alcohol your resistance to colds increases?

By disrupting sleep and reducing the effectiveness of immune cells, alcohol prolongs the duration of the illness. The systemic effects of alcohol place an added burden on an already compromised system, diverting energy away from the immune response. Although a drink may initially make falling asleep easier, alcohol fragments the later stages of the sleep cycle. The body’s primary tool for recovery is restorative sleep, which alcohol actively sabotages. However, alcohol consumption depletes glutathione reserves and activates enzymes that produce more NAPQI.

Are some alcoholic beverages better for the immune system than others?

Of the participants, 83.4% reported drinking alcohol, and 55.4% reported having at least one cold in the last year. Health authorities generally do not recommend drinking alcohol during a cold. Of over 200 viruses that can potentially cause a cold, rhinoviruses are the most common. In this article, we will discuss whether alcohol helps treat or prevent a cold and what impact it has on the immune system.

Symptoms

Sleep disruption is compounded by the diuretic effect of alcohol, which causes frequent nighttime awakenings to urinate. Cough suppressants containing dextromethorphan (DXM) also interact negatively with alcohol. This reduction in the natural clearance mechanism allows mucus to build up, compounding congestion and potentially increasing the risk of secondary infections. Dehydration causes the mucus lining your respiratory tract to thicken, worsening nasal and chest congestion. Remember, prevention is key when it comes to protecting your immune system and overall well-being.

Does alcohol help the immune system?

When fighting a cold, the body needs ample fluid to thin mucus and support the immune response, making dehydration counterproductive. This decision involves evaluating how alcohol interferes with recovery and interacts with common over-the-counter treatments. Additionally, make sure to practice good hygiene by washing your hands regularly and avoiding close contact with individuals who have cold symptoms. No, the type of alcohol does not significantly impact the immune system. While guidelines vary across countries, it’s generally recommended to drink alcohol in moderation. In fact, it can increase your susceptibility to catching a cold by weakening your immune system.

Can alcohol help prevent colds?

It may temporarily alleviate symptoms such as congestion or sore alcohol as a seizure trigger throat, but it does not treat the underlying cause of the cold. It impairs the production and release of immune system cells called cytokines, which are responsible for regulating inflammation and fighting off infections. Alcohol, especially when consumed in excessive amounts, can have detrimental effects on multiple aspects of our immune system. Let’s explore the relationship between alcohol and our immune system to find out. Instead, people may be able to relieve their symptoms with OTC treatment or home remedies, such as getting rest, inhaling steam, or using saline nasal spray. Alcohol is not a treatment or cure for colds, and it does not act as a decongestant.

However, long-term alcohol misuse causes long-term inflammation throughout the body. This could be because alcohol influences aspects of the immune response. Alcohol has different effects on the immune system depending on how much a person consumes. The Centers for Disease Control and Prevention (CDC) also advise people who do not currently drink to avoid starting for any reason. Abstaining allows the body to dedicate its full resources to healing, supporting a faster return to health. Lack of adequate rest suppresses immune function, delaying the effectiveness of the white blood cells needed to clear the virus.

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However, there is no overall cure for the common cold. It reduces the amount of time spent in Rapid Eye Movement (REM) sleep, hindering the body’s ability to repair and recuperate. Mixing these with alcohol, which is also a depressant, significantly magnifies side effects like extreme drowsiness, dizziness, and impaired motor coordination. Other cold remedies also pose risks when combined with alcohol, especially central nervous system depressants.

Another goal of therapy at this stage is to help clients identify their denial. One of the main goals of therapy at this stage is to help clients understand what self-care means and why it is important . During emotional relapse, individuals are not thinking about using. The goal of treatment is to help individuals recognize the early stages, in which the chances of success are greatest . Third, the main tools of relapse prevention are cognitive therapy and mind-body relaxation, which are used to develop healthy coping skills.

A behavioral strategy is to call and engage in conversation with a friend or other member of your support network. Distraction is a time-honored way of interrupting unpleasant thoughts of any kind, and particularly valuable for derailing thoughts of using before they reach maximum intensity. But life is often unpredictable and it’s not always possible to avoid difficulty. Of course, that requires understanding what your triggers are. Negative emotions play a larger role in relapse among adults.

What are the stages of a relapse?

Help can come in an array of forms—asking for more support from family members and friends, from peers or from others who are further along in the recovery process. Taking quick action can ensure that relapse is a part of recovery, not a detour from it. Relapse is emotionally painful for those in recovery and their families. Seeing addiction instead as a deeply ingrained and self-perpetuating habit that was learned and can be unlearned doesn’t mean it is easy to recover from addiction—but that it is possible, and people do it every day.

Plan to Avoid Relapse

If we think relapse is failure, know that most people relapse in the first year, let alone at any point later. Borderline Personality Disorder (BPD) is marked by intense emotional instability, impulsive behaviors, and difficulty in relationships. It can significantly interfere with daily routines and quality of life. There is no cost or obligation to enter treatment by requesting a call. Contact us now to take the next step toward maintaining sobriety and reclaiming your life. Having a sense of direction not only strengthens your recovery but also improves overall well-being and self-esteem.

Deviation from treatment plans

If there’s a wedding that might trigger you because of alcohol or family issues, you need to start thinking about how you’re going to manage that, way before you’re there and craving alcohol. Did you know that about twenty percent of relapses happen because of social pressure? We don’t want to wait until after a relapse to start planning what to do next. You can never guarantee sobriety, nor can you guarantee someone will relapse. What makes you think addiction is so special, so different? Relapsing is a normal and expected part of the struggle with addiction.

They might abandon their efforts, feeling that quitting is too difficult. In a health condition, they involve the return of disease symptoms. For a shopaholic trying to follow a budget, a relapse could be going on a full shopping spree. If they had just one drink, they might be considered as having a “slip” but not a complete relapse. For example, for someone who had completely stopped drinking for a period of time, say six months, with the goal of total abstinence, it would be problematic if they had even one drink.

Examples of Relapses

Prolonged stress during childhood dysregulates the normal stress response and can lastingly impair emotion regulation and cognitive development. And most people who experience trauma do not become addicted. Sleep deprivation undermines recovery in indirect ways as well. They rob people of the power to resist impulses. The power to resist cravings rests on the ability to summon and interpose judgment between a craving and its intense motivational command to seek the substance. Moreover, the brain is capable of awakening memories of drug use on its own.

The RP model shows the greatest success with treatment of alcoholism but it has not been proven superior to other treatment options. The various behavioral approaches to treating relapse focus on the precursors and consequences of drug-taking and reinstatement. This method of therapy is complex and multi-faceted because the brain target for the desire to use the drug may be different from the target induced by the drug itself. Drug-priming is exposing the abstinent user to the addictive substances, which will induce reinstatement of the drug-seeking behavior and drug self-administration. Comparably, addicted individuals show an increased susceptibility to stressors than do non-addicted controls.

• They feel they have lost part of their life to addiction and don’t want to spend the rest of their life focused on recovery.
• If you or someone you care about is struggling with mental health problems, request a call to speak with a knowledgeable treatment specialist.
• Relapse-prevention therapy and mind-body relaxation are commonly combined into mindfulness-based relapse prevention .
• During this stage, it is common to experience feelings of guilt, frustration, and shame.

Just as becoming addicted is a process that involves learning mechanisms in the brain, so is addiction recovery a learning process, and like most learning and growth, it does not occur overnight or in a strictly linear manner. It encourages people to see themselves as failures, attributing the cause of the lapse to enduring and uncontrollable internal factors, and feeling guilt and shame. No matter how much abstinence is the desired goal, viewing any substance use at all as a relapse can actually increase the likelihood of future substance use. Recovery from addiction requires significant changes in lifestyle and behavior, ranging from changing friend circles to developing new coping mechanisms.

Clinical experience has shown that addicted individuals typically take less than they need, and, as a result, they become exhausted or resentful and turn to their addiction to relax or escape. Without it, individuals can go to self-help meetings, have a sponsor, do step work, and still relapse. The negative thinking in all these objections is material for cognitive therapy.

Coping With a Relapse

But most individuals begin recovery by hoping to get back their old life without the using. A denied user is in chronic mental relapse and at high-risk for future relapse. It is remarkable how many people what is the relapse prevention model have relapsed this way 5, 10, or 15 years after recovery. Part of creating a new life in recovery is finding time to relax.

Tips on how to handle an emotional relapse

There is an important distinction to be made between a lapse, or slipup, and a relapse. For that reason, some experts prefer not to use the term “relapse” but to use more morally neutral terms such as “resumed” use or a “recurrence” of symptoms. It reflects the difficulty of resisting a return to substance use in response to what may be intense cravings but before new coping strategies have been learned and new routines have been established. It is important to know that relapse does not represent a moral weakness.

This can include moods, attitudes, situations, behaviors, and environmental changes that tend to precede a relapse. People can move on from the relapse with a stronger commitment to preventing future relapses by avoiding or managing triggers before they occur. But happy events can also trigger a relapse, especially if others celebrate with alcohol. It is important to remain focused on recovery immediately after a relapse. This approach helps people in recovery anticipate the factors that might cause them to engage in their addictive behavior again—and to plan ahead for these situations.

What is more, negative feelings can create a negative mindset that erodes resolve and motivation for change and casts the challenge of recovery as overwhelming, inducing hopelessness. In addition, feelings of guilt and shame are isolating and discourage people from getting the support that that could be of critical help. Typically, those recovering from addiction are filled with feelings of guilt and shame, two powerful negative emotions.

• They are sometimes reluctant to even mention thoughts of using because they are so embarrassed by them.
• The goal is to help individuals move from denied users to non-users.
• Mind-body relaxation plays a number of roles in recovery .
• Clinical experience shows that when clients feel they cannot be completely honest, it is a sign of emotional relapse.
• Clients are encouraged to understand the concept of a recovery circle.
• Create profiles for personalised advertising.

Numerous studies have shown that mind-body relaxation reduces the use of drugs and alcohol and is effective in long-term relapse prevention 28,29. Individuals use drugs and alcohol to escape negative emotions; however, they also use as a reward and/or to enhance positive emotions . It helps to acknowledge these benefits in therapy so that individuals can understand the importance of self-care and be motivated to find healthy alternatives. To understand the importance of self-care, it helps to understand why most people use drugs and alcohol.

Managing daily stress

One way of ensuring recovery from addiction is to remember the acronym DEADS, shorthand for an array of skills to deploy when faced with a difficult situation—delay, escape, avoid, distract, and substitute. But not all situations linked to relapse are negative. • exposure to environmental cue related to drug use

It also may mean seeking out a mental health professional for a brief course of therapy. People of all ages can have post-traumatic stress disorder. We trialed and implemented the screening for all red and yellow trauma patients. However, social services staff have provided anecdotal evidence that patients and their loved ones benefit from the conversation during the screening administration. We use a different screening tool for pediatric patients. We are trying to identify which patients who experience traumatic injury will later develop PTSD.

If a traumatic event causes stress and other problems that affect your life, see your healthcare professional or mental health professional. If you think you may have post-traumatic stress disorder, make an appointment with your healthcare professional or mental health professional. At the same time, the tool helped them bridge to conversation about patients’ and their loved ones’ post-traumatic mental health.

If the symptoms get worse, last for months or years, and affect their ability to function daily, they may have PTSD. But with time and by taking good care of themselves, they usually get better.

What data or anecdotal evidence has the group collected so far about the outcomes of the screening?

You can develop post-traumatic stress disorder when you go through, see or learn about an event involving actual or threatened death, serious injury or sexual assault. Most people who go through traumatic events may have a hard time adjusting and coping for a short time. Coping with traumatic stress takes time, and there is no set time for recovery.

Whether it’s ASD or PTSD, talking with a mental health professional can help. Finding ways to be mindful of the impact of traumatic events and building further awareness is important. This was a precursor project to the American College of Surgeons (ACS) mental health and trauma screening project. This institution had great success with this tool, and healthcare professionals there published a six-month follow-up in a 2018 issue of Trauma and Acute Care Surgery.

• Your mood and other symptoms may get better within a few weeks.
• It’s available to all trauma centers at all levels.
• It’s great that this is available, as there aren’t many screeners available to assess patients for PTSD or depression risk.

Symptoms

The wife later experienced stress, anxiety, sleepless nights, and obsession with the memory of the crash and her husband’s death. This would allow us to not only save lives but also improve patients’ lives. Sometimes it can be hard to remember all the information provided to you. Your mood and other symptoms may get better within a few weeks.

• After surviving a traumatic event, many people have PTSD-like symptoms at first, such as not being able to stop thinking about what’s happened.
• Support from others also may prevent you from turning to unhealthy coping methods, such as misusing alcohol or drugs.
• People of all ages can have post-traumatic stress disorder.
• Post-traumatic stress disorder symptoms may start within the first three months after a traumatic event.
• If you know someone who’s in danger of attempting suicide or has made a suicide attempt, make sure someone stays with that person for safety.

Traumatic events that raise risk

After obtaining institutional permission, our group built the screening tool in EPIC to trigger a best-practice alert for case managers and social workers for patients who’ve experienced traumatic injuries. Post-traumatic stress disorder treatment can help you regain a sense of control over your life. After surviving a traumatic event, many people have PTSD-like symptoms at first, such as not being able to stop thinking about what’s happened.

International Patients

I’d say that awareness of mental health concerns is on the rise. It’s great that this is available, as there aren’t many screeners available to assess patients for PTSD or depression risk. Now, patients at high risk will not be sent home to figure out life on their own. I’m happy that this screening not only meets the ACS objectives but is also good for our patients.

Appointments at Mayo Clinic

During hospitalization, we identify which patients are at the highest risk of PTSD or depression and plug them into inpatient and outpatient mental health services, working in collaboration with social workers and case managers. However, someone who develops PTSD after trauma cannot move beyond the haunting of that traumatic event and needs intervention. About 3 to 4 years ago, focusing on the mental health needs of patients we see for trauma care became a national initiative through the American College of Surgeons. Preparing and anticipating questions will help you make the most of your time with the healthcare professional. You and your mental health professional can talk about what type of therapy or combination of therapies may best meet your needs. All these approaches can help you gain control of lasting fear after a traumatic event.

Post-traumatic stress disorder symptoms may start within the first three months after a traumatic event. Post-traumatic stress disorder (PTSD) is a mental health condition that’s caused by an extremely stressful or terrifying event — either being part of it or witnessing it. You might have many talks with your loved one over weeks or months as the person works through feelings during or after getting help from a mental health professional. Most trauma patients resume life as usual in 3 to 6 months and are no longer haunted by the traumatic event.

Trauma

Your therapist can help you build stress management skills to help you better handle stressful situations and cope with stress in your life. A diagnosis of PTSD means a person has gone through an event that involved an actual or possible threat of death, violence or serious injury. Support from others also may prevent you from turning to unhealthy coping methods, such as misusing alcohol or drugs. Fear, anxiety, anger, depression and guilt are all common reactions to trauma.

But most people exposed to trauma don’t go on to develop PTSD. Healthcare professionals aren’t sure why some people get PTSD. You’ll soon start receiving the latest Mayo Clinic health information you requested in your inbox. If you are a Mayo Clinic patient, we will only use your protected health information as outlined in our Notice of Privacy Practices. Sign up for free and stay up to date on research advancements, health tips, current health topics, and expertise on managing health. Or, if you can do so safely, take the person to the nearest hospital emergency department.

Getting timely help and ptsd alcoholic parent support may prevent usual stress reactions from getting worse and leading to PTSD. Also, see a health professional if you’re having trouble getting your life back under control. But sometimes symptoms may not appear until years after the event. This stress could be from an accident, abuse — such as verbal, physical, domestic or sexual — military combat or another type of trauma. You can support someone who is dealing with stress after a scary or painful event.

For patients we deem to be at low risk of PTSD or depression, we provide educational resources in case PTSD or depression arises. Both depression and PTSD can arise because of experiencing severe trauma or witnessing it. You may be given questionnaires to fill out that will ask you about events you have had and your symptoms. At the same time, you may feel guilty that you can’t fix your loved one or speed up the healing process. You may find yourself avoiding your loved one’s attempts to talk about the trauma or feeling hopeless that your loved one will get better.

The experts felt we needed to address post-traumatic stress disorder (PTSD) and depression, specifically, for patients who’ve experienced trauma. Your healthcare professional or mental health professional will ask more questions based on your responses, symptoms and needs. Post-traumatic stress disorder can disrupt your whole life — your education, job, how well you get along with others, physical health and enjoyment of everyday activities. Take time for the things you enjoy, accept help from others and talk with a mental health professional if you need help coping. We completed a feasibility study write-up, and the feedback we received from healthcare professionals was that adding this screening tool was not an incredible work burden.

After formal training with the screening tool, we implemented it in a feasibility study in the spring of 2024 including a trigger for a consult screen. We then conducted a review in September 2024 to find out which trauma centers were using the tool. We now have a data management plan for a practice change to implement this screening for the ICU and the general care and trauma units.

Getting treatment as soon as possible can help prevent PTSD symptoms from getting worse. Over time, PTSD symptoms can vary in how severe they are. Symptoms can vary over time or vary from person to person. Symptoms may include flashbacks, nightmares, severe anxiety and uncontrollable thoughts about the event. Supporting someone through trauma can be hard.

An assessment of how we’re meeting our patients’ mental health needs is now part of our verification process. Trauma and mental health experts explored issues our patients might experience and how we might tackle those issues. Hearing about a trauma that led to your loved one’s PTSD may be painful for you and even cause you to relive hard events. PTSD can greatly strain the emotional and mental health of loved ones and friends. Tell your healthcare professional about any side effects or problems with medicines. You and your healthcare professional can work together to figure out the best medicine, with the fewest side effects, for you.

Although withdrawal is usually viewed as a physiological process, recent theory emphasizes the importance of behavioral withdrawal processes . Withdrawal tendencies can develop early in the course of addiction and symptom profiles can vary based on stable intra-individual factors , suggesting the involvement of tonic processes. Additionally, the intervention had no effect on subjective measures of craving, suggesting the possibility that intervention effects may have been specific to implicit cognitive processes . Relative to a control condition, ABM resulted in significantly improved ability to disengage from alcohol-related stimuli during attentional bias tasks. One study found that smokers’ attentional bias to tobacco cues predicted early lapses during a quit attempt, but this relationship was not evident among people receiving nicotine replacement therapy, who showed reduced attention to cues .

Also, many studies have focused solely on pharmacological interventions, and are therefore not directly related to the RP model. It is important to note that these studies were not designed to evaluate specific components of the RP model, nor do these studies explicitly espouse the RP model. Given the rapid growth in this area, we allocate a portion of this review to discussing initial evidence for genetic associations with relapse.

• Finally, the results of Miller and colleagues (1996) support the role of the abstinence violation effect in predicting which participants would experience a full-blown relapse following an initial lapse.
• We describe the development of nonabstinence approaches within the historical context of SUD treatment in the United States, review theoretical and empirical rationales for nonabstinence SUD treatment, and review existing models of nonabstinence psychosocial treatment for SUD among adults to identify gaps in the literature and directions for future research.
• It has also been shown to promote a decrease in symptoms of anxiety, depression, and specific phobias, all which have a comorbid relationship with substance use disorders.
• There has been little research on the goals of non-treatment-seeking individuals; however, research suggests that nonabstinence goals are common even among individuals presenting to SUD treatment.
• This may be at least in part because of the high prevalence of polysubstance use; indeed, multiple SUD diagnoses are the norm rather than the exception (Rounsaville, Petry, & Carroll, 2003), and about 1 in 8 individuals with SUD have co-occurring AUD and DUD (SAMHSA, 2019a).

Changing how recovery is viewed

Advocates of managed alcohol programs also note that individuals with severe AUD and structural vulnerabilities often have low interest in and utilization of abstinence-oriented treatment, and that these treatments are less effective for this population (Ivsins et al., 2019), though there is limited research examining these claims. A primary concern regarding nonabstinence goals is that individuals with SUD will not be able to achieve moderate or controlled use. The abstinence violation effect is believed to result from an inflexible, binary view that those with SUD are only capable of abstinence or disordered use; thus, any substance use is equated with a “full-blown reversal” or treatment failure (Miller, 1996, p. S22). In this context, researchers have argued that strategies for managing returns to substance use are essential components of effective SUD treatment, and that inflexibility around abstinence can lead to poorer outcomes (Larimer, Palmer, & Marlatt, 1999; Miller, 1996).

Continued empirical evaluation of the RP model

• One study found that the Asp40 allele predicted cue-elicited craving among individuals low in baseline craving but not those high in initial craving, suggesting that tonic craving could interact with genotype to predict phasic responses to drug cues .
• The Relapse Prevention (RP) model has been a mainstay of addictions theory and treatment since its introduction three decades ago.
• One study found that smokers’ attentional bias to tobacco cues predicted early lapses during a quit attempt, but this relationship was not evident among people receiving nicotine replacement therapy, who showed reduced attention to cues .
• Research supports that expectancies could partly mediate influences such as personality factors , genetic variations 51,52, and negative affect on drinking.
• The realization that HIV had been spreading widely among people who injected drugs in the mid-1980s led to the first syringe services programs (SSPs) in the U.S. (Des Jarlais, 2017).

For example, Bandura, who developed Social Cognitive Theory, posited that perceived choice is key to goal adherence, and that individuals may feel less motivation when goals are imposed by others (Bandura, 1986). Individuals with fewer years of addiction and lower severity SUDs generally have the highest likelihood of achieving moderate, low-consequence substance use after treatment (Öjehagen & Berglund, 1989; Witkiewitz, 2008). There were no significant differences in problems related to other drug or alcohol use, medical issues, family, or employment at months 6 or 12 (Roos et al., 2019). Indeed, a prominent harm reduction psychotherapist and researcher, Rothschild, argues that the harm reduction approach represents a “third wave of addiction treatment” which follows, and is replacing, the moral and disease models (Rothschild, 2015a). Importantly, there has also been increasing acceptance of non-abstinence outcomes as a metric for assessing treatment effectiveness in SUD research, even at the highest levels of scientific leadership (Volkow, 2020). Regarding SUD treatment, there has been a significant increase in availability of medication for opioid use disorder, especially buprenorphine, over the past two decades (opioid agonist therapies including buprenorphine are often placed under the “umbrella” of harm reduction treatments; Alderks, 2013).

Genetic influences on relapse have been studied most extensively in the context of pharmacogenetics, with the bulk of studies focusing on nicotine dependence (for recent reviews see 83,84). Second, the likelihood of abstinence following a behavioral or pharmacological intervention can be moderated by genetic influences on metabolic processes, receptor activity/expression, and/or incentive value specific to the addictive substance in question. Broadly speaking, there are at least three primary contexts in which genetic variation could influence liability for relapse during or following treatment. Specifically, we focus on recent, representative findings from studies evaluating candidate single nucleotide polymorphisms (SNPs) as moderators of response to substance use interventions.

Outcome expectancies

As the client gains new skills and feels successful in implementing them, he or she can view the process of change as similar to other what is end-stage alcoholism situations that require the acquisition of a new skill. In the RP model, the client is encouraged to adopt the role of colleague and to become an objective observer of his or her own behavior. One of the most important efficacy-enhancing strategies employed in RP is the emphasis on collaboration between the client and therapist instead of a more typical “top down” doctor-patient relationship.

Of note, other SUD treatment approaches that could be adapted to target nonabstinence goals (e.g., contingency management, behavioral activation) are excluded from the current review due to lack of relevant empirical evidence. Research on nonabstinence DUD treatment has generally focused on medication for opioid use disorder (OUD), including the opioid agonist medications methadone and buprenorphine (Drucker, Anderson, & Haemmig, 2016), while very few studies have examined psychosocial DUD treatments. One mechanism theorized to explain this finding is the “abstinence violation effect,” which refers to a negative cognitive and affective response experienced after a return to substance use that contributes to more severe and problematic episodes of use (Marlatt & Gordon, 1985).

2. Relationship between goal choice and treatment outcomes

People susceptible to AVE are theorized to engage in all-or-nothing thinking in which they interpret any use as total failure and not as a temporary setback. Encyclopedia of behavioral medicine. These groups can help you understand that you are not alone; others have had your concerns, and you can learn helpful information from these groups to help you with your goals. Positive—I know I can do this because I have already shown it, I have a dedicated support network, and I can continue this journey one day at a time. I can use this lapse as a teachable moment—progress, not perfection. For example, I am a failure (labeling) and will never be successful with abstaining from drinking, eating healthier, or exercising (jumping to conclusions).

Mindfulness-based relapse prevention

Thus, one could test whether increasing self-efficacy in an experimental design is related to better treatment outcomes. Although many developments over the last decade encourage confidence in the RP model, additional research is needed to test its predictions, limitations and applicability. RP modules are standard to virtually all psychosocial interventions for substance use and an increasing number of self-help manuals are available to assist both therapists and clients. As outlined in this review, the last decade has seen notable developments in the RP literature, including significant expansion of empirical work with relevance to the RP model. Over the past decade RP principles have been incorporated across an increasing array of behavior domains, with addictive behaviors continuing to represent the primary application. Implicit cognitive processes are also being examined as an intervention target, with some potentially promising results .

As a result of identifying those warning signals, the client may be able to take some evasive action (e.g., escape from the situation) or possibly avoid the high-risk situation entirely. Such warning signals to be recognized may include, for example, AIDs, stress and lack of lifestyle balance, and strong positive expectances about drinking. Even in clients who have already become abstinent, self-monitoring can still be used to assess situations in which urges are more prevalent. Ongoing cravings, in turn, may erode the client’s commitment to maintaining abstinence as his or her desire for immediate gratification increases.

Based on the classification of relapse determinants and high-risk situations proposed in the RP model, numerous treatment components have been developed that are aimed at helping the recovering alcoholic cope with high-risk situations. Finally, therapists can assist clients with developing relapse road maps—that is, cognitive-behavioral analyses of high-risk situations that emphasize the different choices available to clients for avoiding or coping with these situations as well as their consequences. The cognitive-behavioral model of the relapse process posits a central role for high-risk situations and for the drinker’s response to those situations. However, it is also possible that adaptations will be needed for individuals with nonabstinence goals (e.g., additional support with goal setting and monitoring drug use; ongoing care to support maintenance goals), and currently there is a dearth of research in this area. This could include further evaluating established intervention models (e.g., MI and RP) among individuals with DUD who have nonabstinence goals, adapting existing abstinence-focused treatments (e.g., Contingency Management) to nonabstinence applications, and testing the efficacy of newer models (e.g., harm reduction psychotherapy). Given low treatment engagement and high rates of health-related harms among individuals who use drugs, combined with evidence of nonabstinence goals among a substantial portion of treatment-seekers, testing nonabstinence treatment for drug use is a clear next step for the field.

Findings also suggested that these relationships varied based on individual differences, suggesting the interplay of static and dynamic factors in AVE responses. Shiffman and colleagues found that restorative coping following a smoking lapse decreased the likelihood of a second lapse the same day. One study found that momentary coping differentiated smoking lapses from temptations, such that coping responses were reported in 91% of successful resists vs. 24% of lapses. One study found evidence suggesting a feedback cycle of mood and drinking whereby elevated daily levels of NA predicted alcohol use, which in turn predicted spikes in NA. Knowledge about the role of NA in drinking behavior has benefited from daily process studies in which participants provide regular reports of mood and drinking. Heavier and more frequent alcohol use predicted a greater probability of high negative affect and increased negative affect over time.

Although reducing practical barriers to treatment is essential, evidence suggests that these barriers do not fully account for low rates of treatment utilization. There are significant practical barriers to treatment access in much of the U.S. (e.g., availability of treatment, distance from treatment, cost, lack of insurance; Park-Lee, Lipari, Hedden, Kroutil, & Porter, 2017, Priester et al., 2016), but evidence suggests these barriers account for only part of the disparity between the need for and receipt of treatment. For those who do receive treatment, about 30% of all psychosocial SUD treatment episodes are terminated prematurely (including all causes; Lappan, Brown, & Hendricks, 2020).

1.1. Harm reduction treatments specific to alcohol use disorder

Stimulus-control techniques are relatively simple but effective strategies that can be used to decrease urges and cravings in response to such stimuli, particularly during the early abstinence period. In such a matrix, the client lists both the positive and negative immediate and delayed consequences of remaining abstinent versus resuming drinking. In addition, specific cognitive-behavioral skills training approaches, such as relaxation training, stress-management, and time management, can be used to help clients achieve greater lifestyle balance. This reframing of lapse episodes can help decrease the clients’ tendency to view lapses as the result of a personal failing or moral weakness and remove the self-fulfilling prophecy that a lapse will inevitably lead to relapse. This perspective considers lapses key learning opportunities resulting from an interaction between coping and situational determinants, both of which can be modified in the future. Thus, clients are taught to reframe their perception of lapses—to view them not as failures or indicators of a lack of willpower but as mistakes or errors in learning that signal the need for increased planning to cope more effectively in similar situations in the future.

Whereas tonic processes may dictate initial susceptibility to relapse, its occurrence is determined largely by phasic responses–proximal or transient factors that serve to actuate (or prevent) a lapse. Against this backdrop, both tonic (stable) and phasic (transient) influences interact to determine relapse likelihood. Overall, the RP model is characterized by a highly ideographic treatment approach, a contrast to the “one size fits all” approach typical of certain traditional treatments.

A therapist can help you with self-compassion, restructuring negative thinking, exploring coping strategies, and support you with the goals you have set for yourself. The current review highlights multiple directions for future research, including testing the effectiveness of nonabstinence treatments for drug use and addressing barriers to implementation. Though decades of empirical evidence support nonabstinence interventions for AUD, there is a clear gap in research examining nonabstinence psychosocial treatment for DUDs. Thus, while it is vital to empirically test nonabstinence treatments, implementation research examining strategies to obtain buy-in from agency leadership may be just as impactful. Additional research is needed to further examine this relationship; for example, researchers who develop and test interventions to reduce drug use stigma may also consider whether these interventions could lead to greater acceptance of nonabstinence outcomes among treatment providers. Low acceptance of nonabstinence goals among providers remains a significant barrier to implementing nonabstinence SUD treatments (Rosenberg et al., 2020), even for AUD treatments with established effectiveness.

Irrespective of study design, greater integration of distal and proximal variables will aid in modeling the interplay of tonic and phasic influences on relapse outcomes. Ideally, assessments of coping, interpersonal stress, self-efficacy, craving, mood, and other proximal factors could be collected multiple times per day over the course of several months, and combined with a thorough pre-treatment assessment battery of distal risk factors. The merger of mindfulness and cognitive-behavioral approaches is appealing from both theoretical and practical standpoints and MBRP is a potentially effective and cost-efficient adjunct to CBT-based treatments. Findings from numerous non-treatment studies are also relevant to the possibility of genetic influences on relapse processes. In another psychosocial treatment study, researchers in Poland examined genetic moderators of relapse following inpatient alcohol treatment . In a secondary analysis of the Project MATCH data, researchers evaluated posttreatment drinking outcomes in relation to a GABRA2 variant previously implicated in the risk for alcohol dependence .