Cocaine Relapse Recovery
Cocaine is a particularly difficult drug to stop using, and many users relapse before they attain long-term sobriety. If you or someone you know has experienced a relapse, you may be feeling ashamed, guilty, and confused.
This article is intended to support the road to recovery for cocaine users by providing helpful information on the following:
What Is a Relapse?
Relapse is often part of the addiction cycle, which for many in recovery can be defined as a span of time in which periods of remission are interrupted by episodes of recurring drug use.1
Although exact relapse statistics are difficult to pin down, the National Institute on Drug Abuse has published a finding suggesting that people treated for drug addiction experience a rate of relapse between 40% to 60%, which is similar to individuals with other types of chronic illnesses. 3
Cocaine is often associated with a high degree of relapse. According to research, the first 90 days of recovery is when relapse is most likely to occur for users of crack cocaine. 2
Why People Relapse on Cocaine
Both environment and biology play significant roles in the timing and severity of cocaine relapse. In particular, there are several factors that magnify the potential for returning to cocaine use.
- Being stressed. Research has found that stress can lead to increases in cocaine cravings, which can in turn increase the risk of relapse. 4, 14
- Being in an environment where drugs are present. Spending time in places where cocaine or other drugs are used, or being around people who use drugs, can dramatically increase the risk of relapse.
- Believing that you can control your use of cocaine or another drug. Some people who have been in recovery for a while begin to think that they can go back to using cocaine in moderation or use another drug. This type of thinking is dangerous, and using one time – even if it’s another drug – can lead to a downward spiral of use.
- Not having a prevention plan or having an ineffective plan. A relapse prevention plan includes actions you can take if you feel the urge to use. It should include your triggers and how you can avoid and cope with them, as well as stress-management techniques.
How to Recover From a Cocaine Relapse
Setbacks are a natural part of the addiction cycle. However difficult or disheartening, recognize that relapse can be managed.
The following list includes helpful tips to help prevent and manage a cocaine relapse.
Stop Using Cocaine
Although it may seem obvious that quitting cocaine is the first step to recovery, this is much easier said than done. Asking for help is a way to regain control and stop using immediately.
In addition to being the first step in addressing relapse, commitment to total – as opposed to partial – abstinence has been linked with more favorable long-term recovery. 5
Reflect on How the Relapse Happened
Understanding the events, feelings, or behaviors that led to relapse is a crucial part of the cocaine recovery process.
For example, ask yourself:
- ”Did something specific happen right before I used the drug?”
- ”Was I stressed or bored?”
- ”What was I feeling right before I used the drug?”
These are helpful ways to begin a personal dialogue of self-discovery. Awareness of the patterns and cycles of use are essential to changing them.
Whether it is a sponsor, a counselor, a family member, or a trusted friend, having support is an essential and necessary pillar of recovery. 6
Association with a 12-step group, such as Cocaine Anonymous or Narcotics Anonymous, is the most common way to find a sponsor. Sponsors are people who also have a history of cocaine use but are in remission. With first-hand knowledge of the cocaine addiction cycle, a sponsor is able to reflect on personal experience and use an understanding of it to support other addicts.
The level of treatment depends on the severity of the relapse.
Research has shown that early intervention yields the most substantial gains in the treatment of substance abuse and other possible co-occurring disorders such as a mental illness – which is often seen in combination with cocaine addiction. 7
The level of addiction treatment you need depends on the severity and duration of the relapse. If the relapse was severe and went on for days or weeks, you may need to enter detox and inpatient rehab again. Even if you have been a part of a rehabilitation program in the past, a relapse offers a unique opportunity for growth. Maybe the prior treatment wasn’t the right fit for you. You may want to discuss other options with your sponsor, therapist, or another addiction professional.
Consider the Possibility of Mental Illness or Trauma
In 2014, 18% of individuals 18 years of age or older were either diagnosed with or experienced a disorder that met diagnostic criteria for a mental illness, with depression being one of the top diagnoses. 8 For some, cocaine has become a way to self-medicate symptoms of a pre-existing mental illness. Statistically, 44% of all cocaine consumed is by those with a mental illness. 9
In addition to mental illness, trauma has also been connected with cocaine addiction. Post-traumatic stress disorder (PTSD) is the result of experiencing, witnessing, or perceiving an event as life-threatening. Individuals with PTSD usually endure intense residual behavioral symptoms such as anxiety, hyper-arousal, sleep disturbance, and intrusive thoughts. 10 Studies have suggested that exposure therapy can produce positive results in the treatment of cocaine users who are also diagnosed with PTSD. 11
Have a Plan
One of the best ways to get a handle on cocaine addiction is to formulate a relapse prevention plan if you don’t already have one. A relapse prevention plan must be realistic and must address what a person needs to stay sober. An effective cocaine relapse prevention plan can include the following:
- An assessment of relapse triggers and patterns. This is completed through an investigation of thoughts, beliefs, and behaviors that lead to cocaine use. This assessment is an effective tool for looking at the use of cocaine as a coping mechanism. Coping mechanisms are typically something that the person uses to try to feel better when he or she has become upset or feels out of control. A person may turn to cocaine, for example, when there are problems with friends or family or when the person becomes stressed.
- Education that normalizes and destigmatizes relapse. Relapse is a normal part of the recovery cycle. Dignity and respect are prime motivators and are also necessary for the accountability and responsibility required to support recovery.
- What you need to remain stable and balanced. This step might include phrases such as, “When I am/when I feel [blank] I need [blank],” as well as action steps to regain control. Examples of action steps might include speaking to a sponsor, therapist, or trusted friend, going to an NA meeting, or engaging in hobbies or activities such as exercise or meditation. 12
- Staying away from negative people. People who make you feel bad about yourself are triggers for relapse. You should also build a support network of people you can trust.
- Learning how to manage your cravings. Many techniques are available, including such cognitive reframing, thought-stopping, distraction, or urge surfing.
- Entering sober living. If you think you may not be able to abstain from cocaine, consider entering a sober living program.
Warnings Signs of a Relapse
In addition to creating a relapse prevention plan, becoming familiar with the warning signs of a relapse can help you avoid a return to cocaine use. Common warning signs include:
- Being stressed. As mentioned above, stress is one of the main reasons people relapse on cocaine. Everyone gets stressed from time to time, but some people may go back to cocaine to relieve stress if they haven’t learned how to manage it properly.
- Re-connecting with friends who use drugs. If you don’t have a sober support network, you might be tempted to hang out with old friends who are still using drugs. But it can be extremely difficult to stay sober around people who might offer you cocaine or another drug.
- Spending too much time alone. Sobriety can be a difficult adjustment, and it takes work. Sometimes, you may not feel like being around other people, or going to a 12-step meeting, support group, or counseling session. However, social isolation can cause feelings of loneliness and depression, which can lead to the urge to use cocaine.
- Reminiscing about your cocaine use. If you find yourself often thinking back to your days of using cocaine, or about how you can get cocaine, call your sponsor, therapist, or a friend or family member. These thoughts can easily lead to going out and buying cocaine again.
Reframing a Relapse
Cocaine relapse is not a sign of failure. Sobriety can take time, and relapse is often part of addiction.
Typically, cocaine recovery is a long-term process defined by periods of abstinence followed by “slips” or relapses. It includes repair and growth states in between periods of use. 13 Throughout this process, success may not always come in the form of sobriety, but in the ability to learn from mistakes and make positive changes that support goals like recovery.
Find a Relapse Prevention Recovery Program
Remember that above all else, there is always hope.
. American Society of Addiction Medicine. (2011). Definition of addiction.
. Pedroso, R. S., Goncalves, V. M., Guimarães, L. S., Rosa, R. L., Pettenon, M., Kessler, F. H., & Pechansky, F. (2014). Trajectory of treatment, hospitalization, and relapse of crack users. Drug and Alcohol Dependence, 140, e172.
. National Institute on Drug Abuse. (2014). Drugs, brains, and behavior: The science of addiction.
. Preston, K. L., & Epstein, D. H. (2011). Stress in the daily lives of cocaine and heroin users: Relationship to mood, craving, relapse triggers, and cocaine use. Psychopharmacology, 218(1), 29-37.
. National Institute on Drug Abuse. (2016). How is cocaine addiction treated?
. Substance Abuse and Mental Health Services Administration. (2011). Recovery defined – A unified working definition and set of principles.
. Substance Abuse and Mental Health Services Administration. (2016). Prevention of substance abuse and mental illness.
. National Institute of Mental Health. (2014). Any mental illness (AMI) among U.S. adults.
. The National Bureau of Economic Research. (2016). Mental illness and substance abuse.
. American Psychiatric Association. (2013). Posttraumatic stress disorder.
. National Institute on Drug Abuse. (2010). Comorbidity: Addiction and other mental illnesses.
. Perkinson, R. R., & Jongsma, A. E. (2009). The Addiction Treatment Planner. Hoboken, NJ: John Wiley and Sons, Inc.
. Melemis, S. (2015). Relapse Prevention and the Five Rules of Recovery. Yale Journal of Biology and Medicine, 88(3), 325-332.
. Sinha, R. et al. (2006). Stress-induced cocaine craving and hypothalamic-pituitary-adrenal responses are predictive of cocaine relapse outcomes. Arch Gen Psychiatry 63(3):324-331.