Expanding the continuum of substance use disorder treatment: Nonabstinence approaches PMC

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). Many advocates of harm reduction believe the SUD treatment field is at a turning point abstinence violation effect definition in acceptance of nonabstinence approaches. 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).

Acknowledging your triggers and developing the appropriate coping skills should be a part of a solid relapse prevention program. Lastly, treatment staff should help you to learn how to recognize the signs of an impending lapse or relapse so that you can ask for help before it happens. In order to understand AVE, it is important to realize the difference between a lapse and relapse. Again, many experts agree that a one-time lapse into using drugs or alcohol does not equally relapse. Relapse occurs when this behavior accelerates back into prolonged and compulsive patterns of drug abuse.

Social Skills Training

That being said, the authors indicated that many of the included studies were underpowered and lacked methodologic rigor to provide definitive evidence for or against different means of relapse prevention. After thorough review, the authors concluded that a focus on sustaining initial smoking cessation efforts, by preparing smokers for relapse prior to cessation and providing booster sessions and extended pharmacologic support, may be the most effective in preventing relapse. Harm reduction therapy has also been applied in group format, mirroring the approach and components of individual harm reduction psychotherapy but with added focus on building social support and receiving feedback and advice from peers (Little, 2006; Little & Franskoviak, 2010).

Similarly to Hajek et al. [20•], these authors cited a lack of clarity in the operationalization and delineation of relapse prevention as a serious limitation of its clinical application and interpretation of the research findings. The use of behavioral therapy components has become so widespread that these components are often included in different concentrations and forms in various intervention delivery formats, including telephone, Internet-based, psychotherapeutic, and brief advice interventions. Most recently, it has been recommended that behavioral treatment and pharmacotherapy be combined to maximize the effects of both types of interventions [23•]. Such combined interventions have been found to further reduce the risk of relapse following intervention delivery [22]. Self-efficacy is defined as the degree to which an individual feels confident and capable of performing certain behaviour in a specific situational context5. The RP model proposes that at the cessation of a habit, a client feels self-efficacious with regard to the unwanted behaviour and that this perception of self-efficacy stems from learned and practiced skills3.

Planning a cognitive behavioural programme

Dr. Bishop is also a certified open water scuba diver, he enjoys fishing, traveling, and hunting. He then went on to be the Chief Medical Officer at Wellington Regional Medical Center for an additional seven years until resigning from his position in 2013 and started Addiction Medicine. Brie graduated as a high school valedictorian with a major in Health Technologies and continued her studies at Springfield Technical Community College with a focus on healthcare.