The Science of Relapse: Why It Happens and How to Get Back on Track

Understanding the science of relapse helps remove the shame and allows you to respond effectively and compassionately. If you have experienced a setback, the most important thing to do is to act quickly. Arrow Medical is here to help you get back on track immediately, with no judgment.

The Brain Science: Why Does Relapse Happen?

Addiction causes long-term changes to the brain’s structure and function. Even after you have stabilized on a treatment like methadone or Suboxone and your life is improving, the brain remains vulnerable to powerful, often unconscious triggers.

1. Cue-Induced Cravings: The brain is a powerful learning machine. It creates deep connections between drug use and certain cues. As we explain in our article on addiction science, these can be anything:
2. • People: Seeing a person you used to use with.
   • Places: Driving down a certain street.
   • Emotions: Feeling intense stress, sadness, or even extreme happiness.
     When you encounter one of these cues, the brain’s reward system can light up, creating an intense, automatic craving.
3. The Role of Stress: Stress is a major driver of relapse. When you are under stress, your body releases the hormone cortisol. In a brain affected by addiction, cortisol can act as a powerful chemical trigger, essentially telling your brain to seek the drug for relief.
4. The Weakened “Braking System”: Addiction impairs the prefrontal cortex, the part of your brain responsible for impulse control. This means that when a powerful craving hits, the brain’s “go!” signal can easily override its weakened “stop!” signal, even when you consciously know that using is a bad idea.

The #1 Danger of Relapse: Reduced Tolerance

This is the most critical safety message: A relapse after a period of abstinence can be deadly.
When you are on a stable dose of medication or have stopped using opioids, your body’s physical tolerance decreases. If you return to using the same amount of a drug that you used before, your body can no longer handle it. This dramatically increases the risk of a fatal overdose. The incredibly toxic and unpredictable street drug supply, dominated by fentanyl, makes this risk even higher.

How to Get Back on Track: Your First 24 Hours

If you have a setback, shame can make you want to hide. Do not let shame isolate you. The single most important step is to reach out for help immediately.

Arrow Medical’s entire model is designed for this situation.

• There is NO Judgment: We are medical professionals who understand that addiction is a relapsing disease. Our only concern is your safety and well-being. You will never be punished or shamed for a relapse.
• Walk In Immediately: You do not need an appointment. You can walk into any of our clinics in Toronto, Barrie, or our other locations, and tell our staff you’ve had a setback and need to see a doctor.
• Rapid Re-Stabilization: Our priority is to get you safe. A doctor will assess you and likely restart your treatment immediately. This may mean resuming your methadone or Suboxone to prevent further use and stabilize you before you leave the clinic.

Turning Relapse into a Learning Opportunity

Once you are safe and stable, a relapse can become a valuable piece of information. You and your doctor can discuss what happened. Did a new stressor appear? Was your dose no longer effectively managing your cravings? This information can be used to adjust your treatment plan and strengthen your recovery for the long term.

A relapse is not the end of your story. It’s a challenging, but treatable, part of the disease. If you need help, we are here. Come see us today.