In the last several years increasing emphasis has been placed on «dual process» models of addiction, which hypothesize that distinct (but related) cognitive networks, each reflective of specific neural pathways, act to influence substance use behavior. According to these models, the relative balance between controlled (explicit) and automatic (implicit) cognitive networks is influential in guiding drug-related decision making 54,55. Dual process accounts of addictive behaviors 56,57 are likely to be useful for generating hypotheses about dynamic relapse processes and explaining variance in relapse, including episodes of sudden divergence from abstinence to relapse. Implicit cognitive processes are also being examined as an intervention target, with some potentially promising results 62. In terms of clinical applications of RP, the most notable development in the last decade has been the emergence and increasing application of Mindfulness-Based Relapse Prevention (MBRP) for addictive behaviors 112,113. Given supportive data for the efficacy of mindfulness-based interventions in other behavioral domains, especially in prevention of relapse of major depression 114, there is increasing interest in MBRP for addictive behaviors.

Abstinence Violation Effect: How Does Relapse Impact Recovery?

Little do we know that once we take that one drink, the illusion of control shatters, and saying no to the next drink becomes even harder. This is called the abstinence violation effect; since we have already “fallen off the wagon,” we might as well go the whole way. But by recognizing that mistakes can happen and learning how to quickly right oneself, long-term abstinence can be achieved. By implementing certain strategies, people can develop resilience, self-compassion, and adaptive coping skills to counteract the effects of the AVE and maintain lifelong sobriety. Additionally, the support of a solid social network and professional help can play a pivotal role.

• Clinicians in relapse prevention programs and the field of clinical psychology as a whole point out that relapse occurs only after a long-term pattern of specific feelings, thoughts, and behavior.
• 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.
• Notably, these individuals are also most likely to endorse nonabstinence goals (Berglund et al., 2019; Dunn & Strain, 2013; Lozano et al., 2006; Lozano et al., 2015; Mowbray et al., 2013).

How The Abstinence Violation Effect Impacts Long-Term Recovery

The AVE was introduced into the substance abuse literature within the context of the “relapse process” (Marlatt & Gordon, 1985, p. 37). Relapse has been variously defined, depending on theoretical orientation, treatment goals, cultural context, and target substance (Miller, 1996; White, 2007). It is, however, most commonly used to refer to a resumption of substance-use behavior after a period of abstinence violation effect abstinence from substances (Miller, 1996). The term relapse may be used to describe a prolonged return to substance use, whereas lapsemay be used to describe discrete,… Relapse Prevention (RP) is another well-studied model used in both AUD and DUD treatment (Marlatt & Gordon, 1985). In its original form, RP aims to reduce risk of relapse by teaching participants cognitive and behavioral skills for coping in high-risk situations (Marlatt & Gordon, 1985).

THE ABSTINENCE VIOLATION EFFECT

The last decade has seen numerous developments in the RP literature, including the publication of Relapse Prevention, Second Edition 29 and its companion text, Assessment of Addictive Behaviors, Second Edition 30. The following sections provide an overview of major theoretical, empirical and applied advances related to RP over the last decade. Identify triggers that may have contributed to the relapse and develop strategies to address them proactively in the future. It’s important to challenge negative beliefs and cognitive distortions that may arise following a relapse.

1. Nonabstinence treatment effectiveness

This approach is exemplified by the «urge surfing» technique 115, whereby clients are taught to view urges as analogous to an ocean wave that rises, crests, and diminishes. Rather than being overwhelmed by the wave, the goal is to «surf» its crest, attending to thoughts and sensations as the urge peaks and subsides. One critical goal will be to integrate empirically supported substance use interventions in the context of continuing care models of treatment delivery, which in many cases requires adapting existing treatments to facilitate sustained delivery 140. Given its focus on long-term maintenance of treatment gains, RP is a behavioral intervention that is particularly well suited for implementation in continuing care contexts. However, it is imperative that insurance providers and funding entities support these efforts by providing financial support for aftercare services.

Abstinence Violation Effect (AVE)

• There is also a need for updated research examining standards of practice in community SUD treatment, including acceptance of non-abstinence goals and facility policies such as administrative discharge.
• Encouragement and understanding from friends, family, or support groups can help individuals overcome the negative emotional aftermath of the AVE.
• 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.
• Here we provide a brief review of existing models of nonabstinence psychosocial treatment, with the goal of summarizing the state of the literature and identifying notable gaps and directions for future research.

As a result, it’s important that those in recovery internalize this difference and establish the proper mental and behavioral framework to drug addiction treatment avoid relapse and continue moving forward even if lapses occur. By identifying and naming what is happening, you will have a better chance to resist the temptations they create. My favorite tool is keeping Sobriety Gratitude Logs, which I share in my free Monthly Sober Curious Magazine. It will help you focus on the positive aspects of sobriety and counterbalance the distorted memories of drinking.