As we learned about Demi Lovato’s hospitalization related to reported heroin use yesterday, the reality is that beating addiction and staying sober over the long term is not an easy feat to accomplish .
The truth is that the odds for relapse are steep, unless you receive ongoing social support, counseling, and medication assisted therapy (MAT) while going through withdrawal, which has been proven to reduce the risk of relapse.
Photo credit: Patricia Schlein/STAR MAX/IPx 2018 9/7/17 Demi Lovato at the Alcides & Rosaura (ARD)… [+] Foundation's “A Brazilian Night” in New York City.
In Lovato’s case, her concurrent struggle with mental illness makes things even more challenging. In 2011, when she was 22, she entered rehab after being diagnosed with addiction and bulimia. Thereafter, she became the spokesperson for the campaign, Be Vocal: Speak Up For Mental Health. The initiative encourages people with mental illness to be more vocal and break down the stigma associated with it.
Yet, as Lovato is recovering from her reported heroin overdose, it appears based on recent reporting that she hadn’t been doing well for several months.
When she released her new hit song last month entitled “Sober”, the truth about her recent relapse after 6 years of sobriety emerged. In fact, she performed the song “Sober” just 2 days before her relapse.
The bottom line is that rates of relapse ultimately vary depending on the substance being abused. For opiate addiction, the rates are quite high, with an 85% chance of relapse one year after ending use. On the other hand, alcohol relapse can vary from 30%-70% depending on the individual, often influenced by whether an individual is in treatment.
Risk factors for relapse for substance abuse also vary from person to person. Ultimately, it’s the need to stimulate dopamine reward centers in the brain that can be a trigger for a person who is used to taking a specific drug. But it’s a combination of external and internal reward factors that typically trigger a relapse .
Internal risk factors may include genetics predisposing to or a family history of addiction, escalating stress or depression, and added psychiatric conditions such as ADHD, depression, anxiety and bipolar disorder. External social factors and psychological stressors can also play a part in relapse including relationship issues, job difficulties, health problems, and complicated family relationships.
But it’s important to realize that co-existent mental illness can significantly elevate the risk of addiction relapse if not addressed and treated. In fact, persons with schizophrenia and bipolar disorder are at a significantly higher risk for relapse of alcohol addiction, with close to 50% of people with bipolar disorder having a co-existent drug or alcohol addiction.
In fact, a 2014 report by SAMHSA revealed that 7.9 million persons in the U.S. experience both a mental disorder and substance abuse disorder concurrently , also known as “dual diagnosis”.