The results of the Niknam et al. study indicated that Marlatt’s cognitive-behavioral training was effective in relapse prevention and craving reduction in females with substance dependency 34. First, during the three stages of follow-up, an increase was observed in terms of lapse and relapse in the intervention group, which highlights the need to consider reminder and booster programs over time in the intervention. Perhaps one of the reasons for this situation is that in the present study, the intervention was limited to Marlatt’s model and some determinants were outside this framework that should be considered. Among these, family, social support, and some sociodemographic factors such as economic status and personal, professional, and organizational conditions could be mentioned.

Abstinence Violation Effect: How Does Relapse Impact Recovery?

• In the context of addiction, a breach of sobriety with a single drink or use of a drug has a high likelihood of a full relapse.
• In addition, in the study of Bordbar, CBT helped reduce anxiety in individuals by changing one’s attitude, increasing self-efficacy and self-esteem, as well as changes in coping strategies 22.
• Emotional relapse is not necessarily caused by these natural emotions but rather by how you cope with them.
• You might imagine a relapse as a single event that occurs during a moment of weakness.
• Nevertheless, 40 to 60% of people who once were addicted to a substance and achieved sobriety relapse at some point, based on estimates from the National Institute on Drug Abuse (NIDA).
• It may be a single occurrence where someone decides to use the substance again.

AVE can be observed in various areas, including addictions, dietary restrictions, and impulse control. As a result, it’s important that those in recovery internalize this difference and establish the proper mental and behavioral framework to avoid relapse and continue moving forward even if lapses occur. Addressing the AVE in the context of addiction treatment involves helping people develop healthier coping strategies and challenging negative beliefs that contribute to addiction. The important thing to consider is that the hardest drug addiction to recover from is the one that you suffer from. The actual statistics on relapse for other drugs have little to do with one’s personal recovery program.

• This aspect of relapse prevention can be beneficial to those in addiction treatment or contemplating treatment since it is not necessarily a failure to exercise self-control or abstain from using a substance of abuse.
• People commonly confront relapse as a part of their process in achieving long-term sobriety.
• If participants could not attend any session for any reason, they attended additional sessions held at the clinics each week.
• There was also a significant difference in the control group, but the results indicated a higher effectiveness of the cognitive-behavioral-based intervention compared to the routine intervention.
• Knowing the different stages of relapse and how to avoid them is therefore crucial.

Bedrock Recovery

As the number of people needing to quit is increasing, there is an urgent need for low-cost, accessible, and effective interventions with lasting effects 20. This study was conducted to investigate the effect of cognitive-behavioral intervention on relapse prevention. The sample size was calculated 130 participants in each group considering 10% attrition. The individuals who were referred to these centers were recruited until reaching the required sample size for each group (See Fig. 1). The inclusion criteria were referring to the considered smoking cessation clinics and undergoing smoking cessation treatment and being able to read and write. Enrolling in another smoking cessation program and withdrawing from continuing participation in the study for any reason were among the exclusion criteria.

• It should be noted that the number of cigarettes consumed daily was measured by a three-choice including less than 10, 10 to 20 and more than 20 cigarettes question (i.e. how many cigarettes do you smoke a day on average? ).
• Relapses are unique to each individual, and your experience with them may be different as well.
• In the intervention group, out of 112 participants, 84 participants had a lapse immediately, 96 participants one week after and 103 people three months after the intervention.

‘This Time Will Be Different’

Some examples of proven coping skills include practicing mindfulness, engaging in exercise, or pursuing activities that bring you fulfillment. Reach out to friends, family, or support groups for encouragement during difficult times. Overall, the Abstinence Violation Effect abstinence violation effect is a complex phenomenon influenced by a combination of cognitive, emotional, and biological factors.

Understand The Relapse Process

The reliability of the questionnaire was examined by using a test-retest method amphetamine addiction treatment among 35 people who smoke outside the intervention group at an interval of two weeks. In addition, its internal consistency was assessed by using Cronbach’s alpha coefficient. Both the Intra-class Correlation Coefficient (ICC) and Cronbach’s alpha coefficient of the whole instrument were equal to 0.93. The Abstinence Violation Effect can have both positive and negative effects on behavior change.

• An individual may experience uncontrollable, stable attributions and feelings of shame and guilt after relapsing as a result of AVE.
• Both the Intra-class Correlation Coefficient (ICC) and Cronbach’s alpha coefficient of the whole instrument were equal to 0.93.
• Therefore, it can be concluded that it was effective in reducing high-risk situations.
• This model provides a conceptual framework for intervening in the relapse process, aiming to prevent or decrease relapse occurrences and ultimately enhance treatment results.

Still, despite preventive programs in Iran, the smoking trend in adults has not declined in the last two decades 5. In addition, the prevalence of smoking among young people appears to be increasing 6. People commonly confront relapse as a part of their process in achieving long-term sobriety. Perfection isn’t required by those in recovery, but rather a willingness to do their best each day with a supportive team backing their efforts.

How The Abstinence Violation Effect Impacts Long-Term Recovery

By reframing lapses as learning opportunities and teachable moments, cultivating self-compassion, and seeking support, individuals can navigate these challenges more effectively, increasing their chances of leading a healthier lifestyle. In the multifaceted journey of overcoming addiction and living a healthier life, individuals often encounter a psychological phenomenon known as the abstinence violation effect (AVE). A period of successful recovery and abstinence is something to be celebrated. However, it can sometimes lead to the thought that you have earned a drink or a night of using drugs. It sounds counterintuitive, and it is, but it is a common thought that many people have to recognize to avoid relapse.