Addiction Recurrence after Prolonged Recovery

~ Jason Schwartz

While there have been a lot of calls for evidence-based responses to Philip Seymour Hoffman’s relapse, Bill White points out that there is no evidence base for understanding long-term recovery and relapse after long-term recovery.

Treatment outcome studies suggest a principle:  recovery stability and permanence increase with duration of recovery, with the risk of future lifetime addiction recurrence declining to below 15% for those who have achieved 5 years of continuous recovery (see White, 2008 for a review).  That said, little information exists on the prevalence or processes involved in such recurrences after 10, 15, 20 or more years of recovery.  In 2009, Mel Schulstad and I published an article in Counselor entitled, “Relapse following Prolonged Addiction Recovery: Time for Answers to Critical Questions.”  We lamented the lack of research on long-term recovery, including research on what we referred to as late stage relapse (LSR, relapse after more than five years of stable recovery).  Here are some of the questions we posed in 2009.

Read all of the the questions here. Here are a few:

  • What is the prevalence of relapse across the life cycle of recovery? Are there points of vulnerability identifiable by age or duration of recovery?
  •  Does the rate of LSR differ by primary drug(s) involved in past dependence; across religious, spiritual, and secular frameworks of recovery; or by gender, race/ethnicity, sexual orientation, and the presence of co-occurring medical/psychiatric disorders?
  • Are there critical transition points between stages of recovery that constitute periods of increased risk of alcohol and other drug use and related problems?
  • Is there a relationship between LSR and the onset or progression of physical illnesses and their treatment (e.g., prescribed medication for acute or chronic pain)?

He minces no words about our failure to seek answers to these questions.

Philip Seymour Hoffman’s death is a tragedy that we as a country are collectively mourning.  But it is also a tragedy after billions of dollars spent on addiction research that we still do not have definitive or even preliminary answers to most of the above questions.  The reason we do not is our failure as a country to formulate and aggressively pursue a comprehensive recovery research agenda and to disseminate findings from that research to those who need it most: individuals and families seeking and in long-term addiction recovery.

Read the whole post at Addiction Recurrence after Prolonged Recovery | Blog & New Postings | William L. White.

Published by Jason Schwartz

I have been an addiction professional and social worker since 1994. I started blogging in 2005 as the Clinical Director at Dawn Farm. I no longer work at Dawn Farm and am now the Director of Behavioral Medicine at a community hospital, and a lecturer at Eastern Michigan University’s School of Social Work. Views expressed here are my own. Keep in mind that the field, the contexts in which the field operates, and my views have changed over time.

2 thoughts on “Addiction Recurrence after Prolonged Recovery”

  1. Sadly, the profit that government makes in “fighting” drugs, and the need for a broad based client population for alcohol, serves to discourage research, since it obviously would work against these profit schemes.

  2. It was certainly a tragedy losing Philip Seymour Hoffman to an over dose. I just recently watched his movie about Scientology. It always seems like the most talented people are the ones that have the hardest time balancing their talent and skill with their inner demons.
    R.I.P PSH

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