By Martha McLaughlin
During a disaster, many urgent tasks demand attention. But for people recovering from addiction, it’s important not to lose sight of recovery tasks as well.
Both logistical and stress-related factors may increase the risk of a relapse when disaster happens, whether it’s because local damage blocks access to needed care or because added stress fuels drug or alcohol cravings.
Let’s take a closer look.
Logistical Recovery Challenges
Logistical recovery challenges are often related to schedule disruptions. This may be especially problematic for people recovering from opioid addiction who rely on methadone to prevent withdrawal. When methadone clinics are closed or inaccessible because of transportation issues, the resulting symptoms may tempt people to look for relief elsewhere.
Disasters may also disrupt self-care routines and create other recovery challenges. For example, during early recovery, people often rely heavily on their support groups or counselors. When someone’s support network is temporarily unavailable, relapse may become more likely.
Stress-related Recovery Challenges
Internally, relapse risk rises when stress does because of the interplay of body chemicals. Drugs of abuse affect neurotransmitters and, over time, can alter the body’s ability to regulate stress. The process of normalization after a person abstains from substance use isn’t instant, and that can leave people in early recovery especially sensitive to the body’s stress response.
Stress hormones can also affect levels of dopamine, the neurotransmitter most often tied to substance abuse. According to National Institute on Drug Abuse researchers, corticosterone increases dopamine activity in the brain. Animal studies show that stress- and drug-related dopamine surges work together in such a way that a dose of cocaine too small to interest an animal who isn’t under stress will motivate one who is.1
A similar mechanism is undoubtedly at work in humans. Biological markers have been identified that help predict addiction relapse risk. Among them are those tied to the stress response system, such as measures of cortisol and the cortisol/corticotropin (ACTH) ratio.2
Monitoring Internal Dialogue
All actions are preceded by thoughts and beliefs, and monitoring internal dialogues and attitudes is an important relapse prevention skill. Some potentially problematic mindsets that might arise during a disaster include:
Even during very busy times, it’s important not to neglect addiction recovery and to make it as much of a priority as possible. Options vary with the situation, but finding a way to stay in contact with a mentor, sponsor or support network is generally very helpful. It’s also important to care for the physical body. This means trying to maintain a regular sleeping and eating schedule and to make meals as healthy as possible.
Balancing the body’s stress response is also essential. It’s natural and helpful to go into fight-or-flight mode when a disaster hits, but staying in that physical state for long periods of time is counterproductive. There are many tools for moderating it, including meditation, journaling, stretching, breathing exercises, listening to calming music, progressive muscle relaxation, moderate physical exercise and prayer.
Neither disasters nor relapses are welcome, but a relapse doesn’t mean recovery won’t ultimately be successful. It’s simply a sign that treatment needs to be altered or reinstated. Disasters are an opportunity to learn and grow so future stress can be addressed successfully.
1 National Institute on Drug Abuse. “Stress Hormone Sets the Stage for Relapse to Cocaine Use.” NIDA Notes, June 4, 2015.
2 Sinha, R. “New Findings on Biological Factors Predicting Addiction Relapse Vulnerability.” Current Psychiatry Reports, October 13, 2011.