Dr. K.J. Foster

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Community-Based Relapse Prevention:  An Addiction Recovery Movement of the Future

Dr. K.J. Foster, LMHC, CAP

In 2015 a group of researchers published Community-based relapse prevention for opiate addicts. A randomized community controlled trial presenting research they conducted between December 2010 and March 2011 to assess the effect of a community-based relapse prevention program (CBRP) compared to aftercare as usual. The CBRP intervention consisted of five components or stages: 1) patient and family engagement, 2) community assessment, 3) community mobilization, 4) organizing community teams, and 5) community-based relapse prevention planning. The results indicated that the participants in the intervention group had a significantly higher rate of abstinence. Interview data about the effects of the process indicated that the patients felt “it was impossible to revert to addictive behavior because of the close relationships” that they had developed with the community members and community members reported de-stigmatization and a change in attitude toward addicts.
Stigma was noted by the researchers as the main barrier to reintegration from treatment, serving as a serious impediment to addiction recovery. Disconnection and psychological isolation (us versus them mentality) feed shame and stigma. Connection, on the other hand, is a chief source of strength for recovery. This means going beyond awareness, going beyond acknowledging addiction as a problem, and taking steps to mobilize ourselves, others and our communities toward recovery. Community education, especially relative to specific relapse warning signs and relapse prevention strategies, was found to be highly beneficial to community recovery efforts. Community mobilization strengthens this powerful recovery strategy of connection. Community-based relapse prevention is a way of actively mobilizing, organizing, and educating communities and represents a vision for the future in addiction recovery. It starts with taking our conversations about addiction beyond the treatment centers, our homes, and our inner circles. It’s about moving the conversation forward, and integrating addiction recovery into the community.
The challenge is that our conversations about addiction are often like those concerning global warming. Those who are far removed from involvement in the crisis either deny it even exists or are kidding themselves to think that it’s not progressing and not a potential threat to the future of our society, and possibly even humanity. And although this is obviously not an article about the global warming issue, it is helpful to look at some of the parallels in the way we tend to think and talk about these issues.

For example, it is apparent to many that there are changes in weather patterns taking place throughout the country, which has been purported to be a real crisis and potential threat to human existence. Yet it’s easy to deny, disregard or get involved, because after all it’s not going to happen today or tomorrow, but one day, maybe, in the far-away distant future. While many people do acknowledge it as occurring and even a significant issue, most people are not concerned enough yet, or reluctant at best, to participate in making changes that might cause any real discomfort, and most likely won’t be willing to do anything at all until it is either mandated or it starts to negatively impact their lives directly. In other words, no one really wants to get involved or do anything about it until it is smacking them in the face.

Now let’s look at drug addiction. Patterns of drug use are changing, with many new, more powerful and dangerous drugs available, posing a real and true potential threat to human existence. No, you say? Just consider the recent influence of synthetic drugs like Flakka that have been turning up, and the severe and long-term ramifications of its effects. Perhaps there isn’t a true threat today or tomorrow, but certainly somewhere down the road if things continue the way they are going. Unfortunately, the reality is that drug addiction is currently having an impact on society and is a true potential threat to humanity. Also, addiction, unlike global warming, is currently spreading throughout our national cities at an alarming rate, leaving a wake of death and destruction in its path. Current impacts of the addiction crisis tend to vary depending upon where you live, but are generally reported everywhere. In fact, according to recent news broadcasts, drug addiction issues, especially heroin, are now being reported in places like New Hampshire and the suburbs of Columbus, Ohio. It’s clearly no longer an inner-city problem.

Nevertheless, people who are not experiencing any direct impact, or so they think, are able to delude themselves into believing they don’t need to get involved. The majority of Americans are quick to agree that addiction is a significant and serious issue in our country, but this is generally where the conversation comes to an end and we move on to more pressing life issues such as what movie to go see or where to have dinner. Unless, of course, addiction is effecting you and your family directly. Yet even then, unlike issues such as global warming, shame and stigma often further restrict and limit the conversations we have about addiction to the confines of a treatment center, our homes and/or our inner circles. It is here where most people are held back or step back, and it is here where one of the greatest opportunities for future impact exists.

Community-based relapse prevention starts with continuing the conversation about addiction and moving it out of our homes, out of the treatment centers, and into the community at large. It’s about creating an addiction recovery movement within our communities, not just within the microcosm of the recovery community. It’s also about a shift in mindset to one that is not focused on fighting addiction (us versus them mentality) to one that’s main focus is on embracing addiction recovery as an entire community (us and/with them mentality) and helping individuals and families move forward and succeed at recovery. Implementing community-based relapse prevention may be idealistic or it just may be the wave of the future. Our future and our society may depend on it.
* Maarefvand, M., Eghlima, M., Rafiey, H., Rahgozar, M., Tadayyon, N., Deilamizadeh, A., &
Ekhtiari, H. (2015). Community-based relapse prevention for Opiate dependents: A Randomized
community controlled trial. Community Mental Health Journal, 51(1), 21–29.




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