Psychology research methods and applications

Abstract
Addictions come in various formats and types. Today, drug and substance abuse has been identified as some of the most prevalent forms of addiction – with most of those affected being the youth. In essence, the future of the world, and more specifically the future of our nation, is largely founded on the sobriety and ability of those in the youthful age bracket to effectively function (both mentally and physically) in an increasingly complex and dynamic world. Drug and substance addiction could cause significant impairments at a personal level. The impact of drug and substance abuse on social systems is even greater – with drug abuse and addiction being linked to increased crime rates, child neglect, increased burden on the healthcare system, etc. My review of existing literature reveals that although various strategies have been adopted in an attempt to reign in the concern of drug and substance addiction, the concern of relapse remains largely unaddressed in most settings. I am of the informed opinion that failure to address the relapse concern and thus embrace effective relapse prevention strategies could affectively pour cold water on addiction prevention and recovery efforts. Thus, addressing relapse prevention is likely to go a long way towards the further enhancement of present addiction recovery approaches.
Keywords: addiction, relapse, drug, substance
Addiction Relapse: Evidence-Based Approaches towards Prevention
Introduction
Drug and substance addiction is often a painful struggle for most people who find themselves hooked to various kinds of drugs after several years of ‘light use.’ It is important to note that over time, a wide range of addiction recovery mechanisms and approaches have been developed with an aim of helping drug addicts make full recovery. As a matter of fact, various organizations and government agencies have come forward in an attempt to help addicts manage their addiction problems and make full recovery. It should, however, be noted that the said full recovery could be complicated or frustrated by relapse. In basic terms, drug or alcohol addiction relapse has got to do with the reoccurrence of addiction behaviors and tendencies that had gone into remission. In the words of Bowen et al. (2014), “relapse is highly prevalent following substance abuse treatments, highlighting the need for improved aftercare interventions” (547). Engel et al. (2016) are of the opinion that there is need for the optimization of current addiction recovery therapies so as to make them more effective. Focusing on relapse prevention methods could be just what is missing in the equation. This is more so the case given that as most studies have found out, a significant percentage of persons “treated for addictions tend to re-use drugs shortly after treatment” (Mohammadpoorasl et al. 2012, p. 124).
Evaluation of Sources
The authors of all three articles highlighted herein are accomplished professionals and scholars in the psychology realm. Further, the journals in which the articles appear are peer-reviewed and respected publications in the field of psychology. It is important to note that in an attempt to ensure that this undertaking is meaningful and that the conclusions arrived at are relevant, only articles published within the last seven years were taken into consideration. The authors of the first article, Bowen et al., are all accomplished psychology scholars affiliated with the Psychology Departments of diverse universities. In their piece, they seek to assess how effective mindfulness-based relapse prevention (MBRP) is in relapse prevention (in comparison to other approaches). The authors of the second article, i.e. Engel et al., are also scholars in the field of psychology and are affiliated to the Department of Psychiatry and Psychotherapy of Carite Campus-Mitte, Berlin, Germany. In this case, they seek to chart the role psychological distress plays in relapse. Lastly, the authors of the last article, Mohammadpoorasl et al., are scholars and aspiring psychiatry scholars in various educational institutions both in Canada and Iran. In their research undertaking, they seek to estimate not only the rate of relapse amongst addicts, but also its predictors. It is important to note that the research pieces highlighted herein were sourced from various settings and backgrounds (i.e. United States, Iran, and Germany) with an intention of widening the perspective of drug addiction and relapse. Steps were taken by authors of all three journals to reduce bias.
Commonality of Relapse
All authors of articles appear to be in agreement that relapse is a serious concern in addiction treatment. As Mohammadpoorasl et al. (2012) observe, “results of several studies have suggested that relapse is common after treatment for drug addiction” (125). Indeed, as Xie et al. (as cited in Mohammadpoorasl et al., 2012) found out in their study, within a period of one year, a third of individuals who had undergone addiction treatment, and had been found to have reached remission, eventually relapsed. On their part, Bowen et al. (2014) point out that relapse amongst addicts continues to be a concern despite decades of addiction studies and development of various intervention measures aimed at treating addiction. It is also important to note that according to Engel (2016) relapse prevention continues to be a rather significant concern – causing a significant proportion of those who are considered to have fully recovered to slide back to addiction. It should be noted that relapse is in this case a broad term which involves a fully blown relapse (which is often referred to as a binge) or a one-time relapse (referred to as a slip). The frequent nature of relapse is an important indication of the need to focus more on relapse prevention therapies, alongside addiction recovery approaches.
Factors that Promote Relapse
According to Engel et al. (2016), some of the factors that have been identified as the main or key motivators of relapse include, but they are not limited to; employment status, marital status, gender, age, education, as well as depressive mood and craving. It is these factors that ought to be highlighted in seeking to prevent relapse. This is an assertion supported by Mohammadpoorasl et al. (2012) who are of the opinion that a wide range of factors including “stress, depression, anxiety, positive mood, social pressure, adverse life events, work stress, marital conflict, family dysfunction, and a lower level of social support have been” cited as some of the key relapse-triggering issues (125). According to the authors, socio-environmental variables happen to be the most common relapse reasons amongst most addicts. Bowen et al. (2014) are of the opinion that relapse is often a consequence of the interaction between diverse factors – and not a single factor. Towards this end, the authors are convinced that relapse prevention must not be ignorant of the factors that precipitate relapse. In the words of the authors, increased relapse risk is associated with “interactions between individual factors (e.g. motivation and coping) and environmental factors (e.g. social influences and access to substances) (Bowen, et al. 2014, p. 549).
Relapse Prevention
Bowen et al. (2014) posit that mindfulness-based relapse prevention (MBRP) is more effective than other relapse prevention (RP) approaches in the long-term prevention of relapse. MBRP, in essence, “integrates evidence-based practices to decease the probability and severity of relapse for patients in substance use disorders (SUD) aftercare” (Bowen, et al. 2014, p. 549). On the basis of the present randomized trial, the authors make a finding that at a 12-month-followup, MBRP is more supportive of treatment-gains sustainability in the long-term. On the other hand, Engel et al. (2016), point out that various research studies have in past indicated clear relations between relapse and psychological stress. For this reason, the authors are of the opinion that the results of their study indicate “that it might be helpful to focus on the reduction of psychological distress in relapse prevention therapies right after detoxification” (Engel et al., 2016, p. 30). Mohammadpoorasl et al. (2012) point out that their findings are supportive of claims that one of the major problems faced by clinicians working with addict is relapse. For this reason, the authors are of the opinion that the relevance of effective relapse prevention strategies cannot be overstated. However, the authors are convinced that effective relapse prevention approaches can only succeed if relapse predictors are well understood.
Application and Research Vision
From the present literature review, it is clear that for addiction recovery approaches to be deemed effective, they ought to incorporate robust relapse prevention therapies. However, for this to happen, the relevance of fully understanding and appreciating the factors that promote relapse cannot be overstated. Some of these factors, as has been pointed out in the review of literature above, include but they are not limited to, depressive mood and craving, lack of social support, family dysfunction and marital conflict, work-related stress, adverse life events, and depression. With relapse having been deemed rather common, those involved in the design of addiction recovery and treatment interventions ought to incorporate the relevant relapse prevention approaches.
The findings of the studies highlighted above go a long way towards further reinforcing my resolve to work with different groups in an attempt to address addiction concerns present in most settings. In this case, I am convinced that the only way I would play a meaningful role in this undertaking is via the application of evidence-based approaches to addiction treatment and relapse prevention. Thanks to this exercise, I have come to learn that relapse is not sudden. Rather, it occurs in stages and is influenced by a variety of factors. Towards this end, I would ensure that addiction recovery/treatment interventions and relapse prevention approaches are capable of identifying the telltale signs of relapse. I fully appreciate that full recovery is an individualistic process of growth tampered with various milestones of development. Viewing recovery in this perspective would enable me to walk recovering addicts through the entire road to recovery. In the final analysis, I have also come to embrace the relevance of mindfulness-based treatment in addiction recovery/treatment interventions and relapse prevention. This is more so the case given that according to Bowen et al. (2014) it has been routinely “associated with reductions in anxiety, depressive relapse…” (548). These are some of the key motivators of relapse that have been identified elsewhere in this text.
Conclusion
In the final analysis, it is important to note that by the time addicts seek treatment or help, or by the time addicts are referred to rehabilitation centers for treatment and addiction management, they have tried to quit the addictive behaviors without much success. Any attempt to quit is often complicated by factors beyond their control. For this reason, it would be accurate to point out that the risk of relapse is often real amongst recovering addicts even after they are deemed to have fully recovered. In that regard, therefore, recovery is not accomplished by the simple act of quitting the substance or drug. Instead, recovery involves substantive and deliberate changes in lifestyle whereby factors likely to trigger relapse are minimized (or eliminated).













References
Bowen, S., Witkiewitz, K., Clifasefi, S.L., Grow, J., Chawla, N., Hsu, S., Carroll, H.A. …Larimer, M.E. (2014). Relative Efficacy of Mindfulness-Based Relapse Prevention, Standard Relapse Prevention, and Treatment as Usual for Substance Use Disorders: A Randomized Clinical Trial. JAMA Psychiatry, 71(5), 547-556.
Engel, K., Schaefer, M., Stickel, A., Binder, H., Heinz, A. & Richter, C. (2016). The Role of Psychological Distress in Relapse Prevention of Alcohol Addiction: Can High Scores on the SCL-90-R Predict Alcohol Relapse? Alcohol and Alcoholism, 51(1), 27-31.
Mohammadpoorasl, A., Fakhari, A., Akbari, H., Karimi, F., Bostanabad, M.A., Rostami, F. & Hajizadeh, M. (2012). Addiction Relapse and Its Predictors: A Prospective Study. J Addict Res Ther., 3(1), 122-126.