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Relapse and Overdose: Why do so many addicts in recovery die when they relapse?

Addiction and Relapse

According to the National Institute on Drug Abuse (NIDA), which calls relapse “not only possible but also likely” due to the chronic nature of addiction, 40% to 60% of recovering drug addicts will eventually relapse.

And there’s no way to know who will relapse and who won’t.

Dr. Scott Krakower, assistant unit chief of psychiatry at Zucker Hillside Hospital in Queens, admits that addiction “is a very complex disorder. We know it has periods of remissions and relapses. Without having ongoing treatment and support, relapse essentially is easier.”

He added that people who are in recovery for opiates, such as heroin, have a much higher relapse rate than other types of addicts, putting their relapse rate as high as 80% or higher.

On relapse and overdose, Krakow says that, “In the past [recovering addicts] may have built up tolerance to drugs, but when they relapse and take the same amount of drugs they used in the past, they die,” he continued. “That happens, and I’ve seen it happen a lot.”

How Relapse Can Cause Overdose

When in active addiction, people have to use more and more to achieve the same effect as when they first started using – when they only needed a small amount to achieve the desired effect – the euphoric ‘high.’

After even a short period of abstinence, such as after a brief stint in detox, rehab, or jail – the built-up tolerance can diminish quickly. Therefore, when the addicted person uses again, they are likely to use the same amount as they were using before this brief period of not using, making it more likely that they overdose.

Basically, when someone has been in recovery for any amount of time, their brain chemistry becomes more sensitive to the presence of the drug because the tolerance they had built up in the past is no longer an issue. As a result of this increased level sensitivity, when a recovering addict relapses and goes back to the same dose they were used to using in their active addiction, they are at high risk of fatal overdose.

Relapse and Overdose: Risk Factors

Most overdoses occur because the person who has relapsed uses more than one kind of drug at one time and the most common combination of drugs that lead to overdose are alcohol, benzodiazepines (Valium and Xanax), cocaine and heroin. Another risk factor is the use of illegal drugs such as cocaine and heroin because their potency is unpredictable – you never know how strong each bag or batch is going to be. And yet another risk factor in fatal drug overdose cases is doing drugs alone; in fact, two-thirds of overdoses occur when the person was using at home alone. Lastly, if you have experienced a non-fatal overdose in the past, this puts you at a greater risk for a fatal overdose.

Recovering addicts need to realize that the chance of overdose after relapse is incredibly high, and can be fatal. Many recovering addicts who relapse can easily overdose because their expectations for use remain the same while their body chemistry has completely changed.

If you or someone you love is struggling with substance abuse or addiction, please call toll-free 1-800-951-6135.





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