Substance Use Disorder is Like Other Illnesses

I’d like to discuss relapse prevention using the analogy of disease or illness immunity. I’m going to show how substance use disorder and alcohol use disorder function like other illnesses and how the concept of immunity applies to recovery from substance use disorder.

In recent content, we discussed how a substance use disorder develops, the vital space between stopping drinking or use and recovery, and the link between stress and relapse. Each of these have bio- psych-social components.

In traditional illnesses, we understand that immunity helps prevent illness or lessen the severity of illness. When a person’s immunity is low, they are more likely to catch things, and if they do, have a more severe experience with it.

I’d like to invite you to view substance use disorder recovery through this same lens.

I created a video using my personal experience to show what this looks like.

Substance Use Disorder – Relapse Prevention as Immunity

What does this look like? Well, let’s consider triggers, for example. Triggers are people, places, or things that prompt a person to have thoughts of unhealthy coping. Physiologically, they activate an established neural pathway of use or drinking or other unhealthy coping. These are the pathways that were established in the development of the substance use disorder and became learned conditioning or the habituated response.

These pathways getting activated is not what determines whether a person relapses, however. A good comparison is how exposure to a virus or other contaminating agent isn’t exclusively what determines the manifestation of illness.

What determines the manifestation of illness is the individual’s immunity. If a person’s immunity level is low due to stress, lack of sleep, poor nutrition, or lack of neuro-beneficial habits, then the person’s chances of having that illness or a severe experience with it increase.

It’s literally the same thing in a substance use disorder relapse. The “person, place, or thing” is not what causes the relapse. What allows, progresses, or facilitates the relapse is the “relapse immunity” of the individual.

This very much goes back to the content of “the vital space between stopping and recovery.” It explains early and frequent relapse. If a person has not put recovery living/lifestyle/habits into action, they do not have a buffer or immunity to relapse. In early recovery, stress, “people, places, and things” can land on a person whose immunity is low because they do not have a rigorous and robust sobriety program.

This is also true to persons in long term recovery If, over time, they have lapsed on the habits of transformation and sober informed habits, they lower their sobriety immunity. They become susceptible to completing a relapse with returning to use, drinking, or other unhealthy coping mechanisms.

All mutual help groups I am familiar with have their own language around this, but they all speak from collective wisdom that individuals in recovery need to keep space between stopping using and drinking.

This space is where you put the recovery habits, which is what builds immunity.

What lowers immunity in recovery from substance use disorder?

• Reduced biological care
  • nourishment
  • compromised sleep
  • unmanaged pain
• Dropping (and not replacing with an equivalent) recovery habits
• Anxiety
• Too little time outdoors
• Smoking
• Grief
• Lack of exercise
• Stress
• Over caffeination/other stimulants like energy drinks or pre-workout
• Insufficient social connectedness

Note: Alcohol, smoking, and drugs are on the top of this list

When a person in recovery has lowered recovery immunity and a life event happens, they are at increased risk of returning to using/drinking/or doing.

What are substance abuse recovery immunity enhancers?

1. Structure
2. Sex – Healthy and aligned to your values, engagement in physical intimacy helps with immunity. 
3. Meaning/Purpose
4. Intentional gratitude
5. Pets
6. Laughter
7. Nutrition
8. Move your body in ways that you love
9. Good sleep hygiene
10.  Recovery content – quit lit, podcasts, sober settings, music
11. Contemplative practice – Yoga, Tai Chi, journaling, Zen coloring

For More Support, Information, and Content on Managing Stress and Substance Use Disorder

I create content like this weekly on YouTube, TikTok, and Instagram. I’d love for you to follow me at any of those places. 

For more information, content, support, and tools on how to manage executive stress and enjoy life without drugs, alcohol, or over-relying on unhealthy coping, I have created a FREE workbook for you! 

**Person-centered language note: As a leading clinician in substance use disorder assessment, treatment, and recovery, I am committed to elevating the language around mental health and substance use disorder. This means I will use “alcohol use disorder” rather than “alcoholic.” It means I will use “person with a substance use disorder” rather than “addict.” I minimize my use of the term addiction because it carries stigma, often people have their own relationship with the word accompanied with misinformation. I use the term recurrence or return to use rather than relapse. However, it’s important that people searching for help get connected with services that benefit them. In this regard, people are not searching “am I a person with a substance use disorder?” They are searching “am I an addict?” They do not search, “can a high functioning person have an alcohol use disorder?” They search “am I a high functioning alcoholic.” They don’t search “treatment for people who have a recurrence” but do search “how do I stop being a chronic relapser?” As such, I want to affirm people with substance use disorders with my care, which includes language but I also need to structure my business in a way that google searches find my material.