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Can Someone in Recovery Go Back to Casual Use?

The desire to return to casual use after achieving substance use recovery is exceptionally common. Many people hope that having achieved a significant period of sobriety, the problems they faced in the past won’t affect them again in the future.

In reality, the question of whether people in recovery can go back to casual use is much more complex.

Understanding Substance Use Disorders

To fully understand the idea of returning to casual use after recovery from a substance use disorder, it’s important to take a close look at the effects of substance use disorders. This includes both short-term symptoms and long-lasting effects, both of which can influence your desire and ability (or inability) to return to casual substance use.

Substance use disorders can be defined in a number of different ways: a mental health condition, a disease, or a chronic, relapsing brain disorder. For generations, substance use disorders were considered intractable conditions; there were nearly no effective medical or psychological treatment methods that would help people recover.

Thankfully, the treatment of substance use disorders has improved dramatically in the last several decades. People hoping to achieve recovery now have a multitude of medical and mental health treatment options that have proven to be effective in helping people achieve abstinence and maintain their recovery for years to come.

However, there are several challenges along the way. Substance use disorders cause a wide number of physical and mental health symptoms, including:

  1. Invasive drug or alcohol cravings
  2. Tolerance to the drug of choice
  3. Worsening physical and mental health symptoms as a result of substance use
  4. Withdrawal symptoms when substance use suddenly stops
  5. Negative effects on personal relationships
  6. An inability to experience positive emotions outside of substance use
  7. Loss of interest in hobbies or activities
  8. Multiple failed attempts to stop

These are just a few of the most common symptoms that people experience when they are in the midst of a substance use disorder, and they can continue for extended periods after people finally achieve sobriety.

Some of these symptoms are directly tied to the desire to return to casual use. Withdrawal symptoms can be incredibly uncomfortable, leading people to try to ameliorate their symptoms by returning to their substance of choice.

Cravings are invasive and frequent and often push people toward contemplating whether they can use drugs or alcohol recreationally without experiencing the negative effects of addiction.

Even as people gain more time in sobriety, these symptoms can have lingering effects. But that’s not the only reason people frequently consider returning to casual use — and why they so often fail to do so.

Lasting Neurological Changes

Neuroscientific studies have repeatedly found that people living with substance use disorders have experienced substantial changes in specific regions of the brain. These brain changes have a direct effect on a person’s ability to regulate and control the use of addictive substances. They can also play a role in the level of gratification and enjoyment people experience in other activities.

These changes primarily occur in regions of the brain commonly referred to as the “reward network.” Essentially, drugs like alcohol, amphetamines, opioids, or benzodiazepines all cause a sudden and dramatic increase in the neurotransmitter dopamine.

Dopamine is the brain’s “reward” neurotransmitter. It encourages people to return to the activity that caused a dopamine release. Outside of substance use, dopamine is typically released during activities such as exercise, sex, socialisation, or engaging in your favourite hobby.

But the dopamine release from addictive drugs far exceeds the release from normal activities, and the brain adjusts and changes to account for this high level of dopamine release. It begins to remove dopamine transmitters through downregulation, which makes it harder and harder for people to feel rewarded from non-substance activity.

Many researchers describe these changes as the neural basis of addiction. It accounts for why people have such a hard time quitting substance use, enjoying other activities, and finding the motivation necessary to make the changes required to live a life in abstinence. But the brain has a remarkable capacity for healing, and it will recover, given time.

Neuroplasticity and Repair

Neuroplasticity is the term scientists use to describe the brain’s remarkable ability to heal itself. A brain can build new neural networks, reorganise connections, and continue to change throughout a person’s lifespan.

In terms of substance use disorders, this means that brains can reverse the changes caused by substance use. But healing from these lasting changes takes time. How much time it takes to fully recover depends upon several factors, including:

  • Length of substance use
  • Typical dose of substance use
  • Frequency of substance use
  • Type of substances used
  • Age

In one study of long-term methamphetamine users, the length of time for a full recovery from the neurological changes caused by substance use took 14 months.

And while 14 months may seem like an exceptionally long time, each month spent in recovery is another month of healing. It isn’t a matter of having to wait 14 months to feel better but continuing to improve substance use symptoms gradually.

Does a Healed Brain Mean You Can Return to Casual Use?

Knowing that your brain can completely revert from the changes caused by substance use, it is seemingly logical to conclude that this means that you are no longer at any greater risk of substance use disorder than anyone else.

But the truth of the matter is much more complicated, and all data indicates that people in recovery are still at much higher risk of returning to problematic substance use.

Long-term research following people in recovery sheds further light on this risk. Data indicates that it takes roughly five years for people in recovery from alcohol use disorders to achieve a 15% risk of developing an alcohol use disorder again, which is the rate of alcohol use disorders in the general population.

This means it takes five years of sustained recovery before you are at no more risk of developing an addiction than anyone else. This is substantially longer than the 14 months it takes your brain to fully recover. What explains this discrepancy?

The Memory of the Brain

Even as the reward network of the brain heals, it retains a memory of past activities that it has discovered to be inherently rewarding. So while protracted abstinence makes it easier and easier for people to enjoy non-substance-related activities, a return to substance use can rapidly trigger a return to addictive behaviours.

Just as you may still know how to ride a bike even if you haven’t done so in years, your brain remembers the experience of addiction. And it can be all too easy, if you attempt a return to casual substance use, to find yourself falling into old patterns of behaviour that you thought you’d left in the past.

And while the five-year mark is generally considered an important milestone in recovery, it doesn’t mean that this memory is somehow removed. It only means that people who have sustained recovery for five years have a reduced risk of relapse compared to those newer in recovery.

Questions to Ask Yourself Before Attempting a Return to Casual Use

Most people who have achieved a sustained recovery consider a return to casual use at some point. While it is strongly discouraged, for all the reasons above and more, it can nonetheless become a pervasive thought.

When you are considering returning to casual use, ask yourself the following questions:

Is It Worth the Risk?

You may have heard success stories from others who have gone back to casual use successfully. You may have the endorsement of your friends or loved ones. But no matter the outside circumstances, you must ask yourself whether the potential benefit outweighs the risk.

Substance use disorders can be devastating, and at this point, you likely already know the profound impact that a life with an addiction can have. Even if you believe the probability of returning to full-blown addiction is low, the monumental impact that a return to addictive behaviours can cause should weigh heavily on your decision.

Countless others who have attempted to return to casual use have found themselves quickly falling into old patterns of behaviour and addiction once again. While there are exceptions, the exceptions prove the rule — not the other way around.

What Are You Hoping to Gain?

People who have recovered from substance use disorders often romanticise their past experiences with substance use. They remember the good times while conveniently forgetting the consequences.

Ask yourself honestly what you hope to gain from substance use. Is it enjoyment? Relief from boredom? Greater social connection?

Whatever the reason you’re considering returning to substance use may be, ask yourself if you can achieve the same goals through other methods. Enjoyment can be found through new hobbies or activities. Social connection can be found by reaching out to supportive friends or family or attending social events.

If you find that there are options to achieve your goals without the use of substances but are considering a return to substance use regardless, the truth may be that you have another motive that you haven’t come to terms with yet.

Have I Stepped Away From the Work of Recovery?

Living a fulfilling life in recovery typically requires intensive self-work and reflection. While everyone’s path to recovery is different, common ways that people incorporate these changes into their lives include:

  • Attending addiction support groups
  • Meeting with a therapist
  • Being open and honest about challenges with friends and loved ones
  • Engaging in regular self-care practices
  • Giving back to the community

Whatever it is that has helped you get and stay sober so far, consider whether you’ve taken a step back recently. Often, the impulse to return to substance use comes from distancing yourself from the self-work of recovery.

When people engage in meaningful and fulfilling recovery work, the temptation to return to substance use is often greatly lessened. Even if you still have these thoughts and feelings, you typically have someone that you can talk to about them rather than acting on impulse alone.

Get Support From APN London

At APN London, our comprehensive addiction and mental health treatment programs are designed to help people throughout every step of the recovery process. Whether that’s helping people break free from substance use for the first time or providing ongoing support in the form of individual or group therapy, our team has an option to help.

Before you decide to return to casual use, call our team at 0203 984 7699 or fill out our confidential online contact form to speak to an addiction expert. Our team can help you understand the desire to return to use, the potential challenges you may face, and how to make the best decision for yourself moving forward.

References

  • Kelly, John F et al. “Beyond Abstinence: Changes in Indices of Quality of Life with Time in Recovery in a Nationally Representative Sample of U.S. Adults.” Alcoholism, clinical and experimental research vol. 42,4 (2018): 770-780. doi:10.1111/acer.13604
  • Volkow, Nora D., et al. “Loss of Dopamine Transporters in Methamphetamine Abusers Recovers with Protracted Abstinence.” Journal of Neuroscience, Society for Neuroscience, 1 Dec. 2001, www.jneurosci.org/content/21/23/9414.