Indiana University Bloomington

Indiana Prevention Resource Center (IPRC)

Predictors of Relapse to Substance Abuse

It is estimated that 80% of substance abuse patients return to using by six months after treatment. Understanding the wide variety of determinants that influence an individual’s susceptibility to relapse is essential to begin reducing these high relapse rates.

Predisposing factors, such as the severity of drug dependence, the number of previous treatments, and age of onset, have been shown to be associated with relapse. Patients with comorbid psychopathological conditions, such as the high comorbidity between substance use disorders and depression, experience a more chronic condition and are less likely to respond to treatment than those with only one disorder.

Substance abusers exhibit a general inability to inhibit their behaviors, which is related to several individual and personality factors, such as increased levels of aggression and hostility, increased susceptibility to negative affective states, and decreased self-efficacy. Substance abuse patients are more likely to experience emotional instability and consequently revert to substance use when experiencing negative affective states, such as anger, loneliness, or guilt.

Environmental cues prime a recovering patient by activating the Mesolimbic Dopamine System, the area in the brain responsible for feelings of pleasure. These environmental cues can be drug-related, such as returning to a location or social situation that one associates with prior substance use, or interpersonal, such as coping with social rejection or responding to social pressure.

Although this wide variety of triggers present a challenge for a recovering substance abuser, chances of recovery are increased if the patient feels motivated, organized, and persistent when preparing for and receiving treatment. Understanding the diverse array of determinants influencing relapse will ideally enable treatment professionals to provide quality care for their patients.


by Sarah J. Stephens, 7/10/2009